The Health and Social Care Bill creates a legal basis for withholding or charging for health services, according to medico-legal experts.
In an article in the British Medical Journal, it is argued that the Bill will drive a transition to a US-style model where private health insurance is the norm for medical reimbursement.
The authors argue that by removing the legal obligation to provide free healthcare and creating a legal right to charge for it, the Bill amounts to “the legal destruction of the founding principles of the NHS”.
Allyson M. Pollock, David Price and Peter Roderick list the following legal consequences of the new legislation:
• The duty of the Health Secretary to secure free healthcare for the population of England and the duty of PCTs to secure health services for everyone living in a defined geographical area are both abolished.
• The new CCGs will determine the scope of services independently of the Health Secretary, and may delegate these decisions to commercial companies.
• Some health services will be arranged by local authorities, who will have new charging powers.
• The Health Secretary will have an extraordinary power to exclude people from the NHS.
Taken in combination, the authors argue, this is a sufficient legal framework for a transition from a free NHS to one that charges many people for many of the services they receive.