March 4: Should people pay to use NHS?

Unless politicians are to sanction further increases in health spending, a move which would inevitably lead to other parts of the public sector being expected to make even deeper cuts, the NHS will have to look to develop additional sources of funding if it is to keep pace with a rapidly growing population.

It is why the Social Market Foundation suggests that patients pay towards their treatment so additional funding can be made available for social care – one sphere of health policy which has not been “ring-fenced” during the Government’s rebalancing of the public finances.

Yet, while some people will welcome a return to personal responsibility and incentives for individuals to lead healthier lifestyles, the likelihood is that it will be the middle classes who will pay the heaviest price for such an approach – they already pay for healthcare through the tax system and such charges are unlikely to be levied against those who allow their abuse of drugs and alcohol to become such a financial burden.

And another point should be made before charging is considered in detail. On the day that the Royal College of Emergency Medicine claimed that only one per cent of £700m intended to alleviate pressures on A&E reached the front line of casualty units, it is another reminder of the need for a more streamlined management structure if NHS and social care budgets are to be merged. There is still scope to accrue huge efficiencies from this process – the difficulty is that the decisions are invariably taken by those bosses who have most to lose from such a remedy.

The blame game

Should care chiefs go to jail?

LIKE TONY Blair’s misguided plan to march young delinquents off to the nearest cashpoint in order for them to pay their dues to society, David Cameron’s threat to jail those public servants who turn a blind eye to child abuse is a knee-jerk reaction intended to garner favourable newspaper headlines prior to the election.

Even though the sexual grooming of hundreds of vulnerable youngsters in Oxfordshire, the Prime Minister’s home patch, has disturbing parallels with Rotherham and other abuse scandals that have shocked the nation, it should be perfectly possible to hold negligent officials to account through the existing “misconduct in public office” laws.

However the challenge, whether it be under existing legislation or the new laws that the Tories want to rush through Parliament, is the apportioning of blame if an allegation of abuse has not been thoroughly investigated. Who is at fault – the case worker concerned, their superior who might be presiding over a dysfunctional department, or those elected politicians who failed to hold officials to account?

Perhaps it would have been more prudent for the Prime Minister, clearly embarrassed and rattled by the sheer scale of Thames Valley Police’s shortcomings in his own backyard, to make public sector bosses far more accountable for the actions undertaken by their own departments – this should not require legislation – and for it to be easier for whistleblowers to come forward and identify injustices. If this was to happen, the public – and abuse victims in particular – might have far more confidence and faith in Mr Cameron’s intentions.

Drivers of growth

Rural roads require investment

IT is thanks to the resolution of campaigners that work has finally started this week on the long-awaited Bedale bypass. Without such persistence, this much needed scheme would not have received the green light.

Not only will the new £35m road help to reduce congestion in Bedale which was not built to handle at least 14,000 cars and lorries a day, but it has the potential to become a new gateway to the Yorkshire Dales and make the National Park more accessible to visitors.

In the week when North Yorkshire County Council started asking motorists for their views on how to reduce congestion in Harrogate, Knaresborough and Ripon, three traffic hotspots, it is a reminder that the issue of transport investment is not exclusive to this region’s great cities and metropolitan areas.

It is also pertinent to the future of Yorkshire’s rural heartlands – even more so if countryside communities are to start fulfilling their potential as drivers of economic growth.