Where is the money going to come from to meet the UK people expectations?

[Pandersmum]

So assuming that:

• everyone who receives disability benefits needs them and may actually believe they should be entitled to more
• pensioner benefits are non negotiable and again many believe they should be greater than current
• working people (most) believe they are already taxed highly and believe they cannot be taxed any more without further impact to their feeling of unfairness and resentment of the system
• it is unreasonable to expect young people with ADHD or other similar ND disorders / mental health challenges to work, even if they have qualifications and therefore they must be financially supported by the state
• Mental health challenges are very real in any age of person and therefore they must be financially supported by the state and if in work, by their employers
• rent (whatever level) should be supported by the state because it is a basic right to have a home
• NHS treatment (& the best treatment) should be free be all, no matter how expensive it is or whatever their age because people pay their taxes
• businesses are businesses and are there to make profits for their owners - therefore they can choose which country they operate in / pay their taxes in - if they don’t like the UK tax system, they can move somewhere else
• ’in work benefits’ are necessary to support ‘low paid workers, often in essential jobs’ to gain similar amounts of financial remuneration to those on benefits
• high net worth individuals can move if they don’t like the UK tax system

So just where is the money going to come from to fund the UK population of financial expectation of what the state should provide?

I suppose there are fewer and fewer people alive who remember life before the welfare state, or who worked towards setting it up and its original aims.

One of my relatives got a job in the NHS when it was just 17 years old! She's really interesting to talk to about the early days of nhs.

My parents generation sort of came along with the welfare state, but thier parents who had memories of life before are all gone.

Awful

My parents were both born during WW1 and the heartbreaking stories my dad told about his childhood in a north east mining community will stay with me for ever. He was so proud of being part of the generation that ensured that nobody would starve or die needlessly through lack of healthcare. He’d be heartbroken if he could see how little respect people now have for that achievement.

Whenever I have an outpatient appt, there's always a line about the cost of missed appointments. In France, if I want a Drs or Hosp appt I have to pay €35 (£30) up front. If I attend, I get it back. If I fail to attend, I lose it. That seems to give some incentive to attend and some compensation if one doesn't attend.

Like what?? 3 million were excluded from covid support schemes as they weren't eligible for furlough and many fell through the cracks and nonsensical exclusions.

Historically, NIC was to finance sickness and unemployment benefits, introduced in 1911.

It was expanded in 1948 upon the formation of the Welfare State to cover a broader range of benefits.

Strictly speaking, it was only Gordon Brown's NIC increases that were "ringfenced" to "save the NHS".

So it's mostly for unemployment, sickness and state pension benefits.

Yes, fine for not showing up to your booked appointment. And investment in a proper online system so NHS doesn't have to spend £100 million on postage. The app is a good first step. Save money on postage, information between surgeries would be more efficient (require less visits. Just observed my bf's referral shitshow) and people might be more able to show up for appointments.

You can't fine people until the NHS sorts itself out. My OH has had cancer for several years and has had far too many appointments where the NHS didn't know he was coming despite him having the appointment letter, they had no record of him when he turned up! Or them cancelling last minute, or even telling him upon his arrival that his appointment is cancelled. Or appointments made for the wrong thing. It's a complete shambles. I'd suspect a large proportion of the statistics of "missed appointments" are caused by the NHS rather than the patient!

Yes, fully agree
The nhs pension scheme has been modified to make it less advantageous. Those who are retired now or retire in next few years will be much better off than those who are 50 or younger.
Its part of our pay package, so it would be unfair to reduce it further. I doubt many private sector workers would like it if their renumeration package was reduced suddenly?
I made a choice to work for nhs for the decent maternity and annual leave, and the pension.

There are lots of comments where people are moaning that the career choices they have made have left them worse off than others in some way.

How about where we have sent a letter, a text reminder and done a phone call to a patient to confirm attendance? And then they don't show up and claim 'forgot'. Would it be reasonable to fine then?

