Labour could propose a tax to save the NHS and people would pay it. So what's the problem?
Labour could propose a tax to save the NHS and people would pay it. So what’s the problem?
What is there to be hopeful about in 2014 Britain? What is there to be proud of?
These aren’t easy questions to answer. Britain today is a place where living standards are falling and secure and decently-paid jobs are harder to come by; where for many the chance of securing a decent home – be it social housing or mortgaged housing – is diminishing; where the NHS is slowly disintegrating and where we and our relatives face a frightening and expensive old age ‘cared’ for by underpaid and often resentful staff.
It’s almost a cliché to observe that mainstream politics has so far failed to provide any kind of light at the end of the tunnel, with nothing on offer but the Tories’ brutal austerity or Labour’s austerity-lite.
As many have pointed out, this lack of hope fosters the darker side of nationalism and the politics of hate pedalled by UKIP.
But it doesn’t have to be like this. In the NHS, Labour has a chance to inspire hope and to markedly improve people’s lives.
When asked what makes us proud to be British, one of the most common responses is ‘the NHS’. An Ipsos Mori poll commissioned by Channel 4 in 2012, for example, asked people to pick from a list the two or three things that made them most proud to be British: the NHS came second, after ‘our history’. In 2013, the NHS topped a poll of icons that make people proud to be British.
And we are right to be proud, not just because it’s morally right that healthcare shouldn’t be the preserve of the well-off but also because, for the moment anyway, the NHS is one of, if not the, best healthcare system in the world in terms of quality, access and efficiency.
In particular the difference between the NHS and the privatised US healthcare system is striking: on average each American spends two and a half times as much on healthcare as those in the UK yet US citizens have a significantly lower life expectancy.
But the NHS faces unprecedented challenges. These are well known. We have an ageing society where people live longer, work – and thus pay tax – for a smaller portion of their lives and require more care. Instead of meeting those challenges, the coalition has cut the number of qualified nurses, spent £3 billion on an unnecessary reorganisation and enforced £20 billion of ‘efficiency savings’ over four years which has left many hospitals facing financial crisis.
The effects? A survey in February found that 57 per cent of nurses believe that wards are ‘dangerously understaffed’. In 2013 the BBC reported that A&E departments are understaffed by an average of 10 per cent. In April Britain’s leading obstetrician said that it was legitimate to ask whether understaffing of maternity wards was contributing to current rates of baby death and brain damage.
Labour’s proposed solution is a mansion tax, a new tobacco levy and a tax avoidance clamp-down. These measures are projected to raise £2.5 billion in their first year and that wouldn’t even be the first year of a Labour Parliament. Compare this with the £30 billion deficit that NHS England is forecasting by 2020.
There is a further problem with the mansion tax: by definition it only raises money from the wealthy, and that money is earmarked for the NHS (it’s irrelevant that money is fungible, it’s the spin and public perception that matter.)
Given the movement towards taking the poor out of earnings-related tax altogether (while off-setting gains with cuts to benefits, of course), Labour risks giving the right the political space to argue that ‘hardworking taxpayers’ (i.e. the rich) pay a disproportionate amount for a health service that everyone can use but to which a decreasing number of people contribute.
The public want a world-class health system that is free at the point of entry and they are willing to pay for it. A recent poll by ComRes found that 49 per cent of people would pay more tax to help fund the NHS, 33 per cent would not be ready to do so and 18 per cent did not know. This willingness to contribute more to the health service is the highest in ten years.
Given the need for funds and the public willingness – desire, even – to pay, it would be extraordinary if Labour didn’t propose a tax to save the NHS.
And yet this is exactly what Ed Balls has refused to do, stating last month that “I want to do whatever it takes to save the NHS under a Labour government, but I am not proposing any tax rises”.
The naysayers will balk at the prospect of Labour discussing a tax rise, but if Labour cannot propose and promote a small increase in contributions to save a national icon, the party is no longer fit for purpose.
The rhetoric needed to rouse and enhance support for this policy almost writes itself. In 1945, the British public gave their support for a national health service free at the point of use that would be funded by the British people. For over 65 years that service has been world-class.
We now find ourselves in a similar position to the British public after World War II. The needs of our changing society are such that we have to be as pioneering as we were in 1945.
That will involve innovation, for example by bringing together health and social care, but it will also need the support and contribution of the public. Not much extra, just a little bit each, but that little bit from everyone means that we can once again be proud of creating a world-class health service that we all own and all benefit from.
Annie Powell is a contributing editor to Left Foot Forward
69 Responses to “Forging a new NHS from the ashes: Labour’s chance to rebuild a British icon”
Leon Wolfeson
So you pay very little direct tax, compared to most people in the world. Then you complain it’s too much.
And yes yes, the NHS saves way too many lives. Heard it before.
Joff
I don’t care what other people in the world pay in direct tax. Me giving over a fifth of my salary to the government is too much, in my opinion. I’m not sure what you have heard before, but I said nothing of the sort.
dodgydosser
Jolf: I have no way of knowing if you pay too much tax or not, and I did not argue that “the highest income earners don’t pay the most”.
I think that your figure that 0.1% pay 50% of tax, may be an exaggeration. According to the Telegraph the top 1% pay about 1/3 of income tax. I don’t know what the figures are for overall tax receipts.
What these figures tell you is that despite all the scams and tricks that the rich get up to, to avoid paying tax, they are so fabulously wealthy that they still provide a 1/3 of income tax receipts. The figures are a condemnation of the criminal levels of inequality in our society.
The other thing wrong with these figures is that we should
be looking at wealth not income. But the point is that since the 2008 crash, government receipts have fallen and someone has to pay. Our charming government seems to think that the only way to do this is to stop paying for the NHS, the disabled and the unemployed.
I’m just pointing out that, unremarked on by our equally charming press, there is the option to tax the people who benefit the most from society, as opposed to the poorest or in the case of the NHS all of us.
BTW the NHS is being privatised. Every observer agrees that it’s on the verge of bankruptcy. The choice is the government pays in more, or we pay individually. No prizes for guessing what this government’s solution will be.
Vast chunks of the NHS (I’ve seen one estimate that 42% of all spending goes to the private sector) are being passed over to private hands via juicy contracts (often to Tory party donors). A system that is controlled and supplied by corporations and for which we have to pay individually is a privatised system. Stone cold fact.
In the US before Obama care, 50,000 people died each year because they could not access healthcare. That would be something like 10,000 people in this country who will die so that the rich can get tax cuts.
It’s bad if they die for other reasons, but personally I find killing people to pay for the wealthy to be able to afford private jets pretty offensive.
Leon Wolfeson
No, of course you don’t care. About a lot of things, as you once more bemoan a very low tax rate.
And I see, you plain don’t support it’s existence, logically, if you want even lower tax than that.
Joff
I didn’t actually say that the top 0.1% pays over 50%. I said they pay more than the bottom 50% of income earners. You are right to say that government receipts have fallen since 2008 but I disagree with your solution. Instead of taxing people more, we should be spending less. I don’t think we need to be looking at any other ways of getting people to pay even more tax, regardless of how “rich” we all seem to think people are.
You may be right that the NHS is being privatised, but WE are still paying more for it in every year of this parliament. The problem is you can go on spending billions and billions more in the NHS but will care get that much better? I don’t think the only option can be to pump ever more money into it. None of the ideas from any of the parties excites me about what they would do. They promise more money (where from?) but no real change. Sad really that we do not have the choice at the ballot box.