Err, yes Frank

NHS could be saved by increasing national insurance, Labour MP says

Tax paid service could be funded by increased tax.

How long did it take you to work this out?

32 thoughts on “Err, yes Frank”

  1. In fact he has said a bit more than that though. This is the first politician even to hint at genuine reform of the way healthcare is governed.

  2. So Much for Subtlety

    He did say saved. If I could quibble, no tax increase can save the NHS. No matter how much money was raised.

    The NHS is in a terminal state of management collapse. The more money we give them, the more they will p!ss away. The only thing that can save them is the pressure of the marketplace.

  3. NI is and always was tax. They never put it aside into a fund as the name deceitfully suggested that they would.

    SMFS is correct –no amount of money could make the NHS into the fantasy tjhat socialism peddled or even a halfway health system. It will fall–the only question is how long the agony will be drawn out. It should be put on its very own Liverpool Pathway.

  4. Right. So now we’ve said the usual stuff about the NHS being a waste, being doomed etc, what are we proposing? What is the ‘marketplace’ we see here? How will that market work? How will healthcare be funded?

    And please don’t anyone try to pretend they’ve never needed a doctor and only the feckless get ill because…

  5. Mutualisation is the key FF proposes, I believe, not just more cash for the NHS as is.

    Seems to me a range of local and regional NHS Mutuals along the lines of now defunct mutual building societies is an option worth considering.

    The funding model and amount of tax raised for them is surely a second-order argument?

  6. So Much for Subtlety

    Ironman – “Right. So now we’ve said the usual stuff about the NHS being a waste, being doomed etc, what are we proposing? What is the ‘marketplace’ we see here? How will that market work? How will healthcare be funded?”

    Well nothing will be done. We will drift, like Byzantium, until the barbarians come. But if we were in the marketplace, so to speak, for a reform, we ought to be making as many hospitals as possible like Academy schools – self managing. The government should move to a pay-for-service model. So patients can move where they like and the government will pay for whatever service they got. Whether it was provided by the public or the private sector.

    Soon we would move to the French model.

  7. Ironman–That’s the key issue isn’t it. Socialism fucks everything up and has trapped millions into depending on its shitty systems for welfare, health care etc. They can’t just be shut down or handed over to various corporate socialist hangers on as the BluLabour parasites suppose. The NHS like all the rest of the evil that is statism/socialism will need 40 years or so to be dismantled one bit at a time to transition into a free market. We need to start with a purge of the leftist boss class.

  8. SMFS

    Thanks. Yes, some form of consumer/patient choice of competing providers is I think the only way to get real reform into the system. Taxpayer – funding is perhaps, as GeoffH suggests, secondary.

  9. @ Ironman
    Yes – one way would be to make private medicine mainstream by restoring some tax allowance (doesn’t have to be at 45%, just enough to attract the mass affluent and empoloyers who want to appear “caring”) on private health insurance. Then people could see the difference between the way the private sector and the NHS state monopoly treated people and scream for improvements.
    Nearly all of the improved facilities in state education are copied from the successful experiments (the unsuccessful ones are usually buried quietly) in the relatively tiny private sector.

  10. John77

    Yes but the outcry would be huge; you are now officially a heretic.
    This is why people like Frank Field are important, because Tories simply can’t say things that need to be said without re-toxifying their brand.

  11. So now we’ve said the usual stuff about the NHS being a waste, being doomed etc, what are we proposing? What is the ‘marketplace’ we see here? How will that market work?

    1. The cost of every medical procedure performed in the NHS is established.

    2. A system is set up whereby private companies can start offering some or all services offered by the NHS.

    3. Anyone who is entitled to NHS services may, if he chooses, go to one of the aforementioned private companies and be entitled to either a full refund or the cost of the procedure in the NHS, whichever is the lower, from the government.

  12. @ Ironman
    No, heretics did at least get tried before being condemned. It is only the Guardianistas and their allies who dispense with trials.

  13. The government should move to a pay-for-service model. So patients can move where they like and the government will pay for whatever service they got. Whether it was provided by the public or the private sector.

    SMFS beat me to it. Yes, the French system minus the NHS monster in the background.

