[Closed] What to cut to fund the NHS?

Get rid of free houses and free-for-all expenses for MPs? It's 2017, give 'em all video conferencing.

Why cut anything, apart from Trident?

Nationalise the utilities and use the profits towards increasing NHS funding.

Trident and military for me and have a bloody good think about all non means tested benefits

Incidentally,

If we leave the EU and scrap our nuclear programme / military, aren't we a bit ****ed?

Ask the banks for our money back?

Cut shareholder dividends, pay employees more, raise more tax.

Cut the austerity bs

All the above

Apart from cutting conventional military, although I'm no way a fanboi of guns and gun fantasists

Easy, change the proposition of 'free at the point of delivery' - it's simply not sustainable, means we're not incentivised to look after ourselves and means we take for granted the value it provides - if it's free, it has no cost... (we believe)

It will get sorted in 20 years time when the population is no longer ageing...

In the meantime, government needs to stand up to the electorate and spell out in clear terms we can't always have what we want...

Everyone should be given a breakdown of the total cost of their treatment so at least we're aware of the cost.
Consider, like charities do, suggesting we make a % contribution to offset that cost.
Make a contribution obligatory and means test it.
Consider tax breaks for private care so those who can afford it are encouraged to go private
Not sure what you do about the majority of the population who're knowingly creating a burden for the NHS by overeating and doing no exercise - I can't see a non-contentious way of dealing with that unfortunately...

As a higher rate taxpayer who's had 4 operations over the years falling off my bike (i.e. I was partly responsible for the costs the taxpayer paid) I have no problem with that... then taxpayers' money can go to those who can't fund it themselves

What about them thoughtless twunts who insist on falling off bikes in forrests and on paved rights of way...
Charge em double

Actually, a costed breakdown of treatments and provisions at the end of year seems reasonable, this is what has been deducted from the pot for your care this year....

In the past everyone had an NHS dentist and used NHS opticians, it seems the majority of people who need those services and can pay for it now go private, I know I do. I do think GPs will the next service that will go that way... perhaps fronted by a government backed Private health insurance scheme with tax breaks like pension contributions.

Easy, change the proposition of 'free at the point of delivery' - it's simply not sustainable,

It's very sustainable. Cost per person is far lower than other countries' privatised or hybrid systems. Having free healthcare means people are more likely to seek help early meaning that treatment is usually far simpler and cheaper than if you wait until you're really really ill because you didn't have the money or didn't want to pay to visit a GP.

End British involvement in overseas conflict.
End Foreign aid to non democratic countries.

Having free healthcare means people are more likely to seek help early meaning that treatment is usually far simpler and cheaper than if you wait until you're really really ill because you didn't have the money or didn't want to pay to visit a GP.

I take your point but how come, if free at point of delivery is so effective at providing good healthcare for a population, we're one of the least healthy countries in the world when it comes to basic BMI/overweight/obesity...

Maybe your point is true for acute illness but not for chronic or self-created illness?

The NHS doesn't need more money, they just need to spend what they have sensibly rather than pissing and wasting huge amounts of it on things like the ever increasing number of departments with all manner of managers who actually do nothing of any use!

Limit tax breaks on pension contributions for high earners, schemes like CTW only give relief on the basic tax rates not the higher rates.
As much as IDS's single payment benefit thing seems a fiasco getting rid of things like child benefit into one payment seems like a good idea.
Stay in the EU.

Raise taxes instead of making cuts.

they just need to spend what they have sensibly rather than pissing and wasting huge amounts of it on things like

It will get sorted in 20 years time when the population is no longer ageing...

Make a contribution obligatory and means test it.

@ notmyrealname Daily Mail reader ?

Easy, change the proposition of 'free at the point of delivery' - it's simply not sustainable, means we're not incentivised to look after ourselves and means we take for granted the value it provides - if it's free, it has no cost... (we believe)

We already incentivise people to be healthier. We have high tax on cigarettes and alcohol and many people are proposing a high tax on unhealthy foods (though the food industry is lobbying against it).
Last time I checked the tax on alcohol raised more than the cost to the NHS.

My mum has lead an incredibly healthy lifestyle and had cancer twice, and been treated on the NHS. I've no idea what we'd have done without the NHS. She wouldn't have been able to afford insurance, certainly not the 2nd time.

