Let's turn the clock back to 1948

I was merely commenting how quaint it was to hear someone talking about jars and all the rest. I then explained how complicated domestic finance is these days. Just as is running the country. I was equating them purely on the basis that in the 21st century, both households and economy are complex entities. I didn't equate them with each other in form.

The Bank of England's Chief Economist has talked about the way QE since 2008 has fed into inflation now www.ft.com/content/02379c68-c206-40e4-90ab-3bf7029fecb0

Correction: 30-35% of money spent on wages ...

Over 50% of NHS spending is on staff wages, so about 30-35% of any money goes straight back to the Treasury in income tax and NICs. Staff spend money on all sorts of items and services and most of that is taxed too. Even the untaxed items are produced by people who pay tax. Their purchases provide jobs for other people, who pay income tax and NICs ... and so it goes on. Equipment bought by the NHS creates jobs and people who pay tax too. Money in the economy keeps people working, which means they're working (ie producing something) and are of more value to society than not doing anything. Nearly all money spent on public service wages circulates and doesn't need to be paid back.

Maizie what a lovely old-fashioned idea: householders putting money in jars. These days household accounts are far more complex with loans and mortages and pension saving, direct debits and so is government finance, but at the end of the day everything we use and spend has to be paid for at sometime and if we increase our spending we have got to find ways to get the cash to pay for it. We can beg, borrow or steal, but it doesn't grow on trees and, as we know to our cost, quantitive easing feeds inflation.

Oh dear.

You really do believe that a national economy is just like a household economy, don't you, MOnica?

Do tell me about how inflation has soared since the first lot of QE in 2008? I know that asset prices went up because of all that nice money floating around for the wealthy to speculate with, but did the country as a whole experience inflation?

Which brings me back to the question, let us accept that the NHS needs more money, how do we fund it?

The Treasury, with the approval of Parliament, tells the Bank of England to pay the bills. It's very simple.

M0nica

Oh, yes it does!

MOnica Sorry, you need to do some basic homework!

Monica 'I do wish people would stop going on as if we were the only health system in the world that provides health care for all at the point of use '

because it is, truly.

My Dad was a rural GP and started work at the start of the NHS, in the late 1940s. I remember listening to him once when he was recounting the horrific things that he used to see when people could not access free healthcare.
He devoted his life to caring for others, and improving public health. He died just before the pandemic, and I am glad he is not here to see what is happening now.

Oh, yes it does!

If you can't accept that, there is wealth in the UK, which could be taxed. The UK is becoming increasingly unequal.

but at the end of the day everything we use and spend has to be paid for at sometime and if we increase our spending we have got to find ways to get the cash to pay for it.

No, macro-economics really doesn't work like that!

M0nica

I do wish people would stop going on as if we were the only health system in the world that provides health care for all at the point of use and every other country has poor people dying in the street because they cannot afford care.

Most European countries and many other big economies, excuding the USA, provide care that is effectively free to all and on every list ranking medical systems, places the UK 10th at most.

No health system is actually 'free', we all pay indirectly through taxes. If it can be shown that the problem with the NHS is money, let us discuss how we should pay it. 5p on income tax? reducing expenditure on education, or reducing expenditure on global warning. How about reducing the government grants to LAs and let them raise Council tax.

The NHS needs more money. How do we pay for it?

I'd shift the burden of taxation from income to assets.

Moreover, as Maizie has pointed out many times, any money invested in the NHS returns (mostly) to the Treasury anyway and, more importantly, improves most people's quality of life, which IMO is what matters.

Charging for GP visits would probably cost as much to administer as it raises and need 10s of thousands of new bureaucrats to administer it.

Maizie what a lovely old-fashioned idea: householders putting money in jars. These days household accounts are far more complex with loans and mortages and pension saving, direct debits and so is government finance, but at the end of the day everything we use and spend has to be paid for at sometime and if we increase our spending we have got to find ways to get the cash to pay for it. We can beg, borrow or steal, but it doesn't grow on trees and, as we know to our cost, quantitive easing feeds inflation.

The money has to come from somewhere and if not from current income, it comes from loans, whatever they are called, which means debt to service.

Which brings me back to the question, let us accept that the NHS needs more money, how do we fund it?

Hmmm ... so, I'm changing my mind about a hypothecated health tax.

I guess a bugbear of mine is that working people of working age pay over 50% more than people who don't have income from working (as a result of NICs), yet expect the same services as others.

PS. I don't agree with paying for visits to a GP

Basically, you cannot run a country's finances like a householder popping their incoming money into a series of jars labelled rent, food, clothes, holidays etc...

Apart from that. I agree with your post.

Paying for GP appointments is a bit behaviourist, isn't it? On the theory that people only value what they have to pay for.

As to a 'specific tax for the NHS', we don't have hypothecated taxes because government accounting and budgeting doesn't work like that. Departments are allocated an annual budget and expected to work within it. The money is paid to them regardless of tax receipts. It couldn't work any other way because tax revenue comes to the Treasury throughout the year and future receipts can't be predicted with any accuracy, So the government pays out from its general fund, to which tax revenues contribute to over time. Sort of like paying down an overdraft. Shortfall is paid for from 'borrowings', which are predominately investments in government securities or state savings facilities.

