NHS free at point of use is a political mirage Doctors warn
A National Health Service largely free at the point of use is becoming a mirage, according to Doctors for Reform, a pressure group that would like the NHS to move from a tax-funded model to a system of social insurance with top up payments. The report shatters the NHS's founding principle that health care should be free for all at the point of delivery.
Faced with long waiting lists and postcode lotteries, the doctors say that patients are increasingly paying extra private payments to upgrade the treatment they receive.
Patients are finding sophisticated ways to "top-up" NHS treatment by paying for drugs, devices and investigations privately - sometimes buying them from abroad over the internet - and combining them with NHS treatment, the report says.
In some cases patients opt to pay for all their treatment. In others they get investigations undertaken privately and more quickly, before returning to the NHS for treatment.
The result they say is inequitable. But politicians and others are reluctant to engage with the issue. "By perpetuating the political mirage of a service completely free at the point of delivery, debate is conveniently stifled," the doctors say. "What is urgently needed is a proper debate on the future of healthcare funding, covering both tax and independent financing".
Despite the Labour Government pouring billions of pounds into the NHS to improve the quality of care, they claim that top-up payments will increase in major areas of the health service such as cancer care and heart disease.
Hearing aids - audiology services - could be treated the same way as spectacles, they say, with vouchers for the poor and a competitive market for everyone else.
Patient groups said the study highlighted Britain's "two-tier health system", where people with money had access to a range of treatments and those without did not.
The report was written by three doctors, including Karol Sikora, a leading professor of cancer medicine at Imperial College School of Medicine.
Published by Doctors for Reform, which represents 1,000 doctors working in the NHS, it accuses the Government of being in denial about the role of the private sector in the NHS.
"It is commonly said that health care in the UK is free at the point of delivery; in fact this mantra is now a political mirage rather than a day-to-day reality," it says.
"Patients are developing sophisticated approaches to purchasing upgrades to their care [in the areas of] the major killers - cancer and heart disease - [as well as] in areas of medicine benefiting smaller groups of patients such as maternity services.
"It has to be recognised that the use of top-up payments is increasing. We need to face up to this rather than ignore it."
The doctors published 20 case studies showing how patients used the private sector to upgrade NHS services. They include a 33-year-old secretary who had been trying for four years to become pregnant.
She was eligible for free IVF treatment on the NHS but her primary care trust was in debt and turned her away. She paid £3,500 for treatment at a private London clinic.
Prof Sikora and his co-authors, Paul Charlson, a GP in Yorkshire, and Christoph Lees, a consultant in obstetrics and foetal-maternal medicine, sent the report to Patricia Hewitt, the Health Secretary, the opposition parties and the Royal Colleges.
They called for an open debate about the future of health care funding.
"Patients are already seeking to supplement their NHS care, after a decade of maximum tax-financed spending increases," they said.
"The Government's position is that the NHS can provide all of the care that patients need. If this is not the case now, can it be so in the future, given that tax-financed increases are slowing, medical costs are rising and patients are becoming more consumerist in their attitude?"
Norman Lamb, the Liberal Democrat health spokesman, said: "We don't want to drift into a system where those who don't have the money to pay for treatments simply go without."
From:
http://www.ft.com/cms/s/9ab02e22-f136-11db-838b-000b5df10621.html
and
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/04/23/nhs23.xml
The short term incompetence of Labour on the NHS will have long term consequences:
On April 19, 2006 Health Direct posted: Health deficits and waste are symptoms of a deeper failure for NHS funding- Blair warns when Tony Bliar remarked that Labour's record spending increases and reform were the last chance for the National Health Service. If they did not work, the prime minister warned, waiting in the wings were politicians who would dismantle the NHS.
The reality is somewhat different. There is no ideological difference between Labour and Conservative. The real difference, in Rumsfeld speak, is that Labour ministers know what they don't know while the Conservatives don't know what they don't know.
Pushing economic power closer to doctors and patients with practice based commissioning is a great idea, but one that will end in chaos if data, management skills and incentives are not properly aligned.
NHS managers are drowning in policy documents and guidance notes, each pushing a new initiative. Their impact on each other has not been thought through. As the system is loosened, financial pressures and rationing are likely to intensify.
Despite all Labour's extra money, the Conservatives' internal market reforms, started in the late 1980s and reversed in Labour's first term, brought average waiting list times down faster and generated NHS output growth almost double that of Labour's first six years.
