Would you pay an additional tax for the NHS?

[Whatisthis543]

I’m torn on this one, surely our taxes should cover a well funded NHS but it seems that they don’t...

Is that systematic I.e too much bureaucracy and poor allocation of resources (within the trusts and elsewhere) or is there genuinely not enough money with an ageing population and rapid growth?

Well, Boris promised the NHS would get an extra £350million a week as soon as we left the EU so we shouldn't need to pay more tax.

Seriously, though, having worked in the NHS I do think it needs an overhaul in management but it also needs more funding. We should be doing everything we can to preserve the NHS. Boris and his mates would happily sell it if they could get away with it.

No, not until tax loopholes that allow large corporations that demand a healthy and educated workforce, transport infrastructure and broadband pay their fair share.
Once they pay, come and ask me again.

@TheWordWomanIsTaken

No, not until tax loopholes that allow large corporations that demand a healthy and educated workforce, transport infrastructure and broadband pay their fair share. Once they pay, come and ask me again.

I'd be more interested in the footballers, formula 1 racing drivers, olympic athletes, pop stars, actors, TV presenters, etc., being stopped from using foreign tax havens.

@OnlyFoolsAndFuckers

If taxes were increased for those earning over £100K and continued to rise progressively, wealthy people would still be wealthy and our healthcare system could be better funded.

The top 5% already pay 31% of all direct tax revenue. I imagine as a demographic, they also take the least out from the system too. Do you think that’s an unfair contribution? How much more would you like them to pay?

There is already a 62% marginal tax rate on earnings between £100-£135k. It's the reason why a lot of doctors now work part time and refuse to do extra shifts. That has had a massive detrimental effect on the NHS as it's caused a shortage of doctors.

You know what would be a really good idea, would be to give every nhs employee who has worked on a ward during covid, a £500 voucher towards a holiday.

It will be a good boost for the travel industry and would be a totally justified acknowledgement of the superb efforts of nhs clinical staff.

I find it depressing when people say that we need to run the wards/service/hospital as they do in the private sector. I work in both and know that the NHS provides safer care in complicated situations.

Better rooms, food and how much easier it is to speak with a doctor always seem to misconstrued as better medicine.

My gut instinct response to this question is Yes. There are some European countries who have higher rates of general taxation who seem to run themselves way better than we do in the UK.

@Binswangers

I find it depressing when people say that we need to run the wards/service/hospital as they do in the private sector. I work in both and know that the NHS provides safer care in complicated situations.

Better rooms, food and how much easier it is to speak with a doctor always seem to misconstrued as better medicine.

Agreed! I had a surgery in a private hospital (NHS funded due to shockingly long waiting lists - more proof of false economy there). I’ve had 6 of these surgeries as an adult and it was the worst experience I’ve had of them all. I received such poor pain management that I discharged myself as I had more effective pain relief at home! Also the only surgery where I’ve ended up with infected incisions.

When my son was waiting months to see an ophthalmologist and I was very concerned about his symptoms, I emailed a private paediatric ophthalmologist and asked if he could see us. I got a reply saying based on symptoms he needed to be seen right away but within the NHS as he may need investigations they couldn’t do,

Private is not necessarily better (unless you’re talking about areas of the NHS which are completely inadequate due to underfunding - like SALT for children, or educational psychologists who work for the local authority!)

TheWordWomanIsTaken
No, not until tax loopholes that allow large corporations that demand a healthy and educated workforce, transport infrastructure and broadband pay their fair share.
Once they pay, come and ask me again.

I'd be more interested in the footballers, formula 1 racing drivers, olympic athletes, pop stars, actors, TV presenters, etc., being stopped from using foreign tax havens

Well yes, goes without saying - everyone should pay their taxes according to their means. But those you mention quite possibly don't use the NHS - no defence to not paying their tax btw.

Large companies such as Amazon expect a workforce that is healthy, security in the form of the police, an educated workforce, a transport infrastructure to transport their goods etc etc.

