The Tory party announced their new ‘big idea’ for the NHS at their conference in Bournemouth today. The Patient Passport. The idea is that if someone pays for private treatment, they should get 60% of what it would have cost the NHS to put towards it. The example used was a hip-replacement. This would cost the NHS £5,000, so they would get £3,000, while the NHS would still have £2,000 to treat those who can’t afford it. Ten people treated privately and enough to treat 94 on the NHS. Voila, everyone’s happy. Wrong.
Where this idea falls down is because it misses out one pretty vital piece of information – what would it cost you to have a hip-replacement done privately? There was a story in tonight’s Manchester Evening News about a woman who went that route and she had to borrow £15,000 by re-mortgaging her house. Three times the cost to the NHS!
The Tories would argue that this is empowering people, saying why should private health care be the preserve of the rich? Fine sentiments, but the reality is that it is only really empowering the middle-classes, (of which I’m a member) the one group of people who already have the education and wherewithal to argue their way up a waiting list. For everyone else, it means going into debt to prop up the NHS.
I have no philosophical problem with the private sector being a part of the NHS economy. Indeed, it already is. In Greater Manchester we have a contract with BMI to provide a range of treatments to get people who might otherwise wait more than six months treated sooner. Taking the idea further, Netcare, a South African company, is going to run a mainstream NHS facility to the same purpose – to get waiting times down.
This works because the NHS is negotiating a bulk contract, so the cost bears comparison to NHS costs. And as statutory bodies, the NHS takes quality issues very seriously. Yes, contracts could be negotiated by others, like bucket-shops, in the same way that cheap holiday companies negotiate your accommodation. But while cockroaches and building sites can be a bloody nuisance for two weeks, I wouldn’t fancy the same system if my future health relied on it.
And that is where the Tories have missed the point again. As an individual patient, you don’t particularly need empowerment. What you need is treatment, and quick. It’s the waiting time that is the issue and you don’t have buying power, but the NHS does. Drive down waiting times, and why would anyone want to go private when the NHS can provide care, whether in the public or private sector?
Left alone and ‘unreformed’ for a year or two, we might, just might, achieve Beveridge’s dream and more. Treatment free at the point of need. Better yet, treatment without the wait.