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NHS patient on crutches
‘The reason people are issued with these devices is because there is a clinical need for them; it is not a nice luxury they could do without.' Photograph: DNY59/Getty
‘The reason people are issued with these devices is because there is a clinical need for them; it is not a nice luxury they could do without.' Photograph: DNY59/Getty

Charging for crutches is the first painful step towards dismantling the NHS

This article is more than 9 years old
South Warwickshire CCG is in trouble, of course, but this move feels like a return to the have and have-nots health system

There is little doubt that the NHS is under huge strain from a period of sustained austerity. In this difficult economic climate it is not surprising that local NHS bodies across the country are having to make difficult choices in agonising circumstances – but we must not allow this to compromise the founding principles which have sustained our health services since its creation.

South Warwickshire clinical commissioning group (CCGs) is clearly facing serious financial issues, caused by the government's failure to recognise that the NHS is struggling to cope with rising patient demand, especially from our ageing society. It is the lack of understanding of these pressures that is causing CCGs like South Warickshire to look at plans like alternative income streams.

Unfortunately in that case consideration now appears to being given to introducing charging for essential medical equipment such as walking sticks, knee braces and wrist splints. Let us be under no illusion that this is a trivial proposal, or something that will not affect patients. The reason people are issued with these devices is because there is a clear clinical need for them from the patient's perspective; it is not a nice added luxury they could do without, it is a key part of reducing pain and improving a patient's life. As such this is a small part of the wider ideology that has made our health service so cherished by British people: if you need help with your health you get it, free of charge, regardless of your background, wealth or status in society.

By putting in place a system of charging for any form of treatment you are eroding and damaging that key principle. The fact is that, with any charge, there are people who will be able to afford these items and those who will not. In this case, many older, frail people, and those on low incomes with small budgets, will be faced with a choice as to whether they pay for devices they badly need or keep the money back to pay for essentials, like keeping their house warm or putting food on the table.

As a consequence we will be opening up a huge gap between the haves and have-nots in the NHS. We will be returning to a dark, terrible period before the second world war when the quality of your health depended on the size of your bank balance. This was an era that as a society we firmly closed the door on – we do not now need to reopen that door by stealth.

From a practical point of view, another economic argument arises that undermines any plan to introduce charges. If people are discouraged by charges for getting essential equipment, then their health will invariable be compromised as their wellbeing will worsen. This will result in patients needing more admissions to hospital, visits to the GP and so on. In the long term, this measure will therefore end up costing the NHS more money and waste further time, exacerbating the very problem that the charging is supposed to solve.

No one should be against CCGs and others making sure every penny is spent wisely. But we cannot and must not set ourselves down a path that devalues our cherished health system, and starts the process of splintering the delivering care based solely on how much money people have in their bank account.

More on this story

More on this story

  • Patients with end-stage liver disease caused by hepatitis C to get new drug

  • NHS group considers charges for crutches and neck braces

  • UK 'has fewer hospital beds per person than most European countries'

  • NHS faces strike threat as 500,000 healthcare staff to be balloted

  • GPs braced for shutdown after 'toxic mix' of loss of funds and high demand

  • NHS patients are missing out on life-saving robot surgery

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