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Report calls for NHS membership fee
People should be charged a £10 monthly membership fee for using the NHS alongside hotel-style charges for hospital stays, according to a new report.
Co-authored by former Labour health minister Lord Warner, the study called for radical changes to how the NHS is funded.
Under the proposals, e very resident would gain "NHS membership" at a monthly fee of £10, to be collected alongside council tax.
The report, published by centre-right think tank Reform, said such membership could entitle more people than now to an annual "health MOT" of basic health checks.
The membership would also " review progress over the previous year, agreeing individualised goals and NHS support for the coming year, with a focus on management of chronic conditions and more support for carers.
"Throughout the year there would be tailored flows of membership information about personal health issues, together with details of approved or kite-marked telecare and telehealth products that would help people meet their own care using their own resources."
Those receiving free prescriptions would be exempt from the charges, the report went on.
It argued that NHS funding from general taxation should only rise with inflation to avoid starving the rest of the public sector of resources.
Other ways of increasing revenue could include taxing alcohol and tobacco more heavily and food and drink containing "excessive" amounts of sugar.
"Betting and gambling taxes could also be increased and used on the same basis," the report said.
Other measures may include "full-cost charging for the administration of vaccinations for overseas travel plus more rigorous inflation-proofing prescription charges" and possibly reducing the number of people exempt from charges.
Patients should also pay "co-payments for the hotel costs of some inpatient hospital care".
The report said: "By the end of the next Parliament, providing there was the political will, it is possible to envisage these changes in entitlements yielding over £6 billion a year.
"A revamped system for prescription charges and other co-payments such as hospital hotel charges could raise over £1 billion a year. A £10 a month fee for a membership scheme with free membership for those exempted from prescription charges might well produce over £2 billion a year for use in local preventative initiatives."
The study also calls for the merger of health and social care to end the "artificial 65-year divide between health and social care and unify them centrally and locally in a National Health and Care Service (NHCS)."
It recommended preserving virtually all current hospital sites but refitting many as primary care centres. Specialist services would then be concentrated in fewer hospitals with 24/7 consultant cover.
"Even with major changes to care, it is now irresponsible to pretend to the public that current forms of taxation alone will be sufficient to provide a good quality health and care system", the report said.
Lord Warner said: "We can no longer pay homage to an out-of-date and unaffordable NHS that's unfit for today's and tomorrow's care needs.
"All politicians allowed the NHS to overdose on higher budgets without shifting more care closer to home and concentrating our specialist services on fewer, safer, more highly skilled, 24/7 centres.
"The day of reckoning has arrived with an obesity epidemic on our doorstep. The NHS has to change radically and fast over a single Parliament with flat-lined funding.
"It should have no more hand-outs at the expense of other public services. It faces a hard slog of doing more with less and a tough conversation with the public about how we change services and accept new ways of funding the NHS."
Jack O'Sullivan, consultant and co-author, said: "This doesn't require another big reorganisation or lots of hospital closures. It focuses the NHS on what it can do with you rather than on what it can do to you."
A Department of Health spokesman said: "The founding principles of the NHS make it universally free at point of use and we are clear that it will continue to be so.
"This Government doesn't support the introduction of membership fees or anything like them. But we know that with an ageing population there's more pressure on the NHS, which is why we need changes to services that focus far more on health prevention out of hospitals."