    The problem, of course, is the NHS would object because the NHS is run for NHS employees and not patients, and this new system would benefit patients at the expense of the NHS employees.

  14. I agree with all of these. Except I think individual patients wouldn’t be able to work their way over the minefield set up by producer (the NHS is per ups the World’s best example of producer capture). So I could foresee patients’ mutual, which I guess is where Frank Field is going.

    One thing is clear though, we do all seem to see fundamentally a tax -based system. Yes a reimbursement system, but it does seem we all favour tax as the funder.

  15. Heh, Sarah Palin. I love how the feminist Guardianistas, who see the patriarchy ready to pounce under every rock, can’t stand any successful woman who doesn’t share their sixth form political views.

  16. What he’s doing is exploiting the belief of the great unwashed that it’s National Insurance that pays for the NHS.

  17. How about if NI was ringfenced to just pay the salary of active practising qualified medical staff. you could probably throw in the baccy and booze tax in that pool as well.

  18. “Seems to me a range of local and regional NHS Mutuals along the lines of now defunct mutual building societies is an option worth considering.”

    The difference there is that I could move my money from one building society to another. What Field is suggesting is that the NHS is still run by elected people. i.e. politicians.

  19. I’d scrap the NHS and switch to a French system (or anything really) but I do think we’re running up against an unfortunate confluence of facts whatever system we go for: we’re all getting older, older people need more expensive care than we could ever afford to make it pleasant, whatever system we use, and no one has any money saved up for their old age any more.

    Country is fucked, the NHS is fucked, we’re fucked. It’s all fucked up beyond all recognition. Not sure how it will pan out. Actual death panels maybe. Or leaving the olds out on the hills overnight.

  20. Reform of the NHS is politically doable. A relentless stream of decades of propaganda has convinced the public that there are only two options: the NHS and complete privatisation. Hence all arguments about the NHS quickly go downhill, as anyone who says they oppose the NHS is immediately asked “What about healthcare for the poor?” I find, if I explain to people that the NHS is not merely about government funding but about government management, and that I support government funding but oppose government management, and that France has government funding without government management and has the best health system in the world, they pretty quickly acknowledge that that’s a reasonable idea. They may not agree, but they see it as reasonable. And that’s what’s needed for reform to be doable: to move the case for reform out of the public perception of “EVIL! EVIL! EVIL!”

    It is worth noting that public approval ratings for the NHS aren’t all that good and never have been. The impression you get from the chattering classes is that they must be well above 90% at all times. But there are plenty of people out there who think the NHS stinks; they’ve just learnt to keep quiet about it. There is scope out there to win elections on this issue.

  21. We have some system of government funding for private companies doing healthcare at the moment.
    Hospices and GP surgeries being the two most people will come into contact with.
    A lot (maybe all?) GP surgeries these days and for pretty much a couple of decades or more has been private companies employing doctors and support staff to run the GP surgery. The company running it can be made up of the GPs at the surgery in a partnership!
    Government pay them for work done, for clinics run, for patients registered and so on. The company decides on what staffing is needed, what services can be offered and so on. Bonuses paid by government for meeting targets for particular clinics.
    Hospices – arguably better end of life care than the local hospital, certainly the government does not fund them in full. And as a regular visitor to our local one (it runs clinics for other services too) its a darn site better building than the hospital.

  22. Martin Davies

    “GPs being private partnerships … pretty much a couple of decades”

    Was always thus… Regulated, sure; state income funded according to size of patient lists (in the past) or in delivery of silly targets (more currently); and more; but always GP or GPs running their own private practices, and hence salaries dependant upon the practice surplus generated each year.

  23. PF – there have been some state run and employed ones. Been over 15 years since last came across any – used to come across them in one job I had and were rare even back then however.

    Yet besides people complaining they cannot get an appointment quick – which is down to the number of GPs and demand – they generally do not complain about their GPs not being employed by the NHS.

    Chuck more money at the NHS and it will give pay rises. Sorting out its problems? That requires political will, not chucking money.

  24. “Chuck more money at the NHS and it will give pay rises.”

    Spot on – we all have the anecdotes!

    “That requires political will, not chucking money.”

    Yep, agreed.

Leave a Reply

Your email address will not be published. Required fields are marked *