UKC

The national concensus is, I believe, that the NHS is under resourced and under funded. 

Would you be willing to pay an extra 1p on income tax if the money raised was guaranteed to go to the health service?

If not  how much would you be prepared to pay?

If you are not prepared to pay anything are you completely happy with the NHS as it is or what is your alternative to provide additional funding?

In reply to Removed User:

I'd be happy to pay if I knew it was going to frontline services and not just another tier of middle managers.

In reply to Removed User:

Yes I would, but I think we would probably see more benefit to the NHS, police and others, if the 1p went to the care system. 

In reply to Removed User:

Does not raise anywhere near enough money.

Just a 1 percentage point rise in all rates of income tax would raise £5.5 billion

2020/21 estimates a shortfall of £30 billion if there are no efficency savings as per a Kings Fund report.

People tend to underestimate how much money is needed.

And this was before Covid.

These are ball park figures.

Social care wants about an extra £20 billion which would again be on top.

In reply to Removed User:

Lib dems tried it two GEs ago. Didn't go down well. 

If you promise more tax for the nhs, but somebody else will pay more tax, that seems very popular. 

In reply to neilh:

I think to match mainland European levels of health funding it will need 2-3% on the base rate. (As you say before covid19 factors). 

In reply to jasonpm:

What about if that tier of middle managers made frontline workers jobs much better through better working conditions, better managed resources, getting more suitable equipment , saving money on building inefficiencies, not having to answer stupid questions from senior management etc?

I do find it odd this notion that for some reason the healthcare industry alone doesn't need managers.

We've all seen inefficient management structures in other industries, and of course the NHS isn't immune to this, but the idea that clinical staff in an organisation as massive as the NHS can somehow just self manage is ludicrous

In reply to jasonpm:

Cutting management and "back office" has been a government euphemism for cutting budgets for decades. Like any other large organisation, public OR private, there will be inefficiencies but mostly those managers are there to make sure the whole organisation works together.

Specifying how you spend your tax is bloody dangerous. I'm not funding stupid climbers rehab, they should have insurance or stay home and watch tv like me

In reply to toad:

'Like any other large organisation, public OR private, there will be inefficiencies but mostly those managers are there to make sure the whole organisation works together.'

I'm all in favour of management but my experience of the NHS style really has not been good; I think the majority of 'managers' that I have encountered over the years would be better described as bureaucrats than managers, and the difference isn't just one of semantics.  

If Cummings was as clever as he thinks himself to be he would use the aftermath of this pandemic to do a root and branch investigation of how the NHS was prepared and performed, what worked well and what didn't. I'm not holding my breath though.

In reply to neilh:

Yes but it would go some way towards it. Would you be prepared to pay more tax?

In reply to balmybaldwin:

I like your sentiment but surely the whole point of management within an organisation such as the NHS is to support patient and front line staff in the first instance? On that point they fall well below standard. What other organisation still relies on fax machines to send crucial information as their IT may not be secure?

There is plenty of excellent staff on the coal face but there is still a huge amount of politics and nepotism going on within it and higher levels at all the various health boards. 

In reply to Removed User:

I'd be quite willing to pay another 3% income tax for this, although I'd like it phased in over, say, three years, to make it less of a shock and allow people to adjust their budgets for it.

I'd much prefer it wasn't called 'a penny for...', though, that's dishonestly pretending it's smaller than it really is.

People should know what they'd be paying. For a £12,500 income tax threshold, you'd pay an extra 1% (or 3% or whatever) of everything you earn above that - so someone on about the median, £30,000pa, would pay an extra £175pa income tax per percentage point increase.

They'd currently be paying £5958 (that's UK numbers; it's £5988 in Scotland), so that's almost a 3% increase on what you pay per "1% increase".

I don't think there's an appetite for this in the UK. It might be slightly easier to sell in Scotland, but I suspect it would still be unpopular - but at least if it was sold honestly, as a 'if you earn this much you'll pay this much more; if you don't want to do this the health service will suffer', we'd know what people wanted.

In reply to jasonpm:

This is wishful thinking, and ultimately a way to pretend that we can get much more without having to pay for it.

