The NHS: Time for some radical thinking.

With the state of the Nation's finances being such a mess,cuts in public spendimg are an absolute must for whoever forms the next Government. The trick will be to do this without adversely afecting frontline services.

By far the biggest budget in Whitehall is the NHS so, purely in financial terms, this seems the logical place to start.

The concept of the NHS is that healthcare should be free at the point of delivery. The simplistic view of this is that nobody pays for anything. In practice this is clearly not the case. We already contribute towards prescriptions and dental care (if you can find an NHS dentist!).

The NHS is under a terrible strain already and healthcare is, weirdly, the only sector where better technological advances mean more expense rather than less. It is, however, quite right that we should invest heavily in new medical technology.

However we cannot allow the NHS an open chequebook. We need to continue to deliver our frontline services for free to the end user; we also need to ensure that as much money as possible makes it to the front line.

So here's an idea (I must stress I am no expert on these matters and although my politics are clear this is my own personal view). Wherever possible the cost of treatment must be reclaimed from somewhere. For instance in the event where someone is injured and is able to make a claim against someone's insurance (a car accident? A trip or fall?) the treating hospital should make every effort to reclaim the cost of treatment from the insurers. Under no circumstances should the patient be presented with a bill but every effort should be made to recover costs from the liable party.

I remain unclear on how this would be implemented or how much money could be saved and I am aware this would have a negative impact on insurance premiums. But it's a start.

The benefits, if taken to a logical conclusion (this blog is called Stream of Consciousness for a reason. I tend to ramble a bit.) could be fantastic. Imagine you've had an accident where the liability lies with a third party. As happens now you would visit your nearest NHS A&E department who would give you basic treatment for free & stabilise you. They'll admit you if it's really serious. They would then refer you for an outpatients appointment that you could wait 6 months for, sometimes leaving you in considerable pain & unable to work.

If the NHS are compelled to claim the cost of treatment from the third party insurer the patient could at that point choose to "go private", getting treated far more quickly, thus enabling them to return to work & start paying taxes again rather than being off for 6 months claiming Employment & Support Allowance. The cost to the NHS is nil as they have billed the insurance company. The cost to the patient is nil as happens now.

I am fully aware that this will increase insurance premiums but with a No Claims Bonus scheme introduced into Public Liability insurance this will be mitigated.

This idea could go alot further (impose a health levy on tobacco & alcohol to go into a healthcare fund, maybe?) but that's for our politicians to flesh out.