I'm not sure BMI is related to national healthcare... i mean look at USA!

Trident and military spending, obviously. No doubt there'll be some rabid tories and 'kippers along in a minute to froth about 'empire' and 'defending sovereignty' or AN Other pile of obsolete bollocks while ****ing over pictures of Maggie pointing a rifle at Ghandi...

Claim taxes from Amazon/Boots/Daily Mail etc?

A good start would be to take all the money that the govt wastes on private sector firms like Capita, Serco, ATOS, Virgin etc to do a shit job on pretty much everything they touch, and use the money to fund a fully publicly owned and run, integrated NHS and Social Care system.

And legalise drugs and ring-fence the taxes collected for NHS and health education.

@ notmyrealname Daily Mail reader ?

Anything but.

Someone who works in the NHS and sees the monumental amount of waste that goes on along with the ever increasing number of pointless managers whose employment provides no benefit whatsoever to staff or patients.

We already incentivise people to be healthier.

With 60%+ of the population being overweight or obese then we're clearly not are we? We may be trying to, but it's not effective...

I've no idea what we'd have done without the NHS.

I'm not sure BMI is related to national healthcare... i mean look at USA!

Eh, I'm going to stop ageing in 20 years?

This isn't about you, it's about the population balance overall. In the past, people died in their late 70s overall. Once you're dead you represent zero cost to the NHS as you have zero healthcare needs.
Now, people are living much longer - but the later years are in declining health, therefore representing a bigger burden on the NHS at the end of our lives than we used to. Coupled with a big increase in the number of older people, means lots more old people needing lots more care.
In 20 years time when the Baby Boomers are dead, this problem will go away - when you look at the demographic breakdown in the UK there are fewer people in the younger age groups...

It is and it is (general taxation).

But clearly not enough money is being provided by this mechanism with 65% of NHS trusts in deficit in 15/16 (up from 8% in 2009/10)

Foreign aid.
Benefits for those who see breeding and/or having a 'bad back' a lifestyle choice.

Get rid of the loopholes that allow so many, often with help of accountants, to vastly reduce their tax bill.

Tax landlords, including live-in landlords, for the whole rent income they receive (so someone cannot use rent as their only source of income to receive their tax free allowance).

Why are people that earn more, allowed to save more tax on buying a bike (or other salary sacrifice things) through schemes run by their employers? This isn't going to save the NHS, but surely those on lower incomes should be getting the most benefit from schemes like this.

If you buy goods through salary sacrifice schemes, such as new bikes, enforce the rules so they must be used according to the rules (for at least 50% of commutes?).

Stop allowing international companies to have outlets in the UK and then barely pay any tax.

Start recruiting more UK students to take up medicine places in universities, so more NHS jobs are taken by UK citizens that are not sending money overseas to their extended family?

Enforce new tax laws that heavily tax car users who use their cars for short journeys of less than five miles, which could (and should IMO) be easily done by bike (or walking, or public transport), creating less pollution and making the UK population healthier (so reducing burden on NHS).

Re-nationalise the railways; electric grid; BT landline phones; Royal Mail.

I'm very tired and grumpy today, some of the above might be irrational rubbish. 👿 😉

I take your point but how come, if free at point of delivery is so effective at providing good healthcare for a population, we're one of the least healthy countries in the world when it comes to basic BMI/overweight/obesity...

Maybe your point is true for acute illness but not for chronic or self-created illness?

Well, there's a multitude of reasons for that. A lot I suspect comes down to overall mental happiness of a large chunk of the population, and their lack of wealth (measured in time and money). Being fit and eating healthy does actually cost a fair bit compared to oven chips and tv. If you're a struggling single parent trying to juggle several zero hours contract jobs, keeping your kids out of trouble, fighting with them every mealtime about salad then finding a babysitter so you could just go for a run (pretty cheap as exercise goes) is not exactly stress free.