Yes, the management could be much better - but that hasn't happened over the last few decades, so it can't be easy to achieve.

But if you really think the money can come from there, great. Let's pay the extra tax AND sort the management, then the extra revenue can be spent on improving it further, on care, on education, or whatever.

In reply to skog:

One of the key problems for NHS management over the past 25 years is that they've been repeatedly, forcefully "improved" from the top down without regard for whether the previous reforms had actually achieved anything. In a lot of cases they'd made siginificant improvements which were swept away in an ideological drive for progress.

In reply to Lemony:

Yep. It's an enormous mish-mash of organisations, and while it's easy to spot things in it that aren't great, it's much harder to actually improve things.

Which is not to say that it can't, or shouldn't, be done. But it isn't a magic bullet that's going to free up lots of funds to make the NHS work better (or even just carry on working as well as it does) without us having to pay more tax for it.

In reply to Rob Exile Ward:

The NHS is one of the few areas I have never worked in but when working for large organisations I find one prevailing trend. It's the upside down pyramid where the managers, planners, procures, schedulers ect are all balanced on top of a small number of people who do the day to day stuff. 

I would be happy to pay more towards the NHS, and the police for that matter too but I want an independent audit.  I deal with companies on the NHS gravy train, some of them are making massive levels of profit because of loopholes in their framework agreements. 

A friend of mine went through an audit that the management brought in to look at cost cutting, he was a security guard for a supermarket chain. One of the things the audit highlighted was for every 3 security guards there were 4 people managing them. 

In reply to summo:

I think that's a bit of an unfair conclusion to draw. I've not seen any evidence to suggest that the reason the Lib Dems have polled so poorly since 2010 is because of their tax policy, as opposed to a post-coalition shift back to a more two party system amidst increasing polarisation. Public attitudes towards increased public spending and higher taxes have been softening over the last decade or so, and the majority of people in the UK support it.

https://www2.deloitte.com/uk/en/pages/public-sector/articles/public-attitud...

I really think the electorate has been done a disservice by the main parties on this matter - Labour's promises of unlimited spending funding by taxing the top 5% and Tory claims that they can end austerity whilst providing tax cuts are both utterly undeliverable bollocks that foster the idea that we can have our cake and eat it (without paying the bill).

In reply to Removed User:

That is too open a question.

If its a realistic assessment of the needs covering both the NHS and Social care then I would consider it. That would include listening to the medics about closing down hospitals/realigning services and and so on. But I reckon most people would be so shocked by the cost. So much so they would say no to the rise.

TBH its not the NHS that bothers me, its social care.They go hand in hand.

So would you also pay an increase in income tax for social care as well?

In reply to Removed User:

I would happily pay more tax for UK public services to be properly funded. However I expect many would not and I think it is something we continually struggle to resolve as a country.

We are caught in the middle - neither the US where there is 'low' taxation and hence low provision nor the scandinavian style model of high tax and high quality provision.

There is a also a temptation to try and do 'everything' with not enough money rather than say we have £xbn we can afford to do 10 things well/properly vs. the current 20.

In reply to Removed User:

Yes, as long as it went to the right people.

I used to work in an industry supplying the NHS front line.  I can tell you that the waste is frightening.  I still work in an industry which supplies the NHS but in back office systems.

I can tell you that the waste is frightening.

In reply to stevieb:

If I heard right. (Newsnight last night). A suggestion was that the care system would be better as part of the NHS and not less supported and financed than it currently is.  As an example. Dementia and cancer patients both need to be well supported. I think care workers are poorly paid for the diligent job they are doing.  

In reply to Removed User:

It's not a binary question though, is it?

Here's another suggestion: scrap Trident.

In reply to Removed User:

I'd be happy with 1p.  But I'd like to see rich folk charged 3p, and I'd like to see the money grabbing organisations like Starbucks and Amazon (etc) mega rich tax avoiders get charged an absolute packet.

In reply to Removed User:

According to the Institute for Fiscal Studies, about 1.2m people in the UK earn more than £100k. Increase the tax burden on these folk by just £10k per annum gives you £12bn. 

In reply to Removed User:

Any way we can claw back the £37 billion spent on death in the Iraq and Afghan wars??

