A survey by the British Medical Association has found that half of the population believe they will have to pay the NHS for health care within a decade. And 93 per cent of those surveyed believe the NHS should continue to be funded from taxes and remain free at the point of use.
The results of the survey were released on the eve of its annual conference in Edinburgh, which is expected to batter the government for the way they have handled the NHS.
Doctors have clashed with MPs over extended opening hours for GPs and the introduction of multi-GP “polyclinics”, which are to be rolled out across London from next year.
The BMA poll findings reflect growing public pessimism about the wider economy and the impact of the global slowdown on the NHS. After five years of record growth from 2002 to 2007 averaging 7 per cent a year in real terms, the NHS’s growth rate this year almost halved to just over 4 per cent.
Costs are increasing with a dozen new cancer drugs priced at up to £100,000 per patient per year in development. Although the NHS has built up a surplus expected to exceed £1bn in 2008-09, health economists say it will not be enough.
The conference is due to debate proposals for “top-up” payments which would allow patients to pay separately for treatments not available on the NHS without losing their entitlement to NHS care. Under existing rules, NHS patients are banned from topping up their NHS treatment by paying privately for extra treatments but the Government announced a review of the ban last month, by the national cancer director, Mike Richards, who is due to report in the autumn.
The issue has become a touchstone for the NHS, highlighting the tension between cost pressures and economic realities. Supporters of top-up payments point to the treatment of infertility where couples receiving IVF mostly pay privately but are not thereby debarred from NHS care during the subsequent pregnancy and delivery.
Opponents – who included the Health Secretary, Alan Johnson – say allowing top-up payments would introduce a two-tier service, with the best care available only to those who are able to pay.
This would create a new market for the private health insurance industry, offering policies to cover treatments not available on the NHS. Western Provident Association, a private health insurer, currently offers a policy covering the cost of licensed cancer drugs prescribed by a consultant but which are not funded by the NHS for a premium of £1 a week.
