Monday, September 13, 2010

Hospital parking charges - a learning moment?

Monday, September 13, 2010

It looks like English hospitals will keep charging fees for parking after all.

The United Kingdom's new Conservative-Liberal Democrat coalition government has announced a probable reversal of the plan (by the previous Labour government) to stop hospitals in England charging for car parking:
In 2009 Labour Health Secretary Andy Burnham promised to scrap the fees, which raise about £110m a year. But the Department of Health has now said the idea to scrap car parking charges was not properly funded. A Department of Health source said it was not a U-turn, because the current government had never committed itself. Health minister Simon Burns said: "For a long time we have been unconvinced that Labour's car parking idea was properly funded and practical.
This seems a good decision to me. But it isn't a popular one. The public reaction so far in England has been hostile.

Will the Coalition government explain persuasively why this is a good policy? If it can, then this could be a good learning moment in parking policy. I don't have high hopes on that but let me explain why I think this is a good decision. I am refining and building on my earlier comment on this (in August).

Hospitals and the UK's National Health Service have a clear mission - health, not parking.  I don't see how this mission can be stretched far enough to justify using the health budget to subsidize all hospital parking.

However, some might say, 'but hospitals can't properly fulfill their mission if getting to them is a hardship for too many people!' It is not a bad point. NewsTechnica, gets at this with a (spoof!) quote in a funny post, "NHS budget in parking-led recovery":
“The NHS remains free at the point of contact,” said health minister Simon Burns. “But we didn’t say anything about getting to the point of contact.”

But I would argue that wanting free parking for everyone who visits a hospital is stretching this logic too far!
  • It DOES make sense for access to hospitals to be a central issue in hospital location decisions. But since it is impossible to have a hospital on every corner, there will always be some costs involved in getting to them. Parking is just one of those costs.

  • Does it make sense for the health budget to pay for ALL transport costs in accessing a hospital? Obviously not.

  • On the other hand, it does seem reasonable to help some people with some of their transport costs to hospitals. Using health funding for the hospital transport costs of people who really need it could be seen as serving a health objective more than a transport objective. There is no clear cut line between the two but a line has to be drawn.

  • So, by all means do give a reasonable travel allowance to those who really need it, such as long-term or needy patients and their families who visit them.
     
  • If such an allowance is well-targetted and if the sum given in each case is about the same as the parking charges that would be incurred, then this should be much cheaper than free parking for all.

  • It should also be consistent and mode-neutral. Don't just give free parking to the needy ones who have cars and give nothing to other needy folk who don't drive! Better to give all the deserving cases a travel allowance, which can be used towards any transport costs, not just parking charges. What is so special about parking that it must be subsidized when other transport costs are not. 

Have I convinced you? Or do you still think hospital parking should just be free?

Don't forget that this is a government that is committed to deep spending cuts. Adding some new poorly-targetted subsidies for parking would be a weird thing for such a government to do, while simultaneously cutting important public services?  

Parking is never 'free'. The only question is who faces the costs.
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1 comments :

  1. Hey,

    'Does it make sense for the health budget to pay for ALL transport costs in accessing a hospital?'

    Your answer is 'obviously not', but the key element of the 'free parking at hospitals' discussion is that the answer should be 'yes'. The purpose of the NHS is to offer medical services regardless of the ability to pay, after all, not just those who 'really need it'.

    Further, people can already access free-at-point-of-use (but very expensive) transport to hospitals via ambulance services. Free parking (where the opportunity cost of providing parking is cheap), or free public transport, or even free taxis can therefore be a financial saving even if only a fraction of people who use them would otherwise have used ambulances.

    As a secondary point, money raised by hospitals from parking tends to go into maintenance budgets - fine - but is often seen as additional money, and used on fripperies such as landscaping or flowerbeds, rather than improving core healthcare services.

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