31/03/2014 06:33 BST | Updated 31/05/2014 06:59 BST

NHS Charges Would Be the Thin End of the Wedge

I've been a GP for 25 years and I am shocked that this think tank is coming up with these suggestions. They will hit the poorest the hardest and are based on a misconception that the NHS is unsustainable. It is not unsustainable or unaffordable. It is underfunded.

Charging people £10 a month would breach the fundamental principle of equity on which the NHS is based. £10 per month may not be much for some people but it is a lot for people on low incomes, on top of all the other rising living charges they face. International research on user charges shows it deters some people from accessing healthcare because they would find it difficult to pay. Then they may end up arriving in hospital in a more serious condition later - when it will cost more and be more complicated to treat. So it's a false economy and would only bring in a small revenue anyway.

These charges would be the thin end of the wedge. They would just get bigger and bigger. Look at what has happened with prescription charges, which have gradually crept up.

I am appalled at the suggestion of means testing people for continuing NHS care. We are talking about some of the sickest and most vulnerable people in our society - mainly elderly people who have complex significant ongoing health problem that need nursing care. Means testing will force some of them to have to pay from their savings for district nurses to visit them to dress pressure sores or leg ulcers or give them their insulin, for example. People who have paid into the NHS all their lives should not have to fear ill health and means tested charges for their healthcare.

Furthermore it's simply untrue that the NHS is unsustainable. It's not unsustainable it's underfunded. NHS spending has not kept up with the funding needs of the NHS. In fact the Treasury has clawed back over £5billion of the NHS budget surplus so far in the lifetime of this government. What has happened to that money? Meanwhile the gap between what the NHS needs to continue to provide a quality service and the funding has grown ever wider. UK healthcare spending as a share of GDP is falling, and we are still lagging behind other comparable countries, who despite austerity, have protected their healthcare budgets.

According the Nuffield Trust, the NHS is facing an unprecedented £30billion funding gap by 2020.

We are already seeing the impact of the funding crisis created by this government, with hospitals and services suffering severe cut backs or even closing, staff being made redundant, staff pay frozen for years, and ambulance services cut back.

This government or the next must commit to funding the NHS properly and stop wasting billions of pounds that could be spent on frontline care. We are calling for the scrapping of the internal market which would save at least £5billion a year. We say there must be a renegotiation of PFI down to a fair rate of return to the haemorrhage of billions of pounds.

There must be a halt to the squandering of money on endless reorganisations like the government's recent one that has cost us £3billion. Millions of pounds have been wasted by this government on sacking and then re-hiring NHS staff, and on using management consultants. This government has been totally reckless in using taxpayers' money while running down our NHS, worsening patient care and demoralising staff.

Opinion polls show people want an equitable NHS paid for out of taxation and national insurance and continuing to be free at point of use.

Health policy academics have labelled patient charging as a 'zombie policy', because it is a dead idea that vested interests keep trying to bring back to life. We need to kill it off for good.