Forum Topic

Strikes

For the life of me I really do not understand what some of these government ministers are on these days, Steve Barclay (Health) waffling on about how the nurse's claim for 19% rise is too much and he won't discuss it. Surely to God the art of negotiation is that you sit down together and you try and get both sides to reach a reasonable compromise, people do it all the time. Watch some of the dealers on T.V. programmes whether it be bargaining over cars,  antiques, salvage, whatever - it works because both sides want to have something the others have. All the government wants to do is demonise the Trades Unions for doing what they exist for, representing their members and protecting their pay and conditions. It's bugger all to do with negotiation, this is an ideological exercise by this rubbish government, our way or the highway 'cause we're the hard men here - pathetic. It seems patently obvious to most people that all these public sector employees going out on unprecedented strikes is because they've had enough, this government is quite happy to keep ensuring all their mates carry on lining their pockets, then they wonder why the people at the bottom of the pile are getting stroppy. They should get down off their high horse and start proper, meaningful talks - there are deals to be done the unions have intimated as much, the ball is in the government's court.

Vanessa Smith ● 1370d99 Comments

The Government's refusal to sit down and discuss what is happening speaks volumes about their sincerity. A lot has been made about the Independent Review Board's recommendations yet it seems that when the Chancellor was Health Secretary he decided to ignore the Independent Review Board's recommendations.

Philippa Bond ● 1370d

19% is too much in my opinion.They are asking for 5% above inflation and when inflation goes down it will be even more above.They do have a good case for a sizeable increase and this intransigent government needs to get a grip on negotiating a solution,but looks like that ain't gonna happen any time soon.

Keith Iddon ● 1369d

I hope the government have really underestimated how much support the nurses and ambulance drivers have

Vivienne Cox ● 1369d

There was a young woman on the World at One this week who is a chemo nurse in Newcastle and she earns £22k a year. That's just f***ing ridiculous.

Susan Kelly ● 1369d

The average oncology nurse salary in the United Kingdom is £37,000 per year or £18.97 per hour. Entry level positions start at £33,302 per year while most experienced workers make up to £49,069 per year.Perhaps you misunderstood her

Jayne Thorburn ● 1369d

Or maybe they were a band 3 nurse who's starting salary is £22k. Or like you said, perhaps it was a misunderstanding.

Andrew Jones ● 1369d

Where would Vanessa get the extra money from ? Regardless of the rights or wrongs somebody gets more money somebody else has to pay fo it.

John Southey ● 1369d

Yes where would we get the money from?We have endless money for war. We seem to have endless money to had to hand over to Tory favourites for useless PPE.This horseshit excuse has been the go to answer from them for years. People have now seen with their own eyes a money tree does exist for certain people.At least get round a table with the nurses and negotiate.

Basil Finnis ● 1369d

I think there is a lot of concern about 'on costs', particularly the pension contributions,associated with any big rise inn salaries.I think that with NHS pensions,which are recognised as being pretty good,employees contribute 10% of salary and employers 16%.That was the situation a couple of years ago I believe, but whether that has changed or not I don't know.When we say the employer has contributed, we mean the taxpayer.

Keith Iddon ● 1369d

Yes, Basil.And they could waste £37b on a useless track and trace and seem to have turned a blind eye to the fraudulant claims made for money made by some sheisters during lockdown.That's another £7b.

Keith Iddon ● 1369d

Don’t think we can compare the money tree as it’s called debt hence tax rises to pay it down. I also don’t think we can compare support for Ukraine and covid for obvious reasons, our future security and global pandemic respectively. Trainee nurses I believe are grade 1 to 3, I think if they considered a tiered approach for wage rises that could be an option clearly many staff in the NHS earn a pretty sum and they should not be included. Plus of course many also do private work so it’s a very complex picture because it is so big.

Jayne Thorburn ● 1369d

My thoughts are that money is budgeted for defence as money is budgeted for the NHS. Money for wars is borrowed money as was the case for covid.The treasury i believe has never borrowed money for wages thus boosting the national dept. And goverments and the treasury have never taken money from one pot to pay more into another pot.

Julian Pavey ● 1369d

Where would Vanessa get the extra money from ? Regardless of the rights or wrongs somebody gets more money somebody else has to pay fo it.Given that Theresa May kept saying there was no money tree and then promptly found a small forest of them when it suited, and since then we've had the scandals of the track and trace fiasco, all the PPE now being destroyed that cost a mint and as for the money spent on Brexit and now Baroness Mone ripping us off, I'd say there always money to be found when it suits the government. Also, I think the majority of people would have no problem paying a bit more in tax if they know it's ring fenced for the NHS. The crux though is to TALK - the TUs have made it abundantly clear they are ready and willing, all these things come down to bargaining until a satisfactory compromise is found. Sunak putting his political future before the country is despicable - but, sadly only too typical of this Tory rabble. They're not hard men, they're arrogant idiots.