America spent $2.7 trillion on death, but of course can’t afford nationalised healthcare!

In reply to skog:

That would be about 50 pence a day. That doesn't sound so bad, does it?

In reply to mick taylor:

Amazon and Starbucks should pay tax commensurate with their profit. Starbucks should NOT be paying more tax (measured as a %) than your local greasy spoon, but neither should they be paying less. Ditto amazon, google etc. I seriously think we should simply be taxing international transfers of funds between wholly owned subsidiary companies and their parents as profit, and present them with a tax bill accordingly.

In reply to Rog Wilko:

No, it doesn't sound bad at all; that'd be a much better way of presenting it than "a penny for".

In reply to Removed User:

I'd happily pay 1p extra.... but on the proviso that we reduce our defence spending by 50% and un-triple-lock pensions and use that money for social care etc. 

In reply to skog:

Would 'Two Days' Work For The NHS' (ish) be more palatable too, maybe?

In reply to mick taylor:

Why Starbucks. It’s U.K. turnover is only £300 or so million. Petty change. It’s not a big company. 

In reply to charliesdad:

Only if that revenue is actually brought in. Evidence suggests it wouldn't be though. 

In reply to Removed User:

Remember that approximately 43% of UK citizens don't pay any income tax anyway, so  maybe you should specify that only those who are actually tax payers are in a position to answer your question in an unbiased manner?

In reply to Rob Parsons:

Here's a suggestion: cancel HS2, spend it on the NHS instead. Here's another, don't waste all that money on overseas aid, spend it on the NHS instead. Don't let my neighbour build that ugly extension - spend it on the NHS instead...

I'm sure we can all find little projects that we don't agree with (for the record: I don't want to scrap HS2 or reduce aid spending and my neighbours aren't really building an ugly extension) but it is dishonest to suggest that the money spent on these comparatively trivial projects could fix the funding issues of the NHS. If we really want to fix the NHS - and I do - we (nearly) all need to pay a bit more tax and accept sacrifices elsewhere.

I especially dislike people hanging their pre-existing opposition to a particular project to underfunding of NHS. I did actually see a banner: "Cancel HS2, spend it on the NHS instead!", the other day when out on my local exercise. I can't help but think a more honest banner would have read: "Protect my house's value in Kenilworth instead of those in Birmingham, Manchester, etc."

In reply to neilh:

It was an example of a rip off company who dodged paying what it shud. Feel free to add to the list. 

In reply to mick taylor:

You are out of date by 2/ 3 years Starbucks pays now a bit £14 m a year corporation tax which would be about the right current  rate for a company of that size. 

its an old story for them. 
 

In reply to NathanP:

Quite. I lump the "not spend money somewhere else" argument in with the "cut out monstrous waste", "sack middle managers" and "they're not paying any tax" arguments as excuses and ways of not saying "no I don't want to pay any more personally for a service that is vital to my health and the health if my family". 

People are economically liberal but fiscally conservative. By that I mean that most people would agree that welfare should be properly funded but when asked to pay for it they come up with all sorts of arguments for not doing so.

In reply to neilh:

Fair enough

In reply to NathanP:

Little? Trivial?? Trident???

The estimated cost for the programme is over 200 billion - which would fund the entire NHS for two years.

Might be worth consideration!

In reply to Removed User:

2-4p would be fine, I'd like big business to pay what they should also, and end rich people being able to do things the rest of us can't, the Duke of Westminster is a great example - no inheritance tax on inheriting a massive chunk of London.

And I'd want to stop selling off bits of it to privatised companies, we pay for it, they end up buying the best bits and ripping us off.

And as others have said, fuck Trident off and all nuclear weapons, and use that money too. Paying so much for something we hopefully will never use and if we do will only harm innocent people, seen so stupid in the face of Covid.

In reply to Rob Parsons:

£200 odd billion over 30 years though. Peanuts by comparison.

In reply to Removed User: I see a lot of people like to bang on about waste , and it's frightening, but that's true of very large private enterprises as well... I've worked in situations where mistakes get made and whoops, there goes about a £100 million,,,,  .  I'd like to believe that large parts function quite well given that they've been reorganised on political/ideological grounds any number of times (rather than for reasons of real effectiveness) and routinely choked of cash for some years now.

