The NHS is in crisis and
approaching the point where it can no longer be afforded, so that the aim must
be to reform the service to make it viable. It has become a world service with
health tourism to the UK very attractive, which we, with our limited resources,
cannot meet.
Of course it is only a small
part of the cost, but why should visitors or immigrants not take out Health
Insurance; we need to when we go abroad and this is mandatory with the US and
other countries.
The NHS should return to being a
true health service and not an accident and repair service; it should be restricted
specifically to UK residents who are ill and who pay all the costs of the
service. It is not an indulgence for self inflicted health problems or a
charitable organisation free for all.
We all pay motor and home
insurance; Business have transport and accident policies; risk pastimes take
out insurance as do major events organisers and anyone liable to risk, so why
should this Insurance not meet its full obligations.
Of course premiums may go up, but no-claims bonus could restrict this to
claimants, but the basis is insurance against accidents.
The self indulgence of smoking,
drink, drugs and obesity is another major cost area, but charges could be related
to Mandatory rehabilitation courses, with even a health tax on major suppliers
of offending products. There is the question of affordability, but they find
the money to by the stuff in the first place.
Normal health care at point of
need should not be affected with NHS number or Insurance detail (passport for
tourists) as required. Record of treatment will be necessary, but this is being
done anyway and billing could be from Central Trust on these records. Private
hospitals and business do this as routine.
There would be a need for a set
of standard charges, agreed with Insurers for accident claims, but the overall
cost should not be too high and is rechargeable. The main change would be one
of attitude.
There will be some grey areas
and also social ones like childbirth, IVF etc which should be on NHS, but
generally the position is clear cut, normal health risks or external causes.
Food poisoning is one area, where it is commercial it would be part of
compensation, in the home it would be health risk.
There is a lot of money being
made on accident claims and it is right that this should include treatment costs.
In many ways this could be interpreted as privatisation, but it is only in the
areas that are already privatised, of Insurance and compensation.
The main objective should be to
give health care to UK residents who pay taxes to finance it, anything outside
normal health consideration should be paid for at the event. It is difficult to
assess how much this would save, but non-health treatment is currently a major
part of NHS costs and should be paid for when provided.
It is only logical and sensible
that such a separation should occur for natural health issues and those arising
from choice and controllable events; in the majority of cases the insurance
exists and therefore should meet its obligations in full.
The boundaries are well defined
in general, with very few grey areas and the laws on insurance accepted for all
parties and exploited by some; they just need to be applied by the Health
service. Most A & E and Ambulance service costs relate to rechargeable
events, as do long term hospital treatments, whereas GP’s are primarily
concerned with basic health, as are most out-patient care.
It is probable that most
accident treatment would revert to the private sector, apart from A & E,
once it was charged for on insurance, relieving pressure on the NHS. Why should
the State or taxpayer subsidise the Insurance Companies or individuals who
behave carelessly or live dangerously.
There is a stark choice, we
either see the NHS steadily decline under forced savings to an ineffective service,
with the drift towards private care for those who can afford it, or remain the
excellent NHS it can be , but limited to true health care, free at point of
need.
The basic care would not change,
but the funding basis would, to the benefit of all who use the service, whether
due to ill health, accident or misfortune.
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