Looks like it could soon be 'RIP the NHS'?

Yes, it could be changed so there is no limit to what people pay. It could also be changed so that wealthier pensioners pay something.

The point is about it is that's it's not an insurance scheme. If you pay into a private pension scheme, the amount you get back is related to how much you've paid in. National Insurance doesn't act like that, nor do unemployment benefits have any relation to the number of years people have paid nor how much they've paid. They don't have much relation to need either.

A hypothecated health tax would mean that the NHS could remain a service free at the point of use, regardless of ability to pay, but would be paid for by those with the greatest ability to pay. The alternative is to have private insurance schemes muscling in and it wouldn't be long before we end up in a situation like the US.

This is a letter in the Guardian from Dick Taverne, the former Labour/Independent MP and now in the Lords:

www.theguardian.com/society/2016/jul/28/contributions-change-could-save-the-nhs

We just need to be chipping in, on average, the cost of a pint, or a fancy coffee, per week, to fund the NHS. I seen no reason why higher rate tax payers should not pay more than their fair share. One less restaurant meal per month maybe?

Presumably with allowances for those who cannot afford a fancy coffee or a pint each week?

I would suggest the lottery money goes to it, but that would tax the poor, not the rich.

There is a health service lottery. Anyone know where that money goes?

Apart from which I disagree with people having to pay more for the NHS when others get away with not paying their taxes in full.

Can't wait to see what happens over Apple taxes.

Well if it was on income tax you could allow for that factor of course. Truth of the matter is that Hunt et al on a mission to promote the interests of private insurers and providers and push us towards a haves and have not 2 tier system.

Loving the notion that Ireland desperate to turn down 13 billion euros
This represents a significant chunk of annual tax revenue.

I presume it's because Apple has threatened to move their European headquarters elsewhere if they are not allowed to carry on as they have been.
Some multinationals think they are above the law. They are definitely outside it.

www.taxresearch.org.uk/Blog/2016/08/31/ireland-could-wipe-out-child-poverty-for-a-decade-with-apples-tax-bill-and-doesnt-want-to/

It's not just the 'big players' who escape paying income tax and NI.

I know somebody (my ex) who doesn't pay income tax or NI, but uses the NHS and other public services quite legally. He has a property portfolio worth millions, but claims he makes no profit, because he has to pay mortgages. Any profit is actually channeled through other family members and paid to him. Some of it is kept offshore. He lives abroad for most of the year, so never brings the money back to the UK.

This arrangement was originally set up to avoid paying me any maintenance for our children and to avoid paying back a student loan. It also means that he's not liable for tax or NI. His wealth isn't taxed until he sells the property, but I have no doubt he will time that so that he's living abroad.

I would like to see a wealth tax on assets physically in the UK, so **s like him can't wriggle out of tax.

Country by country reporting goes some way towards that, I would think. Taxes paid where the money is made.

www.taxresearch.org.uk/Blog/2016/08/31/the-apple-tax-case-will-put-globalisation-on-trial/

I do hope the EU doesn't back down on this, particularly as it's to do with competition law.

@dj

I suspect you're right. Apparently the UK is already eying up Apple. Post-BREXIT, the UK will be able to offer 'sweetheart' deals to all these big companies and, if you read some of the stuff people like Liam Fox have written in the past, that's exactly what they want to do. A number of people have predicted that the UK will become a tax haven in its own right, which will provide a handful of jobs for the mega-wealthy, but nothing for the country.

@dj

But we won't be part of the EU and the UK will go its own way.

Have you seen this, daphne?
While we've all been busy fighting off TTIP, big business has been sorting out this with governments.

www.independent.co.uk/news/business/news/ttip-trade-deal-new-what-is-tisa-privatisation-pact-secret-threat-to-democracy-a7216296.html

Anyone who voted Brexit to gain sovereignty needs to read this.

I just get sick of it all.

Daphne, I hope the Apple case gets sorted while we are still part of the EU, before article 50 gets brought into the equation.

More strikes next month.
I wonder what the new PM will do. She has no previous form on the NHS, I don't think.

The NHA take on an increase in NI to pay for the NHS.
Strangely, it's exactly what I think.

nhap.org/no-to-an-increase-in-ni-contributions-to-fund-the-nhs/

An increase in NI hits people of working age, who work for an employer, disproportionately. I have been arguing all along that taxes should be increased for those with wealth (as opposed to income). This includes wealthier pensioners and those who don't pay income tax eg. BTL landlords. Wealth in the UK is relatively undertaxed.

