Supplementary memorandum submitted by
Simplyhealth (formerly HSA Group) (CP 27A)
By way of further submission from Simplyhealth
HSA following our evidence to the Select Committee on Health's
discussion on co-payments, we advise the committee as follows.
A Society is defined by its care for all citizens.
To that end, in our view, the role of the state is to secure the
appropriate acceptable level of health care for all citizens through
general taxation that should be available to all citizens, all
over the country, all the time.
This should be funded through a general taxation
that is a specific percentage of GDP, for example 9.5% of GDP.
Political parties can argue over the exact percentage as they
see fit, but health services will then be funded directly by what
we earn as a country and out choice about the quaity of service
for everyone will be absolutely clear.
It is important to understand that there are
no markets or services of any kind in any area of our lives where
we can all have the very best of everything all the time, how
and where we want it. This is not the case with food or shelter
or education. It is unreasonable therefore to expect it of healthcare,
it is not possible.
If, however, we are all clear about what is
available from the state we can make informed choices about what
else we would then like for ourselves as individuals.
Not everyone takes responsibility for their
health in the same way. A large part of the population spends
billions of pounds each year helping themselves through high quality
foods, vitamins and supplements, alternative therapy, exercise
regimes, health insurance, screenings, and other health related
behaviours and activities. The NHS by no means represents the
whole healthcare spectrum in the UK today as many people do much
to help themselves.
Equally, many do not. They are content to abuse
their health in the belief that if they hit the wall of illness
the NHS is there to fix it all. Consequently (and there are great
parallels with education), they will not invest in any way to
promote their own wellbeing.
It is unrealistic and wrong to determine the
whole healthcare regime for the UK on the taxation only route
for healthcare as you will actively work against those who do
something to help themselves and they should be encouraged.
What the state needs are the institutions that
define clearly for the public what level of treatment they can
expect to be provided through taxation. Bodies like NICE will
define, for example, which drugs the state will provide and their
accountability is to do this within the budget that society through
an elected government mandated them to levy in direct taxation.
If this is clear, then the private sector will
step in and provide access to alternative if that is what people
want to buy.
We need to be very careful not to prejudge what
people will spend their disposable income on. Many, in all income
groups, will decide between a mobile phone or Sky TV on the one
hand, and a healthcare product of some sort on the other, and
we do those people an injustice if we think this is necessarily
an income related decision. Insurance schemes for healthcare start
from as little as £1 per week. Our evidence is that this
is an attitudinal decision and not an income one.
If clarity does not exist then people will not
understand what the state considers the acceptable standard of
healthcare and will not be able to make informed choices about
whether or not that is enough for them.
Being brutally honest, the 11% of the population
who purchase PMI today, pay twice for healthcare because they
are not being offered by the state something they find acceptable
even when it is free!
Cashplan customers are people who take the initiative
and prepare for healthcare issues, partly because they cannot
afford the surprise that a crown brings with it at £300 and
partly because they are placing healthcare at the top of their
agenda of things that matter to them.
By helping people to understand clearly that
there is no appeal against NICE or other institutions that define
our acceptable level of healthcare, those people will then define
what else matters to them.
The concern today about a two tier healthcare
system is antiquated and ideological, something we believe the
public are tired of. There are many tiers in healthcare depending
on what you can afford, where you live, who you know and how educated
The state's role is to protect us all with what
we choose to afford, to defind the inclusive regime behind that
is the true cornerstone of the NHS, but then leave the rest to
the people to decide for themselves.
We believe this would be preferred by the vast
majority of people, whilst remaining inclusive and affordable
to the nation.
Chief Executive, Simplyhealth
14 February 2006