To think the proposed NI increases for social care are unfair?

[shouldbeworkingmore]

I recognise that social care needs funding but think that this proposal unfairly targets the younger generations. Plus we already have income taxes by stealth as the thresh holds have been frozen & wage stagnation is likely to continue for the next decade.

@Maverickess For me a better view is that we get the most bang for our buck so to speak. If a private company can provide the same service 10% or 20% cheaper then the inefficient NHS why wouldn't we do that?

Yes to this... When I left school there were lots of jobs you could do with a handful of o levels... Now the same jobs graduates are recruited.
.

I will be controversial and say I think they should scrap free prescriptions. The only free ones by being an in/outpatient of hospitals.
Getting a 12 month pre payment is about £108. Whilst I realise not everyone can pay this upfront I am sure a process to assist can be made.
I currently get a regular free prescription but as we pay thousands in tax it’s not really free.
A recent private consultation would have meant £35 for prescription but I got it converted to NHS. The private bill was almost £400

@cptartapp

www.telegraph.co.uk/news/2017/08/06/smokers-good-economy-think-tank-finds/amp/

Take into account the net gain, including that on average smokers die younger than non smokers. Therefore less likely to require expensive care home residency.

You can talk about costs to the NHS. Stress (such as that caused by deprivation and the public health emergency of homelessness and insecure housing) is as deadly, if not more, than smoking, and as tough on physical and mental health. Unlike smoking, stress brings in no tax income.

where is the incentive when you're only keeping 58% of any pay rise?

If you’re not incentivised by 58% of something rather than 100% of nothing, it’s difficult to see what financial incentive would do it for you. Having never been incentivised by money once all the bills and some fun money were covered, I find this a very strange concept.

I do agree with a pp that an increase in VAT would not only bring in more money, but also spread the load more fairly.

They are looking at raising free prescriptions to 66 I believe.

The issue you then have is that for younger & poorer people who pay this increased NI means they won't see any free prescriptions & an older pension age. The government are asking people to pay more into a system that will still be worse for them when they need it.
Maybe they aren't targeting houses because so much of the younger ones won't have them to sell?

Yes VAT is better imo than NI

[quote CBUK2K2]@Maverickess For me a better view is that we get the most bang for our buck so to speak. If a private company can provide the same service 10% or 20% cheaper then the inefficient NHS why wouldn't we do that?[/quote]
The only way a private company can do this is with lower standards and fewer and poorly paid staff, given that it has to squeeze a profit as well. PFI and the shocking deterioration in hospital cleanliness following contracting out stand as testimony to that.

I think it’s great as long as it it’s both a high tax and some people still have to sell their homes to pay for it. I would rather a massive hike and everyone get their care for free. Than a moderate home and more people are helped buy others are still walloped with the costs.

@IamtheDevilsAvocado

Yes to this... When I left school there were lots of jobs you could do with a handful of o levels... Now the same jobs graduates are recruited. .

Yes. Tony Blair's cover unemployment figures/scheme to turn higher education providers into businessess primarily concerned with making money instead of research 'Education, Education, Education' was a fraud on both young people and the taxpayer. Of course increasing the number of graduates wasn't goings to magically increase the number of graduate positions. All it meant was jobs that used to be open to school leavers, to train on the job as juniors and work their way up through the company, started to ask for graduates. Young people got into huge debt, as did the taxpayer (many student loans will never be paid off because lots of modern graduates will never earn enough). All to go into the same jobs they would have done pre Blair, straight from school or college - minus the debt. Blair really was a snake oil salesman. I saw what he was at the time but unfortunately for the country (and the wider world) too few did.

Every single job I've worked in had people far senior than me without a degree but a degree was essential in order to get an interview.
Difficult to know how to solve though until employers change recruitment practices.

@shouldbeworkingmore

Yes VAT is better imo than NI

No, because it disproportionately affects poorer people. Everyone pays the same amount of vat, where as NI and PAYE tax is relative to pay.

Maybe they aren't targeting houses because so much of the younger ones won't have them to sell?

That is a very good point.

Although... life expectancy is stagnating, and possibly will start to go down - due to the impact on physical and mental health of insecure housing. But nevertheless many won't die quick enough for the government, and yes, fewer people will have a home to sell.

The problem could hit sooner than some might expect. The over 40s are the fastest rising group of private renters...

There's also the fact that the more wealthy (of any age) are able to afford various schemes to avoid selling their homes. Further limiting the pool of available homes to sell.

I was listening to the radio & there were talking about this point & someone mentioned the plummeting levels of home ownership. So it made me think

For me a better view is that we get the most bang for our buck so to speak. If a private company can provide the same service 10% or 20% cheaper then the inefficient NHS why wouldn't we do that?

In principle, it's a good idea, I agree, however in practice it's not working in the case of social care.

