This paper, presented by the SMF Health Commission, reviews the case for user charges in health care.
It outlines the advantages of user charges, including the fact that they can generate extra income, promote a more efficient use of services, make providers more accountable for the quality of service and promote various forms of patient choice. It also points out disadvantages of the charges, such as the possibility of inefficiency, lack of fairness and high administration costs.
The Commission concludes that the case for new charges, increased charges or extensions of existing charges is weak at this time (September 2004) when the NHS is receiving increased levels or revenue, but might become stronger during crisis periods when demand for services outstrips investment levels.