A read of this interesting pledge in the NHS constitution is enlightening, I am sure the lawyers have read in detail.
But as with all constitutions, it sometimes cannot work as you may intend.
As my own experiences confirm, if you want or need medical care or treatment, it is readily available privately but not on the NHS. Parking the morality of that to one side or even the logic, why is that even possible in such a crisis?
If the NHS is so hogtied, for all sorts of reasons, and with so many having to self-pay their way to good health, surely a big rethink about how private medical care is delivered and treated, as far as tax is concerned, is needed.
After all, there is no discount for NI contributions if private care is chosen and anyone self-funding or paying for private medical insurance is in fact paying twice.
The cost of a hip replacement is significant, as is a cardiac ablation. From what I can see from my cover, the combined claim cost will soon be £25,000.
In 1989 the then Chief Secretary to the Treasury, John Major, argued that PMI “tax relief was well-targeted toward need".
He said: “It is true that the general presumption is in favour of fiscal neutrality, but in practice there will always be room for some carefully-considered and limited tax incentives to meet particular needs.
"The new relief that we are introducing for health insurance is fully justified on merit, as it is well directed at a particular problem.”
In 1997 the then Labour Government abolished this relief on the grounds of cost.
So, here’s a simple thought, if only for a year or two. Revisit the past, Rishi.
For those that self-pay, tax relief at higher rate should be available on the spend.
For those with PMI, premiums should be tax relievable up to the highest rates, borrowing from the old MIRAS model and not taxed as a benefit in kind.
This may be seen by the ‘progressive left’ as jumping a queue, but this is no ordinary queue, it is a Covid queue that has created even greater degrees of delay on top of those already there.
Why not give those self-paying or funding PMI a fiscal pat on the back for doing that?
After all, the positive way to look at my suggestion is that those who can afford to self-pay or fund PMI are taking away a workload from the NHS so that they can deliver to those most in need, those without the money or PMI option.
I think the suggestion above, when considered against the plight so many find themselves in today may see a very different take up.
