# Should we pay more for the NHS?



## Northerner (Sep 19, 2016)

Should we pay a little more in taxes for the sake of the NHS?

It's a question increasingly being asked by mainstream politicians, with two of the East's MPs arguing that it's time we face facts and realise that the NHS needs more money.

The Liberal Democrat health spokesman and Norfolk MP Norman Lamb told his party's conference that the service was facing "a real and overwhelming crisis".

Then he and the Suffolk Conservative MP Dan Poulter, a former health minister colleague from the days of the coalition, joined with Labour's Liz Kendall to launch a cross party "honest debate" on the issue.

"Our NHS and care system is struggling to maintain high standards of patient care under current funding plans," said Mr Poulter.

"The evidence is overwhelming that rationing of treatment, longer waiting times and deteriorating care will become increasingly rife if we carry on as we are."

http://www.bbc.co.uk/news/uk-england-37411742


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## mikeyB (Sep 20, 2016)

I think this idea is possible if there is a rock solid promise that this is a hypothecated tax. That is, it can't be spent on anything else. There is a long established delusion that National Insurance is just such a tax, but it isn't at all. (That would be a separate lengthy discussion)


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## Marsbartoastie (Sep 20, 2016)

I'd be happy to pay more if the money was earmarked for health/fitness/education initiatives.  Simply throwing more money into the NHS pot isn't going to make a dent in the problems we'll face in the years ahead unless we do more to reduce demand.


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## Jonsi (Sep 20, 2016)

I would pay more if it was necessary which I believe it is not. Most UK business look to trim cost all the time. I believe there is massive bloating within the NHS which could easily be trimmed to release cash. The NI payments mentioned are there for Social Security benefits and the like, not the NHS, but at the moment the NHS is subsidising this by providing non medical care which needs to come back under Social Security, Geriatric care being one such example. 
Also, people need to learn that A&E isn't there just to clear up their mess when they've spent the last few hours getting sh*tfaced deliberately pouring alcohol down their necks or putting stuff up their noses.


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## Owen (Sep 20, 2016)

mikeyB said:


> I think this idea is possible if there is a rock solid promise that this is a hypothecated tax. That is, it can't be spent on anything else. There is a long established delusion that National Insurance is just such a tax, but it isn't at all. (That would be a separate lengthy discussion)


This is the problem, it is about trusting politicians. That is never going to happen. If road tax paid for roads and NI paid NHS then maybe. But it never works like that.


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## Owen (Sep 20, 2016)

Jonsi said:


> I would pay more if it was necessary which I believe it is not. Most UK business look to trim cost all the time. I believe there is massive bloating within the NHS which could easily be trimmed to release cash. The NI payments mentioned are there for Social Security benefits and the like, not the NHS, but at the moment the NHS is subsidising this by providing non medical care which needs to come back under Social Security, Geriatric care being one such example.
> Also, people need to learn that A&E isn't there just to clear up their mess when they've spent the last few hours getting sh*tfaced deliberately pouring alcohol down their necks or putting stuff up their noses.


In these cases, they should be charged for self inflicted injuries.


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## Diabeticliberty (Sep 20, 2016)

As a population we run around with our hands over our ears and eyes. The vast majority of the 'healthy' UK population might be able to discuss that there is some shortfall in the NHS but I suspect that the vast majority do not appreciate the real problems as they don't need to. The issues only become relevant when they require treatment which is not fully funded because the NHS more and more cannot pay. I feel that while this is human nature it is kind of 'blind eyeing' our combined social responsibility. I would dearly love to feel that most of us would pay a lot more to prop up our NHS the thing is though it seems quite a lot of people would not. We will only ever get the health service that we pay for. Am I opposed to paying a lot more for a range of services that I do everything I can to avoid needing and fully expect to never need?. No I am not because some people out there without the means to pay quite so much have a need for services that they cannot fund themselves. Am I my brothers keeper? Damned right I am and if I have it and you need it then I should give it to you without even stopping to think about it. That is for me is the essence of social responsibility. If we cannot look out for each other then as a race we are on the way out and to be honest it might be no bad thing  .


