People would be happy to pay more tax if it went directly to the NHS

[Blackcats7]

I think people would be happy to pay more tax if it was guaranteed to go to the NHS.

Assisted dying? the numbers who would take this are relatively small and many not under direct NHS care.... the costs of the elderly on the NHS are through primary care and long term health conditions, these people are at home, being managed in the community (approx 1m receive this type of care at home)

Majority don't want to culled off.

One moment we have "UK worst cancer survival rates in Europe" but now its people have too much cancer treatments?
Yes cancer treatments can be awful but people do have the choice....

Most people however, when given a terminal diagnosis, go down the palliative route, do you want that stopped so they die off a bit quicker?

There is actually. It's called the Long Term Plan.

There's about to be a refreshed one too, in line with the comprehensive spending review.

The NHS also doesn't "fund the same stuff all the time". Every single year the priorities are revised and new things are funded.

@Havanananana

"And if you haven't got £15? Or you and your 2 kids are all sick, so you're looking at £45? Or you're looking at how you pay either for the electric or the food, and simply don't have a brass farthing left for healthcare?"

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And what happens if you haven't got 6 to 9 hours available to wait in A&E simply because others do have the time regardless of the seriousness of their ailment.

Because it is free at the point of use there is no restriction on demand other than queuing. Spending more money on the NHS will do nothing to change this.

I'd argue that no one what hasn't the time, should be at AE.

No one should be there who either isn't in severe pain and/or incapacitated.

You seem to be suggesting that charges should be there to reduce demand?
If so, what reductions in demand would you like to see?

Lets say GP appointments e.g a £25 charge, the wealthy can still go there with a cold, meanwhile a poorer person with bowl issues, puts off the GP visit, when they do go, they now have st4 cancer.

Charge for AE ? The wealthy with a broken wrist goes there, a poorer person with a broken wrist doesn't, when they eventually do, the wrist is badly set, now needs an expensive operation

For those people who are pushing the 'the NHS needs to be reformed and money is not the issue' - how do you account for very high public satisfaction rates with NHS care in 2010, and high rankings for the NHS in international comparisons of healthcare systems from the same period?

Was the NHS structurally different in those days? Did it have a different funding model?

What's changed in the past 14 years to reduce public satisfaction with the NHS from 70% to under 30%?

UK satisfaction rates with the NHS in 2007 were only slightly behind German & Swedish satisfaction with the healthcare system, and ahead of French satisfaction with their healthcare system.

Those people here insisting that the NHS model is unsustainable/fundamentally flawed, need to acknowledge this.

2010 was the high watermark of the additional money poured in during the 1990s and the starting point of austerity when the coalition government changed policy from extra spending to cutbacks to deal with the huge overhang of post financial crisis debt.

It was a very different situation to now. Cost of living, long Covid, post Covid 4 year treatment backlog, general really tense political situation, burden of mental ill healtg in younger people = much worse situation.

"Because it is free at the point of use there is no restriction on demand other than queuing. Spending more money on the NHS will do nothing to change this."

NHS emergency care was functioning reasonably well before Conservative policy on public health and social care turned A&E into the arse end of the healthcare system, where all the failings of Tory austerity policies come to manifest.

Closing down 25% of mental health beds for seriously mentally ill people since 2010 has had a huge negative impact on A&E and on policing.

Conservatives are just a disaster when it comes to public health and that creates major problems for the NHS.

And it's a very right wing approach to think that not putting money in will somehow magically make things more efficient - look at all our creaking privatised monopolies for that lie to be exposed.

We've had nearly 14 years of a (very) right wing Govt who have pledged to reduce waste, make things more efficient etc., etc. But we know from actual evidence that when you privatise public services you don't get greater efficiencies, you just give profits to overseas conglomerates who do the minimum and end up charging more for less.

Was listening to a health analyst discussing what increases the NHS would have needed to keep up with growing demands and growing costs, and it would have been 4% a year. Instead funding has grown by roughly 2% a year. The upshot of that is a huge health burden on the country, with growing numbers of people sitting on waiting lists claiming benefits, or unable to work productively. Everything this government does to address a crisis adds to the crisis and costs us more money. London councils are currently spending 90 million a month on temporary housing because of bloody right to buy and the impact of Conservative housing policy, or lack of it. It's just infuriating.

Yes and add PFI to the credit boom before crash

"There is more than enough money in the system, it just needs to be used properly and the top heavy management needs to be cut back and the focus put on care."

No - there isn't.

We've increased spending at half the yearly rate than all comparable healthcare systems in Europe over the past 14 years, and we were already starting from a lower base.

There absolutely isn't enough money in the system.