So. what might be worth spending money on is an actual independent review of how it should be organised , with care, for the long term, and ideally allow it to be slightly removed from the government and run as an independent body if that is the suggested result and see if these mythical efficiencies actually appear.

In reply to Removed User:

I'd be happy for an increase in tax but as said a 1p increase raises about £5.5bn which is equivalent to about two weeks spend in the NHS. I think it should be closer to 5p.

However, we(or rather the government) should address the problem of very large multinationals avoiding tax in the UK.

The organisation of the NHS also needs looking at but I don't mean the usual way which seems to be on the basis of continual efficiencies as a reason for under funding.

This TED talk by Allyson Pollock gives an interesting view of the NHS - youtube.com/watch?v=Cz5dl9fhj7o&

Dave

In reply to Rob Parsons:

That's only true if you compare CND's (perhaps a bit biased) press release of total project lifetime cost for Trident and everything they associated with it, against a made up number, substantially smaller that what we actually spend on health.

NHS budget this year was £145bn (obviously this has increased a bit recently) so you have to do some serious rounding up to make 200/145=2

In round numbers we spend 10% of GDP (8% public, 2% other) on health and 2% on defence. About 5% of that 2% is spent on supporting Trident - so 0.1% of GDP. Even using CND's number, over 30 years, would only give 0.3%. 

Looking at the CND estimate, by far the biggest element is in-service costs of £142bn. Assuming that is in 2020 pounds, over 30 years that is about 12% of total defence spending, more than we spend on running the whole of the Royal Navy, so I'm a bit suspicious of their calculations.

https://cnduk.org/resources/205-billion-cost-trident/

To get to a similar level of health spending to France (which also spends considerably more than we do on nuclear weapons) we'd have to increase by 2.5% of GDP. 

So yes, I do think that projects like Trident or HS2 (or any other single item) are little, trivial even, compared to current health spending and the amount we need to increase it by to reach a desirable level.

https://fullfact.org/economy/trident-nuclear-cost/

https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/nhs-budget

https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/hea...

In reply to Removed User:

That sounds a sensible idea, except for the fact that I have no faith whatsoever than any money I pay to HMRC which is labelled for a purpose will ever end up at the coalface that it was intended for.  I seem to remember a few years ago that there was an idea around that taxpayers were supposed to get an annual statement showing how much tax they'd paid and where it had been spent.  I don't know if the notion ever saw the light of day, but I don't recall receiving one (but HMRC always make sure that I get the tax demands so they must know where to send stuff!)

In reply to Tringa:

The NHS at the start of this crises had its £13 billion or so deficit at Trust level written off by the Treasury. In one fell swoop it has dramatically improved the finances of the NHS trusts.

Its not the NHS that is going to need money.... its the rest of the economy. Estimate of £50 billion just for furloughing people for 3 months.

Turn the question around " are you willing to pay 10 p for the economy"?

In reply to Removed User:

Gen Y comment - you need to fix housing before I'm going to receptive to funding this type of thing through income tax.  The pressure on the NHS is caused by care issues and people living longer.  I don't think it is reasonable to expect the working population to cover this to protect the assets held by older generations.  If on my salary I can afford a decent family home in the SE, pay my bills and save for a pension then it becomes a sensible proposition (although I don't agree with ring fencing tax - it should be spent where it is needed most)  

In reply to krikoman:

I dunno - it could easily be the case that the Whitehouse will soon suggest exploring their potential as a cure for Coronavirus, and we'd want to be in at the ground floor if they show promise

In reply to nufkin:

You might be right, Polonium Pills anyone?

In reply to NathanP:

Yes, well ... as my old Mum used to tell me: 'Look after those 200 billions, Robert - and the pounds will take care of themselves!'

In reply to Alex1:

So do you think we should confiscate your grandmother's house while she's still alive or wait until she dies? Same for her bank account, clear it out now or later?

Also, do you think people in their twenties are better off now than they were in the sixties?

