NHS debit cards

One idea to improve UK national healthcare has been the proposal to give everyone an NHS debit card they could use to access private treatment if the NHS delay in treating them were deemed unacceptably long.

This idea comes up fairly often in healthcare policy debates, sometimes called ‘voucher’ or ‘health credit’ schemes. Giving everyone an NHS debit card to use for private treatment if NHS waits are too long could have several potential merits.

It would basically extend and formalize the system under which the NHS in some cases pays for patients to be treated privately. It has many advantages, the chief one of which is the faster access to treatment it would provide.

Patients stuck on long NHS waiting lists could gain access to care sooner in the private sector. This could improve outcomes, especially for conditions where delays worsen prognosis such as for joint replacements, cataracts, or even cancer. It should be noted that under the current healthcare system some patients who await life-saving treatment die before they have access to it.

It would also relieve pressure on NHS waiting lists. By allowing some patients to ‘exit’ the queue and be treated privately, it could reduce waiting times for those remaining in the NHS system.

It would help promote patient choice because people could choose where to secure treatment, fostering a sense of autonomy and potentially improving satisfaction.

It would use spare private sector capacity. The UK private sector often has unused capacity, as was seen during the Covid pandemic when the state requisitioned private sector facilities. Redirecting some public demand into that spare private capacity could make better use of national healthcare resources.

Far from threatening the NHS, it might incentivize its efficiency. The knowledge that funding might flow elsewhere if waits are too long could push NHS trusts to improve performance to retain patients and the funding associated with them.

Of course, the ideologues would oppose it and label it ‘privatization,’ as they do with everything that is proposed that might change the structure and methodology of the NHS as it currently stands. But it could just as easily be called the ‘nationalization’ of private resources, since it puts them into the service of state patients.

We might do some polling to see how the public would respond to such a proposal. Since it takes away nothing they have, and offers them an extra and valuable addition, the odds are high that they would support it.

Madsen Pirie