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?

Your experience will vary from one region to another , in the South East I had a very poor experience but since moving to the North East excellent care

Your experience will vary from one region to another , in the South East I had a very poor experience but since moving to the North East excellent care

We are in the SE and dps cancer care was so minimal we ended up having to pay for it. If we had a different address it is likely it would have been free. (Not that the NHS was is free) Dp had been paying into it all his life and when he finally needed them to be there for him the answer was no.

Quite bitter as if the doctors he saw had actually listened to his symptoms and thinking he had bowel cancer seriously and not laughed and told him not to scare himself with Dr Google (Dp was comparing his symptoms with his fathers who died of bowel cancer) maybe even if they weren’t going to do anything, catching it early might have cost us less money.

So far over the last 5 years added up with the extra time lost with no pay, Dp losing his job (which was directly linked to his illness) and the cost of treatment we think it has cost us at least £250,000.

I don’t think paying extra for a service that dependant on your postcode you might not be able to use is something that people would be agreeable to

Lots has been done in the last 10 years to clamp down on tax loopholes such as IR35, ATED, loan/trust tax avoidance schemes, additional taxes on dividends, etc.

Most of the measures have disproportionately impacted the (previously) self employed and directors of small businesses. What’s happened with IR35 is that companies have been forced to hire people, at a lower rate so that they can pay on costs, and those who were previously contractors are on a lower income and paying more tax too. Fair enough but hardly having a significant impact on large businesses.

There is no reason why companies cannot pay tax on profits made in the countries where they make them. Taxes should stimulate the economy - people spend their money, a small percentage of that money goes back into the system to fund the infrastructure made use of by large corporations (where would Amazon be without spending on roads, healthcare limiting staff absence, education etc etc).

You can call it utopian all you like, but eventually there will be no option but for things to change. Unemployment will rise, the percentage of population spending going to a few giant companies headquartered elsewhere will increase, tax income will continue to fall and it can’t all be levied on the population. This is only going one way. There’s no chance that these companies will suddenly be pushed out of the market by smaller U.K. based companies. There will have to be steps taken to ensure that tax keeps coming in. And a PP is absolutely right about tax credits - HMRC is subsidising the profits of every company who don’t pay sufficient wages. Some years the tax gap (what HMRC expect to get vs what they actually get) is around the the same as the tax credits bill - a few years ago the tax gap was over £35bn which would have covered the tax credits bill. It’s alarming how much tax that’s supposed to be paid isn’t, let alone how much tax is lawfully avoided - not paying tax is not an option for the majority. I’m always amazed when people complain about the cost of the benefits system, but accept the position that large corporations can’t be made to pay more tax.

After 35 years working in the commercial sector I've moved to working alongside the NHS. I wouldn't pay more for the way it's currently run - management processes are often outdated and poorly implemented, insistence on clinical experience for senior management roles and low salaries compared to other industries stifles recruitment, and The NHS doesn't exist - it's a series of petty fiefdoms(Trusts) fighting for their budgets and trying to ensure they don't get overwhelmed by other Trust's workloads and responsibilities. There are loads of excellent and brilliant people working in it, but it just doesn't gel.

@Iamthewombat

For all the massive injection of extra cash into the NHS for 10 years rom 1997 under the Blair government there was 1 percent improvement in efficiency and the biggest winners were doctors pay - hospital and GPs.

I’m ex-NHS. Very ex. I have spoken to some of the representatives of GP groups. They told me that they went into the negotiations with the Department of Health, headed by the then Labour health minister, Patricia Hewitt, prepared for a hard negotiation over remuneration. The other side went in with an offer far higher than they were planning to ask for: the GPs snapped their hands off!

You really don't like the idea of the NHS do you?

Yes GPs got large pay rises... because they were leaving the profession, pay rose to 100k p.a. on avg, considering the amount of training Doc's go through, its not over paid.

The Tories came in and have cut GP pay by 20%, GPs are leaving the profession in droves, J.Hunt promised 5000 extra GP's by 2020 - guess what? numbers still falling.

