To wonder why the government don't increase taxes to fund the NHS better?

[Smolgoose]

From a lot of threads on here recently about lack of being able to access healthcare, and my own anecdotal experiences, it seems like the NHS is in a worse crisis than ever, and not able to cope with the demands upon it.

This thread is definately not about individual NHS staff, but about the whole system generally.

Why don't the government increase taxation to increase NHS funding? It wouldn't solve some issues such as the shortage of staff, but funding could be also funneled into increasing the number of people trained.

A lot of people think we are heading down a privitisation route, but as far as I know the government have not yet floated the idea of changing free at the point of service.

[quote Blossomtoes]I worked in nhs management in the last labour government. Their actual plan was to throw loads of money at it, and prove it couldn’t improve even with increased funding. And they were right, as the excess money went to managers, new It, not to the wards and staff

I worked in the NHS then too. And I don’t recognise what you’re saying at all. The improvement was massive, not least because it was aligned to targets. Waiting times went down to virtually nothing and it wasn’t unusual on weekdays to find our A&E waiting room empty or very close to it. Before the usual anecdote accusations are wheeled out - although “My GP drives a Maserati takes some beating - here’s the data.

www.kingsfund.org.uk/projects/general-election-2010/waiting-times[/quote]
How were those waiting times reduced? If you make everything target-driven, you often end up with management working entirely to the targets, rather than doing what's best for patient care.

Management in one hospital (one with a particularly poor survival rate) decided that to reduce waiting times they would fit a fifth bed in a four-bed ward. Those wards were designed to fit four beds, with four sets of power/oxygen etc. supplies and room to pull any of the beds out to resuscitate. They put a fifth bed in and people died as a result.

But what did it matter? They were only numbers on a spreadsheet. There was no target for not having needless deaths, only one for reducing waiting times.

What did they do when a cardiologist, a cancer specialist, and an administrator among others blew the whistle? Did they make changes to improve patient safety? Did they f*. They closed ranks and bullied them out.

I wonder how much of the NHS budget goes on employment tribunal payouts? The Chief Executive who spent £10m trying to cover it up has since been promoted. Utterly corrupt.

Because it pains me that more than half my hard earned money is not mine?

@DdraigGoch
Independent analysis has shown Labours spending on the NHS did in fact reduce waiting times.
But of course you will always get inefficiencies and waste, i ve always worked private sector, anyone who thinks it doesn't happen here is naive.

As well as more medical staff (110k vacancies) the NHS needs more and better managers, IT systems and procurement processes, these have been cut, which paradoxically means more waste!

The NHS score high among the worlds top healthcare systems for efficiency though but poorly on outcomes and diagnosis to treatment times
Those ten years of austerity have cost a lot of lives.

@jasjas1973

I used to like having a tax problem, it meant i was earning alot of money.

250k p.a, still means a take home pay of almost 150k, or almost 8x the minimum wage or over 5 x what a nurse (on max) earns... so count yourself lucky, i always did, so quit moaning, no one is listening.

I'm on the basic rate so I've no skin in the game. You and I could look at that £150k left over and say "I could pay off my house in one go with that, and still have enough left over for all of my other bills and a holiday. From our point of view, £150k looks like a life changing amount.

Then think about it from the perspective of an actual high earner. You were on £200k last year, have just been promoted and am now on £250k but for all of that extra stress, you notice that you are only 25k better off. So you wonder what the point of getting promoted was. Then you phone an accountant and find ways to minimise your tax burden. You buy a home in Monaco, spend six months and one day of the year there and suddenly you are liable for next to nothing.

This is why the Treasury made less money from the 50p rate than it does from the 45p rate. It's also why when it gradually reduced the corporation tax, its income grew.

How were those waiting times reduced?

The careful management of beds, maximising day-case activity, ensuring the full use of theatres, and effective discharge planning, including investment in convalescent step-down facilities to free up beds for elective cases. It wasn’t rocket science.

And mortality rates were definitely included in KPIs.

how were those waiting times reduced?

In our specialty it was through much needed updated equipment, more staff, and funding for further training.

@Blossomtoes

How were those waiting times reduced?

The careful management of beds, maximising day-case activity, ensuring the full use of theatres, and effective discharge planning, including investment in convalescent step-down facilities to free up beds for elective cases. It wasn’t rocket science.

