Examination of Witnesses (Questions 700
- 708)
THURSDAY 16 FEBRUARY 2006
RT HON
JANE KENNEDY
MP, MS ROSIE
WINTERTON MP, DR
FELICITY HARVEY
AND MR
BEN DYSON
Q700 Dr Stoate: Just the opposite.
When I was a junior doctor we used to prescribe sherry and brandy
for medicinal purposes. Long may it continue.
Ms Winterton: Put that in a review.
Q701 Mr Amess: I think these Ministers
have done a brilliant job of blocking everything that we have
slung at them.
Ms Winterton: You always say that.
Q702 Mr Amess: They have even managed
to survive the vicious attacks of Dr Richard Taylor this afternoon!
I shall always remember that expression "refine the principles".
On that very point, as far as the National Health Service is concerned,
does the Government think that the NHS will have to be redefined
so that there will be a core package of services provided by the
NHS above which you could have varying degrees of payments according
to the income of the patient? This would be the bottom line of
what you could get on the NHS and the rest of it, depending on
what money the patient had, you could be charged for all sorts
of other services.
Jane Kennedy: I do not think I
accept that scenario. We have brought forward and established
National Service Frameworks in a wide range of fields and they
set a national standard by which we expect the NHS to deliver
services. What we have done is say it does not always have to
be provided through an NHS organisation, it is possible to allow
other organisations to provide these services albeit paid for
by the NHS. In a sense we already have a definition of what services
should be available through the NHS. What we have been discussing
this morning is where on the edge of that definition it might
be possible for NHS organisations and others, and indeed the state,
to raise resources by charging. That is the debate that we are
having today and we will continue to have, I am sure.
Ms Winterton: I think it goes
back to the Chairman's point about the television that he rented
during his time in hospital because in a sense that was something
that gave a great deal of comfort and relieved the boredom perhaps
or whatever.
Q703 Chairman: I was in traction
at the time.
Ms Winterton: It is about saying
if people want some of those extras, if you like, that not everybody
wants all the time, they can have those. The very basic principle
is that clinically necessary treatment is free and will remain
so under this Government.
Jane Kennedy: On the point Mr
Campbell raised about the gourmet meal and drink, the whole trend
of hospital treatment these days is towards a shorter and shorter
stay in hospital. You could expect to be genuinely asked the question
if you are being offered a gourmet meal in hospital, what are
you doing in hospital when you could be at home? The Health Service
is going through a huge amount of change, not just the reforms
that we are bringing to it but the way in which treatments are
being delivered is being transformed by the way in which new medicines
and treatments are being developed and the new innovations that
are coming down the road. We have to have a service, a public
service, that responds to that as well as providing a service
that protects and provides the quality of service that we all
expect and demand.
Q704 Mr Amess: Finally, looking into
your crystal ball, surely it must be the case that in five years'
time there will be more charging because the way things are going
with the endless demand there is no way we can keep collecting
it all from taxation. Surely it will be the case that in five
years there will have to be a lot of charges.
Ms Winterton: Do you mean demands
for different treatments?
Q705 Mr Amess: Yes.
Ms Winterton: In a sense that
is the system that we have where drugs and treatments are looked
at as to whether they are effective, whether they are safe, whether
it is something that should be widespread across the whole of
the NHS. There is a system which does look at those issues as
to exactly what we can expect the National Health Service to provide
but, as I say, that is rather different from what one might talk
about as added extras that are not to do with a clinical treatment.
Q706 Mr Amess: Surely there is a
worry that with an ageing population, okay not in five years but
ten, 15, 20 years, with less of a proportion working I do not
quite see where the money is going to come from just through taxation
because of the huge demands.
Jane Kennedy: The prescription
charge, if we take that as an example, was 45p in 1979. It rose
to about £5.80 in 1998 and it has gone up by 10p a year since
then. That is a slowing down in the overall charge rate. When
you couple that with the reduction in the number of people who
are having to pay, or rather the growing number of people being
exempt, then the experience of people in the prescription charge
field is that charges are declining in the sense that we are charging
fewer people. In the end it is clearly a matter of political judgment
as to how far you allow the boundary of charging to encroach.
Our position is quite clear: patients should receive the treatment
that they need at the point they need it and it should be free
and not dependent upon their ability to pay, with the exception
of prescription charges.
Chairman: And dental charges and optician's
charges.
Q707 Mr Amess: I am sure that I speak
on behalf of everyone, all those who were here last week to hear
the evidence from the lady who was suffering from cystic fibrosis,
when I say if anything comes out of this inquiry we really, really,
really hope that when you look at our report—I understand
the reasons for not changing anything but the evidence that we
were given last week really moved us.
Ms Winterton: Did you have a private
Member's bill on that?
Mr Amess: Might have!
Q708 Dr Taylor: A very quick question.
Having looked at HC1 I am absolutely horrified. It is the most
impossible form anybody could ever have to fill in even if they
were 50 with an IQ of 150. Could you consider the Citizens Advice
Bureau's suggestion to "simply state anyone on a means-tested
benefit should be eligible for exemption from charges" and
look into that and see what that would mean in financial terms.
This is horrifying.
Jane Kennedy: I am happy to look
at what the Citizens Advice Bureau recommended on that score.
Chairman: Ministers, could I thank you
for coming. I know we have had quite a long session again today
but thank you very much indeed. I hope we will be able to make
some recommendations that go beyond the review that we have had
for the last 25 years.
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