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Terpe
31st March 2014, 08:14
http://news.bbcimg.co.uk/media/images/73874000/jpg/_73874985_tenners.jpg
Should we give the NHS one of these each month?

There are many views about what the NHS should do to cope in the current financial climate.

In this Scrubbing Up, former Labour health minister Lord Norman Warner and Jack O'Sullivan, head of a social policy consultancy, who have written a paper for the think tank Reform, set out their thoughts - including a £10 monthly membership fee.

You might think that all adults (with some exemptions) paying a £10 monthly NHS membership fee would have little impact on an organisation with a budget running at £130 billion a year.

But it's a change that just might help rescue the NHS from its combined care and cash crisis.

Think first about the caring side. The NHS is in serious trouble.

Frail elderly people, those with chronic conditions or mental health problems and those developing obesity and life-style related illnesses often receive very mediocre care.

Too many of them fail to receive help at the right time in community-based health settings.

Eventually, they may be treated in hospital - a much more expensive setting - when they are sicker than they should be and when they could have been cared for earlier, in less costly environments.

Annual MOT

That could all begin to change by making NHS membership a key element of citizenship, creating a new relationship between the state and individuals, 'co-producing' personal health.

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Should the NHS charge like hotels?

Each year, you would have a Health MOT when you and the NHS would agree responsibilities for self-care and services in the coming year.

And the £10 a month, collected with the council tax, would go straight into developing impoverished local community health services.

A membership scheme might also get people more engaged with how we must transform our NHS - shifting resources into merged health and social care services, delivered from revamped community hospitals, open 24/7, and supported by consolidated GP practices.

Under our proposals, specialist hospital services would be concentrated in fewer, safer, better equipped and more expert centres with 24/7 consultant cover and improved transport links.

We know this move would save lives, as has already happened with consolidating emergency stroke care in fewer London hospitals

The membership fee is just the beginning of our plans to expand the tax base for health care.

We must grasp this nettle, because, even if the care side is fixed, the NHS will still need small above-inflation rises every year.

New streams of dedicated revenue are required to allow the NHS to remain largely tax-funded and free at the point of delivery, but not starve other public services of resources.

'Sin' taxes

We suggest a host of well-documented, but currently unimplemented, efficiency improvements.

These include sell-offs of under-used assets for a £15 billion "service transition fund" to renew the NHS.

We also detail much tougher taxes on tobacco, alcohol, sugary foods and drinks, and gambling, to be spent only on health and care.

Elderly people, the biggest consumers of healthcare, could contribute more, albeit after they die: it cannot be fair that just 3.5% of the annual 500,000 deaths lead to payment of inheritance tax.

Some NHS 'free' entitlements, such as 'continuing care' might have to be reduced or means-tested.

Hotel charges for hospital stays could be introduced, as in other European countries.

We cannot afford to ignore these issues any longer. The NHS care crisis remained largely hidden in times of plenty.

Now, amid austerity, it is exploding into a full-blown cash crisis.

The NHS, facing a £30bn deficit by 2020, is becoming economically unsustainable, given our tax base, the state of the public finances, changing population needs and the implications of scientific development.

Meanwhile public expectations of services continue to rise.

It is a perfect storm.

Our study, 'Solving the NHS Care and Cash Crisis', is published today as Simon Stevens takes over as the new chief executive of NHS England.

It makes clear the need for strong political and clinical leadership.

Our public figures must be brave, backing Stevens and facing uncomfortable truths - helping us, the NHS membership, to see the true picture of what has to be done to save our NHS.

Lord Norman Warner was a Labour health minister for NHS reform and Jack O'Sullivan leads a social policy consultancy. Their study, 'Solving the NHS Care and Cash Crisis', is published by Reform, the independent think tank.

Source:-
http://www.bbc.co.uk/news/health-26788377

RickyR
31st March 2014, 08:36
The NHS and Pensions both need major reforms, particularly I think the NHS funding should be broken down from income tax, as a complete and separate payment that people can see. Make people understand that its not a free service, but something they do pay for, make it clearer. Perhaps even two levels of service, and higher earners have a choice between using the NHS at a higher fee or paying for a private medical insurance.

andy222
31st March 2014, 10:07
But this government is not privatising the NHS.:Erm:

stevewool
31st March 2014, 19:08
there will come a time when this will happen

Doc Alan
31st March 2014, 21:08
This 128 page report ONLY applies to England ( but doesn't make that clear ). As “ Life in the UK Test Study Guide “ reminds us, healthcare is DEVOLVED to the Scottish Parliament, and Welsh / Northern Ireland Assemblies . Expenditure on UK healthcare is more like £ 143 billion ( 2011 ), not “ 130 billion “, and the “ affordability gap “ of £ 30 billion quoted is only an estimate.


It's already been dismissed out of hand by those who can hardly have had time to read it ! The Labour Party and Unite Union oppose the headline-grabbing “ £ 10 a month NHS membership charge “. There are other, better, proposals – not least, making changes over a 5 – 10 year period, avoiding the disruption of other recent reorganizations :xxgrinning--00xx3:.


They are are for the next Parliament ( 2015 – 2020 ) and beyond. Key messages are :-


• 1. “ Co-produce health “ - an NHS Membership Fee ( with exemptions ), and an annual “ Health MOT “. No mention of charges for visits to GPs.


• 2. More effective community-based services and public health.



• 3. Merge health and social care.



• 4. Preserve a largely tax-funded ( frozen in real terms ), largely free-at-the-point-of-use NHCS ( National Health and Care Service ).



• 5. NHCS to receive 1% increase per year above inflation, funded from “ hypothecated “ ( dedicated, ring-fenced ) inflation-proofed “ sin taxes “ on alcohol, tobacco, gambling, and “ health-damaging, sugary foods “.


• 6. Strengthen specialist hospital care – fewer sites, but allowing 7-day consultant cover.



• 7. Diversify provision – " end the phoney arguments about who provides services " : universal coverage of financial and clinical risks, not monopoly public service provision.


• 8. Selective " Hotel charges " for overnight stay in hospitals.


• 9. Full cost holiday vaccination charges.


• 10. Inflation-proofing prescription and dental charges.


Our Filipino friends, relatives, and partners must find it hard to understand never-ending NHS reviews and criticisms :doh. The NHS has much to be proud of – especially universal financial coverage and many acute hospital services. Community services, primary care, public health, and mental health do “ continue to be patchy “ – as the report points out.



UK healthcare expenditure is - and should stay - less than 10% of GDP. The report's proposals are to maintain this ! It accepts that the NHS is good value for money - while not responding fast enough to changing lifestyles and disease profiles; an ageing population; and increasing public demand, coupled with chronic disease from poor lifestyles :NoNo:.



Health spending in the Philippines is too low - less than 4% of GDP. " Non-communicable diseases " are catching up in importance – 3/5 deaths are due to cardiovascular disease, cancers, diabetes, and chronic lung disease; compared to 9/10 such deaths in the UK. Life expectancy is less than the UK ; half of health expenditure is “ out-of-pocket “ ; health insurance is not comprehensive ; and poor Filipinos die from curable diseases because they can’t afford medicines and healthcare professionals.






http://reform.co.uk/resources/0000/1247/Solving_the_NHS_care_and_cash_crisis.pdf

gWaPito
1st April 2014, 01:19
Im already subscribing through my monthly tax bill for others to benefit

andy222
1st April 2014, 11:24
I dont mind paying £10 a month if they scrap my NI payment.:icon_lol: