Sajid Javid – 2023 Article on Charging for NHS Treatment

A section of the article published in The Times, written by Sajid Javid, the former Health Secretary and the Conservative MP for Bromsgrove on 21 January 2023.

Too often we hear doctors and nurses frustrated at people making unnecessary trips to frontline services, which takes time from other patients. Would the same level of demand exist here if this Irish model were adopted? This extends to GP appointments. In Norway and Sweden a visit to the GP comes with a contribution of about £20. For some people, just like my parents, that is a noticeable part of the weekly budget. But as demonstrated by so many other countries, it is possible to means-test this provision. Even a tiny fraction of patients reconsidering their visit to the GP (and perhaps visiting a community pharmacist instead), would save thousands of clinical hours.

Co-payments are not the only alternative. Germany’s social health insurance model gives the structural benefit of a greater choice of providers, including non-profit community hospitals, and therefore less pressure on the public system. In the UK, more and more people are moving towards private healthcare (including within NHS Trusts). But provision is limited in comparison. Other systems with a contributory principle have seen a range of providers emerge. Patients in the UK are all directed towards the front door of the NHS, which only worsens the queueing.

For patients, this is not cost free. More waiting can mean an increased risk of illness and discomfort. And for NHS staff, it also means a constant tide of pressure (and sometimes abuse). We have already instilled an element of contribution into the NHS: we ask people who can afford it to pay towards the cost of prescriptions, and dental and optical care. Labour and Conservative governments have had a role in this. We should look, on a cross-party basis, at extending the contributory principle.