Nonpartisan consensus is key to solving NHS funding – Dr Andrew Murrison MP
Aden Simpson
| PoliticsHome
“We cannot avoid the need to spend more money on healthcare”, argues Conservative MP Dr Andrew Murrison, and a nonpartisan commission is paramount to finding a solution.
If we judge the UK’s healthcare economy on its efficiency, the NHS is a world leader.
According to the OECD, the UK spent $3,235 per person on healthcare in 2015, less than half that spent in the States. Other comparators are more costly too: Holland spent $5,217 per capita; Germany spent $5,002; and France $4,124.
When comparing outcomes however, it’s a slightly different story.
“We spend considerably less, and unfortunately our outcomes for common forms of disease are lagging behind too; the one goes with the other,” said the MP for South West Wiltshire, Dr Andrew Murrison.
“And looking at demographic changes and increasing expectation beyond the current five year planning period, we cannot avoid the need to spend more money on healthcare - quite a lot more money.”
The Conservative MP is leading a Commons debate this evening calling for a nonpartisan review of how the NHS is and could be funded, by comparing its ‘inputs’ and ‘outcomes’ with similar healthcare economies, such as Germany, France and Holland.
“I think it’s a useful exercise to compare the systems that apply in other countries, if only to validate our own.
“My personal belief is that the NHS is effective at what it does, and is efficient in carrying out the work that it does, and that the basis of its funding - general taxation - is the fairest and most effective method of doing so.
“But we have to look at how we're going to bring our spending up to the level that other countries have. What’s particularly of interest is ensuring that our outcomes are at least as good.”
While the Commonwealth Fund, a US organisation rated the UK’s NHS the best healthcare system out of 11 advanced economies, its methodology gives more focus to ‘inputs.’
The NHS does less well on ‘outcomes,’ landing further down the tables in terms of survival rates for common diseases such as cancer, heart attack or stroke. A 2014 study by the OECD found that the UK has fewer doctors per person than every other European country except Ireland and has relatively few MRI scanners.
“It might be a concern if people in those countries are appearing to get a better deal than people in the UK,” said Murrison.
Murrison points to three reasons for the inevitable spending increase. Aside from the increasing burden of an aging and expanding population on the health service, the advent of new technologies ‘which are obviously great’ will also require additional funding.
“I think the final thing is people's expectations. We’re becoming less deferential and more demanding, reasonably so, but it does mean that there is a price tag, as people expect more from their health service.”
“The question is how we deal with that,” he added. “The obvious ones are forms of copayment or insurance, but they are not methods I would favour.”
For Murrison the need to ‘gather consensus’ is paramount to any potential solution, and the best way to achieve that is through a nonpartisan commission.
The NHS is “such a precious institution” he argues, that party politicians often feel reluctant to take on such fundamental issues, and if any one political party did so, they are likely to struggle without common consensus.
“People would expect there to be consensus involving consultation with a wide range of individuals and organisations. If it does mean for example that we have a hypothecated tax - a tax that is reserved purely for healthcare - that would be quite a big change and therefore requires a level of cross-party consensus.”
Murrison favours the ‘hypothecated tax’ solution, which has also been mooted in the House of Lords, as it would be made explicit to people how and how much they are paying for healthcare, potentially making it much easier to ‘sell’ a rate increase when necessary. Although the “Treasury would hate it,” he adds, “because it reduces their scope for manoeuvre.”
“So a matter of this sort would be amenable to a nonpartisan commission to examine in depth in an expert and informed way and bring forward recommendations.”
“Their Lordships are obviously very exercised by it, and there’s a discussion about it in the House at the moment. I actually think this is the beginning of a process and suspect ultimately it will have a positive outcome.”
