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.

NIC is a con because people assume that they have made contributions then somehow they are allocated a service. That may have been true when the NHS was founded but it is not true now and hasn't been for 40 years at least.

Since there no hypothecated tax in the UK it would be better dealt with a levy on transactions on assets or possibly income

Obviously I can't speak for this specific occurence, but it may be that that's exactly what the answer is. Often mistakes like these happen because departments are under-funded and under-staffed. People end up scrambling to do extra things at the end of their shift that aren't really supposed to be part of their job; things get left undone when someone quits and hasn't been replaced yet etc.

All else being equal, an organisation (public or private) that is funded to a sufficient level to meet the expectations we have of it will do so with greater efficiency and reliability than one that is not funded nearly enough to do so. This shouldn't be a particularly controversial idea, yet it's remarkable how often people put everything backwards to justify what they're already determined to believe.

The Labour administration from 1997-2010 massively increased funding to the NHS, and outcomes massively improved. Since 2010 its funding has been cut in real terms (and even moreso when you consider the effect on demand from other cuts to social care, local authority funding etc.), and outcomes have plumetted.

This shouldn't be complicated to interpret. But apparently it's because it was always hopeless, the additional funding didn't actually help and we only thought it did because we were all hallucinating.

Public health no longer sits with the nhs, it was taken out and put into local authorities. It made sense to a certain level because so much preventable health conditions are related to things like poverty, poor housing, obesity etc which fall more under the remit of local authorities. However, the money was not ring fenced and because local authority funding has been decimated, there is hardly any money to do any proper public health education or interventions.

the other thing of course is that prevention is really bloody complex. Take falls which cost the NHS and social care about 4.5 billion a year. The things that prevent falls primarily are 1. Keeping active - strength & balance 2. Reducing trip & slip hazards in the home and in the external environment 3. Ensuring people maintain good eye sight & have regular sight checks 4. Ensuring medications are regularly reviewed to ensure they’re not working against each other and causing dizziness 5. Adaptations in the home such a grab rails or aids ti help with walking such as frames

to tackle all of those requires GPs, local authority - social care, housing, the ppl who clear/ repair pavements, opticians, bus companies as falls often happen when an older person hasn’t sat down/got up too soon when bus is moving, pharmacists all to work together. And then for the older person to follow all the information and advice given. It’s enormously difficult and that’s just one small issue.

Stop lying. Most of them have to pay tax. Charles is legally exempt now he's king but is continuing to pay just as the Queen did.

Sight tests are free, my parents don't pay, but I think they do pay for dentistry?

Prevention is sometimes the best cure. Making things like gym memberships, and private healthcare exempt from tax would see greater take up and ease the strain on the NHS.

The NHS is straining under the pressure of poor lifestyle choices and I believe there should be a limit of the free treatment of these issues. For example, my neighbour is morbidly obese, has a constant stream of just eat deliveries and yet is under consultant care for her knees as she believes she needs a replacement...

Totally agree. Fat people shouldn't get treatment at all. Or people injured playing sports, or whilst drinking, or whilst driving to fast (or just driving at all - lazy and fat). Or any accident that's their own fault and avoidable. And pregnant women, there's enough people in the world lets not treat them either, selfish people that they are.
You've solved it... Hardly anyone should get treatment, crisis over.

Free prescriptions should only be free if you need them to be. Most pensioners I know are considerably better off than I am at 36 with a high income but childcare costs and a massive mortgage!

NHS has had so many 'extras' but unfortunately these seem to be swallowed up without making any tangible difference to the service (whether those funds reach the NHS who knows).
I would be in favour of paring back the service to a more physical need basis ie a 'core' service with a smaller remit and then addressing mental health/lifestyle as a separate service or more at a gp/community level but I am sure that this would have its flaws, but then again I don't think any service will fill the need of everyone, but what is on offer is a far cry from the original NHS offering.

And this is our problem. You can't even broach the subject without these kinds of tantrums.

The NHS would be better to start offering "private" style treatments so it could make profit from the people with access to money to spend, rather than the private providers profiteering. It needs to stop the political dogma of everyone receiving the same treatment!

