Hospital dilemma shows muddled thinking

I’ve been lax about blogging recently as between the launch of my new book, Blood, Iron and Gold, and working hard on my next one, Engines of War, and a whole host of other media work and journalism, time has been short. Which is a shame since there’s been no shortage of issues.

But I could not resist a quick few thoughts about Labour’s promise to abolish car parking charges for in patients and their visitors in hospital. First, of course, it will be difficult to carry out this promise since many hospitals built under PFI schemes have incorporated that income into the contracts and therefore trusts may find that they have to provide hefty sums to buy themselves out of the deal.

More important, though, is the lack of coherent thinking behind this. Car parking not only has a real cost – the provision of space in often expensive areas – but acts as a deterrent to people driving. If many people can drive to hospitals free – and what a hassle it will be checking up on each one – then space will fill up.  Moreover,  charges encourage people to think twice before jumping in their cars and will make more people use public transport.

For neoliberals, free car parking is a distortion of the market which favours one mode as against others, for environmentalists it is a short sighted policy which yet again shows that Labour has no real understanding of the damage caused by transport. It is a cheap election gimmick – would it not have been better for the money to have been spent on improving public transport access to hospitals? And indeed, not building them on inaccessible sites in the first place.

  • Ben Oldfield

    If you think hospital car park charges are bad try phoning an patient, much greener than driving. It cost me, from a call box, £2.40 just to get through, then £13.00 for less than 30 seconds.

  • Tom West

    One rule doesn’t fit all…. Some patients have to use cars, either because of their medical condition (which can be verified by a doctor) or lack of public transport in their area (which can be verified by their post code). Those patients should be able to reclaim the cost of parking. Otherwise, parking at hospitals should be charged at the market rate.

  • Norwich Hospital used to be in the centre of the city easily accessible by bus and train. The site was sold for flats and houses – what else? – and a new hospital built on a greenfield site three miles from the centre with a sporadic bus service. Parking is charged at a high rate though there is no commercial reason for stopping there and even the Night nurses are charged. This raises money for the hospital.
    Parking should be free for patients and staff in such situations. The “market rate” would be zero!

  • Dan

    The idea that people are somehow entitled to ‘free parking’ is a strange one to me – but very common obviously – I suppose people think supermarkets have free parking – no they don’t – you pay for the land in the price of the produce you buy (surely). The reaaity of free parking is that it is 1st come 1st served and then people stay there all day – as if you allow, say, free parking for 1 hour – then there is no funds to police that – so all the patient free parking gets taken by staff who get there before the patients and park all day. So anyone who thinks this is a good idea is failing to think it through.

    However, Marrianne makes a good point – you should build such facilities where they are public transport accessible to start with.

    Our local hospitals have done really good work on transport planning and have boosted public transport services, they have probably done some of that with the parking charges they levy – no charges, no incentive to support public transport – that is thus a bad policy.

    If you are going to distribute a public asset (in this case land) reasonably equitably, then you have a duty to share it out on a ‘needs it most’ basis – that could start with staff who have to be on site at times when public transport does not run, and extend to patients who have no realistic public transport option (due to condition or where they live – although where you live is also another lifestyle choice that frankly you can think through the consequences of when you make the choice – if you have a choice of course).

    But the cost of administering all this would be prohibitive – so we revert to the system used commonly on the roads – make it ‘free’, let em queue, back of the queue get nowt – as I’ve mentioned before – the so called soviet union system of distributing goods and services (oh yes, reserve some spaces for the ‘party elite’ – in this case higher paid executives and medical consultants I’d guess!)

  • “The idea that people are somehow entitled to ‘free parking’ is a strange one to me – but very common obviously – I suppose people think supermarkets have free parking – no they don’t – you pay for the land in the price of the produce you buy (surely).”

    And who do you think paid for hospital?

    That’s right: we did. Taxpayers. We’ve already paid for the hospital car park. Why are we expected to pay for it *twice*?

  • Dan

    That may be true Sean – but there is a big difference – the users of the hospital are decided by need (medical) assessed by the medics somehow – with presumably some concept of those most in medical need being treated (in the NHS anyhow) – the car park is not allocated in that way – it’s allocated to those who a) have a car and b) who can get there early enough to have a space.

    This, in my view makes a big difference.

    I might even go as far as to say it is the equivalent of the tax payer paying for taxis for those that don’t have cars..

    And for many parking place users – they are not even patients – they are visitors!

    Also with PFI hosps the tax payer has not paid for the car park – the builder has – as I understand it the tax payer is essentially ‘renting’ the whole facility from the builder – thus increased facility causes increased costs so actually could be argued it means less health service.

    Of course you could allocate the spaces equitably – as I outlined, but the cost of doing that would not be worth the hassle – so the allocation uses a common method for market economies (the NHS not on the whole being provided on a market basis) – ie cost.

  • Peter

    Best thing to do would be to just sell all the hospitals off.

    Then the new owners could decide for themselves what if anything they charge for parking. There is no rational way anyone can decide what a state-run hospital should charge people to park.

    We might just get some better quality healthcare along the way if we are lucky.

  • “And for many parking place users – they are not even patients – they are visitors!”

    And your point is…?

    Hospital patients have had visitors since before the NHS was invented. Visitors are *a key part* of the healing process: they help you get that valuable bed back more quickly! Not taking visitors into account when planning your hospital’s car parking facilities is called “incompetence” in my book.

    The *only* hospitals which can possibly justify a lack of visitor parking are those built before the rise of the automobile. PFI-built hospitals have no excuse. None.