Faced with long waiting lists and postcode lotteries, the doctors say that patients are increasingly paying extra private payments to upgrade the treatment they receive.
Patients are finding sophisticated ways to "top-up" NHS treatment by paying for drugs, devices and investigations privately - sometimes buying them from abroad over the internet - and combining them with NHS treatment, the report says.
In some cases patients opt to pay for all their treatment. In others they get investigations undertaken privately and more quickly, before returning to the NHS for treatment.
The result they say is inequitable. But politicians and others are reluctant to engage with the issue. "By perpetuating the political mirage of a service completely free at the point of delivery, debate is conveniently stifled," the doctors say. "What is urgently needed is a proper debate on the future of healthcare funding, covering both tax and independent financing".
Despite the Labour Government pouring billions of pounds into the NHS to improve the quality of care, they claim that top-up payments will increase in major areas of the health service such as cancer care and heart disease.
Hearing aids - audiology services - could be treated the same way as spectacles, they say, with vouchers for the poor and a competitive market for everyone else.
Patient groups said the study highlighted Britain's "two-tier health system", where people with money had access to a range of treatments and those without did not.
The report was written by three doctors, including Karol Sikora, a leading professor of cancer medicine at Imperial College School of Medicine.
Published by Doctors for Reform, which represents 1,000 doctors working in the NHS, it accuses the Government of being in denial about the role of the private sector in the NHS.
"It is commonly said that health care in the UK is free at the point of delivery; in fact this mantra is now a political mirage rather than a day-to-day reality," it says.
"Patients are developing sophisticated approaches to purchasing upgrades to their care [in the areas of] the major killers - cancer and heart disease - [as well as] in areas of medicine benefiting smaller groups of patients such as maternity services.
"It has to be recognised that the use of top-up payments is increasing. We need to face up to this rather than ignore it."
The doctors published 20 case studies showing how patients used the private sector to upgrade NHS services. They include a 33-year-old secretary who had been trying for four years to become pregnant.
She was eligible for free IVF treatment on the NHS but her primary care trust was in debt and turned her away. She paid £3,500 for treatment at a private London clinic.
Prof Sikora and his co-authors, Paul Charlson, a GP in Yorkshire, and Christoph Lees, a consultant in obstetrics and foetal-maternal medicine, sent the report to Patricia Hewitt, the Health Secretary, the opposition parties and the Royal Colleges.
They called for an open debate about the future of health care funding.
"Patients are already seeking to supplement their NHS care, after a decade of maximum tax-financed spending increases," they said.
"The Government's position is that the NHS can provide all of the care that patients need. If this is not the case now, can it be so in the future, given that tax-financed increases are slowing, medical costs are rising and patients are becoming more consumerist in their attitude?"
Norman Lamb, the Liberal Democrat health spokesman, said: "We don't want to drift into a system where those who don't have the money to pay for treatments simply go without."
From:
http://www.ft.com/cms/s/9ab02e22-f136-11db-838b-000b5df10621.html
and
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/04/23/nhs23.xml
The short term incompetence of Labour on the NHS will have long term consequences:
On April 19, 2006 Health Direct posted: Health deficits and waste are symptoms of a deeper failure for NHS funding- Blair warns when Tony Bliar remarked that Labour's record spending increases and reform were the last chance for the National Health Service. If they did not work, the prime minister warned, waiting in the wings were politicians who would dismantle the NHS.
The reality is somewhat different. There is no ideological difference between Labour and Conservative. The real difference, in Rumsfeld speak, is that Labour ministers know what they don't know while the Conservatives don't know what they don't know.
Pushing economic power closer to doctors and patients with practice based commissioning is a great idea, but one that will end in chaos if data, management skills and incentives are not properly aligned.
NHS managers are drowning in policy documents and guidance notes, each pushing a new initiative. Their impact on each other has not been thought through. As the system is loosened, financial pressures and rationing are likely to intensify.
Despite all Labour's extra money, the Conservatives' internal market reforms, started in the late 1980s and reversed in Labour's first term, brought average waiting list times down faster and generated NHS output growth almost double that of Labour's first six years.
Labels: labour cutbacks, labour liars, NHS charges, NHS deficits, NHS fiasco
posted by Dr Search- Principal Consultant at the Search Clinic at
12:57 PM
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