When the person holding the purse strings and have an interest in making profit are responsible for upholding the standards, and that's not monitored properly, this is the result:

-not enough staff to deliver good or excellent care because pay, training and conditions are the minimum legally allowed (and sometimes below with little or no accountability to the provider to change and attract new staff and keep who they have) providers get to decide the parameters within their home of 'adequate, suitability trained staff to cover the needs and number of residents'. The answer is usually 'manage your time better' when you raise concerns that some people aren't having needs met because you can't defy the laws of physics and be in 2 places at once. Which leads to secondary institutional abuse and being unable to deliver truly centred personal care, which when reported and uncovered leads to the staff on the floor being punished and the providers and regulating bodies nodding sagely and promising lessons have been learned, society up in arms and then ......... It all goes back the way it was.

• residents kept places that aren't meeting their needs because those who asses them don't want to spend more budget, or because the current provider doesn't want to lose a self funded bed and insist they are 'coping'.

• Things like activities being funded by staff, residents and families volunteering their time and fundraising, because it's not paid for by the companies, with the exception of the (minimum) wage of the activities coordinator.

• Meal budgets being tight, with lack of choice and limited kitchen hours, when after that it then falls to care staff to fit in to an already busy shift of caring for people.

• Care staff doing more and more domestic chores to save money on domestic staff, taking them away from their primary role of caring for people.

All those things I've experienced working in care, shift after shift short staffed even by the providers standards, because they won't pay for agency staff and won't increase pay and conditions to retain and recruit, yet no blame directed to the provider, the care staff left picking up the pieces get that, and the residents don't get care.

So while providers are allowed to continue in that way, no increase will ever reach the target it's meant for.

No, because it disproportionately affects poorer people. Everyone pays the same amount of vat, where as NI and PAYE tax is relative to pay.

@Nosferatussidebit I know VAT disproportionately target the poor. The gov are not proposing to change tax just NI. VAT should target a wider pool though as everyone buys things whereas those with investment income don't pay NI nor do people who work who are over pension age.

NI isn't a progressive tax

If you earn 200k you pay £650 a month
earn 50k you pay £400 a month
earn 30k you pay £200 a month

who will feel an increase more?

[quote CBUK2K2]@Maverickess For me a better view is that we get the most bang for our buck so to speak. If a private company can provide the same service 10% or 20% cheaper then the inefficient NHS why wouldn't we do that?[/quote]
I have worked in NHS and social care for nearly 30 years. Every service that I have seen that has been contracted out results in worse conditions for staff and no improvement in the service.

Or why not put a charge on the house of those who need care. It could be capped at a % rather than a cash figure so it's fair for those who live somewhere without huge property gains. Yes there would be less inheritance but it the cap was say 10% you would still get an inheritance & people would still have more money in their pocket but a bit less later on.

Also this proposal will target many of those who work in the NHS, care etc. That can't be right.

No, because it disproportionately affects poorer people. Everyone pays the same amount of vat, where as NI and PAYE tax is relative to pay

In which case, let’s introduce a higher VAT rate on luxuries. Leave it at 20% on the stuff everyone buys, regardless of income, and shove it up to 25% on luxury goods, foreign holidays, new cars, etc. Then, not only would it impact only on those who can best afford it, but it would be optional.

I feel like, with the current housing crisis, inheritance should be capped at £20,000 per child. They should not be able to inherit the house but should be offered first refusal to buy the house.

The proceeds the government gets from the inheritance and the sales of homes should go straight into social housing.

This would solve two problems- social housing and the rich getting richer every generation, widening the wealth divide and further cementing class roles.

This screen shot shows World Bank data on the per capita spend on healthcare. You can see the comparison with the US here, but can compare all countries in this link:
data.worldbank.org/indicator/SH.XPD.CHEX.PC.CD

Look how much more they pay for healthcare in a privatised model. Imagine is we had that to spend on the NHS, if it's budget was more than doubled, it would be amazing! But if we privatise stuff what actually happens is we end up paying more for the same service or worse service. We don't get a more "efficient" service, that is a myth.

We should merge NHS and social care and the state should not contract out to private care companies. There should be a national health & care service. GP services should be integrated into local teams and not private businesses. This would mean more is spent on preventative care rather than delivering a service. Private care companies should exist as people should have choice and control over their care.

It is a messy free for all with councils currently spending millions of pounds on care which should be under NHS but NHS will not fund because they spend all the money on managers rather than following the law around CHC funding.

that's a good suggestion @Blossomtoes

I think that's a reasonable idea. The charge. There could be allowances made for adult children who are without a secure home - especially vulnerable disabled and long term ill, and single parents. (Obviously what we really need is more social housing - a lot of it, but until then what we really don't want to do is make the plight of the vulnerable worse).

I suppose that still leaves the issue of plummeting home ownership (and legal avoidance schemes).

I think an increased income tax would be fairer - with higher increases for those more able to afford it.

Increased VAT? That hits those at the bottom - people struggling to afford the essentials, having to use food banks and go without heating.

I remain convinced that a shorter but happier life is preferable. Eat cake and chips, smoke up...and die before you need a care home. But I realise that's a minority view nowadays.