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## Greyhound Gal (Sep 20, 2016)

A couple of things I find very annoying are
1. car parking at hospitals costs a fortune, and certainly at my local hospital this goes to the private company that run the car park and not back into the NHS Trust.
2. more money needs to be spent on preventative care. May be more in the short term but would pay dividends in the long run. Sometimes it seems NHS is reactive rather than pro-active - and I know that this is partly due to underfunding...


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## Marsbartoastie (Sep 20, 2016)

Diabeticliberty said:


> Am I my brothers keeper? Damned right I am and if I have it and you need it then I should give it to you without even stopping to think about it. That is for me is the essence of social responsibility. .



I don't disagree with your general premise.  However, if an alcoholic 'needs' alcohol...is it socially responsible to simply provide it?  Anyone who's ever been to an Al Anon meeting knows the answer to that one...and the answer is a resounding "No".  What's required is some 'tough love' involving more detox programmes, education, counselling and social support.  The same principle could be applied to all 'addicts'...including those hooked on an unhealthy diet and lifestyle.  Surely we've learned by now that a GP telling someone to lose weight is just a waste of oxygen.  People deserve better and as I said in my previous post, I'd be happy to pay for it.  The NHS could then get on with the job of providing an excellent service instead of trying to cope with social problems.  We really need to stop throwing good money after bad and take a long-term view.  However, as Owen points out, it's difficult to trust politicians.  They take a short-term view because their sights are always set on being re-elected.  It's a thorny old issue.


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## grovesy (Sep 20, 2016)

Having worked in the NHS or related from 1970 till 2012 , I can say no government what ever persuasion , is good for the NHS!
Over that time medical advances have also meant that people are now able to be treated for more complex conditions!


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## Jonsi (Sep 20, 2016)

Diabeticliberty said:


> <snip> Am I my brothers keeper? Damned right I am and if I have it and you need it then I should give it to you without even stopping to think about it. That is for me is the essence of social responsibility. If we cannot look out for each other then as a race we are on the way out and to be honest it might be no bad thing  .


I am reminded of the 2 Yorkshiremen discussing Social Responsibility ...
Jack: If you are hungry and I have 2 loaves of bread I will gladly give you one of my loaves. If you are thirsty and I have 2 bottles of beer I will glady give you one of my bottles. If you are cold and I have 2 overcoats and you have none I will happily give you one of my overcoats.
Joe: So, if I'm hungry you'll just give me one of your loaves, if I'm thirsty you'll just give me some beer and if I'm cold you'll just give me a coat?
Jack: Yup! That's proper Social Responsibility
Joe: Right ... if I've got no Whippets...
Jack: You can sod right off!!! I've *got* two Whippets...


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## Diabeticliberty (Sep 20, 2016)

Toadstool, the issue here is what is desired and what is actually needed. I know ladies who desire larger breasts and the NHS in some instances stumps up for it. We see almost daily on this forum members being declined blood testing equipment. Alcoholics needing drink? Some cannot live without it. Is it socially responsible to provide it?.............I honestly do not know


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## Jonsi (Sep 20, 2016)

Diabeticliberty said:


> Toadstool, the issue here is what is desired and what is actually needed. I know ladies who desire larger breasts and the NHS in some instances stumps up for it. We see almost daily on this forum members being declined blood testing equipment. Alcoholics needing drink? Some cannot live without it. Is it socially responsible to provide it?.............I honestly do not know


I think there's a distinct difference between need and desire and the NHS is all about fulfilling medical need. If I have a medical desire then I should pay for it and not expect everyone else to pay for it for me. It would be socially, morally and _everything_ly wrong to give an alcoholic alcohol, but it is a social necessity that the alcoholic gets the support needed to fight the addiction.


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## Sally71 (Sep 20, 2016)

It's a tricky one isn't it.  I'd quite happily pay a bit more if it was guaranteed that the money would be spent on the nhs, but of course it isn't.  I agree with charging people for missing appointments - I once completely forgot to go to an asthma check up with the nurse, and was mortified when I realised - I would happily have paid a few pounds as a "fine" or whatever.  But I realise that not everyone could afford to do that, so how do you determine who can afford to pay and who can't, and what happens when those people with limited means miss appointments, do they just get away with it?