Notmyrealname

Utter nonsense. The NHS is being deliberately starved of funds. We spend 20-30% less on health care than other countries. Yes the nonsensical structure in England wastes money but the NHS needs more and better quality management and significant more funding

The NHS is failing because it's not allowed to operate on a level playing field. People are sold shit to eat and drink all day, they take little or no responsibility for their health, then they get ill, so the NHS has to pick up the mess.
Big drug companies are able to massively over inflate and fix drug prices, forcing the NHS to fork out huge sums of money.
Many NHS hospitals were coerced into ridiculous PFI contracts to try to modernise which they can no longer afford.
When an NHS trust does fail, it is replaced with Virgin Care, who other trusts now have to compete with to provide a lot of NHS services.

The NHS and late stage Capitalism are not compatible. People need to choose between one or the other. Or we could just do what we always do, wait for the decision to be made for us, then moan about it after the fact.

Cakes, biscuits, pies, pizzas and alcohol, it's the dumb ass overweight folk who are sinking the bloody nhs.

Can't we copy the Scottish model - its much better up there under a centre left government isn't it?

Crisis and war aside, we are close to record levels of public spending as a percentage of GDP, with health only slightly below its 7.9% peak and still forecast to be 7% by 2020.

Still if we want to cut, we know what the big bills are: pensions, (then health) then welfare. Take your pick!

Never forget our £350m though.....

The NHS needs root and branch reform. It was created to suit a very different country and demographic and hasn't changed since and structurally is unsustainable. I'm all for pumping more money into the NHS but not in its current form - its a waste of tax payers money which is a precious and limited commodity.

Trident won't even put a dent in the NHS - the whole 40 year life cycle cost of trident is estimate to be around £100bn, which is not much more than one year's NHS budget. The NHS has to be sustainable and not rely on ever increasing % of GDP being pumped into it or we'll just continue to roll on from one NHS crisis to the next.

I really don't see what's wrong with taking a lead from other nations who don't have a US style privatised system, but have a system that is free at the point of use and does utilise more private sector involvement. they may pay more into their health service than we do, but that is not the answer. It is terribly arrogant and naive to think the NHS is the ultimate health service. Its not. Its failing despite receiving more money than it ever has.

The answer is not to divert more money to it. Defence/security take the ultimate precedent over anything. Without a safe and secure society then we're screwed.

Of course it doesn't help having an increasing head wind of one trillion pounds of debt that costs us over £43bn a year just to pay the interest on that debt and until we get our structural deficit sorted so we make more money than we spend then we're always going to struggle. I'm not against the country carrying debt, but not when our structural deficit is in such crappy state. Austerity has reduced the structural deficit by two thirds but that is not enough as until that has been eliminated then our national debt will always be increasing. I'm just not sure how much longer we can stand austerity. We should have gone far deeper earlier to eliminate the deficit alot quicker, a short term gain for long term pain strategy. I just can't see how we'll get ourselves on an even keel until we sort out the structural deficit.

cut trident .. thats save 200bn over the next 13 years or roughley 18bn a year.. on the downside 5000 folks are out of work and we no longer have a nuclear deterrent..

what else you gonna cut.. biggest spendng per annum is far and away pensions.. who and by how much.. your grannies .. mine.. hers..

next up working age benifits.. who and by how much

cuts of a couple of wuid here and there make ZERO difference cuts to pay for the nhs have to be deep.. deeper than anything ever condiered before..

oh tax the rich and banks .. those ll be the banks that opening offices in the eu to avoid having to pay taxes in a post brexit uk and the rich folks? how rich is rich and if you ve to make 30 billion a year it ll be a fair old wedge from each one.. there are 615000 millionaires on paper at least in the uk divide up the 30 billion a year between them and thats just shy of 50k each every year.. they ll be falling over themselves in the rush to pay it pay it

Why bother? Society would be financially better off if the poor die younger.

I meant a short term pain for long term gain!

Income tax. 50% at circa £100k and 60% at £150k. Not sure that would fully cover it, but it would certainly help. And a fair old chunk of it going into social care (or properly combine health and social care budgets.

Why top at 60%? Tax the buggers, none of them deserve it. It's an outrage.

so.. get rid of grannies, fatties and trident and sort out the taxation system for business and personal income properly.. anything else? 🙂

"Defence".
Healthcare for smoking or overeating related illnesses.
Town improvement plans.
Council and government officials.
Subsidised policing of events such as football matches.
50% of blue badges.
The £40 shopping voucher and £200 fuel allowance for all pensioners...they should find a cheap way of at least cutting these gifts to the well-off.
Erm, lots more that I can't think of right now. But a LOT of the unnecessary spending that local councils do.

