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.

This is a good point. We have private health care as part of my husband’s work package. He pays tax on that on top of the ridiculous tax he pays already at 45%.

It bigger than that.. there's plenty of people.making money from.the nhs. It's not run as a business where in these tough times big decisions need to be made.
People I know work in the nhs on many sides..an ambulance comes in for a refit, so we'll dump the entire contents and buy new £40k...not sensible use of resources..
I expect some would rather pay less and go private maybe there should be an option in future

Unfortunately it would be a drop in the ocean.

We need reform of the NHS, funding arrangements and a new government and even then it'll be a hard slog.

£608,000,000,000 (£608 billion) allowed for the NHS in 2021.

If 32 million taxpayers each paid £1 that's £32,000,000. Sounds a lot but it's a drop in the bucket.

Every baby born will cost the NHS at least £7,000.
Hip replacement around £10,000.
I know someone who was badly brain-damaged in an accident and has already been looked after in a high-level care unit paid for by taxpayers for 12 years. He is only 47 now and they expect him to make it to 70+. He spent nearly a year on a high dependency ward before being transferred to a specialist care home. He's cost the NHS millions and has another 20 years to go.

A single local hospital will have a budget of £400 million plus. So I don't think £32 million annually would make much of a debt honestly.

I also think that what we actually need to do is massively increase the number of people training - at the moment I just don't think money fixes the problem.

I’m an NHS nurse… there is nothing on this planet that could save it…

What health care and doctors could cure in 1947 was very limited. The NHS has increased life expectancy enormously, but not healthy life expectancy. A lot of that is in our own hands to turn around.

The day is coming when there will have to be a cross-party agreement as to whether the NHS in its present form can be preserved, and if not what is worth saving and how it should be re-designed and how it can be paid for. Difficult policy questions need answering.

GPs should be paid by the number of patient appointments they perform, not the number of patients registered with the practice. Patients, except children, should pay a fairly nominal sum for every appointment at the GP or A&E. Not every possible treatment should be available on the NHS.

HCPs should be trained in greater numbers, without fees and with bursaries, but in return should be required to serve the NHS for 1.5x their training duration.

Nope.

Anyway the whole NHS needs an overhaul.

Both my son's have inherited a blood disorder and it doesn't manifest until around 7 or 8 yes old.
The child immunology dept want to see them both at least once a year and with some phone appointments in between.

This is totally not required! It's a complete waste of a consultants time.
If they are doing this for every child I can imagine the wasteage is monumental

It wouldn’t solve it. There needs to be a massive review and overhaul. Opinions within need to shift so that we are not paying £50 for a lightbulb because it’s easier and requires no thought.

Last week I had a phone call to arrange an urgent appointment with a consultant, bringing another one forward. All agreed on the phone with the medical secretary. Today, after the appointment had taken place I received two letters, one cancelling the original appointment and another confirming the appointment that has already taken place. Those letters are a drop in the ocean but reflective of the massive inefficiencies on the system.

It wouldn't make any difference, the NHS is a money pit. So much waste, both time and money.

I’ve just had the same blood test four times. The first three times it wasn’t processed because they wrote the name on the label wrong, then sent it to the wrong team, then left the top off the sample (!) for too long.

Each time they repeated it will have cost money.

The answer isn’t to throw more money into this shambles.

I have no idea if it would be enough. Surely it would have to be on going? I don’t pay tax as I’m a student (will graduate as a vet in the summer providing I pass exams) but even now I’d be happy to pay something if it would make a difference

I would happily pay more tax if I had any faith that it would be spent on health, social care and other vital public services. I don't, unfortunately. Our Chancellor co-authored a book calling for the NHS to be dismantled and replaced with private health insurance. Any increase in taxation under this government will not be used to protect or improve a system many in government are ideologically opposed to and have never had to depend on. It will be used to feather the nests of the already rich and powerful and to fund callous, half-baked and discriminatory schemes like the Rwanda plan they've already sunk £140 million into.

I think we need to pay more, but I also think we need to reassess what the NHS is used for. I think there needs to be some difficult conversations about what is essential NHS use and what isn't.

It's used for so much much more now than when it started, treatments are more expensive, people are living longer and expecting more to be covered.

I also think they need to put money into elderly care, something for those who are too ill to go home and too well to be in hospital. But also, as people are living longer, health becomes more complicated and multiple issues arise. I think thats the issue they need to address as a priority, is care of the elderly population.

@CinnamonJellyBeans

I believe the main way we can ease the burden is by healthy people looking after our bodies as best we can and not getting complacent about the fact that abusing the gift of health will automatically get us new knees, livers, cancer treatments, metformin, BP tablets, mobility scooters, gastric bypasses. We take the NHS for granted. Everyone should receive a virtual bill when they leave, that lets them know how much their treatment would have cost if they had paid.

Yes, indeed, far too many people don't care about the damage they do their bodies and don't lead a healthy lifestyle at all. I don't think they intentionally do it because they expect the NHS to "cure" them, but they just don't think of the consequences. I really don't think many people will think "stuff it, I'm going to smoke like a chimney because the NHS will provide me with an oxygen mask". I think it's more that people just don't think of consequences any more, i.e. re health, dangerous sports, dangerous driving, etc. No sane person would intentionally damage themselves just because treatment was available.

