Increasing taxes doesn't win elections so no one will do it. I'm pretty sure the Tories would rather let the NHS go under and bring in a US style system than do what is needed to support it. They'll just sling mud at doctors/locums/NHSE/individual hospitals until it's too late and bring in insurance based health care.
I'm not sure how much it would raise, but it seems crazy that we have an NHS crisis largely cause by an ageing population, but they pay less tax than everyone else.
I'm not sure how much it would raise, but it seems crazy that we have an NHS crisis largely cause by an ageing population, but they pay less tax than everyone else.
They pay less than anyone else because they have already paid more in total than anyone else and are no longer earning.
What is crazy is expecting those that are least likely to pay, to take up the cost rather than make an attempt to actually solve the issues of why the NHS is costly to fund.
The money you would raise from NI would not put a dent in things.
No wonder there is a recruitment option, its all stick and no carrot.
It will only get worse as demand increases and the government tries to squeeze as much as possible from the remaining doctors at the cost of future recruitment and current NHS workers.
No wonder there is a recruitment option, its all stick and no carrot.
It will only get worse as demand increases and the government tries to squeeze as much as possible from the remaining doctors at the cost of future recruitment and current NHS workers.
The new contract that was imposed on us is amazing.
If you have to work over your paid hours you have to report it. Then the trust can either give you time off in lieu or pay you. No trust has any money so they are forced to give doctors time off in lieu within 7 days iirc.
So as soon as it gets busy the trust then has to start giving TOIL hand over fist to avoid paying anyone and it snowballs.
Working for the NHS is just miserable most of the time. We're so close to going under every winter it's frightening.
They pay less than anyone else because they have already paid more in total than anyone else and are no longer earning.
What is crazy is expecting those that are least likely to pay, to take up the cost rather than make an attempt to actually solve the issues of why the NHS is costly to fund.
The money you would raise from NI would not put a dent in things.
Many over 65s are still earning. They have paid in over their life time, but the rate of NI paid was only that required to support the previous much smaller generation of pensioners (i.e. their parents).
Now pensioners form a much larger percentage of the demographic, and there are not a sufficient number of those of working age to sustain a similar level of care.
Asking everyone in work to contribute equally to the NHS seems perfectly fair imo.
If we had a private system, the cost of insurance for those over 65 would be astronomic, but in the public system the situation is reversed.
Unless we can find a solution, it's the elderly who are hardest hit. It's in their interests to find a workable solution.
The problem is so big that there is no such thing as a cure all solution without taking time and a multi layered approach. People suggest one liner solutions but:
-Taxing people more is not enough to fill the gap
-Recruiting more abroad will just be costly and self defeating in the long run
-Training more local doctors with the way our current system is funded is both not feasible and unreliable and does not alleviate short term shortages
-Restructuring management for efficiency wont see any benefits any time soon if at all on its own and so is bound to fail as patients and staff continue to lose confidence
If responsibility and power to improve the NHS was handed to someone competent with the time to implement a balanced and multi-targeted approach to improve the health service, then we would see small improvements immediately with large ones as new generation of trainee doctors are come through. Sad fact is, very rarely does anyone with that sort of swing has the time to make long term, ambitious and safe plans when the times are already tough. Our politics makes it impossible to carry any plan on that scale out smoothly.
It is fair but it wont solve anything. At most its just a statement to show that we are tightening our belts. How much of an effect do you think that will have?
The people that will feel the effect the most will not be patients, doctors, staff or the high paid earners over 65. It will be the over 65s that still do a bit of work because they cant afford not to, in the grand scheme of things, this money will be worth little to the NHS but much more in the pockets of these over 65s. Most people who work after that age do it for a bit of extra cash and to keep them a little busy, how many would just think it isnt worth working after that age if they were to take a paycut equivalent to NI
It is fair but it wont solve anything. At most its just a statement to show that we are tightening our belts. How much of an effect do you think that will have?
I'm not sure how much it would raise, but it seems crazy that we have an NHS crisis largely cause by an ageing population, but they pay less tax than everyone else.
They pay less than anyone else because they have already paid more in total than anyone else and are no longer earning.
What is crazy is expecting those that are least likely to pay, to take up the cost rather than make an attempt to actually solve the issues of why the NHS is costly to fund.