I also agree that anyone who is only in A&E because they are off their heads on drink or drugs, or with smoking related problems, should pay for their treatment, or at least a contribution towards it, because it's self inflicted; but then where do you draw the line - my hubby had a heavy landing on his paraglider and hurt his back, I took him in to have it x-rayed because he was in so much pain.  Would that be counted as self inflicted too, because he doesn't have to do a dangerous hobby?  Or traffic collisions - you don't have to travel by car etc etc.  People who are truly addicted to alcohol or drugs should get help to beat their addiction, but it doesn't work for everyone, how many times do you try to help someone before you say enough is enough etc etc.  Minefield!

What really annoys me though is people getting boob jobs and the like on the nhs when there are people dying of cancer who can't get drugs that would save their lives (or diabetics that can't get test strips). Unless it's for reconstruction purposes after cancer or disfiguring accidents, I really can't see how not having a 48DD chest is ruining their life, sorry.  If they had any sort of long-term or terminal medical condition maybe they'd think again about what's important in life...


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## grovesy (Sep 20, 2016)

Sally71 said:


> It's a tricky one isn't it.  I'd quite happily pay a bit more if it was guaranteed that the money would be spent on the nhs, but of course it isn't.  I agree with charging people for missing appointments - I once completely forgot to go to an asthma check up with the nurse, and was mortified when I realised - I would happily have paid a few pounds as a "fine" or whatever.  But I realise that not everyone could afford to do that, so how do you determine who can afford to pay and who can't, and what happens when those people with limited means miss appointments, do they just get away with it?
> 
> I also agree that anyone who is only in A&E because they are off their heads on drink or drugs, or with smoking related problems, should pay for their treatment, or at least a contribution towards it, because it's self inflicted; but then where do you draw the line - my hubby had a heavy landing on his paraglider and hurt his back, I took him in to have it x-rayed because he was in so much pain.  Would that be counted as self inflicted too, because he doesn't have to do a dangerous hobby?  Or traffic collisions - you don't have to travel by car etc etc.  People who are truly addicted to alcohol or drugs should get help to beat their addiction, but it doesn't work for everyone, how many times do you try to help someone before you say enough is enough etc etc.  Minefield!
> 
> What really annoys me though is people getting boob jobs and the like on the nhs when there are people dying of cancer who can't get drugs that would save their lives (or diabetics that can't get test strips). Unless it's for reconstruction purposes after cancer or disfiguring accidents, I really can't see how not having a 48DD chest is ruining their life, sorry.  If they had any sort of long-term or terminal medical condition maybe they'd think again about what's important in life...


Unfortunately some of the population, think the NHS should pay for everything that is available, they see it as a right!


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## Marsbartoastie (Sep 20, 2016)

Diabeticliberty said:


> Toadstool, the issue here is what is desired and what is actually needed. I know ladies who desire larger breasts and the NHS in some instances stumps up for it. We see almost daily on this forum members being declined blood testing equipment. Alcoholics needing drink? Some cannot live without it. Is it socially responsible to provide it?.............I honestly do not know


I completely agree that the NHS should better distinguish between desire and need.

On the subject of alcoholism I appreciate that I have a bee in my bonnet...so forgive me for being adamant.  You should NEVER provide the means for an alcoholic to drink.  This can be extremely difficult at times and that's why I used the expression 'tough love'.  To have any chance of recovery you must allow an alcoholic to reach 'rock bottom' and seek the help they need.  However, I want that help to be there in spades...and that's why I would pay more for additional services.


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## Pumper_Sue (Sep 20, 2016)

Money could be saved by cutting back on a lot of backroom staff (pen pushers) and sorting out the menues so no food waste for starters. I would also question the pay of some of the high ranking pen pushers as well.