I would like to see pension contributions tax relief given at basic rate only and, of course, I would like to see the government making more of an effort to close tax loopholes, but I'm not holding my breath. I don't have a crystal ball any more than anybody else, but I suspect that in twenty years time, the UK will make much of its money from being a tax haven.

It's an absolute disgrace that one of the wealthiest countries in the world claims not to be able to afford basic needs such as healthcare and housing for its citizens.

I can't see anything changing until an effective opposition gets its act together.

Wouldn't hold your breath

Perhaps we ought to fund the NHS through the lottery. It worked in Rio. Something needs to be done to rationalise spending and funding.

I agree with people upthread about bloated NHS management who are often not that competent.
Southern Trust being yet another example.

I dont expect praise for this comment!

' “This idea turns up like a bad penny with monotonous regularity. When the government proposes an expensive project disliked by large sections of the public, such as Trident, HS2 or Hinkley Point, they emphasise its economic value. No mention of 1p taxes or increased NI. But the far more efficient boost to the economy that comes from the NHS, estimated to be £4 for every £1 spent, is routinely ignored.

The National Health Action Party will continue to oppose this most socially regressive idea, which hits workers who rely on wages hardest. It harms lower earners disproportionately because the level of salary on which workers have to pay National Insurance is capped by the Upper Earnings Limit (UEL), so very high earners do not pay contributions on their full salaries.

It's yet another way to transfer the costs of universal healthcare from the wealthiest in society to the poorest, even though everyone benefits from it.

There was also a Conservative commitment on tax specifically that there would be no rise in income tax rates, VAT or national insurance before 2020. That's one pledge that could be applied to the NHS, unlike Jeremy Hunt's unworkable and dangerous '24/7 NHS'.

The government should be addressing the problem of tax avoidance. Even if HMRC collected only portion of this money, it would be more than enough to fund the NHS and to properly fund Social Care with a cap on costs to the individual. '

From the NHA. Looks like they agree with you, daphne.

I agree with you obieone, A lot of money is wasted in the NHS, but not many people will admit to this.
A lot of people are in favour of Trident contrary to popular belief, and HS2, but wisely keep their thoughts to themselves particularly on here!!! Hinkley Point is controversial, the involvement of China has made it so.

@niggly

I'm sure there is waste, but where do you think it is?

Germany and France spend about 50% more on healthcare than the UK. Do you think they waste money too?

The fact is that the NHS is underfunded for what people want it to do. When it was set up after the war, life expectancy was much lower and we didn't have the drugs to keep people alive for so long. Stays in hospital are much shorter than they were, so the NHS is more efficient.

£3.2 billion is spent on commissioning, the internal market which was introduced by the coalition government. Millions is also spent on collecting and analysing targets. The Kings Fund has repeatedly said that management costs (apart from the above) are low.

Niggly, which would you rather pay for, the NHS, Hinkley Point, HS2 or Trident?
Personally, I'd rather my taxes went on the NHS, as you've obviously realised by now.

@obieone

Katrina Percy's resignation at Southern Health has nothing to do with wasting money.

It's highly unlikely that any of us can influence the way the NHS is funded at national level in the short term. It seems to me that the only influence we can have is at local level.

I've belonged to a local group for some time and it's become clear to me that finding out who makes decisions and when they are made is a huge problem. Everybody passes the buck. If people think that there is waste, getting involved locally should be a good opportunity to make your voice heard and suggest alternatives.

The 2012 Health and Social Care Act fragmented the system and now it's been decided that fragmentation wasn't good and that Clinical Commissioning Groups need to work together - hence STPs. The STPs are supposed to listen to stakeholders (eg patients), but there seems to be no way of getting your voice heard. I'm meeting somebody on Saturday, who might have some contacts, who know their way around the system. Fingers crossed!

France has a different system. Voted no 1 and best in the world.

Katrina Percy's resignation at Southern Health has nothing to do with wasting money.

Whether it does or it doesnt, it highlights waste

www.dailymail.co.uk/debate/article-3768135/Smug-shameless-240k-health-boss-sums-s-wrong-NHS-writes-IAN-BIRRELL.html