Letter to Howard on his Election Apr05
Part of my letter (06 November, 2003) to Michael Howard MP on the day he was elected leader of the UK Conservative Party:-
B) National Health Service:-
The current annual per capita expenditure on the NHS is £850. The State guarantees comprehensive treatment to all, free of charge at the point of delivery. Unfortunately, the reality is that there are inadequate resources e.g. surgeons, doctors, nurses, hospital beds, diagnostic equipment etc resulting in unacceptable delay in treatment for non-emergency treatment, including surgery.
The State is unable to inject private sector discipline in management of resources e.g. hospital management and carries the burden of risk for the whole population. Rising patient aspirations, longevity, increase in serious illnesses (cardiovascular diseases, respiratory and cancer) impose a huge financial burden on the State that cannot continue to be met out of direct taxation without seriously eroding the competitiveness of our national economy.
1. Shift the burden of risk from the State to the private sector by assisting citizens to insure for comprehensive medical cover.
2. Create NHS Hospital Management Boards by recruiting local and successful entrepreneurs and professionals.
3. Allow each hospital to compete for patients who are covered privately as this will force private sector discipline and ensure efficient use of manpower, equipment, beds and medication, including perishables.
How could such a system be established?
a) Offer tax credit of up to £500 maximum to each person under 20 years old who can provide evidence of comprehensive cover with a bona fide health insurer. Tax benefit would accrue to the parent of minors and/or those receiving education. This will remove the risk of cover for treatment from the State for all citizens under 20 in the first year of implementation.
b) In the second year of implementation, offer a tax credit of £500 maximum to all those between the age of 20 and 30.
c) Continue to cover using a 10 year age band to cover the 50 to 60 year olds in the 5th year.
Therefore, in 5 years of implementation, it is possible to offer comprehensive health cover to the entire population with the exception of citizens aged 60 or over. This group of pensioners would be covered by the State as insurance premiums for this group can vary substantially depending on their state of health.
The shift to private medical cover for the bulk of the population would generate substantial opportunities for both state owned and privately owned hospitals as they strive to offer quality treatment on a competitive basis. The patient would be free to choose the surgeon and the hospital for treatment forcing efficient use of resources. Such a system would generate additional capacity and reduce/eliminate the current delays for treatment and surgery, experienced particularly by pensioners.
This scheme does NOT 'privatise' the NHS because the state hospitals will continue to employ the doctors, surgeons, nurses etc. although they will be judged and paid according to competence as hospitals compete to offer the best for the patient.
This policy for the NHS offers quality and choice to the patient. State and private hospitals, eager to attract patients, would be obliged to publish data on admissions, failures, bed occupancy rates, acquisition of new equipment and details of professional qualification and experience of health professionals. It will encourage medical personnel to advance their training, offer the prospect of modernising the diagnostic equipment, improve substantially the hospital wards and allow health professionals to manage the NHS without interference from politicians!
C) Immigration and Asylum:-
The UK is unable to identify genuine asylum seekers as too many economic migrants arrive and declare themselves as fleeing from their countries. Furthermore, there is inadequate control at our borders resulting in illegal entry of economic migrants, victims of human trafficking and criminals involved in drugs or terrorism.
1) Install trained manpower and advance scanning equipment at every major entry point in the UK to ensure comprehensive check of every vehicle, boat, train and aircraft that enters the UK.
2) Establish and advertise worldwide the criteria, requirements and procedure for all asylum seekers to eliminate those who are using this pretence for entry.
3) Determine the UK manpower requirement by consulting industry, commerce, public services and UK's professional associations e.g. BMA, NUT, Nurses Union, engineers etc.
4) Establish a point system for immigration like that used by the USA, Canada, Australia and New Zealand.
5) Publish the national requirements so that the people can know what numbers of foreigners will be entering the UK.
An immigration and asylum policy based on such criteria helps to eliminate fear and suspicion. It also promotes good race relations, especially important for those ethnic minorities that are established in the UK.
Only the readers can judge whether Mr. Howard’s UK Election manifesto, speeches and interviews reflect any of these ideas I put to him in 2003!