Select Committee on Health Written Evidence

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 your are.

  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.

Des Benjamin

Chief Executive, Simplyhealth

14 February 2006

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