Every user of the National Health Service should be presented with a bill as they leave their doctors’ surgery, chemists’ shop or hospital. They would not have to pay it - that’s how the NHS works - but it would make them appreciate the value of the service.

The NHS costs £100bn a year to run, paid for by taxpayers who do not relate the tax to the benefit. They resent the money they pay to the government but do not value the benefits received. And that is hardly surprising when we do not know if a course of treatment costs £300, £3,000 or £30,000.

But if everyone who handed a prescription to their pharmacy was given a receipt showing the cost to the state when they collected their medicines they might start appreciating the benefit.  Each person leaving hospital would be told what their treatment had cost; everyone visiting their doctor would be told the cost.

Those who receive their treatment free would still do so; the few who pay for prescriptions would see the true cost of their pills (whether or not that cost is more than the prescription charge).

Ideally these “bills” would be personalised, but the state of hospital accounting probably cannot cope with allocating staff times to particular patients, nevermind allocating the cost of equipment used or medicines given.  The hotel trade or motor repairers are quite capable of such calculations but for the health service, a standard cost for different types of procedure would be a starting point. Doctors’ visits might merely say that each five minutes of surgery time costs £5 or £10.

If it ever happened, the next stage might be to collate the cost of each person’s annual benefits received and inform them of the total at the year end.

The bill would probably shock most people - not for its novelty but for the amount. But the outcome should make people appreciate where their tax goes - and possibly make them more willing to accept tax increases. It might make some people hold back from exploiting what they think of as a free service and stop them seeking inessential treatment, thus reducing the cost of a service that accounts for one pound in six spent by the state.

True, a segment of the population would probably see these costings as a challenge, either claiming more as a right or boasting about the cost of their operation just as they currently boast of the complexity. But for all the addition to NHS bureaucracy, we would have a population that better understood the value of what we receive. It might make people better appreciate the job of  the National Institute for Health & Clinical Excellence in deciding which drugs the country can afford.

Whether in the long-term it leads to patients being asked to contribute part of their cost to the health service is a political decision, but having been told to look after our own dental, pension and housing requirements it would not be surprising if a future generation has to pay directly for healthcare too. There is not an infinite resource to finance the NHS - hence rationing and waiting times.

Share this: