Nye Bevan has been rolling in his grave so much this year I doubt he can remember whether he's facing up or down. After NHS privatisation was finally sealed in April, the principal of free and publicly accountable universal healthcare is being further undermined by talk of GPs charging patients for their appointments.
The Independent revealed last week that 51% of GPs support a charge between £5 and £25 for each appointment - effectively a flat-rate tax on healthcare, to 'deter' patients. That most of our doctors now see large patient numbers as a nuisance and problem to be tackled by a flat-rate charge, like air pollution or cigarettes, is worrying. But that such a fundamentally reactionary policy is being mulled over by Tories and Liberals is something that should outrage us, and galvanise us to further action to save the NHS.
Firstly, GPs are not economists. It is probably true that patient levels have become 'unmanagable', due to Tory changes in the GP contract, and only set to become worse as GPs become middle managers as part of the Health and Social Care Act. But there are imaginative ways of paying for care, such as land value taxes, that are all more equitable and fundamentally fairer than lumping the costs of illness, depression and pain onto individuals.
A flat-rate charge is also a regressive tax. Unlike income tax or corporation tax, it does not take into account individual's ability to pay, and is the sort of tax advocated by hard-right market fundamentalists like UKIP's Nigel Farage, who wants a flat-rate of income tax of 31% and 'shock-jock' historian Niall Ferguson, who wants to abolish income and corporation taxes altogether, replacing them with flat-rate sales taxes. This is the world of economic theory into which half of our GPs have descended.
The once unthinkable ending of free healthcare is becoming mainstream. Jeremy Hunt was forced to deny the Tories had plans to cap GP appointments, after 180,000 people signed a petition condemning the policy. It had been floated by the Tory party on the Conservative Policy Forum, asking activists to comment with their thoughts.
Trusting Tories on this matter would be extremely naive, especially since David Cameron said, ahead of the 2010 election, 'We will stop the top-down reorganisation of the NHS' only to follow it with the Health and Social Care Act, the biggest top-down reorganisation of the NHS since its founding.
Normally the Tories have been more honest about their contempt for the state and public services than their Lib Dem collaborators, but here Baroness Shirley Williams is regaining the ground in the race to destroy the NHS as openly and honestly as possible. She spent much of the passage of the Health and Social Care Act reassuring Lib Dem MPs that she was defending free healthcare by privatising it, but then dropped the bombshell that, 'There might be a case for at least considering a nominal charge for GP appointments' because, 'It might get people to value the service.'
How did we get to this situation where Tories absurdly talk of limiting GP appointments, and are only outdone in their cruelty by a former Labour Education Secretary, Williams, talking up GP charges, having just finished persuading her Liberal colleagues to privatise the NHS?
There are conscious forces at work here. Free-market think-tanks like the Adam Smith Institute are the least financially transparent, and have openly called for NHS privatisation. The Institute for Economic Affairs has called plain packaging for cigarettes 'ludicrous' while they accept money from big tobacco like Philip Morris, and have enough cash to offer a €100,000 prize for the best essay on Britain leaving the EU. They are undoubtedly funded by extremely wealthy persons and corporations, and their free-market ideology says everything about promoting those class interests and nothing about healthcare.
They are not intellectually convincing, but they are vocally dominant. The Left needs to organise a coherent response, and argue for greater NHS funding as an alternative to brutally ending free healthcare to suit the people who won't pay the higher taxes required to maintain it.