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?

we pay plenty enough tax in this country to have a world-class health system to meet our needs, it is just political choices over many years that mean the NHS is struggling. For example we are currently pressing ahead with spending billions to reduce the rail journey from North to South by a few minutes and also we are expanding our nuclear arsenal.

(NHS 'Manager' here - if we got rid of the so-called internal market we could get rid of, or usefully repurpose, several thousand of us who work in contract management, managing and monitoring 'contracts' between different parts of the NHS!)

@RosesAndHellebores

Interesting about the Blair years. I had my first baby in 94 and second in 98. Maternity services locally seemed to deteriorate in that period. Also pre 2000 I could book a GP apt in advance but it was the Blair target of 24 hours for GP apts that introduced the ring on the morning fiasco which was impossible for commuters/school run mums at that time when not everyone had a mobile phone.

Grommets weren't available on the NHS in 1996 for DS and neither were they in 1999 for DD.

I think the data was massaged in this period. And let's not forget the bureaucratic tier of PCTs and PFI turning into a juggernaut. I can't remember who was responsible for the sweeping away of SRN/SEN grades but that did nothing to help patient care.

The bit about SRN/SEN isn’t actually true. Popular myth but there is undisputed evidence that a graduate nursing population with appropriate ratios of registered nurses to patients improves outcomes significantly. Many HCAs are now fulfilling the roles of the old SEN. Some are doing work that should be completed by RNs - but underfunding make ‘innovative’ use of staff essential. Same with using practice nurses or paramedics instead of GPs.

@cooliebrown

we pay plenty enough tax in this country to have a world-class health system to meet our needs, it is just political choices over many years that mean the NHS is struggling. For example we are currently pressing ahead with spending billions to reduce the rail journey from North to South by a few minutes and also we are expanding our nuclear arsenal.

(NHS 'Manager' here - if we got rid of the so-called internal market we could get rid of, or usefully repurpose, several thousand of us who work in contract management, managing and monitoring 'contracts' between different parts of the NHS!)

Amen to all of that. And contracts between Public Health - which is 'owned' and managed by LAs - and the NHS. What an absolute waste of money.

I think some reform is required, but not sure what exactly. Like lots of others, it is impossible to get a Dr appointment at our local surgery, (mainly because they never answer the phone anyway).
Prior to Covid, I was at a meeting where I was shocked to discover how many people actually dont bother to turn up for the GP appointment.
It is tempting to think there should be a small charge to route out the time wasters, but then it would escalate, and many would then not be able to afford it, especially if they say only one sympton at a time, etc.
I would like to see how the French and German system manage.

Yes, it is underfunded and needs reform. So much is good about the NHS, but services like midwifery need a massive overhaul.

Re charging for missed appointments
My DD had regular treatment for a minor issue several years ago at the local hospital. It's not that far, but poorly served by public transport. All her appointments were mid morning and I would allow 45 min to get there (via motorway) and then park. Mostly it took 20 min but sometimes the motorway and (more often) the carparks were a nightmare.
The letter (which was pointless as I had all the appointments on an appointment card) had a number to call if you vouldnt make the appointment. Several times I needed to change it if a) I couldnt take time off work or b) I didnt want her to miss up to 2 hours of school (during exams or assesments for example) for a 10 min non emergency apt.
Each time I attempted to cancel or rearrange the apt I was given a lecture at the subsequent apt for not turning up! I'd be pissed off if I had to pay for the alleged missed appointment when I'd called the number provided and given them about 2 weeks notice. I already felt aggrieved that we would have been included in NHS no show statistics. The appointment time would have bee wasted for someone who could have made that time!
Both my parents had a lot of nhs treatment at the end of their lives and whilst the care they received was (mostly) excellent, there were so many incidences of the "system" being ineffective , if not broken, especially in terms of communication.
In the last few months of my Ddads life he had a DNR and agreed with drs for no invasive treatment, palliative care only. He was ambulanced to hospital on a saturday with an infection. When the drs came round they said they were getting him ready for immediate surgery. It was only due to another relative who intervened as she personally knew a registrar there, that the invasive procedure (that he probably wouldnt have survived) was stopped.

Everywhere else in Europe has had recently to adapt their healthcare systems so I don't think it's intrinsic to the NHS. We need a rethink of what we cover - it's no longer feasible to do everything the NHS does without significantly increasing funding. And personally I can't afford to pay any more tax/NI than I do.

