If everyone was taxed an extra pound, would that save the NHS?

[EddyF]

Might be a silly question but if you don’t ask, you don’t learn!

I have just a post elsewhere (not MN) where people are discussing their wait time to be seen at A&E and it’s quite shocking.

I think people would be In favour of paying a slight tax increase of a minimal amount such as £1/1.50 from tax to try and fix the NHS. Is this unrealistic?

I have attended a hospital in the US, and the experience was such a stark contrast to the feel of hospitals here. I know obviously because the US is not ‘free’ like the NHS. I just remember it being like a spa service.

But my point was in reply to some one who said the NHS can never work.
In 2019, whilst not brilliant, it did not take 3 days to get through AE or cat 2/3 calls not responded to in a timely manner.
Social Care was ok too.

All but one of your points have happened to other european countries and they seem to be coping?

However, and i ve argued this long and hard, point no3, Brexit, its the biggest difference & explains why we alone are suffering so much more in regard to health services across Europe.

Thanks. What’s the main difference to here - is it just that higher incomes pay more?

Plus a nominal fee - which could be useful but not enough imo would vote for it

Those who do a tax return get a calculatoin showing what percentage or the income tax and NI they pay goes on the NHS. It is about 20% of your income tax/NI bill. So 20% off if we could opt out is right on that basis but the person above raises a good point as I also pay through insurance premium tax, VAT, car tax, airline duties etc into the NHS via that means, council tax perhaps even and all the rest it is may be that we should also get 20% reductoin on those other taxes too if we could opt out of the NHS.

I agree I would have to take a rsik on death from accident unless there were other arrangements in place - the UK already does treat foreigners over here either to give birh to qunituplets on the NHS - health tourism or who are simply lll wqhilst here but asks for insurance details or payment up front in many cases so we would simply extend that to those of us who opted out.

Also for that massive tax saving I would be prepared to take the risk of death as I would have duringcovid when I accepted that if the state decided those like I am who are unvaccinated would be left to die [the state did not decide that of course} and in fact at height of covid where I lived most people could not even get ambulances unless they could not say more than 2 words - 4 words and you were denied one so I am not so sure there is that much NHS care available anyway. I have also had to pay a small fortune for just about every health thing my sons have had in the last 10 years as there was no NHS cover. Pity I cannot set all those thousands against my huget tax bills.

@helford

Fair points... I agree, Brexit was a catastrophically stupid and expensive mistake.

It sounds good that you could adopt a more French or German system. But, and it is a big issue, you have voters who already say that they cannot give any more. One of the reasons the NHS has such a grip on the public is the fact it is free or appears so.

If you ask British voters, at election, to make these changes, I can quite see a lot of people for whom money is not a big issue, might well accept it. For those who cannot afford more they would certainly vote to keep the situation as it is. An issue as divisive as Brexit, I think.

I live in Scotland and therefore pay more tax plus NHS gets more £… the situation is just a dire here despite more money so more money isn’t the answer, in my opinion.

Yes, I did feel it at the time. The HCP was well aware of what happened, the "electric shock" made me literally jump out of the chair. She apologised and said it sometimes happens, but didn't tell me what to expect in the coming days. It ses like it should be a basic part of their training to me and would have avoided the GP telephone appointment.

GP just listened to me telling them what had happened and told me all would be fine in 6-8 weeks. Didn't ask any other questions at all. I'm sure any HCP could have done that and it would ake sense to me that the "system" and their training had them do it at the time.

I couldn't afford that. I'd be up for 1% of gross income, as long as everyone was paying 1%. Though, I think there is a lot of waste that could be cut first.

@MarshaBradyo My French friends make a modest payment ( I think this is what is called a co-pay in American terms) for using the health system. I think it is a flat fee, but if you fall below a certain income threshold you can apply to have it refunded. Or something like that. We need a French MumsNetter to share her experience

An extra pound might be nothing to a lot of you, but to some it's a lot.

We're taxed enough, well the working poor are and the middles classes

The amount of money isn’t the problem.
It’s the often poor management allowing inconsistencies and wastage and generally not being great at managing.

The NHS has been being sold off bit by bit for decades - so many fingers in pies and Big Pharma fund universities where research takes place so there’s bribery, people on the make and all sorts.

Nothing is straight forward and not everyone involved is doing the right thing.
Obviously there many, many great people working for the NHS but sadly, it doesn’t seem that everyone is on the same page and until they are, nothing will change.

Pay their full degree including maintenance loan in exchange for a few years of service could work. Right now student nurses are effectively paying to go on placement and work for free. There's no incentive many don't feel they owe the NHS anything , paying for the degree has backfired on the government

Yes it's scandalous that students are paying to work on placements (with no employment rights!)

Like hell you'd take the risk, Xenia. It's just an I'm all right Jack approach.

They would just waste it. My local hospital are paying an agency £28 an hour for temp cleaning staff. The cleaners get £12.50 an hour. Pay them £15 an hour so you can retain staff! But of course it would take a time study consultant £100k to look into that and make a recommendation.

They would certainly waste it if they did what you suggest.