Vanessa Smith ● 1369d

"the majority of people would have no problem paying a bit more in tax" Not at the moment they will not. You listen to talk radio stations and even people on middle income wages are suffering. Tax rise now is not the solution and no goverment right now would think that as a solution And many peoples answers are not based on long term money pots but short term solutions. 7.5% has now been rejected by the GMB union in scotland. As i said,the likes of covid was borrowed money,you dont borrow money for wages.

Julian Pavey ● 1369d

The amateur economists are devising new versions of the Golden Rule.

Robert Fish ● 1369d

Afaik governments of either colour have new spent the 'war chest' on public services, pay rises etc, and I don't think they borrow money for going to war(did they during the Falklands conflict?).Apparently a 1 percent pay rise for the NHS would cost £750m.

Keith Iddon ● 1369d

That's 'never spent the war chest'

Keith Iddon ● 1369d

YepNo economists on here,thats for sureAnd money for war is always on borrowed money.NHS in 1984 cost £130m,the war cost 2.8bn

Julian Pavey ● 1369d

' Money for war is always borrowed'First time I've heard that..evidence?

Keith Iddon ● 1369d

Like railways and roads,goverments sell bonds to finance We call them giltsDont need to find evidance,its known fact.Why do we borrow and the national dept goes up. Because money coming in does not cover these things. Like wars,borrowing goes up.

Julian Pavey ● 1369d

Is there anywhere, available, a chart setting out all government spending? It would be good to see it in black and white and understand how much the Rwanda allocation would go to help the NHS staff.

Vivienne Cox ● 1369d

The UK paid the last of its Govt loans for WW2 back in 2006!

Philippa Bond ● 1368d

When did Germany pay its reparations?

Keith Iddon ● 1368d

Isn't it interesting that today's ambulance strike has led to quiet A&E departments? What does this mean? Do people normally call ambulances and go to A&E when they really don't need to? Or are we going to see another surge in excess deaths in a few months time as people didn't get timely treatment?

Susan Kelly ● 1368d

Because people are told to dial 111 if they are feeling ill, next thing an ambulance arrives.  Think it's 111

Janice Evans ● 1368d

Ukraine is a good example Keith.

Janice Evans ● 1368d

I have to say when we have had to 'phone 111 - only twice from memory - we've found them useless, let alone them magic up an ambulance. We landed up taking my son to WMUH ourselves - just as well as it panned out he was quite ill with Pneumonia after the 111 'advice' that he wasn't that ill to warrant an ambulance, even though we all but had to carry him!

Vanessa Smith ● 1368d

Must be hit and miss.  I have had useful help from 111.  Last time they organised a very quick telephone call with a doctor who then asked to see me straight away.

Vivienne Cox ● 1368d

I was 20 years in a job where I had to phone 111 for others quite often,and it much depended on who answered the phone as to the usefullness of the advice.I remember the pre 111 days, you know..the days when you didn't have to wait 4 hrs for an ambulance.

Keith Iddon ● 1368d

One of the concerning things about the nurses dispute is the outright lies told by the goverment about the costs.Steve Barclay said  “If everyone in the public sector had a pay rise in line with inflation, it would cost an extra £28 billion, an extra £1,000 per household."The total costs for all NHS staff (not just nurses) in the financial year 2020/2021 was £62.5 billion.  (I do not know if this includes expensive agency staff).So the gross cost of a 19% payrise for all NHS stafe would be less than £12 billion.But at least 33% of this increase would come straight back in PAYE and NI, collected at source even before it is paid.  That reduces the cost from £12 billion to £8 billion.Then (if recent reports are to be believed) many of the lower paid NHS staff recieve universal credit.  This cost may reduce if wages are increased.And that £8 billion net increase in pay will be spent. Let's assume half of that is spent on goods and services subject to VAT.  That's about another £1 billion extra collected by the government in tax.So we are down to £7 billion (at most) before we look at the multiplier effect from spending in the local community (creating jobs, wages, and hence more tax to be collected).And this is before we bring into account greater productivity from greater recruitment, people being "made well" and returning to work sooner, etc.Last year London Economics ("one of Europe’s leading specialist policy and economics consultancies") calculated that 81% of the costs of a 10% payrise would be recovered by the Government.  See https://londoneconomics.co.uk/blog/publication/the-net-exchequer-impact-of-increasing-pay-for-agenda-for-change-staff/So the £12 billion gross costs would in fact cost the government (i.e. us) about £2.28 billion.There are an estimated 28 million households in the UK. So the true net cost per household to fund a 19% pay rise across the board in the NHS is about £82 per household.Even if we take the starting point of £12 billion costs, and only deduct the 33% PAYE and NI deducted at source (so £8 billion) this equates to £285 per house hold - about £133 per person per year.I am more than happy to pay an extra £2.50 a week for a properly paid NHS staff.Frankly, I am happy to pay a heck of a lot more. But that's a personal view.But I am not happy, on any level, being told outright lies by Government ministers about the costs of funding the NHS.When someone lies about their reason for doing something, it means they have another reason.  We can all speculate what the government's true reason is. My view is that this is a step to dismatle the NHS:  "Look. We can't afford it.  We had better privatise it".

