People in England value the NHS but they have no idea how much it costs, MPs have been told. 

The NHS in England costs around £120 billion a year - three times as much as the nation spends on education, experts told a roundtable discussion at Westminster this week, held by the All-Party Parliamentary Group (APPG) on Primary Care and Public Health, and they emphasised the need for an honest, nationwide discussion about healthcare costs.

"If you don't appreciate the costs of something, you can't really appreciate its value," agreed APPG co-chair Nick de Bois, the Conservative MP for Enfield North. 

Should this include doctors telling patients about costs of medicines, and encouraging them to choose the cheapest option?

Experts at the roundtable generally felt that they should, but pointed to the need for caution and balance.

GP David Roberts told the meeting that he often gives out information on drug costs to patients during consultations. He advises patients that the use of a cheaper drug which saves just 30 pence per person per month can, if extended to 10,000 people, "pay for your and other people's cancer drugs in the future," he said.

Dr Roberts also stressed the need for more effort to cut waste out of the system. Because of the failure to decommission treatments and procedures which should no longer be used, "we are paying for things two or three times - this is huge waste," said Dr Roberts, who serves on the governing body of the NHS Cambridgeshire and Peterborough Shadow Clinical Commissioning Group (CCG). The NHS in England is not short of money, “but we are short of the sensible use of it," he said.

Dr Laurence Buckman, chair of the General Practitioners' Committee at the British Medical Association (BMA), agreed that patients should know, in general terms, the costs of what they are asking for, but emphasised that this should not be part of the consultation process because of the pressure that this will place on patients. 

Paul Watson, regional director for Midlands and the East at the NHS Commissioning Board (NHSCB), also stressed that provision of this kind of information has to be targeted. It is right to point out to a patient that, out of two identical drugs, one costs six times more than the other, but to send patients "a bill" after their hospital treatment itemising the costs gives them the message - "you're a drain on the nation, on the public purse," he warned.

Dr Watson also pointed out that doctors as well as patients might not necessarily know the cost of things they are prescribing.

People should know how much things cost - "treat them like adults and they will respond like adults," added Howard Stoate, chair of Bexley Commissioning Cabinet and a former Labour MP, and he also criticised the government for failing to make its case to the public and explaining the reasons for the need to reform the NHS.