An NHS financial crisis on the horizon
A commission, set up by the King's Fund has warned that 'hard choices' will be necessary to overhaul a health and social care system no longer fit-for-purpose.
Its five-strong team, led by Kate Barker, a former Bank of England economist, suggests more patient charges may be needed to ease a continuing cash squeeze.
They could include fees for hospital and GP (general practitioner) appointments and removing the blanket exemption from prescription charges for the over-60s.
The report, entitled A New Settlement for Health and Social Care, explores the possibility of extra revenue from a decision to 'extend charges for dentistry'.
But it concludes: 'NHS dental charges already raise some £650 million a year, covering more than 20% of the cost of the service.
'The commission sees little room for extending those.'
The total cost to the NHS of dental treatment, in 2009-10, was £3.2 billion, of which £2.73 billion was spent in England.
The report noted: 'Free dental treatment is now limited to those on working-age benefits in England.'
Instead, health savings plans, which allow patients to 'smooth the cost of dentistry', are put forward as a possible model for general care, in the confidence that insurance companies would provide products.
Under this idea, patients would seek insurance to cover new health costs up to an annual cap on charges, of £500 or £1,000.
The commission's interim report was published as all three main political parties decide how to approach the challenges of health and social care in their election manifestos.
It concludes: 'A crisis in social care is already with us and another looks to be on the horizon for the NHS, at least in terms of finance.'