T P Howell ● 1368d

That's all well and good,but I was under the impression  there was an upper limit on national insurance contributions, but I may have that wrong.If there is,then more people will move into it as salaries rise if the limit is not adjusted upward accordingly.Also,pension contributions are not taxable(and perhaps not NI able)so the increased contributions from any pay rise will not be taxed,whilst the employer will pay more in contributions for both tax and NI for every employee.The £285 per household you claim will pay for this rise for many will be a lot,especially if there is only one person in that household.Of course, there are many people who live in places similar to W4 where it will not be too much of a squeeze,but what about the rest of the country?I know the government are smokescreening a lot of the facts,but I think it better if unions moderated their demands to say 12% and there was a cap on who received it.An NHS manager who may already be on £100K+ is hardly as deserving a case as a porter,nurse or admin,staff in my opinion.

Keith Iddon ● 1368d

Possibly some of the households are under the tax threshold, so wouldn't pay more.We also don't really know how much the unions would reduce their demand down from 19% - aren't they saying they want to negotiate, so that must mean some compromise.  Steve Barclay could ask them.

Vivienne Cox ● 1368d

True. But the 33% calculation was based on a basic rate (20%) tax payer.Someone on £100k suffers a tapering away of the personal allowance, so the marginal rate of tax is over 60%.In fact, someone on £100k given an extra £10k a year will pay an additional 66% tax and NI.So in fact my figure of 33% immediate claw back underestimates the true amount because it only accounts for basic rate tax.

T P Howell ● 1367d

'We also don't really know how much the unions would reduce their demand down from 19% - aren't they saying they want to negotiate, so that must mean some compromise.  Steve Barclay could ask them.'Exactly - it's all about talking, the unions have said they are open to a deal - but if the government just turns its face away - preferring to act the 'Big I am' hard men, then what can they do?

Vanessa Smith ● 1367d

NI contributions are for the first £52k of salary.Over that amount,none is paid afaik.

Keith Iddon ● 1366d

I totally support the nurses and ambulance drivers strikes. These people deserve more. And Steve Barclay lied about the actual cost of a pay rise. However, the striking rail staff are just being ridiculous and greedy!  They are already paid enough and their strikes have harmed the economy and continue to do some. The fact that they chose to strike just before Christmas is unforgivable. They have crippled many small businesses at a time when trade was most necessary in order to survive. Their behaviour has been abhorrent. I have zero sympathy for them now.

Steve Taylor ● 1354d

We were visiting a Hospital leading up to Christmas, during and after andnever see any ambulances in a queue.

Janice Evans ● 1354d

From what I can gather, the ambulance queues are more abundant in Wales, Devon and Cornwall as well as parts of the Midlands.

Steve Taylor ● 1353d

Oh is that a fact, ok thanks.

Janice Evans ● 1353d

It is not a fact Janice.Ambulance queues are occurring right now, outside hospitals serving the conglomeration of our towns and cities throughout the country. You can see and hear it daily in the news  bulletins.A few months ago I went with a lady who had broken her arm in a fall that afternoon to A&E at WMH. She waited in distress, along with others for 4 hours before receiving medical attention.During our time there the stressed receptionist had to frequently apologize to the waiting throng for the long delays, due mainly to a fleet of ambulances carrying patients unable to enter the overcrowded waiting area.It was evident to me, and the suspicion shared with reception, that a good proportion of people present had lost patience with a routine GP's appointment for their coughs and sniffles and gone instead to A&E.The system is indeed broken.

Denis I. Fox ● 1353d

I was also at WMH in october with youngest waiting in A&E with possibble fracture due to beinf fractured months ealier and could not walk. We arrived about 1.30 and it was crowded to the point no seats available. By 3.30 - 4.30 about 30 kids and parents had arrived in A&E obviously from schools. They get priority due to age but we did not get seen to until about 8pm. That is about 7 hrs wait and others before us were still waiting.What go me is the children turning up with parents from schools had in about an hour all made short term friends and were all running around playing.Facts are,too many people dont need A&E and others are in  A&E becasue they have even been told to go by 101 or they cant get to see a doctor.Most of those children were called and out within 5 mins. One mother complaining to friend waiting that they have said nothng wrong with XIts a mess

Julian Pavey ● 1353d

Why are Ambulances taking them to busy hospitals if some are not so busysurely driving a bit further for quicker treatment would help.