Yes, of course it would, IF you have proof of all that and the appointment was for the right consultation/treatment at the right time at the right place, AND the patient had genuine opportunity to cancel and re-arrange it, i.e. if the NHS appointments office actually answered the phone number on the appointment letter! Like I say, the NHS has to be squeaky clean as to it's own systems before it can even think of fining no-shows otherwise it will get dragged down with appeals and challenges of such "fines".

But even then, are you still going to charge minors and OAPs, dementia sufferers, seriously disabled, etc., or do you just want it to be another tax on workers by virtue of it only being fit, healthy working age people who'd be fined with everyone else exempted??

Fit, healthy, working age people are those least likely to be using NHS services so that would be somewhat pointless.

So you'd be happy to charge OAPs, minors, disabled, etc.?

Probably because it isn't giving them much welfare and costs them a fortune.

Not too difficult to understand, even if in some instances it might be somewhat shortsighted.

No, I think it’s a ridiculous idea to charge anyone.

HMRC estimates that tax evasion costs the UK £5.5 billion per year.
Domestic violence costs the UK some £65 billion a year.
2 women a week are murdered by a partner or ex; a murder investigation costs an average of 1 - 1.8 million pounds.

There's some potential savings right there.

Or / and we have a limit on how many properties can be bought by non UK resident.
Guernsey has two markets a home market and an overseas one. If you’re not a Guernsey resident you can’t buy on the home market.
That way they pay more and there’s a limit on stock.

Not everyone has the use of apps yet.

And the apps that do exist don't always function well.

Late DF had multiple health conditions and multiple appointments. Use the NHS app for efficiency they said. Spent hours trying to get his phone to take a picture of him that the app could accept, despite followingall instructionsto the letter, after uploading his driving license, presumably to cross reference his identity etc. App would not comply. Surgery couldn't help. Efficiency denied on both sides....

I would have thought just putting people to the back of the queue would be enough to ensure they attend appointments.

Doctors always appear to be late anyway, so they probably factor in a % of non attendance.

I think the NHS was perceived to be affordable because we had a stiff upper lip and waste not want not culture, so people only went to the doctor when they needed to and didn’t expect a national health service to be as all-encompassing as it is now. Some people are still like that, but many people expect the NHS to be like an expensive private service and to achieve miracles. It means we have an NHS that struggles to provide the basics people would expect, while also providing others with what might be perceived to be luxury or inessential care.
Furthermore, the pharmaceutical industry has taken off in a big way since then. There are now fantastically expensive drugs that we could only have dreamed of and it’s almost impossible for the NHS to make the right call on which to offer and which not to offer.

Yes to apps not working properly. I had a pneumo jab last week. I booked it on the NHS app and got a text/email back confirming the date and time. Turned up at the right time only to be told I'd missed my appointment. On the receptionists system it was showing a hour earlier - she didn't believe me until I showed her the text/email and then she sort of shrugged and said "it happens a lot".

I really don't think people have an extravagant expectation of the NHS at all.

I'd just be grateful if they could actually provide the appointments they book you for, provide the prescriptions on the day they say they'd be ready, provide referrals for tests/consultants etc within a few months (as per their timescales as advised to you), book you in for the right tests etc.

You know, the simple/basic stuff. Yet they can't even get that right far too much of the time.

Another thing that gets me, is when there is a tech fubar, and you bring it to people's attention, it's always "you were just unlucky - it works fine for most people". So if you pursue it, you feel you're painting yourself a persecuted victim. But in reality, if it works fine for say 75 people out of every hundred, it means 25 people are also having issues, which cause extra problems for those at the sharp end, negates efficiency and erodes faith in the systems, making people less likely to try again etc. Depending on the scale of numbers involved it begs the question just how helpful are these new innovations?

I'm fed up of "being unlucky" so often 😆

Of course post is still needed. It just isnt needed to the extend that it is used now. The app is not perfect, but step to the right direction. That's why an investment in good online system is needed. I work for NHS and the amount of postage we send is insane where as in other places the same things have been handled online for decades.