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Phillip Lee MP: NHS itemised account bill aimed to provoke debate

By Victoria Smith
March 07, 2012

In presenting my Ten Minute Rule Bill in the House of Commons on 22nd of February 2012, I was trying to provoke a national debate.

The Bill would have required the Secretary of State to instruct GPs to issue annually to each person eligible for care provided by the NHS an itemised account of the cost of his or her healthcare in the preceding 12 months.

Phillip Lee MP bid for itemised NHS billing fails

Judging by the response, it certainly achieved that goal.

Previous political generations have said ‘don’t touch the NHS’.

For far too long ‘informed’ political opinion has had us all believe that it would be political suicide.

However, increased obesity, changing demographics and increased treatment costs have placed significant financial strains on the current NHS. My political generation have no option other than to face the challenge of increased healthcare costs driven by increases in patient demand.

We urgently need to bring forward plans that are truly sustainable in the longer term.

Thus, I would like to see a more informed debate, rather than one which is emotionally driven.

As I mentioned in my speech, it is time to tell it as it is, not as we would wish it to be.

The present healthcare reforms are all about modifying the supply of care.

The real challenge is on the demand side – that is why I introduced my Bill.

We desperately need a sustainable, long-term solution, so that everyone has proper access at their time of clinical need.

A new system could be better than the one we presently have.

Although services are now described as ‘free at the point of delivery’, we all know that we are actually paying for our treatments in the form of taxes and National Insurance contributions.

Healthcare is not free.

Throughout my GP career, I have increasingly encountered significant wastage of prescription drugs and failure to attend GP appointments. This cannot continue.

And before we think that our NHS system is the ‘envy of the world’, we should ask ourselves the following question – how come no-one else in the developed world has copied us?

Without doubt, outstanding care is delivered in Berkshire by doctors and nurses on a daily basis.

That doesn’t mean the system is the best that it can be.

It just means we have some of the best doctors and nurses in the world.

Raising awareness of the true costs of the NHS would allow us all to be honest about the future provision of healthcare in this country.

In attempting to optimise our healthcare system by encouraging a shift in focus from supply-side to demand-side reform, I believe that Britain could have a healthcare system that is the envy of the developed world.

Sadly, I believe that if we fail to educate people about the true expenditure on healthcare, then a system available to all generations at their time of need will not exist in the future.

By issuing annual statements showing the costs per item such as for drugs, outpatient appointments, diagnostics and treatment, Britain and the people of Bracknell constituency would be more receptive to NHS changes.

I strongly believe that knowledge is empowering – a more informed and transparent debate would follow.

That is why I presented my Bill to Parliament. Sadly, it didn’t pass this time.

It needs to soon, though. It is because I care about my country and its people that I am determined to communicate that there are better ways to provide healthcare.

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Again again and again...the man protests too much. His inaction and actions are fully indefensible

Timothy Jefferies
13/03/2012 at 11:02

How thoughtless of Dr Lee: what earthly benefit does he imagine will come from his hare-brained idea of effectively making people feel bad (and powerless) if they need NHS treatment, through no fault of their own. Come to think of it why don't we ask the government to send an annual itemised bill to every MP detailing how much taxpayers' money they have cost? The bill would of course be sent to all constituents as well. The sort of insane, punitive and deeply stupid arrogance that drives Dr Lee's idea is all too common among his colleagues. Shame on you, Dr Lee.

Howell
11/03/2012 at 17:07

Let's cut to the chase. I'm going to send a letter to Dr Lee. This is the simple question I will pose to him.

Dear Dr Lee

In light of recent articles that have appeared in the local press I wish to pose a simple question that requires a yes or no answer.

Under the article headed 'Phillip Lee MP: NHS itemised account bill aimed to provoke debate' you are quoted as saying "Previous political generations have said ‘don’t touch the NHS’. For far too long ‘informed’ political opinion has had us all believe that it would be political suicide...Thus, I would like to see a more informed debate, rather than one which is emotionally driven".

Further, you go on to say "Although services are now described as ‘free at the point of delivery’, we all know that we are actually paying for our treatments in the form of taxes and National Insurance contributions. Healthcare is not free".

My question is this: Do you support privatisation of the NHS? If not do you believe in privatisation, but believe that citizens should be made aware of how much their care is costing the NHS, do you believe ultimately that a charging criteria should be introduced to tackle the funding of NHS care?

Let's see EXACTLY where Dr Lee stands.

As an aside to this debate will Dr Lee comment on the fact that he is drawing two salaries from the tax payer? Surely part of the whole NHS funding debate includes staffing resources and GP remuneration?

Winstanley, Bracknell
08/03/2012 at 10:36

Who voted for this guy? Come on, own up!

Damiano_Tommassi, Wokingham
08/03/2012 at 09:44

Apologies. Of course it's Mr Lansley, not Langley.

Dids, Bracknell
07/03/2012 at 21:42

The man is an idiot and so completely out of touch with his residents

"It is better to be thought a fool than to open ones mouth and remove all doubt" - Confucius

Tom Edwards, Bracknell
07/03/2012 at 18:02

unfortunately the BBC are failing to adequately cover this - to many of us - traitorous act. The BMA have just passed a vote of no confidence in Mr Langley. Yesterday when he visited a hospital he was surrounded by Police who still failed to stop heated protests from a doctor that the Government's actions were a disgrace. The doctor and reporters were hustled away. That also failed to make the news. There is a huge protest meeting in London this evening but we shouldn't expect decent coverage. For all the upheaval and protest taking part all over the country, there is little or nothing on their online news pages. It's a disgrace. But then, there is a well known Conservative sitting in the head man's chair, so why am I not surprised.

