Gordon Brown warns Tories are “testing the water” for two-tier healthcare

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<p><figcaption class=Photo: Murdo MacLeod/The Guardian

Ideas such as Sajid Javid’s suggestion that patients should be charged for visits to GPs or hospital A&E departments show the Conservatives are “testing the water for another type of NHS”, Gordon Brown said.

Writing in the Guardian, the former Labor prime minister says service charges will end up failing to diagnose early and undermine the entire foundation of the NHS.

Javid, the Conservative former health secretary, told the Times on Friday that the NHS could not “survive much longer” without radical changes, including on some charges.

Javid, who will step down as a Tory MP at the next election, cited as possible examples the fee of around £20 required for patients to see a GP in Norway or Sweden, and the £75 fee for those coming to the ER without an referral.

Brown wrote that Javid’s intervention was “no accident”, noting that Rishi Sunak used private health services and when he ran for prime minister, he proposed a fee for people who missed their GP appointments.

“And so again, as they did in opposition at the turn of this century, with alternative prescriptions [a 2002 Tory document on ways to finance the NHS]The Conservatives are testing water against another type of NHS.

Today’s conservatives could applaud [for] NHS nurses and health professionals at the height of the pandemic; however, they are not only opposing a fair wage for them, they are also considering a more privately funded healthcare system,” Brown wrote.

The move to payments would create a “two-tier healthcare system” where better-off people would buy private coverage, Brown argued. This would be “not only morally disturbing, but also the most costly and economically wasteful.”

He wrote: “As overseas experience in billing and income checking shows, fees not only mean higher administrative and collection costs, but also discourage patients from seeking treatment late – when more serious problems require not only more intensive, but more costly, interventions.”

Mr Brown said an aging population and a growing number of people with chronic or chronic conditions meant a change was needed, but instead the focus needed to be on tackling social care issues and the drainage this has caused in NHS hospital beds as well as in on dealing with underlying factors.

The Conservatives “seem to find more joy in one person joining Bupa than 60 million people on the NHS,” Brown said, adding: “But what we know about the growing pressure of health inequality, from Michael Marmot’s groundbreaking work, should turn our attention from this ideological depiction of fees and private insurance to the fight against deep-seated poverty and other social determinants of ill health. It is by attacking and eliminating the root causes of ill health that we will do the most to reduce waiting lists and pressure on the hospital sector.”

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