Janice Evans ● 1353d

The NHS was always going to get to a point when in its current form is broken, it has be brewing for years because no government has had the courage to modernise the system. Population size, increase in age, modern technology have all played a part in pushing the outdated system over the edge. The reality is it was on the edge then covid comes along and pushed it over. Super sad but we really need to have a grown up conversation about how we modernise a health/social care system which is fit for the future.

Jayne Thorburn ● 1353d

I was in a job for many years that involved calling ambulances for people and if you are in any doubt that the service has declined over the 8 or 10 years,let me tell you that a 4 or 5 hour wait and sometimes longer for non life threating injury has been the norm over that period.I no longer work in that post,but I know from ex colleagues that it is far worse now.

Keith Iddon ● 1353d

Keith for so many reasons we can’t expect the service to be s good as 10/20 years ago it is outdated but no one dares touch it partly because it is so big now one of the largest employers in the world it will take courage, vision and money both tax payers and private to really transform it into a future proof service. Social care alone is a massive challenge. The numbers using the system run into eye watering numbers daily, big challenge.

Jayne Thorburn ● 1353d

I don't see whay we can't expect as good a service as'10/20 years ago',and that applies to all areas of life.How is there ever progress if we don't expect better? I am a believer in localising power,and that includes the NHS.It still gets a great many things right and is more robust that we are led to believe imo.It does need reorganisation and more targetted funds.

Keith Iddon ● 1353d

From Private Eye:"Nothing can fix the NHS quickly. It has been in decline since the crash of 2008. Its best years were under former Prime Minster Tony Blair, when a thriving economy allowed planned investment, short waiting times and a focus on quality and safety. These were all reversed by a decade of austerity, not helped by former health minister Andrew Lansley's dysfunctional Health and Social Care Act 2012 and crippling PFI debts many hospitals were saddled with by Labour's outsourcing policy."

Vanessa Smith ● 1353d

"Its best years were under Tony Blair"Hardly. Our population has grown by 10 million since Blair and Brown between them opened the floodgates and allowed eastern Europe in. Without any thought to expanding our social infrastructure. Without this seismic decision being on Blair's manifesto.

Denis I. Fox ● 1353d

There has been a deliberate running down of the health service over a great many years because there are people who do not believe in paying more or maintaining a better service as the number of elderly increase and the amount of medical solutions increase, and they themselves know that they can pay should they need to.  Well they and theirs may feel flush now but that may not always be the case. Not all medical interventions cost more money but stretching, straining and underfunding services so that those who work in it now feel forced to strike shows the severity of the problems.The small rehab hospitals are invaluable for extra physio for those needing this before discharge home.  Patients in their 90s have in the past been discharged and delivered home in the middle of night to their empty home with no heating on because that is the only time that ambulances were available.  Many then end up back in hospital again.  Did you know that you can have a hospital where although the doctors have a surgery there they are not allowed to visit their patients on the floor above?Continuity of care and a joined-up system is very important. It isn't just the shortage of underpaid carers both in and out of hospital.  It is the families who live far away from their relations and who are striving and need to earn a living and the elderly who steadfastly refuse to move and live nearer their family and/or to lose their independence and closeness to their own friends.  There needs to be a compromise and solution there somewhere.  Downsizing may mean that you have nowhere for a carer or your own family to stay yet staying in your own home may mean that it becomes too difficult to manage even with adaptations.Not preparing adequately for an expected sometime pandemic or maintaining gas storage for a potential energy crisis is a consequence of a philosophy which only values short-term profit and low taxation.    The prosperity of a country can be measured by the state of its services and infrastructure.   

Philippa Bond ● 1353d

You start by talking about Steve Barclay is telling lies by saying 'If everyone in the public sector had a pay rise in line with inflation, it would cost an extra £28 billion, an extra £1,000 per household."You then go on to talk only about the NHS. Doesn't seem a reasonable analysis when he said 'everyone in the public sector' not just the NHS

david ward ● 1352d

It's surprising the NHS is in such a state with the £350 million extra a year!  Every time a Govt spokesman is put forward "more money than ever before" has been put in.  Considering the population is still growing I should think SO!Those incomers from Europe in the majority are younger, work and pay taxes whereas otherwise we have a growing elderly population many of whom don't and haven't paid in enough tax relative to the length of time people are now living - as raising tax tends not to be a vote winner when it actually comes to the ballot box despite many asserting they would be in favour.  Privatisation is often just of uncomplicated operations - and when anything goes wrong an NHS ambulance is phoned to take the patient to an NHS A&E.There was also the difficulty with the confusing changing views of the Catholic Church.https://theconversation.com/the-pope-and-the-pill-how-catholic-women-got-creative-with-the-churchs-teaching-on-sex-127297

Philippa Bond ● 1351d

What has the Catholic Church got to do with problems in the NHS?The £350m figure is per week, not year.The NHS problems aren’t to do with the amount of money going in but rather where and how that money is spent. There’s an awful lot of waste, unnecessary bureaucracy and poor planning. The current stress on the system could have been alleviated by giving free Covid and flu vaccinations to everyone, not just certain vulnerable groups. The cost of prevention is far less than the cost of treatment.

