NHS insurance voucher plan mooted

9 September 2008

BBC News Online, 9 September 2008

Healthcare organisations should compete to insure patients under a state-funded scheme which would radically transform the NHS, a think tank is proposing.

Plans from Reform would see everyone given a £2,000 "voucher" each year, funded out of general taxation, to buy health insurance.

Competition between private firms and primary care trusts would drive down costs and improve choice, it argues.

But leading politicians from all parties criticised the proposals.

Labour described it as a "step backwards" while the Tories said the idea made "no sense".

'Far-reaching plan'

In a speech on Tuesday, Lib Dem leader Nick Clegg will "welcome" Reform's call for patients to be empowered but reject calls for the way the NHS is funded to be fundamentally overhauled.

Instead, he will urge an end to what he argues has been the government's "command and control" of the health service.

Reform says its "far-reaching" plan would combine the current principle of universal cover with market incentives to transform the way the NHS is funded within five years and improve health standards.

Its insurance plan is modelled on schemes in countries such as France which Reform says have been more successful in helping to tackle acute problems such as rates of cancer deaths and infant mortality levels.

Under the scheme, people would be able to choose whom they buy their insurance from using a voucher worth the same as the NHS currently spends per head of the population every year.

People would be entitled to a minimum range of treatments and drugs, something which Reform says would end the current "postcode lottery" in the availability of certain services.

Accountability

The role of primary trusts would ultimately change to one of purchaser rather than service provider while the government would act as a regulator of the new system rather than running it.

"The ideas in this report would turn a vast nationalised industry into our NHS," said Nick Bosanquet, professor of health policy at Imperial College London and one of the report's authors.

"They amount to a far-reaching shift in responsibility and ownership towards individuals."

But the insurance plan has met with criticism from the three main parties.

Health Secretary Alan Johnson said the concept of a "patient passport" "threatened the financial stability of the NHS".

For the Tories, shadow health secretary Andrew Lansley said such schemes were not "compatible with maintaining universal access to high quality health care services".

The Lib Dems said healthcare standards would not be improved by competition between trusts and with other firms.

Instead, trusts should be made more accountable to local health needs by having their boards directly elected.

"I believe in the power of the ballot box in health," Mr Clegg said.

"Local control and financing will mean a real financial reward for an area from making people healthier."