The European Central Bank has said that joining the Euro would mean the end of the free NHS, reports The Times (we do not link to the Times). Apparently the April edition monthly report of the ECB said that:
Governments should distinguish between “essential, privately non-insurable and non-affordable services”, such as emergency treatment, and those where “private financing might be more efficient”.
In truth, the actual ECB report [pdf file] does not say anything quite so bluntly. The actual report is full of careful conditionals and non-assertions: “governments may have to rise contribution rates”, such co-payments could increase efficiency”, “pre-financing [of geriatric care] has been proposed” and “It has been argued that setting of budget caps…can improve overall performance”. (page 45) Nonetheless, this report should be taken very seriously. It is the formal monthly report; not a mere research paper or discussion document, but the official view with the imprimatur of the body charged with running the Euro. Given the sanctity of free NHS provision in mainstream British politics, to have its underlying rationale brought into question by a multilateral institution of such power and influence is a political bombshell. We are not talking ‘Private Finance Initiative’ here; the ECB is suggesting that for most operations patients should arrange their own insurance voluntarily, pay up when they need it, or go without. In suggesting patient co-payments for operations, rather than mere privatisation of provision with continuing government funding, the report goes far further than anything suggested by the Conservatives.
Chancellor of the Exchequer Gordon Brown is due to report to Parliament on the ‘Five Tests’ for Euro membership shortly. Before then there will be a major Labour rebellion on Foundation Hospitals; giving hospitals slightly greater control of their own funds and services is already too radical for many MPs (including, with little concealment, Gordon Brown). This report is therefore also be an amazingly timed intrusion into that debate.
One can imagine the glee with which Iain Duncan-Smith will seize upon this report: he will be able to simultaineously portray the Foundation Hospitals policy as unduly timid, with the full weight of the ECB as ‘independent experts’, while also saying that the NHS is only ‘safe in Tory hands’ because of the government’s committment in principle to joining the Euro. After all the kerfuffle on IDS’ leadership in recent days, I shall be reserving my judgement on his capabilities to see whether he makes real capital out of this absolute gift from Europe.