The headlines (sic.) in The Guardian don’t do full justice to the proposals I make in the paper published today – How to Pay for NHS – where I consider a range of options and ask for a national discussion on how the NHS can be fairly and adequately funded. I urge readers instead to review the paper itself.
Nevertheless, the co-incidence of our publication with the cross-party’s Health and Select Committee Report on the staffing crisis faced by the NHS over the decade does highlight the need for a proper, long term plan to funding this vital service.
What my paper for Radix actually argues is that the UK urgently needs to undertake a national review of health and social care to decide what we want from the service. We then can decide how much we are prepared to pay and then how we want to pay.
That review needs to look at practice internationally and be open to all options to create a secure funding basis. These options could include increased taxation, an earmarked health and social care tax, fines for non-attendance of appointments and yes – as the Guardian highlights – hotel charges.
Which option or mix of options will be most applicable to the UK environment and culture is, however, yet to be determined.
What we cannot do is try to carry on paying for the NHS in the existing piecemeal, hand-to-mouth way, which has seen this vital service lurch from funding crisis to funding crisis.
Even when the Treasury does find funds, the current approach means that managers cannot make long-term plans and this undermines recruitment, training and investment.
In other words, with 10-15 years to train the staff any long term staffing plan, must be underpinned by a long term financial plan.
So that is what my paper is arguing for. We need a grown-up debate about paying for the NHS, in which we can discuss all our options with honesty and integrity then move forward on the basis of cross-party consensus across all the nations and regions of the UK.
Anything else is to do our NHS a massive disservice, and ultimately to undermine it.
You can find all four of Stephen Smith’s series The Best NHS? on Amazon here. Eight more are planned, so watch this space!
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