Sajid Javid says patients should be charged for GP and A&E visits to ease waits

Sajid Javid, the former health secretary, says patients should be charged for GP appointments. Credit: PA

Patients should be charged for GP appointments and visits to A&E, 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.

It comes as a record number of people in England waited more than 12 hours in A&E in December - triple the operational standard, according to NHS data.

In an article for The Times, he called for a “grown-up, hard-headed conversation” about revamping the health service, adding that “too often the appreciation for the NHS has become a religious fervour and a barrier to reform”.

Downing Street told the newspaper the prime minister is not “currently” considering the proposals.

'It's something that's been discussed a few times': Dominic Raab said he 'welcomes' input from Sajid Javid

Deputy Prime Minister Dominic Raab told ITV News the idea is "something that's been discussed a few times."

He added: "I always welcome Sajid Javid or any other former minister’s contribution into this debate.

"I think we are very focused on the huge investments we’ve put in alongside getting those backlogs down."

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.

Prime Minister Rishi Sunak during a visit to Croydon University Hospital in October Credit: Leon Neal/PA

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.

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“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.