We all want high-quality public services. Up to a point, we are all ready to pay for them. We need to be convinced that the money we pay is going to the services that we think are desirable. We need to know that the money is being well spent. And we need to know that the services we fund are important to us personally, or to society generally. We’re not particularly selfish.

For, above all, we want fairness. We want everyone to get what they need if they are in bad health and to be able to grow up in a safe environment with proper education, a good transport infrastructure and reasonably equal access to vital services.

But, as The Sunday Times has highlighted in its recent campaigns, we all understand that expectations of our public services are rising faster than the money from taxation to pay for them. That’s why Alan Johnson has asked Professor Mike Richards to examine the ways we pay for anticancer drugs. It’s why Ruth Kelly is proposing certain charges for travelling on our roads. That tension between our rising expectations and the resources available from taxation poses hard choices. Either some public services will decline, leaving serious gaps in provision, or private alternatives will expand to fill the gap, probably in a socially divisive way, or we will have to extend “user charges” to bring in more resources, create fairer access and raise the quality of public services. Such charges can be controversial. In 2003 both university tuition fees and Ken Livingstone’s London congestion charge caused real argument. And, far earlier, Labour’s imposition of prescription charges in 1951 led to Nye Bevan and Harold Wilson resigning.

Nevertheless, the potential benefits of user charges are great. To give just some examples: A proper US-style model of funded “yellow buses” would reduce the number of car journeys and increase security Tolls for new bridges, tunnels and roads would modernise the transport infrastructure quickly Further congestion charging will improve environmental sustainability Tenants could invest to improve their properties and their standard of living A coherent and progressive system of pre5 education and childcare could be established, funded on the basis of ability to pay Higher quality extended schooling, before and after school hours, at weekends and in the school holidays could be supported Nursing and clinical care for the elderly could be improved through insurance or housing equity Health treatments and therapies could be extended more widely Greater flexibility between the NHS and disciplines such as osteopathy, podiatry and chiropractics could be stimulated Occupational health could be coordinated with the NHS to improve rehabilitation Regular health checks, scans and foreign health vaccinations could be provided through the NHS User charges are already well established in Britain. For example, in 2006-7 local authorities received £10.8 billion from service charges (not including housing rents), compared with the £22.4 billion they received from council tax. With the help of KPMG, I published a discussion paper, Achieving the Potential, because I believe that there are benefits from extending this approach. Now is the time to debate it fully.

Charles Clarke is a former Labour home secretary

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