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.

For those saying the UK is already a high tax country, there was a study published earlier this week comparing income tax rates in England/Scotland with other countries. UK is actually one of the lowest effective tax rates for income tax, being around 20% for the average wage and its only when you get to 2x average wages that it starts getting closer to other countries tax rates.

Study here for those interested in comparing tax rates: www.taxpolicy.org.uk/wages_chart/

Tax is obviously a political issue and we have just had the additonal NI levy of 1.25% removed by the latest government, after it was introduced last April to help cover health and social care.

I'm not saying increasing NI is the answer but I do think that a lot of UK taxpayers don't realise they pay relatively low income taxes.

The NHS is currently a bottomless pit lacking in accountability due to decentralisation and before we start pouring more more money into it I think it would be sensible to look at controlling spending and making sure money is spent on things that are needed, not on bureacracy, waste or other management issues which don't benefit patients or clinical staff.

Disclaimer: I'm a tax accountant but my family work in the NHS

No because it's not all a Money issues it's a basic function issue as well.

@Wardrobemalfunction22

My friend trained to be a nurse and worked NHS and private. She said in private every pen was taken into account and you wouldn't help yourself to one. .NHS was a free for all.
Absolutely zero accountability.

No, not quite. I needed an ambulance at the end of the summer. One arrived within half an hour and I got a bed the same day.

Have things really deteriorated that much since then?

My mother and mother in law worked in the NHS all their lives. My cousins now do so. All of them say it's a bottomless pit. It's unfundable.

A lot of this has been exacerbated by PFI. A £70 million hospital building will end up costing £350 million by the end of the term. That's Blair's government who wanted to produce shiny new buildings, knowing there wasn't the tax base to really afford them (so they just used capital instead, leaving us all with a mill stone round our necks).

For those that scoff at the impact of waste, let me tell you it all mounts up. I've known of NHS labs that throw away unopened solutions by the bucket load because of bizarre procurement policies. I also know a situation where a hospital was quoted £16k to widen a doorway by two inches. Over time, this stuff means that department budgets are far higher than they actually need to be.

The whole thing needs rebuilding really.

@Delectable the crown estates are the largest landowners in the country (owning things like Buckingham palace, the foreshore etc…). The income from that goes to the treasury, they then get a small proportion of it to maintain the royal collection and for staff costs) it isn’t the royal families personal income.

Why don't they get rid of individual NHS trusts & bring everything under one massive trust & get rid of all the executives? I know that wouldn't raise all the money but it would help, when you see executive jobs being advertised at £150k a year, the same with procurement, if one trust needs scalpels, gloves & PPE foe example, they all need them.

The NHS needs more front-line staff and fewer people sitting round board tables.

I'm a carer and tonight I will be working a 6 hour shift for 4 and a quarter hours pay. This is due to the delights of block pay. I never finish on time either as most visits have been cut by social services to make savings. I can't stand to do a bad job so I do it in my own time essentially. My mileage isn't fully covered and there's nothing towards wear & tear of my car or my business insurance. The company I work for make about £750k pure profit a year which is largely tax payers money from care budgets. The staffing levels are so low because the pay is a joke. If a decent care system was in place where hospitals could discharge non clinical need patients this would free up beds & staff and take off some of the pressure from hospitals. Councils should be accountable for the money they are paying to private health care providers who are providing a sub standard service because they want to make thousands and thousands in profit rather than paying staff fairly so they can have decent staffing levels.

Even 0.01% of a huge figure is still a huge figure!
No it isn't! It is to you, not to the NHS!

Can't you understand that to manage a system of ultimate efficiency cost extra resources? Massive improvements have been made in these areas, but it will never be perfect because perfection will cost more to implement.

It's quite infuriating when those people who don't any experience and clue of what they are talking about criticize those who do and insist they know better then them. All they know is their very limited personal experience, always focusing in what goes wrong if course and taking the rest for granted, and what they hear in the news and then think that makes them experts in the natter and more knowledgeable than those who have worked in the system for donkey years. It's laughable!

I am certainly not saying that the NHS is perfect and blameless but what has been spurted here about what are the reasons for it are frankly risible. Can we once again focus on the NHS biggest problem by million miles, diabetes, 90% of which is preventable?

Pensioners paying higher rate tax could continue to pay NI. (IMO the triple lock should be maintained, for many reasons. This would help make it palatable.)

The HMO system @XingMing and I have been describing does not have public funding (employers make a large contribution). But in practice it works like a public-private hybrid model or like the French system. Again I emphasise that, unlike traditional US healthcare, no one can be excluded and pre-existing conditions must be fully covered.