Simon Hayes ● 1351d

LOL. £350 million a week? -  an even worse PR lie and myth.  Of course it costs a lot but it is less spent per head than in other European countries and better for the whole nation than the American system.  There will always be waste if you look hard enough. and it can be harder to svoid that if you are understaffed and under pressure.  With privatisation able to cherry-pick the easy to outsource interventions the NHS is left with the more complex and chronic ones.  Who exactly still thinks it was such a waste preparing and being prepared for the expected sometime pandemic?  They aren't always world-wide and quick intervention by the wealthier countries in the west has helped to stop other epidemics spreading across countries.  And why were there recently newspaper reports of PPE being destroyed and yet aren't there still scrubs being made by volunteers?  Have we so quickly forgotten the efforts of individuals, companies and schools in making PPE to protect local people working amongst the local population and round the country?What about all the hospital letters outsourced so that they could be warehoused instead of dealt with leaving patients without information and treatment?  Remember how doctors' surgeries used to phone you up with results of investigations and tests - and then just suddenly stopped with no notice?It all adds up to the stresses and strains on a workforce whose number was over 100,000 short before the pandemic and worked right through it.It would be useful to be able to use some of those care homes we used to have to expand into as rehab centres if they hadn't been sold off to overseas companies and asset stripped and turned into empty investment flats.  Of course there will be no staff because so many workers have left the country or are exhausted and are ill or retired and may not be guilt-tripped and persuaded to return again to work if their working staffing and pay conditions don't improve. 

Philippa Bond ● 1351d

The NHS in its current form is just not sustainable it is that simple, this day has been coming for years it needs complete reform.

Jayne Thorburn ● 1351d

Philippa, most elderly have paid in all their life and not just starting to payin so think they have actually paid in far more than many others.

Janice Evans ● 1351d

At the moment the National Health Service is crippled by the lack of a corresponding National Care Service.  As it is, social care is a separate set-up, left to cash-strapped local authorities to look after, who frequently relying on cheap-skate private companies paying rock-bottom wages.  While once we had cottage hospitals and convalescent homes, we now have 'healthy' patients piling up in hospitals because there's nowhere else that's safe for them to go.

Peter Evans ● 1351d

That is true and social care is means tested so not free at point of use, it is a major challenge for society hence the reason the NHS needs reform to incorporate social care. The challenge is lack of staff, how funds are spent, wastage, inefficient practises hence the need for major reform which will take many years

Jayne Thorburn ● 1351d

Exactly.  This time has only been coming because of the totally deliberate actions of a Govt who have been running down the state including the NHS.  Run down so that everything can be privatised including social care.  Not joined up hospital and social health care has caused this particular problem but it has been happening for years. With all the Govt cuts to Councils and a growing elderly need for care they can and will only pay a certain amount to the private care companies.  These companies are supposed to pay travel costs to their workers but many don't.  When I looked at a carer's timetable there were several service users timetabled for the same time or overlapping in their different houses.  No wonder that many have choose to move to better paid and less stressful jobs with easier hours. This has been happening for years too.The children of those needing care are often living miles away and can't afford to give up their jobs although that actually may be easier since the pandemic with working practices changing to be more flexible.  Parents quite understandably may not want to give up their independence and their homes to move closer to their children and away from their friends and familiar places.Low tax suits most those who do not need these services.  Taxes have not been enough for years.  Our tax system has been designed to suit those who don't want to pay it and needs radically overhauling to a fairer system.Brexit was desired primarily by those who were interested in avoiding the impending new EU laws on Tax Avoidance and was sold to the public by pandering to their fears and prejudices..

Philippa Bond ● 1351d

Philippa re tax you don’t know what you are talking about we are highly taxed in multiple way with little or no tax credit. In 1974 Labour spilt off social care from the NHS and Blair brought in means testing. So government recognises there is not enough funds to deliver the standard of services requirement and tax 1% of the population so higher earners will not solve this. The whole system needs rethinking and the reality some services will be charged A&E is not there for things that local clinics, doctors, pharmacies can handle  as a society we abuse the NHS. The NHS can not pick up everything.

Jayne Thorburn ● 1351d

Janice:  We have not been paying enough even if we paid all that we were asked to pay because it wasn't raised because of unpopularity and fear of pay back at the polls.  Pension ages have now been changed for women but many it seems were too busy working and looking after their families and were not aware of the changes and Govt have been accused of not making enough effort to contact them so many have had to suddenly change their plans for the future. There is still a chance to pay more in and those who this may concern should look for the info (Martin Lewis has some) pronto as the opportunity to pay in any more to fill gaps (if you can and if it will be of benefit to you) have a short amount of time to do so.https://www.waspi.co.uk/https://www.moneysavingexpert.com/savings/voluntary-national-insurance-contributions/#

Philippa Bond ● 1351d

Philippa, wasn't it the women's rights that brought about the changes.