They should pay for it. I'm not interested in mealy mouthed 'they pay the tax they are liable for' or 'their employees pay taxes' platitudes. We all know that they might in terms of the law but not morally. And whilst there is no obligation to do the right thing, taxation law needs to be changed to ensure that they do.
It sickens me that these organisations can literally hold governments to ransom in order to 'negotiate' what tax they pay.

Privately everyone knows that the NHS is massively inefficient but very few people - especially politicians - are prepared to say it publicly

The NHS will never have enough funding - so no extra tax from me

@AlecTrevelyan006

Privately everyone knows that the NHS is massively inefficient but very few people - especially politicians - are prepared to say it publicly

Your source? That’s really not my experience nor what WHO and OECD suggest.

Not a tax because those who work are already being taxed enough

Rather a supplement upon usage (a sliding scale per appointment) and a non-attendance fee if you don’t show up for an appointment, but this without a sliding scale. A set fee of £10 for no show. You hear so much on how much is wasted by these skipped appointments. These people don’t appreciate what they have and need to be accountable for just not showing up or being late.

Also, a fee for ambulance service for those who are using ambulance as a taxi

Absolutely not. There are colossal amounts of waste within the NHS and the entire system is full of unnecessary complexity. Throwing more money at it means more waste, when in truth it needs dismantling and rebuilding without all the existing bureaucracy.

Iamthewombat

I'm not sure whether you meant your 'I am laughing' comment to sound as sneering as it did. But you asked

How would you get more permanent staff?

In which disciplines?

The fact that you asked a follow up question suggested that if you got an answer to it you would have something else to offer. When it was answered you laughed at people instead. Not sure what that is about but it's certainly not helping any genuine exploration.

Oh dear. When will you learn not to be a bad loser?

I have every right to ask for clarification on a question. Especially when it is part of a barrage of aggressive questions from someone in a huff at having their ill-advised “turn all doctors and nurses into management consultants with McKinsey, who by the way I hate because I didn’t like the restructuring they did at my trust, figure that one out if you can” idea rubbished.

As for the laughing: which bit of “I am laughing, a lot, at the notion that I am responsible for recruiting 40,000 extra nurses” isn’t clear?

A notion is not the same as a person. Laughing at a notion is not the same as “laughing at people”. Is that clear now? I can explain it again, if you like.

Since you are so keen on ‘exploration’, let’s hear your answers to the same questions that were put to me. I’m guessing that they will be “massive pay rises all round, especially for me!”

I did “offer” something, by the way: I suggested encouraging retail workers who had lost their jobs this year to retrain as nurses. Don’t let that stop you from having a good whinge, though. If it makes you feel better about my raining on your ‘woe is me’ parade.

If I had the power....

1. Create one coherent IT system that has enough flexibility to be tailored to specific locations, but would remain still one.
2. create solutions that utilize AI where possible to reduce workload. This means anything from automated (so not real AI) processes to actual AI driven oncology diagnostic tools. (worked on one, so there is an example already in the world)
3. Create clear and concise processes above the clinical levels.
4. Create the same on clinical levels but driven by the people who actually know best and are doing the job
5. make sure that in all areas there is enough personnel coverage to operate at peak efficiency leaving enough caveat for emergencies
6. Make sure that everyone involved get a proper living wage. That nobody has to moonlight to pay their rent
7. Create a system where information and expertise sharing between public and private is part of the culture. Where each have their place and part.
8. Make patients part of the process not ragdolls being thrown around.*
9. Make patient responsible for their own health through small things like nominal fee for gp visits, extra to pay if not showing up,...

10. Make communication better. Change the culture of talking down to the patient to talking with them. And knowing when to use which. Some people don't want a partnership, but some do. 11. coupled together with all of this, naturally: financial analysis to underpin everything uncovered/designed.

But first of all I would create a small team of specialists to do an overarching, cross country and trust study of what the hell is going on - on all levels.
2-3 business analysts, 2-3 workshop facilitators, 1-2 accountants/financial experts, actual doctors and nurses to provide subject matter expertise and a few admins to help coordinate. A team of max 20. Yes, even the as-is analysis would be 2-4 months.
2 things that will not work:
A) redesign without taking current limitations and/or needs into accounts.
B) tweak the system without in depth analysis.
Both are money thrown out the window.

