Annual Statements of Healthcare Costs

Anne Main Excerpts

Wednesday 22nd February 2012 Commons Chamber

[Mrs Anne Main (St Albans) (Con)]

It is with some regret that I rise to raise concerns about this proposal—

[Mr Speaker]

Order. For the avoidance of doubt, procedure requires that the hon. Lady should not only raise concerns about the Bill but also oppose it.

[Mrs Main]

And to oppose it. I have no doubts about the intentions of my hon. Friend the Member for Bracknell (Dr Lee), for whom I have great respect, as someone who works in the health service. I have serious doubts, however, about the impact of the Bill and the message that it will give to people who are extremely concerned about the future role of health services.

Not so long ago, certain things were routinely prescribed on the NHS that we would now find it ludicrous to prescribe. My mother used to work in an old-fashioned system called the pricing bureau, and people would routinely bring in “scripts” for zinc and castor oil cream or cotton wool. Now, we would find it amazing to see such things on an NHS prescription. We have moved on, and accepted that the NHS cannot provide for everything in our lives. I would welcome a debate on some of the services that people expect the NHS to provide, such as cosmetic surgery, tattoo removal, or even in vitro fertilisation cycles for people of certain ages. That would be a valuable debate, because, as my hon. Friend so wisely says, we have to think about the future and adopt a sustainable, affordable model for the NHS.

However, I believe that giving a person and their family an annual statement of their cost to the NHS could be profoundly divisive. I am concerned, for example, about the effect that it could have on people who have served in our armed forces and come back with life-shattering injuries. They might have had to make difficult decisions about their lives, having been made limbless in the service of their country. What mental effect could it have on them to be told every year what their treatment is costing their country?

Similarly, what mental effect could it have on people who feel that their lives are not worth living, and that they are being burdensome, to be told that there is a tariff associated with their ongoing care? What effect could it have on a family who have fought long and hard for a child with cystic fibrosis or another life-limiting condition, to be sent a bill or tariff, after the child had died, setting out what their child’s life had cost? I believe that such experiences would be unsettling and distasteful for some people.

I am also concerned—I am sure this is a leap that goes way beyond any of my hon. Friend’s intentions—about the Kafkaesque situation that might result, whereby we would start to look at people in the context of how costly they were to keep going, and whether their life was worth that expenditure. If people are made to feel that they are responsible for their own health, whether that is because of obesity, smoking or drinking, so be it, but I am not sure that presenting people with a breakdown of what it has cost to treat them will necessarily make them change their ways.

Having nursed somebody who died from cancer, I can tell hon. Members that people feel like a burden when their life is in a difficult place. They will often say, “I wish I wasn’t doing this to you, to the family, or to others. If I wasn’t around, perhaps you could collect on the insurance, or your life could move on in a different and happier way.” I feel that adding an extra burden for families in such a position, through sending them a breakdown of the annual cost to the NHS, would be unacceptable. That is not a voice that I wish to see coming from the Government, and I do not believe that this suggestion should ever become a Bill. I am comforted by the fact that most ten-minute rule Bills never get anywhere.

If I thought that this ten-minute rule Bill would get somewhere, I would go around soliciting support and testing the waters in Parliament to see whether anybody else shared my concerns. I accept that my hon. Friend simply wishes to ensure that people get the best treatment according to an affordable model, and that people who are being feckless with their own health should be made to face up to and be aware of that fact, but I do not think that having an individual statement of their health care costs that year will make those people change their ways. It might—this is why I oppose the Bill, although I do not intend to press it to a Division—[Hon. Members: “Oh!”] If other hon. Members wish to divide the House, that is up to them, but I have not made arrangements to do so.

I was concerned that the Bill might go unchallenged, because ten-minute rule Bills often are, and I thought through some of the possibilities that, although they are not necessarily implied in my hon. Friend’s plans for his Bill, could creep through if what he has been describing took effect. I was concerned enough to raise my worries today, and to think that if the information locked in the NHS about individuals’ costs were made public, it could be used by the people who argue that we should not save seriously sick people, or treat people with complex needs, or value people with disabilities, because the tariff associated with them is higher than the cost for a healthy person. That is not a society that I wish to endorse, and that is why I wanted to raise my concerns.

Question put (Standing Order No. 23).