And, as I keep on pointing out, tax revenue doesn't consist solely of income tax; there is a variety of sources, company taxation, VAT, licencing fees. there is also government income from other sources. It all ends up in the same 'pot'. It would introduce an impossible level of complexity, IMO, to try to sort out which monies had been paid for which purposes.

If you want your mind to be completely battered, try reading this

gimms.org.uk/wp-content/uploads/2021/02/An-Accounting-Model-of-the-UK-Exchequer-2nd-edition.pdf

Iam64

MOnica I’ve not seen anyone claiming the nhs is the best in the world just that we souls fund ut

I’d have a specific tax for the nhs
I’d introduce a charge of say £20 or £30 to see your GP. Obvs people on benefits wouldn’t pay. I’m retired not eligible for pension tax credits so I’d pay to see my GP

I’d take social care back to l.a and fund it. It shouldn’t be a for profit thkng

I'm not sure how charging to see a GP would work out. Presumably, children, people receiving certain benefits and those with chronic conditions and pregnant women wouldn't pay. I guess that would be broadly the group who currently receive free prescriptions (minus pensioners). Only about 10% of prescriptions are paid for and I've seen arguments that the administration of the system costs more than the income from paid prescriptions. GPs would have to take on extra admin staff, so I'm not sure it would be worth it. My last two GP appointments have been initiated by my GP, not me. Would I have had to pay for them?

Apart from that. I agree with your post.

GrannyRose15

Iam is correct. Running care homes was outsourced by local authorities to the lowest bidders, who now claim they can't provide the services they promised for the agreed cost.

Meanwhile, I suggest you do some homework and find out how local authorities are funded. Most of their funding comes directly from central government, which has been making cuts for years. Councils were penalised for trying to raise extra funds through council tax and the formula has changed, so that councils with the greatest needs have had the biggest cuts. The government has been sneaky because local authorities have been left to take the blame for underfunding, whereas the truth is that it's part of a shift towards taking control away from local government and moving it to towards the centre and profit-making providers.

Not only that, but after 2011, the NHS was forced to transfer many clients to local authorities - to save money. Some of these clients needed medical care, which local authorities couldn't provide and they weren't compensated adequately for the extra responsibilities anyway. Many of these people have now been "lost" in the care system and aren't receiving the care they really need.

MOnica I’ve not seen anyone claiming the nhs is the best in the world just that we souls fund ut

I’d have a specific tax for the nhs
I’d introduce a charge of say £20 or £30 to see your GP. Obvs people on benefits wouldn’t pay. I’m retired not eligible for pension tax credits so I’d pay to see my GP

I’d take social care back to l.a and fund it. It shouldn’t be a for profit thkng

I do wish people would stop going on as if we were the only health system in the world that provides health care for all at the point of use and every other country has poor people dying in the street because they cannot afford care.

Most European countries and many other big economies, excuding the USA, provide care that is effectively free to all and on every list ranking medical systems, places the UK 10th at most.

No health system is actually 'free', we all pay indirectly through taxes. If it can be shown that the problem with the NHS is money, let us discuss how we should pay it. 5p on income tax? reducing expenditure on education, or reducing expenditure on global warning. How about reducing the government grants to LAs and let them raise Council tax.

The NHS needs more money. How do we pay for it?

GrannyRose, local authorities owned and ran residential and day care settings for children and older people, people with disabilities etc until austerity forced them to outsource to the cheapest bidder. Alongside this, excellent buildings and family centres were sold to raise much needed cash as government grants were reduced.

Public services should be publicly funded, not for profit. Social care has never been well funded. The current plan to give the nhs the money for social care is a disaster. The funds will be swallowed up into the wider nhs. That’s why we need co-ordinated planning. It’s something that’s bern the subject of endless reviews and good recommendations. All ignored over the past 12 years. Remember Johnson’s oven ready plan?

How could anyone not have been moved by the mother with a child with life threatening condition talking to the Minister for Health Steve Barclay today. I had tears in my eyes.

The NHS is admired and respected all over the world, where people just are left to die unless they are rich, very rich even. It is probably the best asset we have, and we should all be so proud and grateful for it, and do everything to save it from Tory greed.

Gabrielle56

I find it interesting that you think social care would be improve if it was put in the hands of local authorities. In fact it is, and that is part of the problem. Many care homes have gone bust in recent years because local authorities have refused to pay what it costs to look after the people in them. People supposedly paid for by the local authority have routinely been subsidised by other fee paying patients. And those fee paying patients got exactly the same poor level of care as those who had their fees paid for them. It has been a travesty for years.

I suggest improvements would begin if local authorities started to pay the true cost of care.

*BlondieScot,^Of course the NHS isn't perfect - no healthcare system is or ever will be, but it's far better than any alternative.^

Try looking at these links. Almost every ranking i could find placed us 10th on the list en.wikipedia.org/wiki/List_of_countries_by_quality_of_healthcare

www.william-russell.com/blog/countries-worlds-best-healthcare-systems/

All the medical systems in developed countries had systems that were inclusive of everyone. Not the same as ours, but quite effective and often delivering better outcomes.

The exception was the USA which delivered worse outcomes at greater expense and was not inclusive. It showed what an exception it was to the general trend. When comparing systems we would be better off ignoring the US and looking at how the many countries in Europe work. The answer it seems is better than us with better outcomes.

M0nica

growstuff we will have to agree to differ.

I'm not going to agree to differ about what Wes Streeting actually said. He didn't claim that the NHS needs root and branch reform.