Labour also had a 10 year plan for the NHS, yes better pay but also new hospitals and facilities, waiting lists have never been lower during their time in office.

Compare to the years of austerity, let alone the next 5 years.

Au contraire. I’m very keen on the NHS.

I’m less keen on ill-conceived, self-serving arguments.

I’ll give you a pass, though, because I’ve seen you post good stuff on other threads.

I think the NHS is wonderful but I voted YABU as it needs a complete overhaul. We need to decide what the purpose of the NHS is for the future as this inefficient, mismanaged current state is completely unsustainable. It won’t happen though as it is one of the untouchable institutions in the UK which is sad as it means that it will continue to struggle and the amazing NHS frontline workers will continue to be poorly pain and overworked.

@Purplewithred

After 35 years working in the commercial sector I've moved to working alongside the NHS. I wouldn't pay more for the way it's currently run - management processes are often outdated and poorly implemented, insistence on clinical experience for senior management roles and low salaries compared to other industries stifles recruitment, and The NHS doesn't exist - it's a series of petty fiefdoms(Trusts) fighting for their budgets and trying to ensure they don't get overwhelmed by other Trust's workloads and responsibilities. There are loads of excellent and brilliant people working in it, but it just doesn't gel.

So true. It needs complete reform, the last 40 years have done it untold damage.

No, the solution to a bucket with a hole in the bottom, isn't; simply pouring more water in at the top.

Actually working for the nhs I would have to say no currently. I feel the money isn't being used effectively and would need significant overhaul. Realistically there needs to be taxation levels and premium levels of care but the human rights courts would still find errors with that, financially there is no way out of the current system without total reform.

What reforms are people referring to. It's too easy to say reforms.

What has happened (I worked in the NHS decades ago) is the treatments available, and needed, by the aging population. People seem to 'pop' in for a triple bypass, these used to risky major surgery with a longish recovery. All the treatments for cancer now available........ and the huge prescription lists people have for years.
We can't reform away from this.

There was a martyred attitude when I worked - 'poor underpaid' staff, grudging about anything extra demanded of them. I think that still lingers a bit - we had Australian workers occasionally visiting and working and they expected longer hours and less breaks. Don't know if it's the same now.

There was a martyred attitude when I worked - 'poor underpaid' staff, grudging about anything extra demanded of them

Yes, this. I used to hate having to pick up the phone to ask people to do stuff, even just take a call I couldn’t deal with, as I’d get attitude and huffs.

I hadn’t realised how bad it was until I left as you get a bit brainwashed into the mentality that everyone is so busy and is doing their best under great pressure so it’s to be expected.

I joined a different govt organisation and have been gobsmacked at the difference. Still short staffed, but usually if I pass something on they’ll agree without making me feel like i’ve just doubled their workload. If they can’t help they politely say so, and often point me in the direction of who can.

I also sampled the US health system when over there. A lot less faffing, Doctors specialised so they were experts at eg removing sun damaged skin spots or colonoscopies or whatever and you were zoomed through treatment a bit like a supermarket queue.
And the staff treated you like intelligent equals, they're not superior more knowledgeable beings and not martyrs.
But patients were expected to be independent, to get themselves to the appointment on time and away, everyone drives, to have a family member or similar to get them undressed if they were unable. To follow instructions if need be.
Found similar abroad.

No. It's not fit for purpose and has failed me and multiple family members repeatedly. Unless clear, costed plans were set out detailing exactly how it would be reformed to ensure that it functions and patient outcomes and the level of care are prioritised so that they become comparable to those in most developed countries I'd be furious to be asked to pay yet more.

@ComtesseDeSpair

I think the entire model of the NHS needs reviewing. It isn’t the most effective, efficient or economically beneficial way of delivering healthcare, as numerous international models demonstrate. It isn’t a binary choice between “free NHS” or “US healthcare model where the poor just die if they get sick”, which is where discussion of healthcare models always ends up.

