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?

No.

I want to see an end to the low wage state propped economy we have now so that employers cannot get away with zero hours contacts and less that minimum wage. An end to the cash in hand culture and I want to see employers pay their dues.

Fed up with the middle to higher earners being squeezed and big corporations getting away with paying peanuts.

Also, the NHS is bottomless pit and misused by thousands. Sort that out first.

I wouldn't pay an extra tax. I think we should move to a health insurance model like Germany. It isn't perfect but it works much better.

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.

In most European countries, state benefits are much higher than in the UK too. Do you propose a generous increase of certain benefits too?

I want to see an end to the low wage state propped economy we have now so that employers cannot get away with zero hours contacts and less that minimum wage. An end to the cash in hand culture and I want to see employers pay their dues

This too. Time for employers to pay a living wage and stop expecting the poorly paid to subsidise the wages of the highest paid. Nobody in full time work should need to use a food bank, for example.

In Ireland you can pay a yearly fee for prescriptions that works out cheaper and also if you are on low income or over 65 there are examptions etc. It's not just a blanket "you have to pay". You literally pay when you can and when you can't you can't. A lot of good,large employers will pay health insurance too. I get free health insurance through my job for me and my family. I pay, take a pic of the receipt and send it in on the app...I have it back usually within a week. I was in hospital for a night last week and my insurance paid my fees of €80.

The gp is €50/€60
Turning up at a&e willl get you a bill of €100 so this whittles ppl presenting to a&e for ridiculous reasons. You go to the gp first...he refers you...it is free to go to a&e with a referral letter. There is an after hours emergency gp too.

Most ppl here start any medical advice in the pharmacy- they are very helpful. I lived in the U.K. and I remember sitting in a&e once with a friend and over half the ppl there could have been seen by a gp or sorted in a pharmacy. The guy next to us was there because he had a toothache

I want to see an end to the low wage state propped economy we have now so that employers cannot get away with zero hours contacts and less that minimum wage.

This happened in Ireland a good few years ago. Zero hour contracts are not really allowed...there are several rules around them.

https://www.citizensinformation.ie/en/employment/employmentrightssandconditions/contractssofemployment/contractsswithoutspecificcworkinghoursszerohoursscontracts.html#

A lot of places here will pay the living wage of €12 an hour too.

@Iamthewombat

I note your additional sneering and bullying comments and I am going to disengage from your now as I don't like to talk to bullies.

In terms of my answer, I think we need to fund our NHS to the same degree that healthcare gets funded in other comparable countries and I think we cannot expect the outcomes other places get whilst we continue to put less in. Addressing the massive pressures which staff face means that we will make the jobs more appealing and more possible for people who need more leadership. Many of the retail staff you mention do not have the skills to work in a current nursing role for example and will not achieve that through nursing training at the moment. I am wary about comparing my NHS work to non-NHS work but when I try to with friends it appears a great deal more pressurised not just in terms of the number of hours of unpaid overtime but also the responsibility of the work and the fact that there is literally no time for any sort of break in our long shifts. I think we need to be careful about renumeration packages but think that making the roles attractive and do-able is about much more than just pay. And I'm happy to discuss that further with anyone who can do so in an adult and respectful way as I know that this is a very complicated issue which needs looking at from all angles.

And if you're holding France up as perfection, ask the parents of children with SEN how their needs are met.

A friend whose gold has ODD has had great experiences with SEN provision in France. Her son is now in a M-F residential school where he is taught academics alongside behavioural therapies for his ODD, and they hope to be able to reintegrate him into a mainstream school after a few years.

Admittedly she is from the US rather than U.K., but is delighted with the SEN provision in France.

Yes, I would, and would also happily pay per consultation with my GP.

@BackforGood
When the concept of the NHS was first muted

The concept of the NHS was never muted (silenced), it was mooted (raised as a possibility). They are completely different words with almost opposite meanings.

How about, when this government inevitably comes along to say that we all need to pay more and tighten our belts to pay for what’s happening now, we as a country insist that large corporations go first - and if this government is unwilling to close tax loopholes and stop negotiating better rates, we vote in a government who will?