In reply to Rob Parsons:

Yes, quite. A hundred billion here, a hundred there - soon it starts to add up to real money

Even if you accept CND's estimate (I don't), it isn't 200 billion we can spend now. It is an estimate of total costs from a few years ago at the start of the project to finishing decommissioning the last reactor in the 2070s, a spread of about 60 years. it is 200 billion pounds in the same sense that we are spending 8,700 billion on the NHS.

By the way, I looked through the CND calculation and I can see how they fiddled the numbers to mislead. They state the running cost of Trident is 6% of the defence budget for 30 years. 6% is a bit high but, OK. The budget this year is a bit less than £39bn so 6%x£39bnx30 = £70.2bn but CND state a running cost of £142bn. Instead of stating the cost in 2020 pounds, they have estimate future in-year cash values with compound inflation and added them all up.

In reply to Removed User:

Wait till she dies, obviously. But then impose 100% inheritance tax. Seriously.

In reply to Rob Parsons:

And what if you're living in her house, but can't afford to pay the tax?

I'm all for inheritance tax, but as sensible rates and for everyone, not just the poor.

In reply to Removed User:

Considerably larger inheritance tax (with loopholes closed) is obviously one way to do it - not sure why this is 'confiscation' whereas income tax is 'tax'.  There are also other options (e.g. Land value tax). My point is that taxation policy should consider assets as well as income.

Why is this relevant? The answer to that question will be dependent on what you measure 'better' against. 

In reply to Removed User:

I think I'd rather see some of the loopholes closed that allow big businesses to reduce the amount of tax they pay. For example BigBusiness running a subsidery company called BigBusiness UK that has to buy the rights to use the name which means the UK branch runs at a loss and therefore pays no tax.
I'm more than happy to pay more, but I think that companies that turn massive profits should acknowledge their responsibility to the society in general and the benefits that would result in long term (such as improved employee wellbeing and therefore increased productivity).

These are just the ramblings of a mad man, and I appreciate not a view held by all.

In reply to Alex1:

I noticed the same tendentious phrasing, and had assumed that it's because Eric9Points thinks he would personally 'lose out big' from the former, but not the latter. Which is the problem with all pub-style discussions about these important structural issues.

Eric?

In reply to krikoman:

It's probably more of a thought exercise than a realistic prospect, but imagine what society might be like if people didn't have any expectation of getting anything from their parents upon their death. There isn't really any logical reason why I should come to own a house or saved money I didn't buy or work for, other than because that's the way it's always been

In reply to Removed User:

Absolutely not. Quite a controversial viewpoint on this forum I imagine.

Until we figure out the root causes of the lifestyle related diseases crippling the health service I don’t see the point in pouring an ever increasing amount of money into a bottomless pit.

It’s too simplistic to blame poverty on high rates of diabetes etc, why is the UK population so unhealthy compared to other European countries?

In reply to Alex1:

If inheritance tax were increased then it would be the younger generation that suffer.

Because people in their 80's now were in their twenties in the sixties when life was much harder than it is now. They also lived through the mass unemployment and 12% interest rates of the Thatcher years.

In reply to Removed User:

Yep

I thought they were happy with this pointless clapping lark.  Fu@k needing money for PPE.  

Claps seem just the trick.

Let's have a round of applause for not getting covid and dying on the job while not having the equipment you actually need.

In reply to Removed User:

In terms of access to affordable housing - i.e. of the ratio of average house prices to average earnings - life was much easier in the sixties than it is now. Tell us why you think it was 'much harder'?

I don’t see how this impacts “the younger generation”,  since the inheritors will typically be in their 60’s when their 80-90 year old parents die.

The group most directly affected will be rich old people, surely?

In reply to charliesdad:

Unless all that potentially inheritable wealth disappears on care home costs. 

In reply to summo:

That is a separate (though related) question. But is one which I have no problem with; in fact the conversion of assets which are no longer (housing in this case) to pay for services which are needed (care) sounds eminently reasonable and redistributive.

In reply to Removed User:

I'm in a younger generation - I'm the one saying I would support larger inheritance tax if it avoided income tax rises. I would much rather earn my money than have it arbitrarily given to me based on my DNA.

Still not relevant to this question - we don't decide income tax rates based on age or whether you came from a wealthy background.