FIRST the good news: someone has suggested charging for the sick to stay in hospital.
Now the even better news: it will never happen.
And the bad news? The real solution to funding the NHS was never mentioned.
The reaction in most quarters this week to suggestions from Rob Webster, chief executive of the NHS Federation which represents NHS commissioners and providers, that charges might have to be made for ‘bed and board’ if the gaping hole in NHS funding is to be plugged, was predictable.
Almost to a man, woman and child the suggestions brought quick condemnation.
Which is fine. And probably what Mr Webster was expecting. What he undoubtedly also hoped for, and got, was a nationwide debate on just how we can continue to fund the NHS going forward.
That, I would contend, was worth all the hand-wringing his comments brought forth, especially after someone appeared to pluck from the air a figure of £75 a night to enjoy the luxury of a bed on the wards.
Of course, there is a sensible debate that could be had over whether paying for non-medical services such as bed and board would be a way to increase the NHS coffers. The argument that the NHS was designed to be totally free at the point of delivery is already flawed.
Dentist fees and prescriptions already have to be paid for. With all those exempt from such fees – including children, the elderly, those on forms of benefit – likely to avoid any hospital bed charges, the point could be made that only the reasonably well off would have to pay. A sort of extra tax on the middle-class sick, the rich already enjoying private health care anyway.
But I accept it would be a difficult line to sell, certainly for any politician hoping to keep their seat.
Undoubtedly such charges would mean some who need help would not seek it, which is unacceptable.
Which is why it will never happen, nor should it.
That leaves us with the question of how the hole in the NHS is to be plugged. So far each of the main parties has tried to outdo the others in promising to find the cash somehow from somewhere. Overall the theme was one of tax, reform, and tax some more.
None of their utterances offers a sensible and, I would say, sustainable way to ensure that health services thrive in a future where our aging population and the rising cost of medical care collide.
Do I have a complete solution? If I did then I would be making a lot of money advising someone, somewhere on the issue. But I do think we can start by examining whether the original pact on which the NHS was based is being upheld. That pact is not between us and the Government, or between politicians and medical practitioners, but between ourselves. It is the pact, surely, on which we base all of our welfare state.
We, as a people, agree to pay into a fund that will provide the very best of care for those who are in need. Those who can pay more do so. Those who cannot afford anything do not pay at all. The fund looks after the sick, the elderly, the disabled, those who are injured, the weakest in our society.
And in the knowledge that the fund is not finite, we who are well, fit and able will do our best to remain that way for as long as possible to avoid becoming a burden on that fund until we take our inevitable turn as age or infirmity or ill-luck take their toll.
It’s a simple rule that any sane and caring society should adhere to. So why don’t our politicians admit so?
Why haven’t I heard one politician or commentator in the last week talk about the future of the NHS being everyone’s responsibility?
Instead they have continued to underscore the false impression that everyone can lead whatever life they wish – smoke, drink, eat, sloth – and it is their right to have the NHS there to pick up whatever pieces are left.
The truth is the responsibility for ensuring the future of the NHS is not in the hands of politicians, but our own.
How much money such a change of emphasis would save I cannot say. The £10m the NHS in Hampshire loses each year when people fail to turn up for appointments would be a start. But I have an inkling that a society that truly understands that the NHS is not someone else’s problem to solve will prove far healthier in the long run.
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