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. A government that can fritter away billions giving handouts to friends for non-existent PPE should be pressured to put the money where the vast majority of taxpayers want to see it.
We shouldn’t have to fund food banks either - it should be the government.
And teachers shouldn’t have to pay for education supplies from their own money - it should be the government.
Close the tax loopholes and stop bunging handouts to friends and there would be enough money.

If the govnmt closed the tax loopholes and stopped giving money to cronies and we were still short, then I would happily pay more. My family has received wonderful NHS care at times.

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.

Unless you qualify for a medical card, you pay:

• GP - €50

• A&E - €100 or free with a GP referral which costs €50 as per above

• Hospital in patient / day patient - €80 per day up to a total of €800 in a 12 month period

• Injury Unit - €75 or free with a GP referral which costs €50 as per above

My partner has a chronic health condition (autoimmune disease) & has never received any of the money back he’s paid for treatment, his last relapse cost him €660 in total.

I personally don’t find these fees “nominal”.

@AlwaysLatte

Given the amazing service I and my family (especially my Mum and Dad, who have had a lot of treatment this last year) have had, I would think it was incredibly good value if we'd each paid £1000 a year toward it. If people can afford it then that would be a fantastic injection of cash for the NHS.

So those of us who pay well in excess of that and get next to nothing back should get a refund presumably.

As a Scottish higher rate tax payer, I think I pay enough tax (although I am more than happy to do so: I fundamentally believe that it is the duty of the better-off in society to support others through taxes).

The NHS is based on wonderful idealistic principles, which unfortunately no longer stand up - it requires root to branch reform on an accounting level.

As an aside, some years ago, I did some IT consulting work for the NHS and my day rate would have made your eyes bleed. That was a standard day rate, btw: I tried to negotiate down, but couldn't, as it was 'set as standard'.

Absolutely not. I’ve worked clinically in the NHS for 20 years. It needs to be dismantled and something else brought in. People need to be charged something unless they have an exemption certificate. The level of entitlement just rises and rises. There needs to be a parallel private system so that those who can pay and want to pay can easily access private services. Atm even if you want to pay you have to go through a gp. The whole system is broken.

I’d rather invest in social care to help people stay independent and well. A lot of pressure on the NHS is because of a lack of services to support people on discharge and without this they remain in hospital longer than necessary or become unwell and are readmitted. I’d love to see carers get a much better deal. Professional carers should get much better pay and conditions and time to do their role, unpaid ones need better benefits, training and respite. So many people care for the people they love saving the state billions and get practically nothing in return. The care sector could do with a complete overhaul and parity with other essential services.

Also, absolutely agree with ladyjaye. Those of us fortunate enough to be in well-paid employment should be paying more tax. From each according to his/ her means and all that. And how do any of us know when we might need the NHS? And isn’t it better for us to pay more so that no family has to go through the anxiety of worrying over costs when a loved one is ill?

But I still think the government needs to be brought to account before demanding we pay on top of current tax and national insurance.

@akerman, thank you for understanding the principle behind my post: I read it back after posting and worried that it sounded patronising (too late!), but you're absolutely right - to each according to their means.

I am from a militant, unionised working class background and social responsibility as a moral principle was hammered into me as a child.

The first year I realised I paid out more in tax and NI than I earned in total when I was first employed was a real cause of celebration for me.

No.

DH already pays an NHS subsidy per year on top of the highest taxpayer rate.

This is despite not using the NHS since moving here.

No. I pay an enormous amount of tax like everyone else in this country.

My family didn’t use the NHS much for years. Certainly I paid far more in tax for it than we were taking from it. And then my husband’s aortic aneurysms was discovered and he was in hospital for five and a half weeks with two spells in ICU.

And what if I lose my job tomorrow?

I’d so much rather be part of a system where we all look out for each other and pay what we can afford.

I love in Australia. Our healthcare costs are similar to yours, but care far superior. The UK needs to re structure.

I wondered how long it would take for the 'bring back matron' comments. Modern matrons have been in place for around 20 years! This idea that Hattie Jaques will sort it out is the same mentality that got us Brexit. False nostalgia of an age that never existed in the first place.
I've worked in the NHS for 29 years as a nurse at all levels up to strategic and management roles. It is inefficient in places. Procurement can be frustrating and doesn't always spend resources in the best way.
I now work part time nhs and part time private healthcare. The speciality I work in privately the nhs don't want it so I have no choice but to do it via a private organisation.
So yes bits are getting sold off but it's not all being snatched from the plucky nhs, some of it they just aren't interested in!
That said, throwing more money blindly at the problems won't help. A cultural change and a more joined up approach would be helpful. But each Trust operates like it's own little mini kingdom which makes this impossible at times.
Years ago I wanted to implement a system in a large Trust so that any child attending hospital with a child protection plan could be flagged on systems to ensure I information Shari g with children's social care. The Trust had over 30 different electronic systems in place all with their quirks. It wasn't possible to get them all to link up with each other. The whole project failed as a result costing a fortune to reach that conclusion.
Social care needs significant investment as that places a huge burden on the nhs and the structures aren't good enough for it to work well.
Ambulances stacked up outside ED like they are costs lives. This is not new to the pandemic. There should be a national outrage at that. But instead people are labelled as time wasters and should be made to pay for their care if they were pissed. That's dangerous territory and will cost lives if implemented. There are times in my life that I just wouldn't have had the money to pay for a gp appointment and my health would have suffered as a result. There are many reasons why people misuse the nhs and they aren't binary 'they are all entitled or stupid). I work with so many people who fall through the cracks of society, have complex social needs, are living in awful housing, have poor education, addiction issues etc etc these people would just die if charges were brought in.
It's at breaking point in the pandemic because it was cut to the bone already and had no wriggle room. I'm looking forward to a breakdown of where this £350 million a week will be spent....