As for 'top heavy management' - 1. a high percentage of NHS managers are also clinicians, and 2. Evidence from healthcare research shows the NHS has a far lower percentage of managers per head of workforce than the vast majority of other private organisations. https://www.nuffieldtrust.org.uk/news-item/fact-or-fiction-the-nhs-has-too-many-managers

No. I already pay for something I don’t use because (don’t get me wrong - I’m tremendously grateful that I CAN) I pay for private to ensure decent healthcare for my family and myself. If I believed that redirecting money I spend on private HC would result in similar (if not the same) quality and speed of access, then - sure, I’d pay even more so that others can access it too. But I am not prepared to take the risk for my family’s health for any UK government to experiment without a clear plan or still end up paying for private. When my kid gets sick, I want to see the GP that day, not in 2 weeks. If I need an MRI, I want it done within a month - not have GP forget to send the referral and discover that 2 months later. That’s why we all moved to private and it’s the last ‘luxury’ we’d give up.

Well, lets hope none of you get a chronic long term illness or need A&E then, because private healthcare tends to be a bit sh*te or completely unaffordable when it comes to things like that.

@TheKeatingFive

"It's quite depressing to realise that both parties would prefer to let it disintegrate rather that table the hard conversations that could lead to reform."

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I completely agree with you but
If any political candidate or a political party did propose reform of the NHS they would never get elected to be a politician or a Government. It would be a guaranteed vote loser

So who is the problem here the candidates or the voters?

Well, lets hope none of you get a chronic long term illness or need A&E then, because private healthcare tends to be a bit shite or completely unaffordable when it comes to things like that.

Oh I agree that private healthcare is shite for a lot of stuff but for things like when my DD had an infected ingrowing toenail and was offered a nurse appointment for 3 weeks time, it was good being able to have her seen by a private GP and given antibiotics within a day. Having the toenail removed wouldn't (apparently) have been available on the NHS anyway.

They can still use the NHS though with private for other stuff

The "problem" have been Labour and Tories who have both "weaponised" the NHS in elections for a few decades which has caused it's demise as it has stopped progressing the changes that the NHS needs. Both parties should be ashamed of themselves.

The ONLY hope of saving the NHS in anything like it's current form is for both parties to de-politicise it and work together with a long term strategy. Will never happen of course.

Yes, and the more people who go private, the more resources freed up within the NHS for everyone else. I'd actually quite like to see some kind of tax relief or part funding to encourage people to go private if they can afford to which would reduce pressure and waiting lists within the NHS.

I mentioned this too as Aus has a tax rebate

It’s an incredibly fast non reform way to increase disposable income spent on overall health

As pp rightly says it’s the kind of thing the public won’t vote for

People love extra tax not rebates - look at the VAT one

@izimbra , you mean like when 111 thought DH was having a stroke and sent an ambulance which didn’t show up for 5.5h? Or when GP suspected I may have a brain tumour and forgot to send the referral to the hospital? Or when I found a lump on my breast and got a call back from my GP’s office 3 months later? All of which happened while we were still believing in NHS and before we went private for everything.

@Alexandra2001

"I'd argue that no one what hasn't the time, should be at AE.

No one should be there who either isn't in severe pain and/or incapacitated."

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I would fully agree with you on this, unfortunately in reality this is not the case.

"You seem to be suggesting that charges should be there to reduce demand?
If so, what reductions in demand would you like to see?

Lets say GP appointments e.g a £25 charge, the wealthy can still go there with a cold, meanwhile a poorer person with bowl issues, puts off the GP visit, when they do go, they now have st4 cancer.

Charge for AE ? The wealthy with a broken wrist goes there, a poorer person with a broken wrist doesn't, when they eventually do, the wrist is badly set, now needs an expensive operation"

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I could easily flip this around that a person who is time rich such as being retired or simply not working can go to the doctor with a cold and wait. But a single working mum will not have that time so puts off going to the doctors with a bowel issue eventually ending with stage 4 cancer.

Or a charge for A&E? My son broke a finger but couldn't spare the 9 hour wait at A&E so he strapped it up himself. It set badly so at some point he will need an expensive operation to fix it.

Yes just like supermarket carrier bags you do need charges to manage demand. Otherwise you have to use queuing to manage demand which discriminates against the time poor.
l

How on earth could that ever happen?

Both parties have entirely different ideas on the NHS, the Tories want it gone, with just an emg service state run and Labour still believe in a national health service.

@taxguru

"Yes, and the more people who go private, the more resources freed up within the NHS for everyone else. I'd actually quite like to see some kind of tax relief or part funding to encourage people to go private if they can afford to which would reduce pressure and waiting lists within the NHS."

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A slight tangent but I never understood why adding VAT on private education is generally popular but most would object if VAT was added on private healthcare.

Both save taxpayers money.

Both parties have entirely different ideas on the NHS, the Tories want it gone, with just an emg service state run and Labour still believe in a national health service.

I think that thinking summarises exactly why no party has the balls to make necessary changes.

Adding VAT just increases the state burden though when you need the opposite