And mortality rates were definitely included in KPIs.

Obviously not in Coventry.

Of course not @DdraigGoch. When the KPIs were agreed, they all had Except Coventry in brackets after each one. 🙄

Then think about it from the perspective of an actual high earner. You were on £200k last year, have just been promoted and am now on £250k but for all of that extra stress, you notice that you are only 25k better off. So you wonder what the point of getting promoted was. Then you phone an accountant and find ways to minimise your tax burden. You buy a home in Monaco, spend six months and one day of the year there and suddenly you are liable for next to nothing

Thats not how it really works, you don't see your kids, your mates at the golf club, no track days or Covent garden, you d need to be a lot better off than 250k to move out of the uk for tax alone.

This is why the Treasury made less money from the 50p rate than it does from the 45p rate. It's also why when it gradually reduced the corporation tax, its income grew

The 50p rate wasn't in long enough to know and CT rates are now going back to just 1% less than Corbyn wanted.

So presumably the Tories think rising them will increase revenue?

For me, its about a better society, all the money in the world doesn't help you if your robbed, rapped, your partner burnt alive... that happened to my nr neighbours in Midrand South Africa, we used to go out on plot watch, spot light & gun.

My next posting was Sweden, massive tax hike but i felt safe, a very nice and happy place to live... bloody cold though but great coffee and cake.

You were on £200k last year, have just been promoted and am now on £250k but for all of that extra stress, you notice that you are only 25k better off

Or £2,200 a month better off. More if you put some of it into your pension. And you get to keep your life.

Lol @ the idea of someone on £250k leaving the country for tax reasons. Even the people who subscribe to the theory that tax sends talent overseas wouldn't use that kind of wage as an example.

Plus Monaco is quite spendy.

@Blossomtoes

Of course not *@DdraigGoch*. When the KPIs were agreed, they all had Except Coventry in brackets after each one. 🙄

I jest, of course. In practice there was an attempt to manipulate the figures

@SunshineSum

Lol @ the idea of someone on £250k leaving the country for tax reasons. Even the people who subscribe to the theory that tax sends talent overseas wouldn't use that kind of wage as an example.

Plus Monaco is quite spendy.

I used Monaco as a dramatic example. Other, less drastic methods of reducing one's tax burden are available, even including not bothering to earn as much in the first place. High taxes are a drag in productivity.

I used Monaco as a dramatic example. Other, less drastic methods of reducing one's tax burden are available, even including not bothering to earn as much in the first place. High taxes are a drag in productivity

I don't know where you get your figures and ideas from but the UK languishes way down the league on productivity, a lot worse than countries with far higher income tax rates, its a far more complex problem than cutting tax rates.
blogs.lse.ac.uk/businessreview/2020/03/07/if-the-uk-is-high-tech-why-is-productivity-growth-slow-economists-weigh-in/

We already pay enough taxes. And at the higher rate, some choose to use private medical services and are happy to pay twice.
The government that will stand the test of time will be the unpopular one deciding to restructure the NHS - and that will never happen.
There is too much sentimentality attached to the idea and even to the reality of the NHS. A harsher and more realistic approach is what is needed, not more taxes.

We already pay enough taxes. And at the higher rate, some choose to use private medical services and are happy to pay twice

Try using that medical insurance when you smash yourself up in a car accident and need not only AE but emergency surgery in another part of the hospital?
Or when you need long term cancer care (many policies restrict this or don't cover) they also don't cover many other chronic illnesses.

The UK spends less on health services than most european countries and has done for decades, its why it has so many front line vacancies and low retention rates.

One of the problems the UK has, is it still wants a large standing military and believes we are still a superpower so has a very expensive nuclear arsenal and of course it loves vanity projects like HS2/3.

These also come out of our taxes

I totally agree you'd need to use the NHS as you illustrate but the higher tax payer who chooses to use private medical insurance where possible is already paying a lot of tax.
Contributing to two systems: one through the taxation system and one by choice which frees up the NHS on a lot of instances.

which frees up the NHS on a lot of instances

Private healthcare cherry picks relatively simple elective surgery. If you’re really ill it won’t touch you as @Bluethrough has pointed out. What you get privately is a shorter wait, a nicer room and better food. Oh and you’re taking up a surgeon’s time when they could be working in the NHS.