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

Are you saying you want more people to die?

No child should be waiting years for an ADHD assessment. It’s a disgrace that any are. The solution isn’t to make all children wait years. The solution is to ensure the NHS is adequately resourced so that its offering is of a good standard and can be accessed within safe and reasonable timeframes. Something that was done much better under the Blair/Brown governments.

This means looking at the tax system as a whole, not being specifically punitive where people pay for private healthcare or imposing conditions on doctors that are less favourable than in other countries, so they just go abroad. This doesn’t work and is only for virtue-signalling and punishing those who can afford to go private (many of whom can only just afford it).

We don’t want a return to the 1970s where the country was crippled by ideological taxes that didn’t result in the outcomes desired. We need to be intelligent about how we solve the problems, not just knee-jerk to take away things from people who are just trying to navigate a system that doesn’t work and causes harm, that they’re not responsible for creating. We want fewer people disadvantaged not more.

Like private school parents are taking the strain off the education system?

Most doctors/consultants work in both sectors. Is this an issue?
Should doctors only work for the NHS? Should the evenings or 1 day a week doctors work in private practice be worked within the NHS?
If you believe So perhaps one of the radical reforms the NHS needs is that all staff can only & solely work for the NHS? Perhaps their working hours can be any hours with a 7day/24hr roster. So operations can be carried out 24hrs a day 365 days a year. (Not emergency but all ops)
there should be no enhanced rate for weekends/nights/bank holidays??
no bank/locum staff because you must be on a permanent NHS contract??

if this was all implemented perhaps people wouldn’t need to resort to private health care often at the risk of high debt??

The consultants I've seen privately were all at or beyond state retirement age - in one case by some years. If they didn't practice privately then they'd presumably retire. They've almost certainly maxed out on their pension anyway.

Don't underestimate the extent to which private healthcare and education are propping up the state systems by providing a safety valve (extra capacity) and a more flexible service (problems dealt with before they become acute).

In my case, if I hadn't had my varicose veins treated privately (3-4 wait on NHS for less good more old fashioned treatment) then I'd have had to leave my teaching job. And given that one of them was nearly at the DVT stage, it could have been a lot worse than job loss. Best money I ever spent!

You do realise that everyone pays NI even if they also pay for private healthcare. Same as private schools. There isn't a flipping opt out or tax rebate scheme if you don't use the NHS. You just pay twice.

Having spent a lot of time in hospitals recently, it isn’t just money that the NHS needs. So much money is wasted in the systems they have, appointments missed etc. It’s more than money they need, it needs a complete overhaul.
I can see your point but do think they are different. I’ve recently gone private. If I hadn’t, I’d still be off work.

Except there would be no staff to implement it on as they would leave. Yes they have families etc but they are a very mobile workforce, highly desirable elsewhere. More - not less - consultants now work in the private sector. That is the direction of travel without reform and reform is improved working conditions and pay not shackled service

I agree with your point OP. Children’s education is fair game for VAT, but not people queue jumping to get an ADHD diagnosis. Tax it all or don’t, just be consistent

Private schools fees £2k per month vs private medical insurance for our family at £1k per year. It is often included in work packages as well. It's no where near as unattainable as private school fees (coming from someone who could/does afford both).

No, I'm saying I don't want people to die because somebody else jumped the queue. Re-read my post.

Why are you talking about jumping the queue? The private healthcare system is a completely separate from the NHS system. If anything, the people paying are reducing the waiting time for those on NHS waiting lists.

Yep! What the education system needs is a complete overhaul. Starting with teachers being paid properly.

So is this going to create a huge waiting list for private healthcare now? Effectively meaning there's no point having it?

I also think this is a disingenuous thread about VAT on private school fees yet again 🥱 but in fact yes I think VAT on private healthcare is a great idea

Private health is a luxury that should be taxed
Private healthcare depletes the NHS of the very scarce resource of staff who are sorely needed and Drs are harder to replace, more costly to train than teachers

I would never pay for private education
Unlike Keir Starmer I am willing to admit that in a crisis I might pay for private healthcare (I wouldn't pay for insurance on an ongoing basis) but I am lucky to be able to do that and I am happy for it to be taxed.

