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A special tax to save the struggling NHS won’t work. Here’s why | A special tax to save the struggling NHS won’t work. Here’s why |
(about 1 hour later) | |
This idea distracts from what’s needed: a bipartisan royal commission to stop NHS money being wasted, then reform | |
Mon 5 Feb 2018 11.18 GMT | Mon 5 Feb 2018 11.18 GMT |
Last modified on Mon 5 Feb 2018 12.31 GMT | |
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A special NHS tax is a bad idea. The concept as put forward today by a group of health professionals is naive. First, it will not happen and is thus a distraction from getting more money for health. Second, if it were introduced, every good cause would want its own tax: housing, schools, student fees and the army. The Treasury would just slash existing spending on them. | |
That 10 senior figures from the NHS, general practice and nursing, on a panel set up by the Liberal Democrats, should want more for their service is not surprising. | That 10 senior figures from the NHS, general practice and nursing, on a panel set up by the Liberal Democrats, should want more for their service is not surprising. |
No profession will suggest radical reform of itself, least of all doctors | No profession will suggest radical reform of itself, least of all doctors |
This winter has seen the biggest flu epidemic in a decade put intense pressure on hospitals. As usual, this has led to critical operations being postponed for lack of beds: the big NHS squeeze point is moving people in and out of hospital. This does not prove a lack of money, but reflects a breakdown in coordination between GPs, hospitals and that Cinderella of the health service, local council community care. | |
Massive resources were tipped into the NHS by Tony Blair and Gordon Brown. The chief beneficiaries were medical salaries, drug company profits and private finance initiative contractors. After 2010, the coalition’s austerity cuts slashed community care by as much as a third, inundating surgeries and clogging hospitals. Money was poured into the NHS, but withdrawn from home care, day centres and other ancillary services on which maternity and a soaring number of elderly people depend. A special tax for the NHS and social care in England will not cure this, and a special council tax for community care will lead to howls over postcode lotteries. | |
The welfare state was founded on a tax called national insurance. It was initially ringfenced – but soon merged into general taxation. Car taxes were supposed to go on road building. It was promised that the lottery would not replace normal spending on the arts and sport. It was all rubbish. A health surtax on incomes would merely enable the Treasury to cut or freeze existing spending. | The welfare state was founded on a tax called national insurance. It was initially ringfenced – but soon merged into general taxation. Car taxes were supposed to go on road building. It was promised that the lottery would not replace normal spending on the arts and sport. It was all rubbish. A health surtax on incomes would merely enable the Treasury to cut or freeze existing spending. |
It was a good idea by the Lib Dems to put together a 10-person inquiry into the NHS, a bad one to set up a lobby for the NHS’s ancien regime. No profession will suggest radical reform of itself, least of all doctors. The best ideas would be for a bipartisan royal commission to see where NHS money is being wasted, whether on drugs, agencies and PFI, or on archaic professional barriers between GPs, consultants, nurses, pharmacists and care workers. We all know that demand for the NHS is soaring, with the Care Quality Commission predicting a “sharp decline” in future service. Most overseas systems – many now outperforming the NHS – ration by selective pricing or the “nudge” of reclaims or insurance. | |
The British NHS rations by congestion, delay and bad publicity. It may be that taxpayers should go on paying more for it, but there should be no taxation without reformation. | The British NHS rations by congestion, delay and bad publicity. It may be that taxpayers should go on paying more for it, but there should be no taxation without reformation. |
• Simon Jenkins is a Guardian columnist | • Simon Jenkins is a Guardian columnist |
NHS | NHS |
First thoughts | First thoughts |
Tax | Tax |
Tax and spending | Tax and spending |
Health | Health |
comment | comment |
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