Over the years the government have made it much less desirable for company directors to take a low salary and dividends, which mainly benefited small businesses. Seems the only ones who haven’t had to fairly pay their way are the large companies, some of whom are literally involved in U.K. tax law planning. Some companies like ATOS have had giant government contracts yet paid no U.K. tax as they’re based abroad. In fact how about the government stops getting private companies to run things like benefits assessments and prisons and public services generally? Given that these companies have to make a profit and have to pay at least minimum wage, there’s no way it’s cheaper longterm for them to be run privately.

How much profit do we think Amazon has made in 2020? Very happy to take our money, not so happy to pay the correct proportion of that money back to the state despite relying heavily on U.K. infrastructure to make their millions.

How about, internationally, companies being made to pay tax in the country where the turnover came from? The U.K. is far too profitable for companies to withdraw their business, and if they did someone would move in to fill that void - we have low CT rates compared to other countries as things stand.

How about we stop subsidising private companies profits through things like tax credits and funding railways despite seeing very little of it back through U.K. taxes? Rail ticket prices across most of Europe are significantly lower than ours, partly because some are large shareholders in the providers here and use that money to subsidise their own networks, partly because some are nationalised.

www.independent.co.uk/news/uk/home-news/trains-uk-railways-renationalise-countries-operators-companies-a9058961.html

Sooner or later, we will need governments to do this, as workforces are increasingly replaced by tech, and some businesses have such a giant market share. We need governments to have the balls to call time on this before sticking it to the public once again, through tax rises and public service cuts. I expect we will see a lot of complaints about forthcoming tax rises but little pressure to actually address these issues which would be a far better solution.

When the government starts taxing companies properly (we have a very small limited company and I would be more than happy to increase CT) and funding the NHS properly, and stop privatising as much of it as they can meaning less value for money for service users, then we can talk about whether further funding through NI / tax is necessary.

@Elle200

Yes, I would, and would also happily pay per consultation with my GP.

The problem with paying for consultations is that some people genuinely can’t, and others will put off seeing a doctor until the issue is much more serious, difficult and expensive to treat. I know quite a few Americans with serious health issues who waited far too long to seek medical advice as the costs were prohibitive. It may well be a false economy.

I wouldn’t mind to pay more via health insurance in the same way people do in some countries in Europe.
However i would want their sort of health system in return.... not out current nhs with its very long (pre pandemic) referral times. If I want to see a gynaecologist I just want to call them and make an appointment. I don’t want to have to pass all the gatekeepers of gp’s and their receptionists to get what I need.

The problem with patients referring themselves to specialists is that some of them might refer themselves to the wrong department. For example, someone with chest pain might need a gastroenterologist, not a cardiologist and someone with weakness in a limb might need a neurologist, not an orthopaedic specialist. And most patients won’t need a specialist at all. IIRC, GP surgeries deal with 90% of patient queries themselves.

Also, GPS are well-placed to put a jigsaw of seemingly unrelated symptoms together and spot the underlying issue. I remember a GP correctly guessing that a patient with a broken wrist (and a history of other problems), was an alcoholic.

@Cattenberg

The problem with patients referring themselves to specialists is that some of them might refer themselves to the wrong department. For example, someone with chest pain might need a gastroenterologist, not a cardiologist and someone with weakness in a limb might need a neurologist, not an orthopaedic specialist. And most patients won’t need a specialist at all. IIRC, GP surgeries deal with 90% of patient queries themselves.

Also, GPS are well-placed to put a jigsaw of seemingly unrelated symptoms together and spot the underlying issue. I remember a GP correctly guessing that a patient with a broken wrist (and a history of other problems), was an alcoholic.

It works well enough for dentists, opticians, audiologists, pharmacists, etc., who quickly check eligibility, quickly do an examination/check etc., and then either provide the treatment required or refer you to someone else more relevant.

Of course, lots of conditions aren't obvious and need someone to signpost them, but an awful lots of what GPs do is wasted time for both the GP and patient.

My son needed an ingrown toe nail removed - it took several GP visits before they finally relented and referred to podiatry. I've had ingrown toe nails myself in the past so could see what was needed and would have gone straight to a podiatry appt had that been possible.