Lots of ways it could raise funds from people able and willing to pay. Things like continue offering free hearing aids, but also offering better ones at a cost so that they get the profit rather than private hearing clinics. That kind of thing worked with dentistry of opticians for decades - i.e. you can have a basic filling on the NHS or a better one at a cost, likewise free glasses for some on the NHS or you can pay for better frames.

Take "upright" MRI scanners. None available in any of our local NHS trusts. My OH paid £1200 to a private firm to have one done. He'd have happily paid to have it done by the NHS if they'd have done it. But, no, the profit on his £1200 is now in a private firms' bank account instead of it being in the NHS.

Likewise private side rooms in wards. Could be made available (if not needed by others), for a daily charge. In fact, that's what was offered to me when I had my son in the maternity ward - we were told in the antenatal classes that private rooms may be available for a daily charge if they weren't needed for others. In reality, I had an emergency c-section so was allocated a private room for clinical reasons and didn't have to pay, but I'd have happily paid for the room if I'd had a normal birth and no one needed it.

Until the main political parties stop using the NHS as a political football, we can't have these kinds of discussions, and that's the real tragedy.

Not if you don't work even if your pension is as much as the average wage.

Glad someone brought up the elephant in the room.

It's horrible to admit, but our aging population is only getting big, and medical ability are also getting more advance.

At some point difficult decisions need to be made about who and what the NHS can and can't treat. And how adult care is going to be funded.

The majority of GP appointments are for muscle/skeletal issues. There is very little a GP can do for you. So, back to personal responsibility. Take pain killers, move, exercise, lose weight, go a physio. Going direct to a physio costs about £40, same price as seeing a GP. Perhaps if we all had our own pot of health spend, we could use it more wisely.

25% of the working population pays no income tax at all, ZERO ! , so you need to start comparing eggs for eggs.

Yes this is why the NI increase was such a bad idea. Paying more towards the NHS is fine(ish) but doing it through NI means anyone whose income comes from anything other than a salary pay nothing

And how poor have you got to be to pay no income tax.
It's a disgrace that 25% earn so little.

I agree, in fact I think you should get tax relief on gym memberships and private healthcare, not be taxed on them. It's another kind of the political dogma, i.e. people who can afford them should be taxed on them because it's "unfair" they can afford it when others can't. Dogma like that prevents sensible discussion as it always comes back to it being unfair that "the rich" can afford things that "the poor" can't, so they need to be punished!

I'd far prefer to encourage "richer" people to make their own arrangements, whether it's health, education, or whatever, leaving the state funded alternatives with fewer people to look after.

No, but if the rich and super rich were taxed proportionally it would make a humongous difference.

They don't pay income tax because the personal tax allowance has more than doubled in the last few years. That's a GOOD thing, not a bad thing. It's not a matter of earning too little, it's a matter of increasing the threshold at which people pay tax by far more than inflation or average pay rises over several years.

Have "lifestyle related health issues" gotten worse in the period the NHS has existed? Genuine question - I'm not sure. On one hand I suppose obesity is probably worse. On the other, far fewer people smoke now.

I also wonder how many health issues are NOT in some way lifestyle-related, and where you draw the line. Healthy lifestyles are also easier for the economically comfortable to maintain than for the poorest, for a variety of reasons.

I already pay a ridiculous amount of tax and National insurance thanks!

£700 totally deductions a month 😪
My take home after this is 1,700 so not loads either!

In France tax is based on family income so if one parent is part time or doesn't work the other parent gets the benefit of the tax allowance.
Much fairer imo.

The reality is that lifestyle based disease is going to be subtly privatised.

And even that would suit both parties politically. The Tories want those services because it is good money. Excellent money because lifestyle disease can last years and years. For Labour, it would be a return to the original purpose of the NHS, acute care and management of chronic medical need.

You can already see it. Medical devices on the NHS are nowhere near as good as privately available hearing aids, mobility scooters, dental treatment, glasses, Physio, therapy, recouperation.

62% tax/nic on earnings between £100-£125k is already plenty don't you think?

Tax people too much and you end up worse off. Look at how the pension tax has affected doctors and dentists who are reducing their working hours or taking early retirement to avoid punitive high taxation charges. Or the damage done by enforcing IR35 rules onto the NHS locums etc (meaning it's not worth them working extra shifts because of the punitive tax & nic they have to pay).