The former health secretary said the “extension of the contribution principle” should be part of radical reforms to deal with growing waiting times.
It comes like A record number of people in England waited more than 12 hours in A&E in December – triple the operating standard, according to NHS data.
In an article for The Times, he called for a “mature, sober conversation” about transforming healthcare, adding that “too often an esteem for the NHS has become a religious fervor and an obstacle to reform”.
Downing Street told the newspaper the Prime Minister was not considering the proposals “at this time”.
During his campaign for the Tory leadership, Rishi Sunak laid out plans for a £10 fine for patients who miss doctor and hospital appointments.
However, he backed away from the pledge after it drew widespread criticism from health leaders, signaling controversy over reforms that could jeopardize the principle of free NHS care when needed.
Mr Javid said the NHS’s only rationing mechanism – to keep people waiting – should be replaced by means-tested charges, while “those on low incomes are protected”.
“We should try across party lines to expand the contributory principle,” he wrote.
“This conversation will not be easy, but it can help NHS rations manage their limited supplies more effectively.”
He pointed to Ireland’s “nominal” fees of €75 to visit an injury unit without a referral and £20 fees for doctor’s appointments in Norway and Sweden as possible models.
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“Too often, esteem for the NHS has become a religious zeal and an obstacle to reform,” the Bromsgrove MP said.
“We need to shake off the constraints of political discourse and start having a mature, sober conversation about alternatives.”
Mr Javid, who will not stand in the next election, argued that “the 75-year-old model of the NHS is unsustainable”. Calls for an overhaul of the NHS are increasing, and not just within the Tory party.
Wes Streeting, Labor’s shadow health secretary, told The Guardian: “Reform is not a conservative word.
“In the last election, the left gave many people the impression that the answer to everything is to put more money into it. Of course, investment in the NHS is needed, but ask any patient about their miserable experience and it’s partly about culture and systems. That too must change.”
After weeks of speculation about whether Mr Sunak pays to skip queues at the NHS to see a doctor, he recently said that while he was registered with an NHS GP, he had paid for private healthcare in the past.