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NHS Contribute Extra: A return to the NHS's core values

Christoph Lees & Edmund Stubbs, February 2015

It is hard to exaggerate the need for increased funding for the NHS. The health service is threatened by a funding gap which could be as large as £30 billion per year by 2020. Even if current yearly efficiency gains were doubled by 2020, it could still be looking at an annual funding gap of £16 billion. Further savings due to efficiency improvement seem optimistic, considering our ageing population and rising levels of chronic disease.

More than a quarter of healthcare trusts finished the 2013/14 financial year in deficit, directly threatening the provision of services in some areas. The NHS’s rising financial unsustainability could threaten its very existence unless we are bold enough to take effective action. We need patients to take more responsibility for their own healthcare and health affecting behaviour.

In this paper, Dr Christoph Lees and Edmund Stubbs set out the case for an NHS contribution scheme which could generate increased income in a progressive manner while reducing overall demand for already stretched services. It would encourage patients to become involved in their healthcare and thus modify their lifestyles. Contributors would be highly aware of their own standard care budget, using it, with increased flexibility, at NHS or non-NHS providers of their choice, sometimes with extra, out of pocket payments.

“The proposed voluntary contribution scheme will aid the restoration of the current NHS model to its original founding values, as envisaged by William Beveridge,” they write.

“The scheme will enable healthcare to be built more upon cooperation between the state and individuals, with the opportunity for individuals to voluntarily enhance their care above a substantial and secure minimum level that is already firmly established in the UK.

“Enhanced choice will ensure that people who are left unhappy with health services in their area will have a wide variety of options at their disposal, not simply voting for a new government in the hope that healthcare reforms could take place. Importantly, this will enfranchise those for whom completely ‘private’ healthcare would never be affordable.”

‘…if we wish to maintain the standard of healthcare to which we have become accustomed and indeed wish it to improve, then higher levels of funding will be needed…’

In the Media

Patients could pay £10 a month to choose where they’re treated in future Daily Mirror

Let patients top up their budget for NHS treatment to solve funding crisis, report urges Daily Mail

Patients should be able to go private by topping up NHS funds The Daily Telegraph

About the Author

Christoph Lees is a Consultant in Obstetrics and Fetal Maternal medicine, a Clinical Reader in Obstetrics at Imperial College London, and a founding member of the Doctors’ Policy Research Group at Civitas. Edmund Stubbs is healthcare researcher at Civitas

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