Hospital Carparks: Making them fair is better than making them free

Tuesday, November 1, 2016
Dr. Jon Stanley


A real bugbear in our free at the point of use health service is that some things, not directly related to healthcare, are not free.


For some populists on both the right and left car parking fees are a national outrage of epic proportions. They aren't for anyone working in the NHS because there are bigger concerns and lots of them. In any case high fees need not be a bogeyman.

We have had car parking fees for a long time. They have risen in recent years reflecting higher land values and as deterrence for frivolous use. They raise money for hospitals. Here, the attacks become tedious.

Hospitals are not money-spinners, much the opposite, and given their budgets they are devoted to providing healthcare. Why is this such a bad thing when they do raise a few pounds here and there?

No hospital in the country raises more than 1% of its income from the car park that I can find. Often it's less than half of that. Car parks have attendants that need paying, they use a lot of land, and of course they are needed for NHS staff too.

The most expensive are found in city centres and, in the case of Hereford County, next to three major supermarkets and the town centre. Very handy for some, no doubt.

It does not take a genius to work out why free parking would harm patients. The free slots would be filled by commuters and shoppers so patients arriving after the early morning commute would mean parking even further from the hospital than is the case now. It is so painfully obvious that a free-for-all will come under attack from many angles and be seen as opportunist and ill thought out.

One leadership candidate for UKIP would have every fee waived and spend £200 million to fund this. This isn't wise. There are many ways in which hospitals can spend £200 million far better than free parking, popular as it is.

More doctors, nurses, patient transport, clinic slots and better meals are all worthy causes without becoming bogged down in more complex areas of policy.

One big concern is that those visiting frequently have to pay the most fees and this is unfair for those who are chronically ill or have to visit vulnerable relatives. This is very legitimate and equity, or fairness, should be part of a sensible policy.

So how can we change this for the better? Minimal change in current practice and a sense of fairness for frequent users is what people want and this is possible.

One way would be to copy current practice for prescription charges where patients can prepay a fee to cap their costs. A prepaid parking permit for say £50 to £75 to be valid for any NHS hospital in England would cap costs for frequent users. It could even be issued on the back of receipts for fees already paid.

The NHS would give a block grant to every NHS Trust based on this annual permit and while a top up from government would be needed to compensate for a loss of fees, this would be far less than £200 million. This would afford the same protection for frequent users and preventing the obvious abuse of car parks near central London hospitals by the general public.

Few areas of policy in healthcare need be difficult. Joined up thinking is a level above good old "common sense" and with our NHS as it is we need less shouting and more talking to solve its issues.

Dr. Jon Stanley is Health Research Fellow, a Junior Doctor and a Member of the Royal College of Surgeons