Former health secretary the multimillionaire Sajid Javid deserves at least a modicum of respect for telling his truth about the NHS. He wants parts of the NHS to be means-tested whereby we would all pay for A&E visits and GP appointments. We need a “grown-up, hard-headed conversation”, he adds, which is another way of saying that the NHS always being free at the point of delivery is not grown-up and hard-headed. Let’s be very clear about this. Javid is flying a kite either in a personal capacity or on behalf of law-breaking Prime Minister Brand Rishi Sunak, who is not “currently” considering the proposals, the word “currently” doing all the heavy lifting here. We see you, Mr Javid.
In his Times interview, Javid cites the examples of Ireland and both Norway and Sweden who long ago introduced charges. In Ireland, if you attend A&E “without a referral” you will get a bill of £66. In Norway and Sweden, just seeing a GP will set you back £20.
Let’s not get caught up in the means-testing malarkey because it’s a red herring for the vast majority of people because we all know full well how it would work, with only benefit claimants without capital being excluded. The vast majority of us would have to pay. Can you imagine how it would work?
You are theoretically on a good wage, but you haven’t had a pay rise for years, your mortgage has been dramatically increased by the actions of this government and you are struggling to pay your heating bills. You have something wrong with you and because you know serious conditions are often averted by early diagnosis and treatment, you book a GP appointment. But as you are already overdrawn at the bank, you pay for your GP appointment by way of your credit card and you pay for your prescriptions, in England anyway, by the same method. What happens when your bank calls a halt to your overdraft? And if you suffer, say, a heart attack and you arrive at A&E without anyone having referred you, do you spend the first part of your hospital visit filling out forms before you get, perhaps, life-saving treatment? This is not a joke. The new reality will have to be something like this.
This will also be the thin end of the wedge because if this is introduced and the government believes it has worked, then why not extend the principle of paying for your health care? Let’s install payment meters in ambulances, just like with taxis, and introduce hotel-type charges in hospital? And why not bring in turnstiles at medical centres where you a contactless payment system can grant you access to not just the GP, but nurse appointments, flu and Covid vaccines and all the rest of it?
Can you imagine the sheer expense involved in creating a means-tested system for the NHS? You would need many thousands of additional administrators to manage all the payments, plus a brand new fraud department to deal with instances of abuse. With the NHS already on its knees, let’s have less doctors, nurses, porters and the like and more pen-pushers and bean counters instead?
None of us will be exempt from Javid’s big idea. Millions of pensioners, especially those without private pensions, are already struggling and depending on where means-testing begins will they be exempt? Those with capital – perhaps life savings and a steady private pensions – will need to be assessed to see how much they would have to pay for their care. That, my friends, is means-testing. If you have put something aside for that rainy day, then more fool you.
In my view, it’s either or. We either have a properly funded NHS with treatment free at the point of delivery or we don’t. And if we all come to a view that it’s better to pay for GP appointments and A&E visits then just think about just who would benefit from such a situation: the vultures and parasites of private healthcare who would spy a golden opportunity to bump up their prices and, in some instances, literally make a killing.
At least Javid openly says what many Tories are thinking. The Conservatives have never believed in the NHS but politically they’ve never gone further than undermining it by way of lack of funding. Now a right wing politician, soon to leave politics to spend more time counting his money, dares to say what the rest of them have not until now dared to say.
This idea needs to be strangled at birth. Yes, we need to reform the NHS, not least by way of changing people’s lifestyles and making them less likely to need healthcare in the first place (and yes, this includes me). But we either stand for the principles of the NHS or we don’t. Javid’s ideas represent the beginning of the end of the NHS. At the next general election, we will have a stark choice to make.
