Topics / Health
Should the NHS remain free at the point of use and funded through general taxation?
Should the NHS continue to provide care free at the point of use, funded mainly through general taxation, and if so, with how much money and what changes? Positions differ on values such as equity, choice, shared responsibility and value for money, and on contested evidence about what drives health system performance.
Positions
- Yes, fund it more: Universal, comprehensive care free at the point of use and funded through general taxation is the fairest and most efficient way to provide healthcare. The NHS's current problems stem mainly from a decade of slow funding growth and underinvestment in buildings, equipment, staff and social care, so the answer is sustained higher investment.
- Yes, with reform: The founding principle of care free at the point of use and funded through taxation is right and should be kept. But the NHS needs serious reform in how care is organised, delivered and managed, with more prevention and community care, better technology, integration with social care and stronger management, so that money delivers better results for patients.
- Move to a social insurance model: The UK should move towards a social insurance model like those in Germany, France or the Netherlands, where compulsory universal insurance funds care from a range of providers. These systems keep everyone covered while delivering more capacity, more patient choice and better outcomes than a centrally run, tax-funded NHS.
- Allow charges for some services: The NHS should remain universal and mainly tax-funded, but modest charges for some services, such as GP appointments, missed appointments or non-urgent care, with exemptions and caps for people on low incomes and those with long-term conditions, would raise extra money and encourage more careful use of a scarce service.