I wonder if we'll end up with a similar system to France in the end. So most, and in some cases, all care is paid for, but the public can take out a policy to cover any gap and to offer maximum choice. Interestingly a fee is charged for B & B in hospital too.

The desire is for touchy freely doctors these days - but someone who spends their day staring at bones on screens or cross sections of brains is possibly more techy than touchy so could explain the shortage in radiologists,

Yes, I'd pay more tax for the NHS.

As others have mentioned it needs an overhaul.
So much waste happens at the top of the chain. But also revisit across all the services check how the funding is being allocated.

For example mental health services - sat in A&E recently a person who was in attendance and hearing the receptionist chatting through with them saying it wasn’t an emergency (they wanted a mole checked) and really needs to see GP etc (it seemed that they regularly attended a&e as the lovely receptionist did mention to them same as the other day when you came in for a check on something else) it was quite obvious to all that they needed support and maybe if they received visits/support they wouldn’t be attending A&E numerous times.

I’d be happy to support and pay more if i knew it was going directly to the end services & paying nurses more.

As someone who has a bad previous medical history, even though it doesn’t affect me now I struggle with life insurance and even holiday insurance - that worry’s me when people mention insurance based!

I wouldn't be keen.
Money seemed to be washed through covid contracts that could have been better used elsewhere. The whole system seems very inefficient so money already send to be wasted.

I'll admit I'm lucky in that I'm fairly healthy and don't use the NHS much. But I can't get an NHS dentist for love nor money. I've had to sign up with a private one, so I already feel like I'm paying an extra tax on top of my standard taxation to get this service.

Is the NHS efficient and making the best use of the money now? Unless the answer is yes, then I'm against tipping even more money into it.

We also need to make people a hell of a lot more responsible for their own health. Too many people seem to want to do whatever they want and the NHS to sort it out in the long term.

Out of interest, why the hell is smoking still allowed on hospital sites?

Out of interest, why the hell is smoking still allowed on hospital sites?

It’s not. All Trusts have nonsmoking policies. Whether or not they’re enforced is another matter. It’s a pretty heartless person who’d try and enforce it with someone who’s just been bereaved and is falling apart.

Not that it has any relevance to NHS funding.

I believe there is less spent per head on healthcare than most other western nations.
So yes more money needs to be spent but it also need overhauling. Clinical staff need to be treated better and paid for their skills relative to other comparative profession and to the rest of the western world.

@Returnoftheowl

I wouldn't be keen. Money seemed to be washed through covid contracts that could have been better used elsewhere. The whole system seems very inefficient so money already send to be wasted.

I'll admit I'm lucky in that I'm fairly healthy and don't use the NHS much. But I can't get an NHS dentist for love nor money. I've had to sign up with a private one, so I already feel like I'm paying an extra tax on top of my standard taxation to get this service.

The Covid contracting was down to central government not the NHS. That £39 billion on track and trace was misspent by SERCO led by Dido Harding, a Tory Baroness with no prior experience. Those VIP fast track contracts were via Tory cronies and taken out of usual procurement process. Firms used to providing PPE were not awarded contracts whilst donors set up firms with no staff and were awarded million pound contracts. Nothing to do with the NHS. The Nightingales were also out of NHS procurement and control .....and a total waste of money for a bit of propaganda and political posturing. The government were told very clearly they were a total waste as they couldn’t be staffed.

No. How does this work if you are unemployed, or you actually work for the NHS?

@cptartapp

Only if it was overhauled, and only if everyone paid. Not just the under 65's. After over thirty years of working in the NHS we also need difficult conversations about how long to throw everything at prolonging life, often with very little quality or poor likelihood of outcomes.

*@cptartapp:* You ignorant woman, first of all you obviously are referring to people of pension age pension age is 66 not 65, you are too stupid even to get the age right, and secondly as a working pensioner who paid in for the best part of 51 years before getting my pension, I actually pay DOUBLE the amount of tax than I paid in tax and NI alone before I got my pensions, tax BTW I wouldn't have to pay of my pension were working age benefits like tax credits or UC, so don't fucking tell me I m not paying tax.

I would. Without a doubt. And for a social care service- although I’m far off needing nursing care (I hope!) I think it’s appalling we haven’t started to address the needs of our elderly population. Would also gladly pay more tax to extend free early years childcare.

I’m not a very high earner- or even a high earner- but I’d gladly pay more tax if it meant the services we need for a healthy, safe, resilient society were in place.

