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”
Joff
I don’t care FOR paying taxes at their current level. Do you understand that? I don’t class over a fifth of my income going to the state in direct taxes as “very low”. If you don’t think yours are high enough feel free to make a voluntary donation to HMRC, just don’t ask me to pay more. Why does it matter what I would cut?
Joff
A good point. I am mainly of the opinion that the more choice the individual has , the better (s thin reason of course). Lower taxes means more money in their pockets. If the state provides less services (likely) then the individual has to chose whether to pay for services themselves.
blarg1987
I think we would have to agree to disagree as my concern for the vast majority of people is that private provision will mean there will be less money in people’s pockets as private provision will cost more as a percentage of overall income.
Unfortunately as far as I am aware there has been no data to prove or disprove if people in countries with lower taxation pay more or less for the same level of service provision as a percentage of income that we receive here.
Leon Wolfeson
Yes, you’re trying to use semantics. Because it’s directly relevant what else you’d cut – your calls for slashing the tax base massively, well, it has to be paid for.
And you’re making up chimeras to try and distract from your low tax rate.
Joff
How can you say that private provision will cost more, then go on to say there isn’t enough evidence to say whether it will cost more or not in lower tax jurisdictions? I am not actually in favour of a full private provision of healthcare as I think the state can provide decent care in places, I just think an over reliance on the state is not the best way to go