Dids, Bracknell
07/03/2012 at 17:25

I fail to see how itemised bills will cut waste or impress upon people how much they're costing the NHS. Surely GP's and surgeries should bear some of the responsibility for drug wastage - stop issuing them needlessly.

Anyway, surely if people pay their NI then they are entitled to free healthcare.

That's why it's National INSURANCE - like an insurance policy you pay in year after year and may not need to use the services it funds for years. But one day you might.

I'm also assuming that Dr Lee is expecting every citizen to give a cr*p how much they cost the 'system'. He clearly hasn't encountered the real world and the many people - including in Bracknell - who don't give a hoot how much they cost the state or taxpayer.

I agree with his statement that "...increased obesity, changing demographics and increased treatment costs have placed significant financial strains on the current NHS. My political generation have no option other than to face the challenge of increased healthcare costs driven by increases in patient demand."

But where's the joined up policy that tackles such issues as obesity, smoking, or alcohol abuse outside of just an NHS perspective? Government could be tackling this from all fronts - business, health, treasury, etc.

I'm also confused by Dr Lee describing his bill as " [requiring] the Secretary of State to instruct GPs to issue annually to each person eligible for care provided by the NHS an itemised account of the cost of his or her healthcare in the preceding 12 months."

Andrew Lansley wants desperately to abolish his responsibility for the NHS and would mean he could require no such thing! Doesn't speak of a coherent or thought through idea by Dr Lee.

I'm afraid all I've taken from Dr Lee's article is that the NHS is expensive and unsustainable. How an itemised bill solves that has not been articulated beyond some vague hope that citizens have a conscience.

If his Bill had been successful where would it lead? It strikes me as one short step from an itemised annual bill to actually charging for elements within the bill. Then it'll end up we get charged in full. Whilst abuses and waste within the NHS must be tackled it can have the adverse effect of having catastrophic effects for those people who pay their NI and taxes but also rely on the NHS to stay alive on a daily basis.

The inaccurate scare-mongering that the US right used against President Obama's healthcare reforms (NHS death panels) would be in danger of becoming a reality.

Do you remember this from the Hippocratic Oath Dr Lee?

"I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick"

Winstanley, Bracknell
07/03/2012 at 16:47

And I would really like this paper to print a list of all the Members of Parliament that are voting for the privatisation of the NHS [because that's what it is] that have interests in private Healthcare Companies.

Dids, Bracknell
07/03/2012 at 16:33

Mr Lee. I'll not call you doctor because I don't think you deserve the title after your little try for fame in the House of Commons the other day.

You are supporting changes that will cause our NHS to be profit driven to the detriment of many of us. If you like that sort of system so much, I suggest you travel to the US privately at your own expense, avoid healthcare corporate hospitality no matter how many free drinks and meals they press on you, and see for yourself what privatisation does to peoples health. Shame on you!

Dids, Bracknell
07/03/2012 at 16:21

What just a handful of people in Bracknell think more like!

As GPs are to hold most of the money in the new system they would be the best people to write out the costs. I would like to also know what decsicions have been mad for me like with statins.

see http://www.ncbi.nlm.nih.gov/pubmed/14686571 - why to people get smvastation and not rosuvastatin?

Crimson Dawn, Bracknell
07/03/2012 at 16:15

Hi Brad.

Winstanley, Bracknell
07/03/2012 at 16:06

Disagree, heavily. "no-one else in the developed world has copied us" - because it's an expensive, almost socialist system; not because it isn't good (or, most significantly for the NHS, THE RIGHT THING TO DO).

I'm in favour of itemised bills - show people how much time they're wasting by missing appointments, or by bothering the doctor over trivial matters. but to use it as an excuse to dismantle, outsource, privatise or reduce funding for the NHS??? NO! You won't win many votes with that suggestion, sir. The British are proud of this system, which helps people who need it and not just the rich. Do not try to take it away from us.

It's sad to hear CMA's story, and I have friends in the NHS who tell me similar things from their side; in particular, the lead clinical diabetic podiatrist for one of the local NHS trusts, who has to now fir patients into shorter time periods than were allowed a year ago due to a lack of funding. And the appointments weren't long enough to begin with. The podiatrist has to skip lunch most days and stay late/start early, just to try to keep up.

I am a member of no political party and hold them all in a certain degree of contempt, but this is what happens; you vote Tory, they cut the NHS budget, tell you it doesn't work, and try to privatise it.

Damiano_Tommassi, Wokingham
07/03/2012 at 12:49

If only Phillip Lee MP took the time to read these websites and see what the people of Bracknell really think...

CMA
07/03/2012 at 12:40

I agree that wastage needs to stop, but I also think the way GPs treat patients needs to change a lot.

I believe that if a patient has noticed something out of the ordinary, or something wrong, they should be able to visit a GP, be treated respectfully, and be told what it is and given the necessary treatment, without feeling like they are being judged or pushed out the door.

The doctors also need to make sure they know what it is without just guessing. I have been given anti-biotics unnecessarily 5 times because GPs misdiagnosed tonsiloliths as tonsillitis. I was also going to be left without treatment for a growing bone tumour (exostosis) on my leg that was causing pain and difficulty walking, because a GP decided it was a ganglion cyst on the ligament, without actually checking.

This is what needs to change.