Exactly. We need to look at France, Germany, Australia, the Nordic countries etc and learn the lessons on how to set up a functional health care system suitable for 21st century society.

I have been mulling something over for a few weeks after watching a programme about paramedics. They got called to someone choking so it was lights and sirens and straight there. The patient was totally fine, not choking at all. She was eating and it felt a ‘bit stuck’ she described classic reflux. All of her vital signs were fine. The paramedics advised gaviscon and visiting her GP, she insisted she wanted to be taken to hospital to get it checked. Waste of time, resources and money. Could they have refused to take her or does that leave them open to compensation claims down the road?

@Whatisthis543

I completely agree that there are probably too many chiefs, also contractors on mega day rates to keep their staff numbers ‘down’ and ‘looking good on paper’

To keep the staff numbers down ?. WTF are you talking about. If you are referring to nursing staff we doing all we can to get the staff numbers up. I work with hospital admin all the time and they have played a vital part in this pandemic. You can’t expand critical care from a seasonal requirement of 24 beds to an overnight demand of 142 very sick patients without some pretty smart and professional management. As for contractors. The only ones we have are builders. Regarding funding. You can’t keep raising taxation beyond a certain point before you start to depress the economy so if you give more to the NHS you have to take it from elsewhere , where do you suggest , education , foreign aid or Benefits and Pensions ? Defence is always a favourite for cuts but Cameron and Osborne cut that to the bone and without the military our covid response just would have collapsed.

Starting to irritate that well funded NHS to some means a huge (especially in the current climate) pay rise.

The NHS has been allowed by both main parties to just plod along, growing without any oversight and the expectations of some as to what should be provided by the NHS is nowhere near what it was set up for.

Cosmetic surgery. Life at any cost where there is no actual quality of life. Elective surgeries. It needs a grown up discussion.

Does privatisation have a place? Do you go to a GP practice? Dentist? Opticians. Private. So yes, they do.

As for taxation, what are you taxing with say Amazon? Warehouses or server centres? (If there are any experts on here, could they include me on the response as to where the transaction with Amazon actually occurs. The site is the invitation to treat. The buy now is the offer. The purchase successful is the acceptance. Where does that actually happen?)

No. I already pay 40% tax on a considerable % of my earnings and private health insurance. I'm not really up for paying even more.

No. I only work part-time and earn sod all.

In short, no. I've completely changed my views about the NHS over the past 10 years and especially this last year where we've constantly been told how brilliant it is when I've had 9 previous years of seeing the appalling way the elderly are treated - rudeness, lack of respect, total lack of joined up thinking, obsession with 'safety' to the detriment of kindness, consideration and quality of life. It's been a horrible and upsetting experience for elderly relatives again and again, so being told how great it is has made me really bitter.
I still feel very strongly that we mustnt allow the breaking up and selling off of departments to godawful US and other private companies, but I think there needs to be a sea change in our expectations of health so that more is spent on public health.

No.

In Ireland they change a nominal fee for Doctors and A&E ( which is refunded if your condition is serious for treatment) there is no payment required for children retired or benefit recipients.

Not true. GP costs 60euro or more, a&e charge 130. No refunds given. Children pay too over age 6. Only medical card holders don't pay.

No I wouldn't unless they cut how much £ is wasted. NHS supplies, bank staff, stupid training schemes and IT changes.

I'd be happy to pay a nominal fee for doctors appointments and A&E visits and think if you go to A&E drunk or under the influence there should be a few.

Working in the NHS I would say it nisnt simply a case of more funding; under funding has gone on for too long now and caused myriad other systemic issues. I work in a highly specialised profession but due to chronic under staffing (can't recruit) I am frequently asked to perform duties (badly) to plug the gaps. Our current admin team is run ragged and people are going off sick with stress - we need more admin staff! Take away the bottom rungs and the whole ladder starts to malfunction.

I'm unsure what the solution is but it's a very complex problem.