No. It shouldn't do. Private hospitals have a lot of spare capacity and there are many medics keen to do private work without the flare for entrepreneurship. So what happens is private equity firms/entrepreneurs set up companies that deliver NHS contracts in private hospitals. NHS doctors simply come in, deliver the service and leave. They are not responsible for the management as you would be in your own private clinic. It makes private practice more accessible for more medics. So may well increase NHS waiting times in the long run

However, along side training more healthcare professionals - we may just spin in place.

There seems to be a disagreement about how this works out. Some people think that private takes time and resources away from the NHS, thus meaning that people wait longer or don't have access to a particular doctor with particular expertise. To be honest, I'm not sure who is right. I would be in favour of having no (or low, maybe 3%) VAT on both healthcare and education. But, then, I think there a lot of things that shouldn't be included in VAT. It's ridiculous that the government pays out pensions and benefits and then taxes those people when they turn their heating on.

But the NHS will be great so probably won't need it

Last time we had a Labour government they did waiting list initiatives where Drs were paid to do eg extra surgical lists on weekends which most are willing to do for the right price and this cut the waiting lists down quickly. I could never really understand why they don't just do that now post Covid but probably it's because it costs a lot of money short term.

There isn't really any 'spare capacity' in the private sector as all the Drs working privately were NHS trained and gained their experience there and work most of their week for the NHS they just find it more lucrative to work some days privately. With the erosion of NHS salaries in real terms and the pent up demand post Covid more and more Drs and doing more and more private work. I am in a minority of my consultant colleagues in not working privately.

I am a Dr who does not do private work, have private health insurance or privately educate my kids because I live by my principles. I would do a wait list initiative though because it would
help NHS patients

Banning private work is not the way to go as this will only alienate more Drs and lead to more of them leaving altogether.

NHS consultant contracts were set up specifically to allow them to continue private work. That was one of the many compromises that had to be made in order to set up the NHS out a network of private and charitable medical practices/hospitals. It is those compromises and complexities built into the system from the start that cause many of the problems now.

I don't agree with VAT on private schools fees or on private healthcare. I wouldn't / don't use either so technically it doesn't make much difference to me personally. But if people are using private hc and private sch they are lessening the burden on government services, they are also likely to be the higher tax payers.
We'd all like a better economy, we'd all like more money and we'd all like better services. But adding VAT isn't really the answer. The UK is the fourth highest giver to foreign aid spending £888 million in 2023. Perhaps until our economy and services have improved we should reduce our foreign aid budget?
Perhaps we could also get rid of the bloat in many government organisations, we're rapidly becoming more of a service than manufacturing economy and that's not good for longer term economic forecast.
Unfortunately the last labour government borrowed very heavily and Brown sold off a fair amount of our gold deposits. Whilst this helped to release funds for short term investment in services it wasn't sustainable longer term. The reason for austerity was to try and rebuild the deficit labour created.
I'm all for a labour government now, because for the first time labour won't be inheriting a 'healthy' economy. It'll be interesting to see how they rebuild it. Let's see how Starmer sorts out the current financial mess.

Is is true that private hospitals have a lot of spare capacity? I have unfortunately had to use private healthcare a lot in the past and used to be able to get an appointment within one or two weeks. Waiting times are now typically two months for an appointment, which while much much better than the 18 month wait on the NHS is a lot longer than it used to be. Presumably because so many people are now having to use private healthcare in order to avoid an 18 month wait.

A family member is a consultant and works in both the nhs and the private sector. They work 100% of the contract they've signed + more for training junior doctors and answering calls out of hours. They also work weekends for the nhs to help alleviate the long waiting time. Only the remaining time goes to private.

If they were to work longer hours more budget will be needed hence more pressure on the government.

I agree

If you're buying a service, why should some be VAT free? Doesnt make sense.