Three cheers for hospital car parking charges!

Earlier this week, I appeared on BBC Essex to make the case against Robert Halfon MP’s Private Members’ Bill to introduce free parking at NHS hospitals in England. This has already been the case in Scotland and Wales since 2008, but I don’t think we should follow in their footsteps.

I think that there’s two main reasons to oppose free parking in NHS hospitals. The first is about opportunity cost: spending money on this means not spending that money elsewhere. In this case, the opportunity cost of free parking is (according to Rob’s recent article on the topic) around £200 million in foregone revenues. Rob argues that better procurement practices and a continued emphasis on generic drugs could pay for his measure, but even if we can find £200m that way it’s not clear why scrapping parking charges would be the best way of spending it. Local health trusts, not politicians, are best placed to decide their own budget priorities, and I’d be very surprised if they viewed free parking as a better use of £200 million than spending more on frontline care, mental health services, or any number of other options.

The second argument against free parking is that this is not just a poor use of money; it’s actively harmful. Parking spaces, like most things in life, are scarce. Prices act as a rationing device by allocating scarce resources (in this case parking spaces) to those who value them the most. Without some form of pricing, spaces are more likely to be taken by people who aren’t using hospital services or are most able to use alternatives such as public transport: penalizing those who need parking spaces most.

It's obviously a good thing to have a cheap parking space when you really need it, but the most important thing is being able to get that parking space in the first place! This has been an issue in Scotland and Wales, with Wrexham Maelor Hospital and Edinburgh's Western General being two such examples of how free parking can go wrong. Whilst many hospitals already provide free or discounted parking for certain groups (disabled people, long-term patients, and staff), mandating this for everyone is a step too far.

Proponents of free hospital car parking argue that the issue of overcrowding and abuse could be solved with a token system. This would not only mean that are hospitals no longer raising revenue to fund treatment from car parks, but also that they are also going to have to pay for the token systems: including the initial capital required, maintenance costs, and lost staff time. If, as Rob Halfon claims, parking charges operate as a “stealth tax” with no transparency, how are people going to deal with more complicated enforcement mechanisms that people will be even less informed about? The experience of visitors to St David’s Hospital in Cardiff after they were forced to install a complicated registration system is a warning of what might happen:

One employee said:

“This new parking scheme just doesn’t work.”

“People’s main concern when they enter the hospital is to make sure they know which ward to visit, not whether or not they’ve registered their car.

“As parking is free, people get confused as to why they need to do it. I’ve heard countless examples of people being fined because they didn’t understand.

“There’s only so many times people on reception can ask people if they’ve registered their car. I’ve seen visitors reduced to tears because of it.”

In his ConservativeHome article, Halfon makes the point that car parking charges clash with the principles behind the NHS:

Hospital car parking affects everyone who uses the NHS. We cannot say, in good faith, that the NHS is free at the point of access if people face extortionate and unfair car parking fees to get to their hospital appointments, go to work in our vital public services or visit sick relatives.

If you carry this logic to its conclusion, you’d need the NHS to cover everyone’s public transport costs to hospitals, pay for motorists’ fuel, and perhaps subsidize their MOTs if they’ve used their car to travel to a hospital. As Reform’s Andrew Haldenby pointed out when this was brought up a few years ago, most Brits (begrudgingly) accept that there are a small number of things (like prescription charges) that aren’t free on the NHS for common-sense, practical reasons. Hospital car park charges firmly belong in this category.