Doesn't really help when we do things like give £71m aid to China, despite their economy being 5x that of ours and them winning business all over the world by undercutting Western firms.

No, not without reform.

The NHS definitely has to do a lot with a smaller budget than other comparable countries. This is true. However, I don't agree that it is more efficient - I mean, it is on some of the crude stuff you can measure, but when you actually compare what you would get as standard in France or Germany, you are getting at least 2x the service and that isn'r accounted for in the efficiency figures (which just show how many appointments/operations are done for the money).

I know France best, so I'll start there with the areas I know:

Maternity

• consultant led care in maternity (no offence meant to midwives, many are brilliant, but the lack of consultant oversight at any point in any pregnancy not deemed high risk is extreme by the standards of most countries - the ideal would be IME to have some consultant care with management by midwives - would certainly have picked up a few issues that I had earlier)
• generally at least one more scan as standard
• hospital stay with options for partners to stay, in a private room (and be fed)
• post birth physio and assistance with breastfeeding as standard
• access to paediatrician in baby's first year of life (this is IME a lot better than the health visitor service, which refers you back to a non specialist GP for almost anything anyway)

Cancer

• GP appointment within days, with full examination and referral on
• biopsy within a week
• operation within two weeks

GP appointment

• at least twice as long where needed
• covers preventative measures regularly and on registration (ie will advise on height, weight, blood pressure, do a breast exam, will run bloods, may run an ECG if over 50, just to ensure they have up to date health info on file).

In France, all your healthcare prescriptions and key health details/notes will be scanned onto your card that provides access to treatment - you can scan it to pay any excesses, you scan it to get prescriptions in the pharmacy. You also, if you need an operation, book the date yourself on the online system (or your GP receptionist can if you are elderly etc), down to choosing an anaesthetist - this cuts down on cancellations and administrative errors because fewer people have to be involved in shuffling things around. Plus you get a level of choice AND see how much what you are receiving costs.

The NHS is based on providing services based on a top down allocation - ie what management think should be the allocation based on what is available. France and Germany work more from bottom up - i.e. the money flows up from the patient based on what the patient needs. The patient takes more responsibility in their health management and has access to more specialists as standard. My personal view is that bottom up is better for the patient and more efficient for the service because you have less energy wasted on administration and missed appointments etc. Win win.

*People calling ambulances because they can't drive

a. some people cant afford to learn to drive or afford to run a car , some of whom will be the key workers y"all been clapping for.
b. round here the taxi drivers are jacking it in because the restrictions are sending them out of business.. no hospitality means less taxi use. no nights out means less taxi use. No Christmas parties means less taxi use, No NYE parties means less taxi use.......so they go out of business. So if you need to get to a hospital and cant drive what other choice will there be.
Not everyone is capable of driving or can handle it. How do you think more of this on the road will help.*

That mentality doesn't work - I didn't learn to drive so will use an emergency ambulance to ferry me to hospital when it's not an emergency.

The overuse and misuse of ambulances is Terrie.

*terrible

And I would add that procurement is shoddy and uncommercial - it is ok on generic drugs etc, where you just rely on economies of scale. More sophisticated things and projects that require more than just "finding the lowest price" is done poorly (reason why the NHS sounded 20bn on an IT system that never happened) - this is the case across a lot of the civil service, to be fair.

Incompetence/lack of commerciality and hierarchy that promotes arse covering means that errors are made and corruption can slip through.

Not in it’s current state no. I’d be happy to pay more for a better system though. It needs a complete overhaul, as does a lot of the public sector. I’d Also bring in small charges for appointments, £5 a time. And change all staff to be in line with the private sector, higher pay for everyone, proper pay rises completely performance based (no automatic increments or pay band caps) pensions, holiday and sick pay in line with average private sector and easier to hold to account. It would mean the many hard workers are rewarded properly.

NHS massive piece of piss at the moment, spent 2 weeks in intensive care (got morphine dose wrong twice, could have killed ds). The bin lids were all broke and didn't close quietly, twice a day the staff used to put a clean folded continence pad under each lid to dull the sound.......................... (20 bins twice a day!!!!!!)

And don't get me started on the "caring" nurses!!

A significant increase in people living with long term conditions for many more years. This what costs the NHS most. A combination in improvements in treatment keeping people alive and people looking less and less after themselves.

Add to this staff constantly working under pressure, to meet target and just to be perfect at all time and people are leaving the profession.

Massive staff shortage significantly impacting on service delivery.

NO WAY