21 July 2006
The Commons' health select committee has asked the government to review the system of prescription and other NHS charges and to consider whether charges for services 'not clinically necessary' could be levied.
Committee member Richard Taylor, who won his independent Wyre Forest seat in 2001 after a campaign to save a local hospital from closure, said: 'We are suggesting the government should have a widespread review into the possibility of establishing a set of core services which will be free and a set of treatments for which the NHS could charge.'
'We've got to face up to the fact that, with everybody living longer, there's going to come a time when the NHS cannot afford everything free. This is a sort of euphemistic way of saying: “We've got to really open up to wide public discussion the whole question of what the NHS can afford and what it cannot” in other words, health care rationing.'
The committee proposes the government consider the merits of a system similar to that in Sweden, whereby patients are charged for treatments that are not 'cost-effective' – such as the use of branded drugs when effective generics are available – and cosmetic surgery.
Fees might also be used to deter patients from cancelling appointments or turning up unnecessarily at accident and emergency departments. 'Hotel fees' could be charged to cover the non-medical cost of overnight stays in hospital.
The committee also urged a review of the current charges for prescriptions, car parking, hospital telephones, dentistry and eye tests, which committee chair Kevin Barron labelled as 'ad hoc' and outdated.
The committee said it was concerned that additional charges might also be introduced in an ad hoc way. Barron singled out the 'Jentle Midwifery' scheme at London's Hammersmith hospital, where women could pay £4,000 to secure the midwife of their choice throughout their pregnancy.
'We believe that this is unacceptable,' he said. 'This is cut-rate private care within an NHS hospital,' he said. '[It] should be available to all or paid for at full cost… We really ought to know whether or not these types of charges are potentially the future of the NHS.'
A Department of Health spokesman said: 'We will study the recommendations of this report carefully. We are committed to NHS treatment remaining free at the point of delivery.'
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