The money you would raise from NI would not put a dent in things.
I usually agree with you but I think you are not quite right on the age issue. Yes NI contributions don't fund the NHS but certain pensioners are going to have to contribute some way. Take my nan for example. She requires quite a lot of treatment (she is 80) but only ever really worked part time roles. I am almost certain that she exhausted her working contributions by the time she was 62!
The NHS was simply never designed for it's current needs. In 1950 the life expectancy was probably not much more than 65 so post-retirement you would only be a "burden" on the system for a few years rather than the 20+ there is now.
The new contract that was imposed on us is amazing.
If you have to work over your paid hours you have to report it. Then the trust can either give you time off in lieu or pay you. No trust has any money so they are forced to give doctors time off in lieu within 7 days iirc.
So as soon as it gets busy the trust then has to start giving TOIL hand over fist to avoid paying anyone and it snowballs.
Working for the NHS is just miserable most of the time. We're so close to going under every winter it's frightening.
You are right in saying that many elderly people are costing the NHS more than they contribute but my point is that charging them a tax would be financially crippling on low income earners and would make very little difference to overall funding.
A tough question but i would be looking at tackling costs, recruitment and negative issue before starting to think about charging tax payers more. there is an order to implementing several solutions to the same problem that could make things easier and asking the public to pay more would be much easier to swallow if they didn't have the mentality that it would be wasted cash.
As i posted earlier as an example solution of what i would do to alleviate the pressure the NHS is under:
First problems to look at is cost (not funding) and a lack of doctors. We are wasting money on agency doctors to fill the gaps in the immediate short term. We are also wasting money recruiting overseas to fill specialist roles. The lack of doctors in the NHS can be put down to a lack of appeal to work due to conditions and also more appealing pay. Unfortunately these are all necessity's at the moment, as well as the money we splurge on subsidising medical training for local students, which most end up private or overseas in more appealing jobs.
It seems like a leaky trade ship where money is being used to plug the holes. We need to plug the holes but at this rate we wont be able to keep up with this venture.
What do we have to our advantage in the UK?
We have great medical schools, an abundance of applicants (while the job role still seems appealing), apart from money we have all the resources to train them.
Medical students pay a different tuition cap to other students due to cost of training. Local students are HEAVILY subsidised straight from NHS budget as well as the schools budget. I would take away the NHS subsidy as it is and replace it with a loan which becomes void after x years service in the NHS or can be paid back at a % if they leave prior to that. This creates an influx of new NHS dedicated doctors, does not discriminate on personal wealth and makes becoming a doctor more appealing. Unfortunately results wont be seen until the mid term. Short term alleviation of NHS pressure would have to be achieved by external hiring or offering slightly lower tax incentives to NHS workers. Offering lower taxes for NHS workers wont harm the the overall budget as the NHS wont be paying the insane premiums that agencies receive to fill doctor/nurses gaps.
The resource for this solution is essentially the applicants for medical courses. They would suddenly see a increase tuition bill but with a clause that they needn't pay it if they complete x years service. This cost of their training at the moment is unseen by students.
This is the classic carrot and stick method for doctors. Stay and do your time in the NHS and you dont have to pay back the extra cost (after tuition) of training you (which is not paid by anyone but taxpayers at the moment) and enjoy the benefits of small tax incentives while we still require external hiring to cover roles we are desperate for. Or go big bucks private after you qualify and pay it back with every pay-cheque, you have benefited from our training which was paid for by loan from us, you can pay it back.
Conditions will inevitably improve in the NHS with doctors choosing to pay off their training cost in service and tax incentives wont be needed to attract specialists.
After all this, a tax increase pill may even be easy to swallow if the public saw that service and recruitment has gone up without a tax increase and just having a tighter grip on NHS resources.
Why is all this impossibly difficult too implement in our current climate?
It requires not money but power, no accountability for political backlash and time. You cant implement a 10 year plan that requires the most powerful people in medicine and education to implement when these people are swapped out all the time for the sake of politics. Opposing politicians will label it an obscene increase in tuition fee when really there would be no increase if the doctors did their NHS service. The money is being spent already, it is just the bill goes to the NHS rather than the student but with no guarantee the NHS will get anything back from it
Unfortunately politics would make it impossible to implement.
