I was recently talking to someone who was complaining about people getting free prescriptions when they are not entitled to them.  This got me thinking about what could be done about such things.  Years ago, I lived in the United States, and everything that involved dealing with the government there usually required quoting your Social Security number.  In the States, things like driving licences have the same serial number as the Social Security number, and it serves as a personal number for everything to do with government.  I thought that this might be the way to go here, using the National Insurance number.

I have a National Health card which shows my personal NHS number, indicating my eligibility for NHS care.  As yet, I have never been asked to produce this card at any of the numerous hospital clinics that I have had to attend in recent years.  I don’t know what other government agencies issue personal numbers but I would suggest that any numbers issued by a government agency should be the National Insurance number.  This would enable a central database to have full details of what any individual is entitled to receive from the State.  If the dispensers of State largesse, doctor’s surgeries, hospitals, benefit offices, jobcentres, and the like could access this database, they would know instantly whether the applicant was eligible for the benefit they are applying for (I class free medical treatment on the NHS as a “benefit” for the purpose of this article).  Such a system would help to combat things like prescription fraud and health tourism.

When doctors issue a prescription they can check whether the patient is eligible for free prescriptions and mark it on the prescription at issue, so that the pharmacist knows whether to charge or not.  If you don’t have a valid National Insurance number you don’t get any benefits, unless you can prove some other way that you are entitled to them.  Of course, life-threatening illness and injury will always be treated by hospital A&E departments without demanding NI numbers from casualties before treatment is given.  I certainly don’t know my National Insurance number off-hand, but if it was something you needed regularly, you would either remember it or note it down somewhere.  In order for this system to effectively combat fraud, we would have to change the current system in which National Insurance numbers are given out to anyone on demand.  Nobody should get a National Insurance number unless they are entitled to one.

This system would, however, require a comprehensive, accurate, and efficient computer system in order to work properly.  Given the track record of recent governments of both parties when it comes to national IT systems, this is an area that is likely to be fraught with difficulties.  However, IT is the only option available and there must be some IT company out there that can produce a reliable system, on time and on budget.

I believe that this universal number system would make public administration a bit easier and will help with things like finding illegal immigrants.  I’m sure that some part of the civil liberties community will find something to bleat about with a system like this, but if it helps good old Mr Taxpayer out a bit then it could be worthwhile.

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