Highlighting a funding gap that could rise to £30bn by 2020 across the health service, Reform argued increasing existing charges and bringing in some new ones would broaden the base of available funding.
Chief among its recommendation are changes to the prescription charges, which Reform said this would be most ‘politically acceptable’ option.
Thomas Cawston, research director at Reform, said: ‘Few will want to debate higher NHS charges but the funding outlook for the service makes it unavoidable. Prescription charges are the easiest route to new revenue, with exemptions for people on low incomes built in.’
Prescription charges rose by just 5% in real terms over the 2000s, Reform noted. This compared to a 68% increase during the 1980s and a 57% increase during the 1990s.
Raising the prescription charge from £7.85 to £10.00 and the cost of a Prescription Prepayment Certificate from £104 to £120 would raise £130m annually, the think-tank said.
Consideration should also be given to imposing prescription charges on retired people, who currently receive free prescriptions. This would increase the proportion of prescriptions dispensed that are subject to the charge from 10% to 20%, and bring in another £450m a year, or £650m under a raised fee.
Following the French model, and dispensing only 20% of prescriptions for free, but lowering the charge to £3.00 would raise an additional £1.4bn a year.
But policymakers also need to consider introducing charges for other services such as GP visits, the ‘hotel’ costs of hospital stays and some accident and emergency visits, Reform said. The think-tank noted that the majority of developed countries routinely charge for a range of health services.
However, it acknowledged that people on low incomes should not be deterred from seeking healthcare when they need it. ‘Any reform should include exemptions for people on low incomes, as is common in all developed countries,’ Reform said.
Concerns should also be balanced against the service improvements charges could deliver. A charge to visit the GP, for example, could help finance extended hours and weekend consultations.
