VAT on private health

[Simonandrod]

Am I right in thinking there isn't VAT on private health care? Is it completely unfeasible that it could be put on and money raised go to NHS? Or is it too complicated as so many people who use it have health insurance? Just interested

But why ban it? If people want to pay, the income can fund the waiting lists in the NHS. The doctors won’t be affected as their private sector work will continue and the people waiting longest will have shorter wait times?

I also can’t see half our doctors upping sticks and moving to Australia! People have families, houses, kids in school etc

Indeed - I suggest £10 per GP appointment; £15 per hospital appointment. These are nominal amounts but given 200,000 ENT outpatient appointments a year in a single hospital in London - think how much it could raise for the NHS.

And everyone pays so not tokenism - real funding and impact.

These are tiny amounts - why burden those already bearing the bulk of the burden?

quite frankly if you can afford private healthcare then there should be no problem in paying an extra 20%.

You’re quite wrong. Such is the dire state of the NHS these days that many people who are not at all well off are using private health care out of desperation and getting into debt or severely scrimping to do so. An increase of 20% would be prohibitive for a chunk of private healthcare users.

Of course, the NHS should d be far, far better than it is. Thousands of people die unnecessarily every year because it’s so shit. People are desperate and will beg borrow and steal to pay privately. It needs to be improved so there’s fair access to decent healthcare for all. Pulling the rug out from under people before it’s improved to a decent standard, however, helps no-one. It simply disadvantages more people when we should be looking to disadvantage less.

17k doctors left the NHS last year. There are approx 350k doctors in the NHS. You will be surprised what highly educated skilled people who know their worth will do when pushed. They predominantly left due to poor working conditions and poor pay. If their private sector work is strangled - far more would leave

As it is, there is now a shortage with a rapid proliferation of non-doctors to do jobs traditionally reserved for highly skilled medics.

Lovely theoretical discussion but VAT on private health are would never happen because the people who would suffer significantly would be those without funds.

I think it’s a terrible idea to pay per appointment. We would end up with people not seeking medical care because they don’t have the money.
Again, I could afford this so no bias, but it would potentially cause more problems than it would solve. It would hit the most vulnerable in terms of wealth and health.

Exactly this. I work in private healthcare - in the past 10 years it has gone from being something reserved only for the very wealthy to people using their life’s savings to fund hip replacements as they simply cannot wait any longer on the NHS. The misconception that only ‘rich’ people go private really bothers me - the demographic has massively changed in recent years and it is all due to our failing NHS.

I agree. I used that scenario to highlight the fact that what seems small is not small to some. It feels arrogant for someone to say because you can pay £4k, you surely must be able to pay £4.8k.

The Australian system seems the fairest - a basic NHS core funded and accessible to all but private system paid for by private insurance/small self payments and government insurance.

The economy needs to grow in the UK for any of these sorts of ideas to work but the current funding and delivery model simply doesn't work. And even with double the funding, which the country can't afford - it will still be substandard without significant reform

Well I think most people recognise that the NHS is in need of more funding which will be difficult to achieve without major tax increases.

Listening to friends in the NHS, I don’t think it necessarily needs more funding, just a lot better management of funds already there.

You pay tax if your employer pays it as part of your employment package as a benefit in kind, you don't pay tax if you pay your own but you have already paid tax on the money you earned to pay for it. The only thing is that companies generally get it cheaper by bulk enrolling, so you would pay slightly less benefit in kind. There is no VAT on health insurance.

The NHS needs root and branch reform, not just more money thrown at it. In the meantime, people going private is about the only thing keeping it afloat.

Errrrr....the queue-jumping is an obvious divide, but they are paying way more in tax PlUS freeing up the NHS.

Again this can be applied to private schools.
I find it interesting. Why treat one differently to the other. But I think posters who mention that it's not as much of a vote winner and harder to put into practice are right.

I can't see all the medical staff going though. Those who are newly qualified maybe but those who are settled or who have parents etc here, no.

The same argument could be applied to private schools and isn't the hope that as they shut, the teachers will filter back into the state system so better availability for all?

Chelsea & Westminster Hospital has a private hospital within the NHS hospital, including the Kensington Wing which provides maternity services. Kensington Wing provides pre natal testing, for a fee (which is only available in certain circumstances on the NHS) and is processed in the same NHS facilities. The income from the private hospital is reinvested into C&W’s NHS services. I haven’t come across another hospital that does this, but given they already have the site and the staff, this seems like a sensible thing to do? Not really related to VAT but how users of private hospitals might fund the NHS.