As for a virtual bill, I'd be against that kind of thing as it just creates more layers of bureaucracy and there'll be doubts as to the reliability of the figures as there are different ways of working out costs, i.e. marginal costing, absorption costing, etc. We already have crazy figures for things like calling out a fire engine which aren't transparent as to what's included, and the old "lie" about raising a purchase order costing £40 when in reality the marginal cost is just a couple of pounds, but using absorbtion costing (inc the building, admin, management, equipment, etc it's much more). The general public can't understand the nuances of cost accounting.

I recently had a letter requesting we go paperless, which I agreed to. I get text reminders (unless hospital appointment) and use the mychart system which pings all blood tests and medical letters to you - you get an email asking you to log in. I've also recently downloaded the NHS app and just waiting for the GP to link my childrens accounts and then I should have access to the 3 of us in there too. So it's certainly doable in some areas/with some demographics. But I know for a fact my grandma wouldn't/couldn't use the technology to allow for that. So it would need to be a hybrid system, but I totally agree there should be significantly fewer pieces of paper, and systems (like release of results) should be automated as much as possible. I've set up new systems like that in other industries in past jobs, it's a long hard process with much testing needed, and a lot of upfront expenditure, but over time pays for itself.
Tons more needed or course, but this is one of those areas that can remove a lot of tedium

@Fadedpicture you are of course correct about personal responsibility but people get really irrational if it’s even mentioned.

@Fadedpicture

I also think too much is left until it's bad enough before the NHS will treat, which means expensive or long term treatment when they do. E.g DS had an infected ingrown toenail. NHS don't operate on in grown toenails, here's some antibiotics, but it will keep recurring. So I got it done privately, £40. Left to the NHS DS would have been having regular GP appointments and prescriptions indefinitely, all for the want of a £40 procedure.

Our DS finally got his ingrown toe nail treated by podiatry after 6 months of GP appointments. He kept getting told to do salt baths, prescribed creams, etc., and inevitably it got infected and he needed antibiotics. I've had ingrown toe nails (twice) myself and the only thing that worked was their removal, so I knew the GP surgery were just wasting time by not referring! We kept asking them to refer but just got excuse after excuse, the best being that "podiatry have a 12 month waiting list!" In reality, after referral, he had his consultation within 2 weeks and minor surgery the following week - they said they didn't even have a waiting list and were calling people for appointments the day the referral letter from the GP arrived!

I know, that's why I feel a nudge campaign is needed. It used to be OK to drink and drive and now the vast majority would see that as abhorrent. Anti smoking campaigns have made a big difference too. This needs to be the next one IMO, it is possible to bring change.

The NHS is not underfunded. It's just very badly managed. If they can pay 115 grand for a "director of lived experience " then I'm.sorry but they ain't anywhere on there arses!!

Nope, I’m not willing to pay extra tax. The NHS needs completely scrapped and rebuilt from scratch.

Nope, it's unsustainable in its present form, needs a complete and absolute reincarnation and run by people who know how to manage it efficiently financially and by medical need.

I agree with PP that the Public must have some accountability also. I think if you are taken to hospital because you are pissed you should be charged a sum for your treatment. Same if you smoke
No IVF, Obesity or gender reassignment surgery for free.

Some really tough decisions must be made and it won't be easy but is absolutely essential

@XingMing

GPs should be paid by the number of patient appointments they perform, not the number of patients registered with the practice.

Absolutely. It's no wonder they don't make appointments available when they get paid anyway. They definitely need to be paid for what they do, not number of patients they may or may not see. It would also solve the problem of them claiming for people who've died, moved abroad, registered with more than one surgery, etc.

DH was working as an external consultant with the NHS for years. He has recently pulled out as he can't cope any longer. It is a behemoth. Creaking and stuck with a model no longer sustainable in the 21st century. What you have to remember is that "the NHS" really isn't a contiguous blob. Government set budgets, NHS England set frameworks, and trusts deliver the care. It is the trusts that actually make local decisions, as they should, it makes sense to respond to local needs. HOWEVER, some trusts are literally shit. They are run really badly, have terrible outcomes, some come to court, as we see often. DH can name and shame a handful of badly run trusts, and those are always the ones in the news. And yet, still, those Trust leaders are kept in post, or shuffled off somewhere else, to do the same in another trust. There is very little consequence for failure in the NHS. Jobs for life and all that.

Well run trusts, are just that, well run. Open to new ideas, new technology, new ways of running a modern system. It can be done.

DH had a long period of illness before his death, multiple hospital appointments, a letter sent to confirm each one, at a cost of what, £1 each for just the stationery and stamps, let alone the time. Now, people working in the system will tell me why it can't support any electronic communication, but it should
Posts like this make me laugh. It shows how the average person in this country has absolutely no clue how the NHS is run, the issues it faces, and the scale of these.

The biggest cost to the NHS is diabetes and associated health issues. We are talking about one billion pounds a year, close to half of the full costs of the NHS. And you mention a £1 letter!
To clarify, many efficiencies have been introduced such as reducing letters when appropriate except that this sadly leads to more appointments missed and a higher cost. This still is nothing compared to the savings the NHS made if we tackled the obesity crisis, something that the majority of people could manage themselves.