THOSE who have worked hard all their lives and paid their contributions would say they should be entitled to free treatment through the NHS.

Not everyone can afford private healthcare either, but those who can may opt to fund their treatment which will go some way to alleviating the financial strain already placed on the healthcare system.

But a think tank has suggested that making people pay towards their NHS treatment could be used to reduce the pressure on funding for social care and may also 'nudge' the public into leading healthier lifestyles.

The Social Market Foundation (SMF) has put forward a proposal to introduce Personal Care Accounts, where both the individual and the state contribute towards the costs of NHS and social care treatments.

The report outlines how people would make payments for their treatment set at a small percentage of the actual cost of care. These payments would be capped each year and over an individual's lifetime, with the state funding the remaining costs.

But those on low incomes or with low levels of wealth would be exempt, the SMF said.

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The think tank said its plans would redistribute the costs of social care more fairly across the population and fund a £12 billion funding gap in health and social care services by 2020.

SMF research director and the report's author, Nigel Keohane, said: "The UK's current care system imposes many costs on the individual but they are spread very unevenly and haphazardly across different aspects of care (social care, dental care, optometry and prescriptions).

"This is unfair, illogical and inefficient, and people face markedly differing costs and experiences simply because of the nature of their condition; have a broken leg and be dealt with for free; have dementia and face care costs into tens of thousands.

"There is little point talking about integrated care unless we address this huge anomaly. A Personal Care Account would spread the private costs that currently apply in care more evenly across society and would make the system fairer. By broadening the number of contributors and making the costs more transparent, the scheme would also boost the sustainability of funding into the future."

Elizabeth Milwain who runs the Community Interest Company, the Memory Tree, providing specialist support groups for people with dementia and their carers in North Bradford, says: "I think it is something that needs discussion and a clear way forward in terms of spreading the cost more fairly and having a clear idea of what the State will give so the individual can plan ahead."

She says chatting with a group of eight carers who attend The Memory Club at the Kirkgate Centre, Shipley, many felt there was a lack of 'joined up-ness' between health services and social care.

"They agreed with the principle that there is inequality and feel they are getting a raw deal and that what is needed is clarity. It is so unclear what they are entitled to, more clarity is needed," says Elizabeth.

Putting Patients in Charge: The future of health and social care also recommends all areas follow the example set by Greater Manchester, which is now able to make its own decisions on health and social care following a landmark agreement last week to devolve £6 billion a year of health spending.

The paper also argues that NHS England should seek to promote innovative commissioning approaches and promote the role that the market can play in delivering integrated care.

A spokesman for Healthwatch Bradford and District, says: "Healthwatch is here to make sure that the views and experiences of patients are at the heart of changes to the way services are designed and run. It’s important to have an open and honest debate about the future of health and social care, in a way that really engages with the public. Those making policy should take the opportunity to listen to what matters to people and involve them in these big decisions about services which we all rely on.

"Healthwatch Bradford and District hear from people across the district about their experiences of health and social care; so we know that better joined-up health and social care services is something that people want to see. Local people recognise the significant pressures on both health and social care and have plenty to contribute to the debate about reshaping the system to better meet the needs of our local population."