The cost of our health: the role of charging in healthcare

Document type
Cawston, Thomas; Corrie, Cathy
Date of publication
1 November 2013
Reform ideas: no. 9
Health Services
Social welfare
Material type

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This report argues that new charges could raise nearly £3 billion per year to fund NHS services. England is an exception to other developed countries in the extent to which citizens make personal financial contributions to their healthcare costs.Most other developed countries commonly charge for a greater range of prescriptions, for visiting GPs and for elements of hospital care. Similar reforms in England could raise up to £1.4 billion, £1.2 billion and £0.2 billion per year respectively. The report recommends that any reform should provide exemptions for people on low incomes, although not necessarily all pensioners.

The funding gap facing NHS services, estimated by NHS England to be up to £30 billion by 2020, is the reason to consider higher charges in future. The report argues that new charges would broaden the base of NHS funding, reduce its reliance on taxation and generate valuable revenue. It focuses on reforms to prescription charges, which it sees as most politically acceptable. At the moment approximately 62 per cent of the population is exempt with 90 per cent of drugs dispensed for free.

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