Janice Evans ● 1351d

The NHS could do a couple of things to bring in a small but significant amount of money by charging patients for missed gp and hospital appointments where the patient has not informed the surgery or hospital of non attendance(ever missed appointment like this denies someone else treatment) and tighten up on charging for 'health tourists'.No NI number or proof of residence,no treatment without insurance or payment.This would not be for emergencies etc. but for anyone from abroad trying to get free on going treatment for any condition.It is a finite resource and cannot be abused like this as those who have paid their taxes and NI are entitled to be seen first in my opinion.

Keith Iddon ● 1350d

Good point Keith that has been going on for a very long time.

Janice Evans ● 1350d

We cannot blame them really it was never sorted.

Janice Evans ● 1350d

There are measures in place to ensure that people not ordinarily resident in the UK need to pay upfront the cost of any treatment. No one really knows the true cost of ‘health tourism’ but it may or may not be about 0.3% of the total NHS budget - there is evidence to suggest that the system is abused significantly by British people who live abroad but who return temporarily as they do not want to pay in the country where they are ordinarily resident.

Stewart Jones ● 1350d

There are some measures in place now but fairly recent I believe, that'strue that some Brits do return for treatment but had paid towards it in the past.

Janice Evans ● 1350d

That is a very good point I know a few and that’s just me 😂😂😂 it needs sorting that we all know. I don’t think people would have an issue to pay a small amount for every doctors appt and contribute to procedures, everyone paying a small amount at point of use would go along way to help funding along with  fixing health tourism etc.

Jayne Thorburn ● 1350d

0.3% if indeed it is that figure of the NHS budget, is a significant amount of money.

Keith Iddon ● 1350d

Janice  As I understand it there used to be a mandatory retirement age for both men and women. I'm not sure that it was anything to do with women's rights.  Women were still considered to the husband's chattel and could not take out a loan for hire purchase when I was at college.  But women also have done most of the child care and elderly care in a family and so often were only earning part-time. It doesn't seem that long ago that a women's pay was spoken of as 'pin money'.  This is interesting:https://www.historyandpolicy.org/policy-papers/papers/the-scandal-of-womens-pensions-in-britain-how-did-it-come-about

Philippa Bond ● 1350d

It is but reducing it is not going to resolve the financial problems that the NHS faces.

Stewart Jones ● 1350d

Idid not say it would.I said it was a rewlatively small but significant amount of money.Have you any suggestions?

Keith Iddon ● 1350d

Charging small amount to see GP and small contribution for procedures which will of course be mean tested that’s the way it is going. I agree that missed appointments should be charged and possibly drunk behaviour attending A&E 😂😂😂😂

Jayne Thorburn ● 1350d

As I have pointed out there are measures in place to ensure that people who are not ordinarily resident in the UK pay in advance for their treatment so that leaves you with one of your suggestions left - I don’t disagree necessarily with charging for missed appointments.

Stewart Jones ● 1350d

The sad truth is that we can no longer afford the NHS in its current format no amount of tax rises can fund the billions it needs the only option is to charge not huge amounts for residents, all overseas visitors must pay no exemptions

Jayne Thorburn ● 1350d

Yes there are procedures in place to charge tourists or non residents for anything bar emergency care,but it could probably be tightened up to reclaim that relatively small but significant sum,which could be used to by much needed equipment or whatever else.But when we also have a government that has written off the 5 billion of our quids that were  fraudulently claimed during lockdown.

Keith Iddon ● 1349d

We can afford it. We choose not to.

Stewart Jones ● 1349d

The sad fact is that the NHS is abused. 64% of people booking a GP appointment don't actually need one. They book it because it's FREE.  58% of people turning up at A&E don't need to because it's not an emergency. They go there because their GP is fully booked with the 64% of hypochondriacs who don't need to be there. Charge everyone £35 per GP appointment and £50 per A&E visit and you will soon find that these people are miraculously cured. Offer a FREE service and they will continue to abuse the system. It's shameful.

Steve Taylor ● 1349d

The striking rail staff are just being ridiculous and greedy!  They are already paid enough and their strikes have harmed the economy and continue to do some. The fact that they chose to strike just before Christmas is unforgivable. They have crippled many small businesses at a time when trade was most necessary in order to survive. Their behaviour has been abhorrent. I have zero sympathy for them now. The average pay for a train driver is 3.5 times more than the average pay in the private sector. Even nurses average pay is £11k more than the average private sector pay but it could be argued that by the nature of their job, they deserve. As do Ambulance drivers who are paid a third of average train drivers pay.