*Use the same basic concepts of interactions that we use when eg designing an ecommerce system.

No

No

I pay enough and that is what NI is for

The system is broken, it is being exploited at all levels and I don't agree that more money would solve the issues.

People at all levels should contribute, even a small amount, to value its worth. Yes that's people on benefits even if that's 70p a week. Retired also as mentioned in the thread should contribute, as retired does not equate to poor.

No more prescriptions for any item under £12 purchasable from a pharmacy is a start. It infuriates me when people get iron tables ect.

And in addition the prevention of the NHS being sued for liability for turning away people wrongly using the service. Yes it will cause more workload to begin with but it's the only way people will learn

• Doris has a gp app for a pharmacy issue = appointment terminated and sent to pharmacy

• David turned up at A&E for go issue - sent out of a&e and advised to phone gp

Also GPS surgeries to open 7-7 7 days a week. How on earth we are still in the culture of 9-5 mon-fri is beyond me

@waitinggame108

No

I pay enough and that is what NI is for

The system is broken, it is being exploited at all levels and I don't agree that more money would solve the issues.

People at all levels should contribute, even a small amount, to value its worth. Yes that's people on benefits even if that's 70p a week. Retired also as mentioned in the thread should contribute, as retired does not equate to poor.

No more prescriptions for any item under £12 purchasable from a pharmacy is a start. It infuriates me when people get iron tables ect.

10000s of retired people do actually pay tax even if they get only get a small private pension added to their state pension, my DH (and myself in March when I get mine) pays tax, and if the rate goes up both of ours will go up as well and I have no problem with that, but benefit claimants??? my god that will start a shit storm to end all shit storms we are told that the benefit system is not fit for purpose anyway with the benefit cap, having to pay back loans, having to wait longer, high rent which may not be covered by benefits not being able to have savings, the 2 child rule, child care issues, free school meals issues etc, to say to some people on benefits you will have to pay a little bit back or get less benefits to contribute to the NHS will likely cause howls of protests, personally I don't think any political party would dare go there

I pay enough and that is what NI is for
oh Christ, here comes another one

No more prescriptions for any item under £12 purchasable from a pharmacy is a start. It infuriates me when people get iron tables ect.

How do you expect people on very low incomes to afford this? Up to £12 per item, potentially several items a month - do you know how much statutory sick pay / carers allowance is, for example?

@Deathgrip

No more prescriptions for any item under £12 purchasable from a pharmacy is a start. It infuriates me when people get iron tables ect.

How do you expect people on very low incomes to afford this? Up to £12 per item, potentially several items a month - do you know how much statutory sick pay / carers allowance is, for example?

I agree but that is what happens in most European countries that are being sold as better. France is pay and get reimbursed a percentage. Switzerland is get private healthcare insurance. USA is private healthcare and/or private payment.

@waitinggame108

And in addition the prevention of the NHS being sued for liability for turning away people wrongly using the service. Yes it will cause more workload to begin with but it's the only way people will learn

• Doris has a gp app for a pharmacy issue = appointment terminated and sent to pharmacy

• David turned up at A&E for go issue - sent out of a&e and advised to phone gp

Also GPS surgeries to open 7-7 7 days a week. How on earth we are still in the culture of 9-5 mon-fri is beyond me

Your first paragraph is unbelievable, and quite ironic - in fact the only way that systems and dangerous processes change is when it’s acknowledged that there’s a risk of liability which will cost them, or when compensation has to be paid.

Who are they, and what do they need to learn?

The idea that those who suffer lifelong disabilities or the families of those who’ve died as a result of medical negligence should not be able to take legal action is preposterous - what do you think will happen to medical care if there’s no risk of liability?

No more prescriptions for any item under £12 purchasable from a pharmacy is a start. It infuriates me when people get iron tables ect.

I am on carers allowance - £67/week. I would not be able to pay that. Do you mean that poor people should not have access to medication?