The Problem: The NHS is short of money and does not offer enough choice to patients.
The Solution: Provide the NHS free to all at the point of use, but with optional extras for a fee, like EasyJet.
I’m a fan of EasyJet. Cheap flights have opened up Europe, democratising travel, and enabling redistribution of wealth internationally through spend in poorer European countries.
I think the NHS could learn a lot from EasyJet, and it should form the basis of a new model of how the organisation is run.
With EasyJet, everyone who has a ticket gets from A-B at the same time; that is the NHS free at the point of use.
However, they offer a whole load of extras people can choose to purchase if and only if they want or need them; from luggage to food and drinks. If someone just wants to get from A-B they need only pay for their flight, but for those happy to spend more they are offered the chance to do so, and that keeps the price down for everyone else.
The NHS should adopt a similar model; a basic service offered free of charge (like the flight, but every citizen gets a free ticket as it's the NHS), but with a host of optional extras that are paid for.
I’m not a fan of wealth buying everything, so I would exclude some things, such as waiting lists for critical surgery, as these should be more equitable. However, I would suggest offering a small number of fast-track slots would be worthwhile, as this would have limited overall effect on waiting lists but could raise a significant amount of money. However, it would have to be limited, otherwise poor people would never get to the top of a waiting list.
Other examples would be booking GP appointments a week in advance; at the moment this is very difficult to do, usually you can only get them up to 48hrs in advance, so I would make that a premium service where you pay £20 to book an appointment beyond 48hrs.
I would also offer private rooms, better choice on times and days of appointments and surgeries to be more convenient for individuals, and walk-in X-rays, MRIs and other scans, among other paid-for options.
To increase equity, households on the lowest incomes would be given some credits they could use each year.
The key point of such a scheme is to increase revenues for the NHS without increasing overall taxation and making the NHS more responsive to people’s needs and wants. Instead of a one-size-fits all approach, there would be increased choice, enhancing efficiency and encouraging innovation and customer service within the organisation to identify added extras which could improve patient experiences and generate revenue.
EasyJet flights are cheap precisely because they don’t offer everyone everything; with less luggage on their flights they can take more freight, generating revenue, which they pass onto customers as savings. It means their flights fly full and efficiently and provide a cheap service for those that only want something simple, while also offering a full-scope service for people wanting something more (I once saw a VIP driven up to the door of an EasyJet plane in a stretch limo!).
I found the concept really interesting with my only concern that private companies would want to take over and make it a proper pay for service. But otherwise I'm onboard with your basic standard of care being taken care of, and if you want shiny and frills you can add those as extras. I definitely would have paid for a fast track on my ECG, I had to wait a month for that and then two weeks for the results.