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## Diabeticliberty (Sep 20, 2016)

Alcoholism is an illness as real and as corrosive as the worst conditions any of us have to face. As regards treatment? I would personally leave those decisions in the hands of the clinicians. I would however personally be ethically opposed to a policy decisions to refuse to treat such poor unfortunates on the basis that they brought their condition on themselves. My own house has far too many windows for me to start chucking half knacker house bricks around


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## Marsbartoastie (Sep 20, 2016)

Diabeticliberty said:


> Alcoholism is an illness as real and as corrosive as the worst conditions any of us have to face. As regards treatment? I would personally leave those decisions in the hands of the clinicians. I would however personally be ethically opposed to a policy decisions to refuse to treat such poor unfortunates on the basis that they brought their condition on themselves. My own house has far too many windows for me to start chucking half knacker house bricks around


I agree entirely.  Well said DL.


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## Jonsi (Sep 20, 2016)

Diabeticliberty said:


> Alcoholism is an illness as real and as corrosive as the worst conditions any of us have to face. As regards treatment? I would personally leave those decisions in the hands of the clinicians. I would however personally be ethically opposed to a policy decisions to refuse to treat such poor unfortunates on the basis that they brought their condition on themselves. My own house has far too many windows for me to start chucking half knacker house bricks around


Just for the record ...people who go out to get bladdered on a weekend without thought to consequence and end up in A&E deserve (IMHO) to be left lying in their own pool of vom ... alcoholism is a totally different illness altogether.


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## mikeyB (Sep 20, 2016)

On the subject of self inflicted injuries, when I worked down in Maidstone, the local parachute club at Headcorn used to supply us with a regular supply of broken ankles and such. Events got to such a head that the orthopods started sending bills to the club, whose insurance readily paid.

And Greyhound Gal, car parking in Scottish NHS hospitals is free. I bet that annoys you even more...


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## Marsbartoastie (Sep 20, 2016)

Jonsi said:


> Just for the record ...people who go out to get bladdered on a weekend without thought to consequence and end up in A&E deserve (IMHO) to be left lying in their own pool of vom ...


But if we left them in the streets they'd pose a serious trip hazard.  Anyhoo, we've all been there (well most of us).


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## Jonsi (Sep 20, 2016)

Marsbartoastie said:


> But if we left them in the streets they'd pose a serious trip hazard.


Only to other drunks ...that's natural justice IMHO


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## Marsbartoastie (Sep 20, 2016)

Jonsi said:


> Only to other drunks ...that's natural justice IMHO


Ooh that's harsh Jonsi


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## Hazel (Sep 20, 2016)

Wow, what a fascinating thread - a real pleasure to read

Living in Scotland, we pay nothing for prescriptive medication, nothing at all.

As an insulin (T2) dependant diabetic I would happily pay toward my non diabetic meds.

I think it is a minefield to say who should, or should not have NHS treatment.    It will take a very brave, or foolish, politician to try to enforce it.

It you have ever sat in an A& E department (I live very close to one) there is a real mix of people.    However, lots of adult and children with sporting injuries, as a nation getting fatter we are told to exercise more.........

In the winter, they are inundated with injuries resulting in fractures and brakes, so do we tell people not to go out when the weather is bad.

As a very overweight person (who is losing, and to date nearly 4 stone), I hold the very controversial view that:
Smokers to not need cigarettes to survive,
Drug addicts do not need drugs to survive,
Alcoholics not not need booze to survive
But fat people do require food to survive, but not the nationwide thing of, go on it's only a piece of cake, or just a sweetie, would you office an alcoholic 'just one drink'?

I feel more preventative education needs to take place.     We have generaions coming up who can't cook, feeding their families on processed foods, MacDonalds etc   Just how obese will their children be in 20 years or so.

Years ago 2 major initiatives were introduced which did help the NHS.   Wearing seatbelts and the dangers of smoking.     But I fear just a drop in the ocean - education, i believe in the key and in particular, food and cooking.

Right, that is me off my soap box, thank you for listening xx


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## Marsbartoastie (Sep 20, 2016)

Hazel said:


> Wow, what a fascinating thread...


What a thoughtful contribution Hazel...and bloomin' well done on your weight loss!  Keep at it and you'll achieve your goal my lovely. x


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## Northerner (Sep 20, 2016)

Hazel said:


> I feel more preventative education needs to take place. We have genetaions coming up who can't cook, feeding their families on processed foods, MacDonalds etc Just how obese will their children be in 20 years or so.
> 
> Years ago 2 major initiatives were introduced which did help the NHS. Wearing seatbelts and the dangers of smoking. But I fear just a drop in the ocean - education, i believe in the key and in particular, food and cooking in particular.


