sherbert wrote on Jun 10^th, 2010 at 3:00pm:

You may have found that there were plenty of spaces in the car park and free parking spaces available in the surrounding streets. Increased car ownership and use, and the measures taken to control the ill effects of this, are significant factors in explaining the difference between now and 25 years ago. To visit the old Royal Free site in Gray's Inn Road by car you would now have to pay the Congestion Charge - should that be refunded by the NHS?

"I remember when" I could park for free outside my own front door. That was less than 10 years ago. Others in the area could not park anywhere near their home, so they asked for and were given a residents only parking zone, for which we have to pay. (I am not happy with the process used to make these decisions, but that is a quite separate issue.)


Times have changed, in many ways for the worse. The core principles of the NHS however remain largely intact after 60 years. I seek to protect them by halting a creeping erosion. I fear that if we try to extend them, e.g. by adding a right to free parking for all patients and visitors, we may lose the more modest bit of ground that we are fighting to win back.

Money is tight, especially at present. I do not want those who manage hospital budgets for us to be forced into the position where they have to sell off the land presently used for public car parking because they are not allowed to use it in the way that any other landowner would. I have said before that I am fully in favour of potentially complex schemes to provide free or discounted parking for patients and visitors.

NHS Hospital sites, including their car parks, are public spaces (owned by us all). Free parking, as I believe it is applied in the "nations", means free for all. When there were fewer cars on the road there was generally no justification for parking charges, so there was no issue. Times have changed.


(Thanks for stimulating my thinking on this subject. I will put some further thoughts into a blog posting and provide a link when it is done.)

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sherbert wrote on Jun 10^th, 2010 at 3:32pm:

Yes. I hope the difference between the taxpayer and the patient paying is understood. This difference is fundamental to the concept of the NHS, indeed to the principles of taxation.

If there were no difference, as may be implied, why would there be a problem with use of revenue sharing, or indeed true premium rate, telephone numbers if they helped to raise money to pay for NHS services?

Barbara wrote on Jun 11^th, 2010 at 8:31am:

I may sometimes write at undue length, however I am confused by the brevity of the comments on this point.

The term "taxpayer" could be said to cover all citizens; there is no need to argue about that. The term is however normally used in this type of discussion, rather than "citizen", to imply some sort of consumer right proportionate to the amount that is paid for a service through taxation. Paying taxes that are due is but one of a citizen's many responsibilities, shared ownership of the NHS including treatment "free at the point of need" is but one of a citizen's rights. Clearly some particular point is being made by picking out this relationship between the two as if it had some special significance. I cannot understand what point is being made.

Is it being suggested that because there is no difference between "patients" and "taxpayers" it does not matter how NHS bodies cover the cost of their telephone systems and other costs? Is it equally acceptable to do this through use of revenue sharing telephone numbers, which indirectly impose a cost on patients, and charges on patients for car parking, as against revenue from the exchequer derived from taxation?

sherbert wrote on Jun 11^th, 2010 at 11:13am:

I am tempted to make an equally rude comment about "understatement", which is too kind a word to descibe postings that make no contribution whatsoever to the discussion.

Please will somebody explain the relevance (if any) of "taxpayer" = "patient" to this topic.

sherbert wrote on Jun 11^th, 2010 at 11:46am:
Not necessarily. Those without UK residency are entitled to some NHS services at no cost. Outpatient A&E is one example. I am not a UK taxpayer. I am not a UK resident. I could be classed as a patient but not a taxpayer.

Perhaps it would help comprehension if I repeated my postings one sentence at a time.
SilentCallsVictim wrote on Jun 11^th, 2010 at 10:32am:

SilentCallsVictim wrote on Jun 11^th, 2010 at 5:58pm:

As well as NHS 24, it also applies to other NHS providers in Scotland, including hospitals.

I look forward to a possibly interesting discussion about whether English and Scottish taxpayers and NHS patients represent one, two, three or four distinct groups. I say two, but perhaps not the same two that others may be thinking of.

idb wrote on Jun 12^th, 2010 at 12:22am:

Can you not provide any helpful comment on the relevant point with reference to taxation, which is about whether there is any difference between the cost of providing NHS services (e.g. the switching system needed to support incoming telephone calls) being met by "taxpayers" or "patients"? I believe that most people would understand the difference, without having to consider the tax-paying status of the patient, and I cannot see how any genuine confusion could arise.

Perhaps I see things too simply. If a feature of a non-geographic number is thought necessary for the delivery of a NHS service, with a 03 number the taxpayer pays for it, with a 084 number the patient pays for it. I cannot understand what grounds those who cannot see the difference may have for being concerned about use of 0844 numbers in the NHS, or indeed having any concern for the NHS.