For starters, cleaners are rarely employed directly by the NHS and if they did employ directly with a hourly rate of £15 ph, they would earn more than most Nurses or Physios.

The NHS has been underfunded for decades (compared to EU health services) for many years and the monies it does get are used inefficiently, to fire fight and sticking plaster reforms that do not address underlying problems.

It needs a 15 or 25 y plan with guaranteed funding year on year.

Incidentally, where are the 40 new hospitals the Tories promised?

It depends on what service you are using. I’m not a “frequent flyer” anymore so most of the hospital stuff listed below is from memory and is indicative.

A GP’s appointment costs currently I think a flat fee of €25.

A Consultation at your local hospital might (depends on circumstances) cost in the region of €50.

Most other services (e.g. MRI/CT scans, lab test) will attract at least some sort of charge though it’s often a very notional amount (region of €50 ish or less for a “scan”).

In-patients hospital stay will see you charged a notional B&B fee of maybe €10-20 euro a night - that’s for a single room, cleaned top to bottom each day and good food…….

Good news most of the above can be claimed back of your insurer, there is a safety net for the low paid and for long term conditions such as cancer etc you may well be exempted from most of the charges - the State picks up the bill.

If the hospital employs the cleaners directly, it will have to pay them sick pay, holiday pay, employers' NI contributions and God knows what else. It will also probably be subject to greater union involvement with implications for how staff are employed, what various staff can and can't do etc.

You can't simply compare an hourly rate when signing someone up to an in-house contract of employment, with an hourly rate paid to an agency for self-employed contractors. It's meaningless. If you want to talk about the waste involved in how capitalism syphons off profits generated by workers to a parasitic non-working elite then I'm all ears, but given that NHS trusts along with everyone else have to work within the capitalist system we have (and that most people here seem to be arguing for MORE of), they'll sometimes find that contracting out services is the most efficient way to do that.

Someone will have done the sums to compare the two solutions, taking into account all these factors and probably a hundred others I haven't thought of, and decided that it's financially better to contract out the service. But of course that person will be a "manager" (oooh . . . BAD!!!) and the NHS shouldn't have any of those. Just because it's the biggest employer in the country coordinating a mind-bogglingly complex set of processes with very serious consequences for failure, doesn't mean you actually need people who understand complex financial matters to run it.

Herein lies the NHS's problem: they waste all their budget employing people to make these calculations and decisions, when they should just ask the Armchair Accountants Of Mumsnet!

I read this morning that GPs in France are planning a strike to demand the consultation fee goes up to €50.

Interesting, @XingMing Hardly extortionate if those on low incomes continue to be protected, but more detail would be interesting. At the moment the French standard of care suggests to me that this could be worthwhile

I think many already “en greve”, AFAIK ends next week.

There are multiple gripes, one of which is they reckon €25 per consultation often doesn’t cover associated costs…

The GPs’ demands include:
A €30 payment per consultation, rather than the €25 paid today
A €60 payment for older people, or those who are suffering from a long-term condition
More doctors and resources to avoid time pressures and too many patients per doctor.

Though what that has to do on a thread about paying more into the NHS i don't know.

It's not unreasonable, but the availability and quality of appointments would have to improve. People aren't going to be happy to pay £50 to be fobbed off and then have to go back 2 or 3 more times before they get proper treatment.

I'd compare it to a recent consultation we had with a vet. She was absolutely hopeless, clearly didn't know anything about the pet we took to her and basically just prescribed a bottle of antibiotics (but she'd already said there were no signs of an infection). We complained to the manager and got an appointment with a different vet who had experience with our kind of animal and got a proper diagnosis and treatment plan. Then they tried to charge us for the second consultation too. Needless to say, we refused to pay twice when one consultation was useless. GPs need to be aware of the need to be able to provide "value for money" if they want to charge their patients directly, which I think will be quite a culture shock for many of them.

I'm against a pay per GP visit, reasons below -

Extra admin cost.
If it mirrors prescription charges, vast majority would be except anyway so minimal money raised.
The only people who would have to pay are NOT necessarily the poorest, plenty of people who needed a doctor, then couldn't afford to see one.
If A&E remained free, people would just go there.
Rich pensioners wouldn't pay.
The people who do have to pay are already the ones funding public services, if they are then the only people excluded form free access to those services, resentment builds.
Payment has worked out so well in dentistry (not).

I agree.
But we get what we vote for.
The people who voted for this can own it, 100% their fault, they 'knew what they voted for'.

Yep, fully agree with that chain of thought. It'd be just yet another "tax on workers". Like the suggestion of fines for missing GP appointments, with the add on throwaway comment of "of course certain groups would be exempt such as OAPs, those on certain benefits, etc". So what's the point?

I'd really, really, want to see some proper, audited, figures showing the numbers of appointments missed, broken down into age groups, workers, benefit claimants, and reasons for missed appointments, and then we could see exactly who is missing appointments and why, as a starting point before fines.

Exactly the same would apply to GP appointment charges. We need transparency as to who would pay, who'd be exempt, etc., before even thinking of going there. The last thing workers need is yet another tax on working. I'd be more keen on means testing based on total income/total savings rather than the lazy method of looking at wages only.