No - they won't all go. But significant amounts will and are already leaving. If 5% left last year and the system is struggling - even 10% will be felt by the entire system. And yes - we can plug the gap by getting more foreign doctors but they too want good work environments and many are choosing Canada/Australia and parts of Europe ...

I don't think that is the hope re private schools. It sounds like the government want and expect there to be little movement so they can fund the gaps in state school directly from private parent pockets. If these parents move - they will have to find extra cash to educate the additional kids. So no - they aren't expecting/anticipating or wanting an exodus

This is very common across the NHS. Moorfields have it too, Royal Free, Guys etc. Most NHS hospitals have it. The fees clinicians make from those set ups are often much lower than independently. But there are conveniences like familiarity with staff/equipment etc

Most hospitals actively try and promote use of their own private set-up as it is revenue generating and clinicians do make use of them but many also choose not to - if the numbers don't work as well for them or their hospital provision is out of the way for their clientele for example

I totally agree. There are many people who already avoid going to the GP. More would just end up in A and E in a bad way.
And I would object to paying £15 for a monitoring hospital appointment. I would personally just turn it down.

Unfortunately I know many families in that exact position - none of them feel that private healthcare is a luxury either. Like us, it became a necessity and they did what they had to do in order to raise the money needed for their child’s surgery. For a lot of families this has meant leaving dignity aside and turning to local media and GoFundMe (which is an absolute bloody disgrace in a so-called first world country). For far too many kids private care is a lifeline and I do not believe for one minute that adding VAT will do anything meaningful except for swarm the NHS even further.

Duh! That is one of the many reasons it should not be taxed. It would raised fuck all but it is to gain votes.

I have private health care as part of my job package. I pay tax on that as a benefit. In order to see a consultant that the NHS may have trained, but has also paid personally a lot of money for uni to study for 7 years and couldn't work and study like a lot of university degrees, I need a GP referral. If I can manage to get a GP appointment (almost impossible) I have to then pay £40 for the referral letter. (Out of taxed income and trying not to add to the NHS waiting list)
My asthma is excluded under my policy. I have had a persistent cough for a long time. The private gp service that is part of my insurance is only online and they say I need to be seen in person, to determine whether its asthma or not and whether i can be referred to a consultant so I have to go via the NHS. The private gp doesn't offer in person appointments. My NHS surgery can only offer me an appointment with a paramedic as a cough isn't serious enough to get to the top of a needs a gp list. The paramedic said she would ask the doctor for advice and get back to me. Despite chasing 12 times I have heard nothing. 5 months later I have now seen the asthma nurse who suggested I see a doctor as she doesnt know whether its asthma related or not! I am now considering paying for a consultant appointment as I am still coughing but can't use my private healthcare as I can't get a referral letter as i cant see a gp. I believe in the NHS and I want it to work for everyone. I know I am lucky too and as a higher rate tax payer I am happy to contribute but I am not sure how I would feel about vat on private healthcare. Maybe its because I think more money will not fix the NHS and that it needs a full overhaul.

Just to clarify, in your scenario who is subsidising who through tax?

The one paying nil and getting a tax-paid service, or the one paying full cost for their service (plus tax to fund the first person)?

I'm not totally against VAT on private health (because I'd favour putting VAT on everything, reducing the threshold and halving the rate, and cut out the absurd complexity and inconsistency of the VAT system), and there's also an argument that private health providers benefit from public training and the A+E safety net in a way that they don't fully pay for.

But your argument sounds a bit like: subsidies for me, but not for thee.

Well, exactly. If I take my child out of state school they might learn to read quicker than yours, or they might not. They might end up with a better job than yours; but there's not guarantee. If I jump the queue for healthcare you or a member of your family might literally die. But it's OK for me to put my needs first now because it's 'literally the difference between life and death'?

Plenty of kids (as has been done to death on the private school threads) are at private schools because they have been in emotional and mental (and sometime physical through bullying) pain for years. The state schools can't address their needs. They are NOT there because it's "posh". I agree with the OP that the differences in argument are hard to see.

I don’t agree with this. Doctors are leaving the NHS because of pay and conditions, the same with teachers. The solution is to fix pay and conditions, not trap them in the state funded option by taking away the alternative.

There’s a societal problem with the existence of private education, and I think that’s what Labour really want to address. Children should all have equal access to good education, we need to improve social mobility, and having a country where the top jobs are dominated by a small minority of privately educated people is grossly unfair. I think Labour want to price people out of private education. Obviously, there comes a point where so few people can afford private education that the taxes raised are not sufficient to top of the shortfall in funding for state schools.

On the other hand, private hospitals don’t negatively impact users of the NHS. If anything, they take away some of the burden.