The idea that so called "health tourism" presents a significant financial burden on the NHS was de-bunked years ago
Another ignorant comment fuelled by the media. Almost all trust now employ a team to pick up patients not entitled to NHS treatment. There are national systems in place that allow potential fee paying patients. Being registered with a GP and having an NHS number won't allow you to filter through the process. Dors the public know that overseas visitors are billed at 150% of the NHS costs? I bet not!

God forbid we learned anything from Europe.

Type 2 diabetes is, with ageing, the biggest single element in NHS care at about 10% and a lot is preventable by better diet; it's even reversible in the early stages. But that would require the general public having the self-awareness to recognise their obesity and the determination to correct it.

Smokers usually die younger, and pay huge extra tax on their addiction. At one time, before smoking declined, tobacco contributed significantly to the NHS budget. For all I know, it may still.

£1 how often?
I'd guess at about 30m people in U.K. paying tax. So a monthly £1 would bring in £360m pa. Nowhere nearly enough.

But that would require the general public having the self-awareness to recognise their obesity and the determination to correct it
Indeed, much better to blame the proportionally very few executives for the fall out of the NHS!

The facts are there, clear and real but let's keep talking about the waste of pencils. Honestly, it's utterly pathetic. If people started to take even a once of responsibility, the NHS would be much healthier but instead, people continue to ignore the obvious and blame anything and anyone else instead! The NHS is only going to collapse as a result. It's the public's fault!

I'm not sure whether you're an idiot or deliberately attempting to misconstrue what I stated. The US system is not something to be desired. The NHS is even less desirable. Other countries, European countries, have far superior health systems to the NHS.

Why can't you even deign to look at them?

So at what level of income would you start levying NI on pensions?

We didn't fix the roof while the sun shined.

Or in this case, the escape valve which is actually the foundations of a nationalised health service: Social Care. Bed-blocking was recognised as major problem in 1980s, known to be getting worse in 1990s. WTF has been done about it?

Why would sporting injuries not be covered? What happens when someone who isn't well off plays a game of football and breaks their ankle? You'd just leave them in the road?

Weird.

The idea of the deserving and undeserving unwell is Puritanism crap spouted by the church in the Victorian era.

If you're sick you're sick.

@KnittedCardi I have had to reply to this as I’ve always had
back pain but ignored it with painkillers. At aged 33 I was admitted to hospital as after a particularly acute pain, I couldn’t walk. Lo and behold, have scoliosis and degenerative spinal disease. I will now be a strain on the NHS. If at 10 when I first cried in pain I was taken seriously, wouldn’t be facing life in a wheelchair.

I'm not a politician but many have retired at 60 living until 90s even 100s. They haven't paid enough in for the scale of care needed. Every UTI , medications , every fall, dysphagia , special diets, 24/7 supervision, pressure ulcer all needs funding out of the pot

I would add that the number of staff the NHS pays pensions to is also increasing. DM, for example, was a Dr. She retired at 55 and is now 90. She's been receiving an NHS pension for longer than she ever worked for the NHS. I imagine this applies to lots of people.

And then, people are much more litigious these days. All the law suits and compensation paid comes out of the NHS budget.

@Hereeverysaturdaynight - I like to deal with the facts.

The fact is that many Tory politicians retain links to the US medical industry.

If there had been any appetite at all for the changes you are describing, then they could have been done a decade ago. These issues are not new.

The point is you are talking about changes that would require a different set of politicians to be in charge: what makes you think that the systems you describe have a fighting chance given the way the majority of British people vote?

Would they arrive in five years, ten?

Or would the trajectory which had been set a decade ago be followed? Which is a US style system, by degrees? I feel your angst, but people do not vote for that. There are enough people who say they cannot afford more on tax or other payments: do you think most voters do anything other than vote in their own self interest?

It is not stupid to look at where you society is headed, is it? And plan accordingly

The three best known HMOs in the USA are Kaiser Health in California, Health Insurance Plan of Greater NY and Puget Sound. They're not new: the NY programme started in 1947, the same year as the NHS, and they are not-for-profit corporations. The membership and their employers pay a fixed per capita or family rate but are restricted to the choice of practitioners and hospitals that are contracted to the HMO. Few exclusions and no opting out of covering people with pre-existing or chronic conditions. I don't know about restrictions for genetic conditions as when I was a member, there was little understanding of the human genome... it was the 1980s. They tend to be favoured by academic institutions affiliated to the national non-profit pension and insurance system which was created for universities, museums and the like in 1917.