07.10.14
NHS may have to start charging for room and board - NHS Confed chief
The NHS may have to consider charging patients for room and board if funding continues to fail to keep up with demand, according to the chief executive of the NHS Confederation.
Rob Webster, speaking to the Independent, said that hospital bosses will have to “think the unthinkable” unless more is done to address the looming £30bn deficit in NHS finances.
The Department of Health immediately ruled out such a move, saying: “These proposals are not under consideration.”
But Webster said: “If the NHS cannot afford to fund everything, then it will need to make tough choices about what it does fund. Do we think about increasing our tolerance for longer wait [for care], or do we say ‘NHS funding is only for the health aspects of care and treatment’, which means patients being asked to cover their hotel costs for bed and board?”
NHS managers may also have to raise the thresholds at which some minor conditions are considered for surgery, Webster added.
No detailed plans for charging patients “bed and board” have been drawn up.
Such a move would be a major departure from the founding principles of the NHS and require Department of Health approval. However Webster has said that if funding does not keep up with demand then “unpalatable” changes would be inescapable.
At their respective conferences all three major political parties have pledged to protect or increase NHS spending in the next parliament, but health experts warn that none of the pledges go far enough.
The NHS Confederation has said a “transformation fund” of at least £2bn per year for two years is needed to enable the NHS to maintain current levels of service.
Webster said: “Overall funding allocation for health and social care is a political choice. Flat funding in real terms is a choice. Funding that doesn’t match increases in demand is a choice. One-off ‘lumps’ of money, which get newspaper headlines but don’t allow health service leaders to plan effectively, are a choice. The consequences of these choices are what NHS Confederation members all over the country manage every day of the year.”
Another senior NHS source told the Independent that failing to significantly increase NHS funding would force the health service to “do things we have never done before”.
“You would get into a position where you were doing anything that you can that reduces cost, that brings in money, where you can justifiably say: ‘this isn’t paying for healthcare’.
“Do we say to reasonably well-off people: ‘your healthcare is free, but we are going to charge you £75 per night board and lodging’?”
NHS bosses are also said to be considering letting waiting lists increase, which could see a return to routine one-year waits for procedures like hip and knee operations.
This would allow surgeons to prioritise patients with urgent needs, while also releasing pressure by driving wealthier patients into seeking private treatment.
A Department of Health spokesman said: "The NHS will remain free at the point of use. We know that with an ageing population there's more pressure on the NHS, which is why we’ve increased the budget by £12.7bn over this Parliament and are investing in community services to keep people living healthier at home for longer.”
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