Would you like to receive something for free? Or would you prefer to pay for it, out of your own pocket? Phrased in those terms, the issue of top-up payments for medical treatments appear to be a no-brainer. But these are not the alternatives we are faced with in healthcare, and it is a serious misunderstanding to think of the issue in this way.
The NHS is under severe financial pressure. Demand for healthcare services is growing, and this trend is expected to continue, which means that maintaining a given standard of healthcare - never mind improvements - will get more and more expensive. The Nuffield Trust forecasts an annual funding gap of at least £12billion (in today's prices) by 2021, even under the assumption that public healthcare spending continues to increase in line with economic growth.
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