I agree Hazel. There are so many areas where we could improve things so that people don't even need to go to hospital (or at least not as much). Better education, social care, better resources for mental health, better facilities for those trying to beat addictions. As the past decade has progressed we have just been doing more and more firefighting on less resources. At the same time, no public service employees have been able to share in any growth in our so-called 'strong' economy, with capped pay rises, grants abolished for nurses and huge demoralisation throughout the services at all levels 

Investing in the workforce as well as the nation's health should be a no-brainer as the rewards to the economy would easily pay for itself in time. The kind of fractured society emerging over the past 30+ years where every little thing has been separated out from the whole and charged for like a budget airline is hugely wasteful. And of course, we see the fallacy of making short-term 'savings' when we look at how many of the 3m Type 2 diabetics are subjected to inadequate care instead of acting now to educate and treat before things become catastrophically expensive in cash and quality of life.

Clearly, there are some savings that can be made in the way the NHS is run, but I think it also needs to be remembered that it is a MASSIVE organisation - biggest employer in the world after the Chinese army. You do need good administrators to deal with all the complexity. Sadly, not everyone is good at their job, but many are and shouldn't be tarred with the same brush or scapegoated.

Rant over! (For now )


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## Diabeticliberty (Sep 20, 2016)

Hazel please do not sign off by thanking me for listening. You have lots to say and it is very interesting to hear it  

My own take on providing petrol to the addicted arsonist is that I believe it is inherently wrong to choose who gets the support that they need and who does not. I do not think for second that a 'bag head' starts doing drugs with the intention of not wishing to live for anything but their next hit. A lot more heroin addicts than you might believe have 20 or 30 year habits and hold down regular jobs and appear to have normal lives. They then go home after work and get blitzed out of their brains and somehow make it to work the following day. I am sure that at least a chunk of these people would love to be able to kick their habit but cannot. A similar scenario for alcoholics then. I don't see anybody in life who would take their fist ever drink with the intention of killing their own liver and then themselves. People however sadly do. My brother did..Some people lack the personal fortitude of knowing when enough is enough and they pay for this 'weakness' very dearly indeed. I do not feel it in any way wrong to provide funding in an effort to help people shore up their own weaknesses. Healthcare is not only about sticking a plaster over the end of my thumb as I cut it peeling spuds last night.

Your own weight loss story? WOW lady that is some kind of result. I am proud of what you have done and as I keep telling you I am proud to call you my friend


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## Owen (Sep 20, 2016)

Jonsi said:


> Just for the record ...people who go out to get bladdered on a weekend without thought to consequence and end up in A&E deserve (IMHO) to be left lying in their own pool of vom ... alcoholism is a totally different illness altogether.


Its the injuries when they get into fights that gets my goat


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## AlisonM (Sep 20, 2016)

Marsbartoastie said:


> But if we left them in the streets they'd pose a serious trip hazard.  Anyhoo, we've all been there (well most of us).


Speak for yourself. I've never been that blootered, in fact, among my cronies, I was the designated rememberer. The only one who could remember what occurred the night before and my Swiss bank account has grown humungous as a result of all the fees paid me for my services, or possibly for withholding my services. I'm  actually a gazillionaire, but don't tell the tax man... not that it would do you any good, he owes me  few too.


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## AlisonM (Sep 20, 2016)

On topic, I would think we don't actually need to pay more for the NHS, we just need to ensure that the money we already pay gets to them... Instead of being syphoned off to pay for MPs salaries and Calais walls.


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## mikeyB (Sep 20, 2016)

AlisonM said:


> On topic, I would think we don't actually need to pay more for the NHS, we just need to ensure that the money we already pay gets to them... Instead of being syphoned off to pay for MPs salaries and Calais walls.


... And the garden bridges, crossrail, HS 2, wars here and there, repairing their playpen, the list goes on. An underfunded NHS, underfunded by a Tory Government who couldn't give a toss about the sick and disabled of the country, because they tend to vote labour.


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