Wealthy Britons should pay fees to use NHS, suggests Tory peer Ken Clarke

‘Better-off patients’ could be asked to make ‘modest contribution’, says former chancellor

NHS is under severe pressure this winter (PA)

Former Conservative chancellor Ken Clarke has said Rishi Sunak’s government should consider making wealthy Britons pay to use the NHS.

The Tory peer said it was time to discuss “modest” fees for GP appointments and some procedures for “better off patients” to help raise money for the health service.

“We can’t demand European standards of public service but continue to pay below European levels of taxation,” Lord Clarke told Times Radio.

“I do think – and I would have reacted to this ferociously at any time until the current crisis – we may have to look at some means of making the better off patients making some modest contribution to their treatment,” he said.

Lord Clarke pointed out that the NHS charges for prescriptions. “We may have to look for other small payments ... We can’t rule it out,” he said on the idea of means-tested fees.

“How do we cope with an ageing and the huge demand for all the marvellous treatments that weren’t available until the last decade or two? How do we finance that? The health service budget is swallowing up a bigger proportion of GDP every year,” he added.

Lord Clarke, health secretary between 1988 and 1990, recalled “heated arguments” with then-prime minister Margaret Thatcher when she suggested moving to US-style compulsory health insurance.

“She thought the American system was marvellous, and I thought it was one of the worst in the western world,” he said, adding that he had been a “great defender” of the free-at-the-point of delivery NHS.

“It is a very high ideal,” he said – saying he did not want to dismantle it, but was now worried about the NHS was now “taking an ever-increasing amount of GDP”.

Former cabinet minister Andrea Leadsom rejected Lord Clarke’s call. “I’m absolutely clear in my own mind, always have been, that the NHS must be free at the point of delivery,” she said the Tory MP.

It follow Sir Keir Starmer’s insistence that free at the point of delivery would remain an “absolute governing principle” under a Labour government, as he defended his call for greater use of the private sector to help drive down NHS waiting lists.

He told Sky News’s Sophy Ridge On Sunday programme: “We’re not talking about privatising the NHS. The NHS has always used elements from the private sector, GPs are an example of that.”

Lord Clarke also backed the government’s approach to strikes by nurses and ambulance staff – saying the country could not afford to “take more out of the service” to meet pay rise demands.

His comments come as health secretary Steve Barclay talks to health union leaders on Monday about the pay review process for 2023-24, starting in April, in a bid to avoid looming strikes.

Royal College of Nursing (RCN), GMB and Unison have played down the chances of breakthrough – saying they would urge Mr Barclay to discuss this year’s pay dispute.

The Sunak government is said to be considering a “one-off” hardship payment for nurses and ambulance workers to avoid the strikes set to take place later in January.

Mr Sunak did not rule out a one-off payment when asked about the idea on Monday. “You wouldn’t expect me to comment on specifics, but the most important thing is that the conversations are happening,” the PM told reporters.

Meanwhile, Mr Clarke said it was “not impossible” that the Tories could win the next general election under Mr Sunak despite huge poll leads currently enjoyed by Labour.

“They only way they could win is by demonstrating competence,” the moderate said – revealing that there had been times during the last few years when he was so “disillusioned” that he was not sure he could vote for his party.

“I’m an optimistic, reconciled, moderate Conservative because at last we’ve got highly intelligent, sensible people – particularly Sunak and [Jeremy] Hunt,” said the senior figure.

“They’ve got to resign themselves to being very, very unpopular for the next few months because things are getting to get worse before they get better.”