The royals

HS2.
Biggest waste of public money ever.

Trident.
Never going to be used.

House of Lords.
Don't need them interfering.

What about them thoughtless twunts who insist on falling off bikes in forrests and on paved rights of way...
Charge em double

The surgeon from my one and only hospital overnight was adamant it was much better/cheaper for the NHS to do the occasional quick repair to someone injured whilst keeping fit and healthy 🙂

I'm not saying it was perfect, but the pro-active health promotion side of the NHS has also been decimated and/or thrown over to local councils who have generally then stripped the budget even further to shore up other services.

The NHS is failing because it's not allowed to operate on a level playing field. People are sold shit to eat and drink all day, they take little or no responsibility for their health, then they get ill, so the NHS has to pick up the mess.

That^

The NHS needs root and branch reform. It was created to suit a very different country and demographic and hasn't changed since and structurally is unsustainable. I'm all for pumping more money into the NHS but not in its current form - its a waste of tax payers money which is a precious and limited commodity.

That^

The NHS doesn't need more money, they just need to spend what they have sensibly rather than pissing and wasting huge amounts of it on things like the ever increasing number of departments with all manner of managers who actually do nothing of any use!

And that^!!

We as a country are so used to not having a connection forced upon us about how our lifetyles affect our health due to the fact that it's 'free' to get any ailment or injury fixed. If we had the cost of each set of pills or consultation shown to us at every step then maybe behaviours would change. Us lot on here don't really reflect the view of the general public about the link between lifestyle choices and health as we generally partake in exercise-bases activities so we have a reason to worry about what we eat, drink and do. The average person sadly doesn't make the connection with eating junk food, drinking fizzy drinks and doing no exercise with why they have a bad back from carrying too much fat for example.

One example I have of NHS waste: Every time a battery-powered device is used in a surgical theatre, even if only for a second, the batteries have to be replaced with a fresh set before it can be used again. A sensible thing to do as you don't want the battery to die at a critical time. So you would think they would use a load of rechargeable batteries with their cycles monitored, like you get for commercial walkie talkies used by security staff in shops for example. Nope, they use single-use AA, C and D batteries from Duracell, Energizer and Toshiba. All very expensive and just thrown away after a single use!! One of my friends works as a Theatre Nurse and she always has a load of batteries rescued from the bins to give out to her friends.

wobbliscott - Member

Trident won't even put a dent in the NHS - the whole 40 year life cycle cost of trident is estimate to be around £100bn,

Nobody actually believes that though, do they? It's like Hinkley C will cost us £6bn, and the government will spend £8bn on the NHS.

I bet they buy the batteries from Harrods aswell.

I'd raise a small amount of money with:

A better version of mansion tax.

Tax on unhealthy foods/drinks.

Tax on non eecyclable packaging.

I'd bin trident but spend that money on the armed forces and get them doing nice things around the world. Digging wells/ building schools etc.

if you want to find money the only place to make cuts is pensions, failing that you have no choice but to raise taxes.

You need to get away from low tax being a good thing and state being bad.

If you take NHS funding and compare to other comparable countries, GDP spend is lower, number of beds is lower, doctors lower etc etc etc. Which suggests the NHS has made lots of savings already. Things that ned to be addressed, social care, mental health, and lifestyle.

Cut the kleptocratic transfer of wealth from public to private:

1. Subsidies for private companies to run our railways
2. Deliberately inflated and expensive (for the taxpayer) PFI contracts for schools, hospitals and prisons
3. Bail-outs of banks who take the nation's wealth to the casino every night, and occasionally lose.
4. Wasteful and unnecessary public works. Aircraft carriers with no aircraft anyone? HS2, trident replacement.
5. Giving our national infrastructure away to foreign interests (public and private) - ie Hinkley Point.

But why do any of that when you can start at the bottom and hammer the poorest hardest. Roared on by the middle classes, nouveau riche their lackeys and pretenders.

No need to cut anything. We'll have £350M a week shortly.
Oh wait...