Same with my own hearing aids - under NHS you can't refer yourself to audiology nor Specsavers - has to be done via the GP. So, I needed a couple of GP appts to get the magic referral to audiology.

So much could be taken away from the GPs leaving them more time to concentrate on what they actually need to do.

cattenburg, self referral is working fine in other countries such as Germany. why wouldn't it here.

@Whatisthis543 we already do It's called National Insurance

There are not enough consultants for people to self refer & whilst you Kazzy, might be responsible, most would just by-pass their GP and take up valuable time for things their GP could treat, leading for even more delay for genuine cases.

Anyhow, post CV the NHS will effectively fall apart with years of waiting for so called non urgent treatment.
Even private ins companies are having to refund premiums because their patients can't get treated.

33% of nurses want to leave, Consultants can leave the UK and are, there are 110k vacancies, 40k of these are nurses but its across all areas.

Post Brexit, UK becomes less attractive to HCP's and the RoW just isn't awash with them anymore, with many countries seeking to attract medics from other countries, inc the NHS!

Its a bleak picture that money alone will not fix.

@flattyres

cattenburg, self referral is working fine in other countries such as Germany. why wouldn't it here.

Only if you have private insurance and then it is limited, GPs are still the main gatekeeper.

I note your additional sneering and bullying comments and I am going to disengage from your now as I don't like to talk to bullies.

Yep, bad loser. Predictably, out come the insults. Here’s a tip: when someone wipes the floor with your arguments, they aren’t bullying you. They just won the argument.

Many of the retail staff you mention do not have the skills to work in a current nursing role for example and will not achieve that through nursing training at the moment.

Careful now! You almost sound as if you are sneering at retail staff there. Do you think that you are better than them? Why couldn’t they train as nurses?

Did you spot that only 22% of the 180k people who lost their jobs in retail in 2020 would have to retrain as nurses to meet the 40k shortfall you quoted?

I am wary about comparing my NHS work to non-NHS work

Well, clearly not because you’ve just told us that most of the 180,000 people who have lost retail jobs this year couldn’t aspire to your dizzy heights.

but when I try to with friends it appears a great deal more pressurised not just in terms of the number of hours of unpaid overtime but also the responsibility of the work and the fact that there is literally no time for any sort of break in our long shifts.

Your friends are probably just nodding and smiling whilst you moan. I do that with some friends working in teaching. It’s easiest.

You think that paid overtime is a thing for most people? It isn’t. Do you think that other roles aren’t responsible? Tell that to people who work in care, or retail, or hospitality. All of those people work shifts too.

Face it: you don’t want to admit that other people could retrain as nurses and be good at it. People from the industries I’ve listed above would certainly earn more if they did so, and would have a much better pension than they do now. Admitting that they could do it conflicts with your ego and your victim complex.

I won’t expect a response because you are “disengaging”, i.e. sulking.

It might work very well in some cases. But overall, it would be a more expensive system. A nurse practitioner at my GP surgery dealt with the ear problem I suffered from last year. I didn’t need an audiologist or an ENT specialist. This system also avoided the admin work involved in a hospital referral.

I would pay more tax but I don't trust a conservative government to spend the money wisely! They'd just give it to their mates via some bogus companies.

You almost sound as if you are sneering at retail staff there. Do you think that you are better than them? Why couldn’t they train as nurses?

They could, they'd need 2 A levels and/or a foundation degree, then 2/3 years at uni.
4 years before they can start to plug the gap, it also assumes they can afford to and have the time to study.

To enable this would require a major overall of nurse training schemes, so another 3 years whilst they look into to doing it....

what to do in the meantime?

They could, they'd need 2 A levels and/or a foundation degree, then 2/3 years at uni.
4 years before they can start to plug the gap, it also assumes they can afford to and have the time to study.

To enable this would require a major overall of nurse training schemes, so another 3 years whilst they look into to doing it....

what to do in the meantime?

I think we agree that there aren’t 40,000 fully trained nurses sitting around waiting to return to the NHS with no better options. The question was, how do you plug the gap. Not how do you immediately magic up 40,000 nurses to start work on Monday!

Retail staff can have A levels. I bet that many do.

Ah yes, thank you @MaskingForIt
I know that, in truth