I probably wouldn’t back it JUST now on that basis, as it would only go to line some of Hancock’s mates pockets... but yes theoretically I’d back a more scandi taxation model (higher taxes for better services and more heavily subsidised/state funded services)

I would not pay more tax unless a.They stop funding ridiculous unnecessary treatment, b.They start making treatment available to people who actually need it, c.They get rid of the red tape and stop paying stupidly inflated prices for stuff.

@LemonRoses

This always comes up and myths persist.

On the funding it has the NHS is about the most efficient healthcare service in the world. It is few at point of care for everyone regardless of income. We pay far, far less than those countries offered up as more efficient or effective.

That is the choice really. Invest and pay more as virtually every other developed nation does or accept it as a country we cannot keep up.

The NHS delivers an incredible service for most people most of the time, it has comparable (but lesser) outcomes to countries where they have two or three times the funding.

The chronic underfunding has created lots of issues that are not obvious st first glance. The Tory promise of forty new hospitals isn’t real; it’s the emperors new clothes. The truth is hospitals with ancient buildings that are falling down and unfit for modern healthcare - particularly in a post pandemic world.

Recruitment in many specialities is very challenging because of the appalling way junior doctors are treated and the requirement to move around with very little control about where you work. In palliative medicine, for example, there were something like ten specialist training posts nationally (despite it being a growth area and cutting edge medicine). Radiology is often now outsourced to NZ or Sth Africa because of a shortage of radiologists. Psychiatry is failing it’s patients because there aren’t sufficient beds, clinic, doctors or nurses.

Those failings are not the fault of the NHS - blame should be levied at those who asset stripped and incision huge cuts. The government is where the inefficiency and failings are happening. The NHS is being scapegoated to enable selling off without fuss.

This is misleading. The NHS only ever scores well on international league tables based on "efficiency". And these measures are deeply flawed: it's very hard to measure the economic and societal impacts of substandard medical treatment, unacceptable delays in treatment, etc.

On medical outcomes - which is clearly the fundamental point of a health service - it scores generally fairly badly compared to similar developed nations.

They generally spend a slightly higher % of GDP on theirs than we do (I'm not talking about the US trope, but the sensible mixed models in most of Europe) but have far superior health outcomes.

Everybody who can't afford to pay still gets treated. Yet hospitals are clean and well staffed with polite people who don't behave like they are doing you a favour to treat you, far more people survive serious illnesses, people do not wait so long for diagnosis and treatment, people stay is suitable accommodation that doesn't resemble a war hospital (particularly UK post-natal wards as is well documented on here!) and are generally fed edible food.

I'm sure if that was provided for say 2% increase in income tax, most people would be ok with it. But it won't be. Gordon Brown promised his income tax hike would "fix the NHS once and for all" and it's now worse than it was then!

@vivainsomnia

TheNHS model is one of excellence and one that is looked up by many countries including France as its recognised as such.

The issue isn’t money as such although it is indirectly. It’s the massively high vacancies levels and reliance on agencies as a result. Staff have more and more expectation of services running around their needs. Unfortunately, that ends up with a service that isn’t efficient. Staff leave to go to agencies so they can work under their own terms. That means that the service is still inefficient and even more costly.

The department of health tried to introduce terms by which Trusts can only use so many agency staff and only those who meet certain standards. This was supposed to result in staff not getting any work and coming back to the nhs, but it hasn’t really worked as many of these staff were older and just retired.

The new strategy is to recruit abroad. Nurses and doctors who are not as demanding with flexibility meaning services can function to its best efficiency. Brexit has clearly put a spanner to this.

Additional money could maybe mean recruiting more staff despite it not being required but allows more PT work, and flexibility on hours, evening, nights and weekend work, although when this has been tried, they have found that all the staff demand the same terms, young parents want 9 to 3pm shift, no evenings or night or weekend, whilst older staff want PT Tuesday to Thursday.

A bit exaggerating of course, but the gist of it is that it is getting harder and harder to recruit British staff and most hospital and services have to operate short staffed therefore impacting on patient care.

All French people I know go home to get medical treatment because it is far superior, None of them "look up to the NHS". 😆

Not unless it was drastically reformed. No government would touch it with a barge pole. Throwing more money at it is not the answer.

As I posted on another recent thread, I’ve had a chronic health condition for approx 20 years now. The NHS was absolutely dire, so much so I’ve gone private & have done for nearly 15 years. I simply couldn’t deal with them any longer.

@LemonRoses

twitter.com/JadeTaylor8/status/1383714294345322503?s=20

No. But then, I work for the NHS do I get paid fuck all already!