Clegg calls for top-ups...

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...but misses the point about markets.

At an event hosted by the think tank Reform, Nick Clegg became the first of the three leading parties to commit to allowing patients to top-up their healthcare.

‘I'm a liberal. We cannot continue to deny people the right to top up their care’ he announced.

Good – as Tom has written here, preventing patients from topping up their NHS care privately is immoral, impractical, incoherent and (quite possibly) illegal.

However, the Lib Dem leader also rejected plans to move towards an insurance-based health system. Under Reform’s proposals patients would receive a healthcare premium of £2000 per year, which they would then us to purchase health insurance from a range of Health Protection Providers.

He also backed away from the idea of forcing Primary Care Trusts to compete with one another, instead advocating the option of creating local, electorally accountable PCTs with responsibility for the residents under their care. Such a move would, he maintained, remove some of the control that that Department of Health has on the NHS. The state would, however, continue to play a role in the distributing resources, setting standards and altering patient premiums to reward GPs who work in deprived areas.

Of course, what Clegg misses is the fact that, if left to the market, patients, rather than being given a chance to vote just once every few years for a Local Health Board, would vote every time they made a decision on where and in what form to purchase their healthcare. A real market in healthcare would give patients the right to choose and switch providers, thus driving up standards, increasing innovation in healthcare delivery and empowering patients - benefiting the many and not just the noisy few.