Steve Taylor ● 1349d

https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-hospital-beds-data-analysis

Philippa Bond ● 1349d

Steve I agree that people abuse the NHS system because even though some people pay NI which is a contribution to healthcare the perception is that it is free. Free = no value we can’t continue as it is if we want an efficient healthcare system we will have to pay for it at the point of use. I agree that the pressure would drop immediately for those that abuse the system because they would like twice.

Jayne Thorburn ● 1349d

In my experience, an individual's views on the NHS and how / how much to fund it are very closely linked to their Party political preferences.Clearly this won't be 100% accurate as a predictor but I personally know of no Labour Party supporters who believe that any sort of payment at the point of delivery is either desirable or workable and no Conservative Party supporter who doesn't. Stewart's point "We can afford it. We choose not to", seems self-evidently true to me and is a useful reminder of the "Magical Money Tree" which was a precursor to Theresa May's “confidence and supply” agreement of £1bn with the DUP in 2017.In terms of Grant Shapps' strike control bill, just presented to parliament, this would appear to be a deliberately polarising statement by Rishi Sunak to differentiate his party from the others.  A combination of Shapps' recent failures re P&O, TfL funding and Hammersmith Bridge, make this an interesting development to follow.  I hear that he is under fire, again, for allegedly editing his Wikipedia page to create a new reality.  If I were Rishi, I would not regard him as a safe pair of hands!

Phil Kay ● 1349d

Phil you are totally wrong re stereotyping political views it is pure economics and has been brewing for decades under all governments  it no one dares to tackle it. What we expect of the NHS is not fundable just through taxes, the abuse has to stop on every level and the only way forward to a stop abuse and provide an efficient well funded service is reform and money. I know many Labour supporters who agree. There is no magic money tree it’s called debt. Personally I think Rishi was too generous during covid but except no one understand it at the beginning and everything happened to quickly to put in proper checks and balances. The people who stole funds shame on them because they are stealing from us not the government.

Jayne Thorburn ● 1349d

Jayne, stopping any abuse of the NHS is a drop in the ocean and is not going to solve its financial problems. It is naive to think so. The Tories have wasted billions of our money on trying to keep their party united and retaining power. They have had twelve years to change things for the better and nothing has improved. Billions wasted on Brexit for example. £29 million to a Tory peer. Billions to SERCO for very little. This is what the government has done. That’s what we voted for.

Stewart Jones ● 1349d

Jayne, I think it’s also important to point out that the National debt doubled to £2trillion from when the Tories took office and that was before Covid.

Stewart Jones ● 1349d

Hence why I said there is no magic money tree it is called debt and we the taxpayer have to pay it back. I think your point proves throwing money at a problem might act as a sticking plaster short term but long term it doesn’t work hence the need to reform and we have to start paying for healthcare. Covid pushed the NHS over  the edge it is not just the UK struggling re healthcare as a result of covid. Our biggest challenge is that there is no political will to reform there NHS on any side of political parties it’s a hot potato…….personally I have absolutely no issue will making a contribution for GP appointments or hospital procedures if it will improve the system for everyone.

Jayne Thorburn ● 1348d

Low tax and trickle down is part of a blind ideology that has been proved to not work.  Magic money trees pop up all over the place when politicians want to find them for their pet projects. Tax in this country is not fair.  Those who have to pay PAYE have no choice whereas those who have enough can afford to pay a Wealth Advisor to minimise the amount they pay.  We need a progressive tax system that taxes people proportionate to their means and which rules out abuse of loop holes by the wealthy and tax should be raised to cover the cost of services provided to the people.  If people can see that their taxes are genuinely used for the benefit of the population then they will accept the burden of taxation that is required.It is not true that there is no political will to reform the NHS.  The NHS has been subject to schemes of reform for the last 40 years and each time the reforms have produced a worsening situation particularly in the last 12 years of political austerity which has reduced the service to the point of failure.  The Govt was thrown into a state of panic as a result of the lack of planning and resourcing of the NHS for an expected-sometime-pandemic.  The Govt state of panic is evidenced by the rush to buy massive supplies of PPE with vast donations to their friends and benefactors for equipment that has subsequently proved useless or defective.There was the rush to create temporary hospital provision in former exhibition spaces resulting in a reduction in the provision of hospital beds relative to our European contemporaries and the decimation of care home occupants subjected to emergency movement of covid patients into their facilities.When you charge for medical services at the point of need you find that people who can't afford - as you can already find now - all the drugs on the prescription will perhaps just choose none or one and then their condition will deteriorate until they need much greater medical attention.https://taxation-customs.ec.europa.eu/anti-tax-avoidance-directive_en

