Patients should be charged for GP appointments and A&E visits, Sajid Javid has said, as he called the present model of the NHS “unsustainable”.
The former health secretary said “extending the contributory principle” should be part of radical reforms to tackle growing waiting times.
In an op-ed for The Times, he called for a “grown-up, hard-headed conversation” about revamping the health service, noting that “too often the appreciation for the NHS has become a religious fervour and a barrier to reform”.
The Prime Minister is not “currently” considering the proposals, Downing Street told the newspaper.
During his campaign for the Tory leadership, Rishi Sunak set out plans to fine patients who miss GP and hospital appointments £10.
But he backtracked on the pledge after it was widely criticised by health leaders, signalling the controversy surrounding any reforms that could threaten the principle of free NHS care at the point of need.
Mr Javid said that the NHS’s only rationing mechanism – to make people wait – should be replaced by means-tested fees, while “protecting those on low incomes”.
“We should look, on a cross-party basis, at extending the contributory principle,” he wrote.
“This conversation will not be easy, but it can help the NHS ration its finite supply more effectively.”
He pointed to Ireland’s “nominal” 75 euro fees for going to an injury unit without a referral, and £20 fees for GP appointments in Norway and Sweden as possible models.
“Too often the appreciation for the NHS has become a religious fervour and a barrier to reform,” the Bromsgrove MP also said.
“We need to shake off the constraints of political discourse and start having a grown-up, hard-headed conversation about alternatives.”
Mr Javid, who will not stand at the next election, argued that “the 75-year-old model of the NHS is unsustainable”.
There are increased calls for an overhaul of the NHS, and not just from within the Tory party.
Labour’s shadow health secretary Wes Streeting told The Guardian: “Reform is not a Conservative word.
“In recent elections, the left has given a lot of people the impression the answer to everything is to pour more money in. Of course investment is needed in the NHS, but ask any patient about their miserable experiences and it’s partly about culture and systems. That’s got to change too.”
Following weeks of speculation over whether Mr Sunak pays to skip NHS queues to see a doctor, he recently said that, while he was registered with an NHS GP, he had paid for private healthcare in the past.