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In a widely-shared article entitled Government proposes inquiry into moving to a ‘pay NHS’, Open Democracy describe a supposedly surreptitious plot to institute user charges into the National Health Service . This article received over 75,000 shares on Facebook and about 3,000 posts on Twitter.
Richard Grimes, described as an “NHS campaigner”, wrote:
Imagine for a moment that you are the newly re-elected Conservative Prime Minister, and you want to launch an inquiry into whether the NHS should be paid for in future through user charges and insurance, not through tax.
But you’ve got a problem – you’ve just won an election without breathing a word that you were considering such a fundamental change to the funding of the NHS.
So how would you make such an announcement?
Very quietly, of course.
Last week the government did just that.
After considering the “sacrosanct” principle of free-to-use health services, Mr Grimes continues:
But the launch of this inquiry has not been reporting in the mainstream media, at all.
Why? Because it was casually announced by a little known minister, the newly ennobled “Under Secretary of State for NHS Productivity”, Lord David Prior, in the rarefied atmosphere of a House of Lords debate on the “sustainability” of the NHS, moved on 9th July by crossbench peer Lord Patel.
Mr Grimes helpfully links to the start of Lord Patel’s motion in Hansard, where it is immediately clear that this is a motion “to take note”. According to the UK Parliament website :
This formula enables the House to debate a situation or a document without coming to any positive decision and is regularly used for select committee reports. Motions to take note are also used when a minister wishes to put a neutral motion. Such motions are usually agreed to.
A motion is not an inquiry.
Lord Patel’s motion was :
That this House takes note of the sustainability of the National Health Service as a public service free at the point of need.
This has no binding mandate on the government.
However, Lord Patel did believe that an “independent commission” would be the “logical conclusion”:
I hope that today’s debate can start a wider conversation. If that happens, I, for one, can imagine that the logical conclusion will be that we need an independent commission to explore a new way, a new settlement for health that is compassionate and caring, and where all citizens have a stake to contribute to make their life healthier.
Mr Grimes then quotes Lord Prior’s concluding remarks on Lord Patel’s motion, making it clear for the reader that Lord Prior has not announced an inquiry, of which I include a fuller portion :
The sustainability of the health service is an issue that extends out 20 years, probably, but it is one that every developed country faces. I would like to meet the noble Lord, Lord Patel, and maybe two or three others, to discuss this in more detail to see whether we can frame some kind of independent inquiry — I do not think that it needs to be a royal commission. We are not short of people who could look at this issue for us; there are health foundations, such as the Nuffiled Trust and the King’s Fund. The issue is: what will the long-term demand for healthcare be in this country in 10 or 20 years’ time? Will we have the economic growth to fund it?
At heart, our ability to have a world-class health system will depend on our ability to create the wealth in this country to fund it. I am personally convinced, having looking at many other funding systems around the world, that a tax-funded system is the right one. However, if demand for healthcare outstrips growth in the economy for a prolonged period, of course that premise has to be questioned.
In conclusion, perhaps I might address issues such as whether there should be an independent inquiry with the noble Lord, Lord Patel, after today’s debate.
In short, this was a motion to note, where the proposer believed an independent inquiry would be a desirable outcome.
The minister in the debate thought that such an inquiry, which itself would have no mandatory effect on government policy, could be established.
This was, plainly, the start of a discussion about an independent commission, and not the “launch” of this inquiry.
Mr Grimes’ article demonstrates many of the prominent difficulties in debating healthcare: reform is treated as destruction, and to examine British principles of healthcare is treason.
 Grimes, R., 2015. Government proposes inquiry into moving to a ‘pay NHS’. Open Democracy. Available from: https://www.opendemocracy.net/ournhs/richard-grimes/government-moves-to-consider-nhs-user-charges [Accessed: 1st August 2015]
 UK Parliament, 2010. Motions to take note — Glossary Page. Available from: http://www.parliament.uk/site-information/glossary/motions-to-take-note/ [Accessed: 1st August 2015]
 UK Parliament, 2015. House of Lords Hansard for 9 Jul 2015 (pt 0001). Available from: http://www.publications.parliament.uk/pa/ld201516/ldhansrd/text/150709-0001.htm#15070961000762 [Accessed: 1st August 2015]
 UK Parliament, 2015. House of Lords Hansard for 9 Jul 2015 (pt 0002). Available from: http://www.publications.parliament.uk/pa/ld201516/ldhansrd/text/150709-0002.htm [Accessed: 1st August 2015]