Drill down and stop the epic amount of waste. Paying over the odds to private companies/Contracts. Cut management/non patient facing staff. Fine people for missed appointments. Greater tax on booze and fags. Tax unhealthy food. Stop f*****g good staff over so you retain staff/fewer staff off sick so don't have to pay stupid amounts for cover/retraining. Councils to get more money for social care so bed blocking doesn't happen.

Oh and a single intergrated IT system that works and who's creators haven't taken the piss and are employed by the NHS directly

*Not a DM reader, previously worked in the NHS (For a private company!) have many NHS employees as friends/family

So what happens to the level of economic activity (and hence tax take) when taxes are raised?

What happens to the level of tax revenue when the marginal rate of tax is increased? If nothing, why have we not increased the MRT before (or recently in Scotland)?

Just a couple of thoughts....

Given that nearly every aspect of government activity involves some form of public/private partnership why is this so difficult in health? Does the forthcoming privatisation have anything to do with it?

But why do any of that when you can start at the bottom and hammer the poorest hardest. Roared on by the middle classes, nouveau riche their lackeys and pretenders.

Yep. A disgusting but persistent false consciousness.

Oh dear don't mention the IT system, wonder how the court case went? Badly I'm guessing you never see it in the news, brushed under the carpet it would seem.

Greater tax on booze and fags

Nonsense, you want lots more people drinking and smoking, nice premature deaths, inoperable lung cancer with a late diagnosis and poor prognosis, save the country a fortune

Actually. Just shut the whole NHS down, and I mean everything, for a decade and let natural selection do what it's meant to do. Let everything settle and sort itself out, then restart afresh

Abolish the tax loopholes

According to the eejits that wanted Brexit, the money that isn't going to Brussels will be spent on the NHS (which was then rejected after they won)...

http://www.bbc.co.uk/programmes/b086t0mb

Persuade the baby boomers to invest in their children a bit more.

Given that nearly every aspect of government activity involves some form of public/private partnership why is this so difficult in health? Does the forthcoming privatisation have anything to do with it?

three letters THM, PFI. How well is it working

Poorly, true, but that is only one part (albeit an expensive one)

I worked for a couple of years in the NHS, they don't need more money they just need to spend it better - and more importantly stop having an Executive (Govt) that constantly changes its mind and stops bringing in 'targets' that are political (4 hour rule in A&E has just resulted in patients sat in Ambulances waiting for admission).

And as for Managers, they just need better quality ones but at the rates they pay these (plus for other non-medical staff) they aren't really going to get them.

close the house of lords,

abolish the royal family

get rid of trident

reduce mps salaries and expences,

abolish the tory party,

stop building new roads unless they have a dedicated cycle path along each side,

strictly enforce road laws and use the cash raised to pay for the nhs,

Ban the Bake Off.
Or more seriously for long term benefit to society restrict the time of food adds and regulate the content ie have voice over health info about whatever products they are advertising. Reduce any tax on healthy foods. Bring back home economics classes.

gordimhor - Member

Or more seriously.............

Reduce any tax on healthy foods.

You can't reduce tax on healthy foods 'cause there isn't any.

Health Service provision needs radical reform, we need much higher private contributions, we need VAT on food, we need higher taxes across the board at all income levels (all of these things they have in Europe) we need new taxes on GIG economy and online retail.

There are no cuts which would provide enough money, even if you simply abolished the entire military it would barely be enough (given job losses, manufacturing losses etc) and then we'd be out of NATO too.

Trident is £3-5bn pa depending on who you believe. That doesn't even scratch the surface of what's required. NHs spending rising at 4% a year more than double rate of GDP growth so we need extra taxes every year ... forever ... unless something fundamental changes

Here is a chart of NHS spending I posted in the other thread.

[img] [/img]

Look at the terrible job the Tories are doing eh ?

jambalaya - member

Here is a chart of NHS spending I posted in the other thread.

Yes and it's as meaningless now as it was when you first posted it.

Don't be fooled into thinking that just because no one could be arsed to point out that it takes no account of increased wages, building costs, etc, ie inflation, and increased population, people have swallowed your Tory drivel.

