Intended for healthcare professionals

Observations Body Politic

How to tackle the NHS funding crisis? Levy charges

BMJ 2014; 349 doi: (Published 01 October 2014) Cite this as: BMJ 2014;349:g5907
  1. Nigel Hawkes, freelance journalist, London
  1. nigel.hawkes1{at}

Top class healthcare and social care aren’t possible without private payment

The hunt for money to sustain the NHS in England is verging on the ridiculous. I thought that the Barker Commission, assembled by the think tank the King’s Fund to work out how to pay for merging health and social care,1 had hoovered up the very scrapings of the barrel. But then I heard Ed Miliband, the Labour leader, conjuring up farfetched ways to target unpopular people—mansion owners, tobacco companies, hedge funds—to keep the show on the road.2 And I knew that the game was up.

Neither recipe will raise enough for the NHS to continue on its present course, never mind trying to add social care to the mix. And there’s something demeaning in Miliband pretending that a few changes that won’t hurt anybody you know but that will bear heavily on a few you don’t know will solve a really major problem. It’s on a par with Chancellor George Osborne’s plan to tax Cornish pasties, which earned him well deserved scorn.

Kate Barker, who chaired the King’s Fund commission, at least laid some of the costs on service users through a flat rate prescription charge (with no exemptions) and “hotel charges” (for …

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