What did Charles Clarke say?

I've just seen Charles Clarke on Newsnight and, I have to say, am somewhat confused as to what he said. From what I can work out, he said at the LSE that we should charge for (more) NHS services. I don't think he was arguing in favour of privatisation, but instead saying that we need a debate about how to fund the NHS, and that he favoured the state charging for it.

The entire basis of the NHS is that there are some things that you receive as of right, not as of ability to pay. If you introduce charges, you weaken the system by making the rich closer to paying for private, introducing some form of means test for the poor that may not be taken up and ending up with that gap between people who can comfortably pay and those who are covered by the means test. The Labour - not socialist, but Labour - argument has always been that resources are collected through tax based (more or less fairly) through tax and then redistributed according to need. This also protects the rich, in the same manner as insurance, from damage from very large payouts in a short period of time because of a serious incident or series of smaller ones.

Maersk, the world's largest container ship operator, offers, unsurprisingly, health coverage to its employees. It does not have insurance for this - reinsurance, insurance for vessels, but not health coverage, because it is cheaper to cut out the middle insurer. The same goes, but on a larger scale, for the NHS.

Charles Clarke wants to start a debate - fair enough. I'm happy to debate rationing - whether we can or should pay for very expensive drugs like tamoxifen, whether the media is damaging the NHS by reporting a drug like tamoxifen as some kind of breast cancer panacea when it is useful for treating some breast cancers at some stages in some people and so on. A couple of suggestion off the top of my head, particularly as Charles Clarke was suggesting that the continued rising of drug costs would be a problem, would be to stop the permanent revolution in the NHS (including making a decision on regionalisation, seeing as that seems to be the flavour of the month, and Gordon Brown's NHS Board) and to actually have a national health service and national health strategy rather than the national sickness service we have at the moment. The latter point would entail a look at the social causes and implications of illness.

I had an impression that he'd said something at the LSE and started back-peddling on Newsnight, but I may be wrong. It is worth remembering that it was Charles Clarke who introduced tuition fees, which are rising above the rate of inflation and are not leading to the promised increases in poorer students going to university. I freely admit that I supported the policy of tuition fees for a time - it is not one I support any more.

There is an irony in a former Labour cabinet minister going to the Fabian-founded LSE to talk about charging for the NHS. Ah well...



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