You are right in saying that many elderly people are costing the NHS more than they contribute but my point is that charging them a tax would be financially crippling on low income earners and would make very little difference to overall funding.
A tough question but i would be looking at tackling costs, recruitment and negative issue before starting to think about charging tax payers more. there is an order to implementing several solutions to the same problem that could make things easier and asking the public to pay more would be much easier to swallow if they didn't have the mentality that it would be wasted cash.
As i posted earlier as an example solution of what i would do to alleviate the pressure the NHS is under:
First problems to look at is cost (not funding) and a lack of doctors. We are wasting money on agency doctors to fill the gaps in the immediate short term. We are also wasting money recruiting overseas to fill specialist roles. The lack of doctors in the NHS can be put down to a lack of appeal to work due to conditions and also more appealing pay. Unfortunately these are all necessity's at the moment, as well as the money we splurge on subsidising medical training for local students, which most end up private or overseas in more appealing jobs.
It seems like a leaky trade ship where money is being used to plug the holes. We need to plug the holes but at this rate we wont be able to keep up with this venture.
What do we have to our advantage in the UK?
We have great medical schools, an abundance of applicants (while the job role still seems appealing), apart from money we have all the resources to train them.
Medical students pay a different tuition cap to other students due to cost of training. Local students are HEAVILY subsidised straight from NHS budget as well as the schools budget. I would take away the NHS subsidy as it is and replace it with a loan which becomes void after x years service in the NHS or can be paid back at a % if they leave prior to that. This creates an influx of new NHS dedicated doctors, does not discriminate on personal wealth and makes becoming a doctor more appealing. Unfortunately results wont be seen until the mid term. Short term alleviation of NHS pressure would have to be achieved by external hiring or offering slightly lower tax incentives to NHS workers. Offering lower taxes for NHS workers wont harm the the overall budget as the NHS wont be paying the insane premiums that agencies receive to fill doctor/nurses gaps.
The resource for this solution is essentially the applicants for medical courses. They would suddenly see a increase tuition bill but with a clause that they needn't pay it if they complete x years service. This cost of their training at the moment is unseen by students.
This is the classic carrot and stick method for doctors. Stay and do your time in the NHS and you dont have to pay back the extra cost (after tuition) of training you (which is not paid by anyone but taxpayers at the moment) and enjoy the benefits of small tax incentives while we still require external hiring to cover roles we are desperate for. Or go big bucks private after you qualify and pay it back with every pay-cheque, you have benefited from our training which was paid for by loan from us, you can pay it back.
Conditions will inevitably improve in the NHS with doctors choosing to pay off their training cost in service and tax incentives wont be needed to attract specialists.
After all this, a tax increase pill may even be easy to swallow if the public saw that service and recruitment has gone up without a tax increase and just having a tighter grip on NHS resources.
Why is all this impossibly difficult too implement in our current climate?
It requires not money but power, no accountability for political backlash and time. You cant implement a 10 year plan that requires the most powerful people in medicine and education to implement when these people are swapped out all the time for the sake of politics. Opposing politicians will label it an obscene increase in tuition fee when really there would be no increase if the doctors did their NHS service. The money is being spent already, it is just the bill goes to the NHS rather than the student but with no guarantee the NHS will get anything back from it
Unfortunately politics would make it impossible to implement.
At the moment students partially pay their training with tuition and nhs picks up the rest but if you force students to take on the NHS' cost of training by loan which is repayable through income if they seek private work or void if they do a certain so many years within the NHS, you guarantee the people the NHS pay for will dot heir time or pay back what they owe.
Takes a cost of teh NHS and uses it against people who wish to get trained but not work for the NHS.
At the moment students partially pay their training with tuition and nhs picks up the rest but if you force students to take on the NHS' cost of training by loan which is repayable through income if they seek private work or void if they do a certain so many years within the NHS, you guarantee the people the NHS pay for will dot heir time or pay back what they owe.
Takes a cost of teh NHS and uses it against people who wish to get trained but not work for the NHS.
What I've been advocating all along. I'd take them up.on it. The only thing stopping me applying to study medicine again is the tuition cost. Far too sensible though.
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