Philippa Bond ● 1348d

Jayne, to some degree we're saying the same thing in a different way to each other but drawing separate conclusions, based of course on our underlying values, ideologies and assumptions. You say "you are totally wrong re stereotyping political views it is pure economics" but then go on to make what I regard as Party political points.We do not spend as much on the NHS as other comparable countries, as a percentage of GDP.  I do not believe that it's appropriate or helpful for individuals to pay for GP appointments - that's a way of creating a two-tier system, as outlined by Philippa.  A better way is by using a progressive tax system - or our existing one until that improves.  I totally agree with you that government money is our money and this is what should be used to fund the NHS properly.Of course reform is needed - what organisation doesn't need this periodically, especially after a period of under-funding and division?I totally agree that the NHS would be better off if separated entirely from government, to the extent that this is possible.  I see no appetite for this from the main parties. I've never heard of a single Labour party supporter who believes that the NHS would be improved by charging at the point of delivery.  I agree with Stewart that the "abuses" you decry are "a drop in the ocean" and, critically, serve as a distraction to the wider point of what we want from the NHS.  They are not a useful starting point for a discussion on "where do we go from here?".  Again, in my experience this is a Party political divide and Conservative party supporters are highly likely to disagree with me.Overall, it is for us as a society to decide how we want governments to use our money to fund healthcare.  I prefer a well-funded, single-tier system, that recognises that money spent on the nation's health and well-being is an investment in our future.  I regard that as basic economics.  Is it difficult to fund everything we want to create and maintain?  Of course it is, that's why we vote for different parties.

Phil Kay ● 1348d

Phil I respect your view and in a perfect world it would be fabulous to have a free at the point of use NHS system. Personally in todays world with modern technology, improved procedures and treatments I don’t believe that tax alone will ever be able to fund the NHS and all the other public serves we require. If you consider all the taxes we currently pay we are highly taxed already and 99% of companies will be paying 25% corp tax from April in additional to all the other employer taxes they pay. This is high, let’s not run away with the global companies who we all know don’t pay the equivalent percentage tax in this country to the 99% of SMEs. We can not control this one. I just don’t believe it is realistic to rely on employees and employers to pick up the extra billions the NHS needs. So the only logical way forward is to charge a small amount at point of use. Stop over seas health tourism, abuse, etc. reform the whole structure of the NHS which will take decades. It would be good to have an independent body manage the NHS so it is not a political hot potato we need a long term strategy. It will happen maybe not in my lifetime but we can’t continue the way it is.

Jayne Thorburn ● 1348d

JT > "So the only logical way forward is to charge a small amount at point of use."Are you saying that we can afford it if we pay something at point of use, but not if we pay that extra something through taxation?We must also remember that there is a very strong link between poverty and ill health, so those who are poorest will use the service more and will have to pay more or go without!

John Whitworth ● 1348d

Nice try, no I am not and obviously those who are on benefits will be exempt I am saying on top of tax we also need to charge if we are ever going to achieve the level of service we want. The NHS needs so much money and will continue to do so with advancements in technology, treatments etc. to keep up it needs billions in extra funding can not be achieved solely through tax.

Jayne Thorburn ● 1348d

JT > "... I am saying on top of tax we also need to charge..."Why not just increase the amount taken from taxation rather than introducing a charging component with all its overheads?

John Whitworth ● 1348d

Simple the amount of tax that would need to be raised across the working population would need to be significant and that would cause massive in work poverty.

Jayne Thorburn ● 1348d

JT > "Simple the amount of tax that would need to be raised across the working population would need to be significant and that would cause massive in work poverty."I'm sorry, but we're going round in circles!Your argument seems to be that increasing the amount taken from taxation will increase poverty, but taking that same amount by charging at point of use instead will not.

John Whitworth ● 1348d

Don’t get your logic all workers pay a small increase and in addition people using the strives pay a modest amount towards treatment the 2 groups are not the same.

Jayne Thorburn ● 1348d

JT > "... the 2 groups are not the same."What is the breakdown of the group who will be paying a modest amount towards treatment?

John Whitworth ● 1348d

In today's world with changes in technology, treatments and procedures there should be and I'm sure there are improvements which actually reduce costs to the NHS.  Just look at all the procedures that now take place as daycare.https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-hospital-beds-data-analysis

Philippa Bond ● 1348d

There's no need to increase taxes on working people when there's billions tied up in capital and wealth among the 'broadest shoulders' of higher earners, property owners, big businesses, non-doms, tax-havens, etc, etc.

Peter Evans ● 1348d

https://www.kingsfund.org.uk/publications/nhs-hospital-bed-numbersThis is where the number of daycare beds shows so significantly.

Philippa Bond ● 1348d

If you use a service you should pay something this is about future proofing the NHS, covering their very generous  pensions etc. plus we want to see an massive improvement in social care and that bill is just going to keep increasing plus all the other public services that working people have to fund. Just rely on a small percentage of the population to cover the costs for everyone is not fair. You use it you pay a small contribution obviously those on benefit won’t.  Given the millions of procedures every year if everyone who benefits paid something that would increase the pot enormously.

Jayne Thorburn ● 1348d