Did you honestly think that people would believe that for the first 10 years of its creation no money was spent on the NHS?

It's absolutely not meaningless. Remember Labour promised just £2bn pa extra.

Health costs are sky rocketing, we are living longer, population is growing and medical costs are rising rapidly. In many areas of our lives technology is reducing costs, in medicine it is raising them.

No political party of any colour has anything remotely like a plan.

It's absolutely not meaningless.

Well maybe not in Jambaland but I was thinking more of in the real world.

The NHS was created in 1948, your graph shows that no money at all was spent on the NHS until about 1958.

Health Service provision needs radical reform, we need much higher private contributions, we need VAT on food, we need higher taxes across the board at all income levels (all of these things they have in Europe) we need new taxes on GIG economy and online retail.

No political party of any colour has anything remotely like a plan.

yep be nice to see some overlays with population, life expectancy and a few other factors. Maybe even the number of EU migrants working in the front line NHS 😉

[Read the entire thing and don't misquote!!]
In many ways it would work better as a private firm without the massive political interferance that goes on.

In terms of government savings, collecting the tax owed by the large multinationals, perhaps a collective group of countries all committed to stop companies juggling taxes on an Europe wide scale?

Some things are a bitter pill to swallow and in a different situation the challenge I come up against with long term HC solutions is the lack of funding and the fact there seems to be no real long term funding solution.

To take one simple area of chronic health, you have people that will require care/treatment/meeting for their lifetimes (such as diebatic care) if you can put the funding into getting people getting on with their lives and living healthier as it's very possible to do you reduce the emergency and long term issues these things lead to through poor management. To do this though is intensive up front and probably presents no real savings in the next 5-10 years. Is it worth it for a lifetime yes, worth it for the lifetime of a parliament no.

Public/Private partnerships may work but will create a 2 tier system where the rich can skip on through and the poor wait. I've seen other schemes where waiting lists are stopped and anyone new moves onto an immdeiate next week surgery list as the consequences of waiting till the end of the list are huge for excess cost and long term impacts (the impact of somebody not working for a year etc.)

I still don't think throwing money at it is the solution, it needs targeted joined up thinking and people also have to understand the implication when they go to the paper asking for a huge amount of funding for a drug that may have very little impact ( a lottery win type drug) vs waht that money means to 100's of other people for life. Hence my first comments about it may work better as a private company who can deflect and hide from those things.

The ridiculous 10% and any above civil service 1% cap pay increases. 6 million (in wages alone) a year for what?

None of them have any idea how to sort this shit show out - 0 policies from either side.

Ernie £350m in 1950 growing to £1bn by 1962

I chise 1959 as starting point amd data hardly shows as its so small versus the £120bn of today

@mike population data is on the same site 50 million in 1950 and 65 million tofay

Yeah as I said.......completely meaningless.

Here is a slightly more meaningful graph :

[img] [/img]

Note the fall in NHS spending since the Tories came to government - it's the most significant drop in the NHS's history. Which clearly contradicts your claims.

I say it's slightly more meaningful because it obviously excludes future PFI costs.

[url= http://www.independent.co.uk/news/uk/politics/pfi-deals-will-cost-taxpayers-209bn-over-next-35-years-a6966986.html ]PFI deals will cost taxpayers £209bn over next 35 years[/url]

And age, outcomes and life expectancy? Quoting one figure is misleading, did you intend to use that one figure to prove a point or to be part of the debate.
Population dynamics play a huge role too we have more elderly who are taking more out (as opposed to the young healthy immigrants) people have more chronic illness rather than dying young of death. If you can add that stuff in the your graph has meaning.
Another factor would be tax revenue over that time, given we have many more 2 income households the benefit of increasing tax spends can offset the growth in demand.

My point is that health spending is accelerating for a variety of factors and political policies of all parties are failing to deal with it

[img] [/img]

Yes is is growing. It as around the world also, erine's chart is actually more meaningful though as it puts things into perspective. As the UK's GDP has grown we have been able to fund the NHS to do more things. 30 years ago people were being written off and left to die, these days a lot of those people go on to live full and happy lives, contribute more to tax take and society in general.
Some stats

Infant mortality has fallen from 9.4 to 3.9 per 1,000 live births over the last three decades