Paying for the NHS

I support paying for the NHS out of general taxation, with health care free at the point of need for all UK citizens. I see that there are some who now say we need to put up taxes more to meet the future bills. Some are particularly keen to increase National Insurance. I see no need to do this, and do not think it a good idea to increase taxes on work. I thought all political parties thought work a good thing, with a general enthusiasm for more and better paid jobs as the answer to our economic and social prayers. Taxing work more is not the way to do this.

So how can we meet the increases in spending that we will definitely need in the NHS?

The first thing to improve is to remind everyone this is a National health Service, not a World Health Service. The government and NHS need to get better at collecting the money from patients who are not UK citizens for all non emergency treatment. Someone visiting the UK should be welcome to register with a GP and have access to our hospitals if they need it, but there should be a full charge of the costs to them or their insurance company. I and others have urged the government to do this, and it is official policy. I am not sure it is being implemented properly in each hospital and surgery.

The second is to not have a Transition period with the EU but to move to spending our money on our own priorities from March next year.The Treasury should be leading the opposition to delay in getting our money back, not urging us to give the EU more and more for longer. I don’t see what we are buying for the extra £40bn the EU says it wants.

The third is to set tax rates that maximise revenue, which I have discussed here before. Our tax rates on enterprise, saving and investment are reducing the amount of revenue that could be raised by stifling transactions and new activity. The Treasury accepts the theory that above a certain rate a tax collects less, not more, but still imposes rates that are clearly above the revenue maximising level in some cases.

This entry was posted in Uncategorized. Bookmark the permalink. Both comments and trackbacks are currently closed.

125 Comments

  1. Colin Hide
    Posted March 22, 2018 at 6:33 am | Permalink

    Agreed. Wise words as usual John.

    Why is it when I go to a French Hospital I get asked for a swipe of my credit card to cover the cost of treatment – perfectly reasonable as I just claim back on my insurance – yet in the U.K. Nothing of the sort happens.

    The cost of treating people who live overseas should come from our foreign aid budget. Top slice £1 billion to cover it.

    • Hope
      Posted March 22, 2018 at 5:57 pm | Permalink

      Croations quietly confirmed by govt will come here from June 2018 until the end of the extension and be allowed to permanently stay and be allowed the same rights and benefits of living here as you and me without paying into the pot. Another demand on housing, health, energy, water and all blogs JR recently wrote about!

      JR will the U.K. Still pay £3.75 billion to the European Development Fund and an additional amount to the Turkey asylum seeker fund? When will get to see the bill or is this something May is being underhand about? After all she claimed we would know the detail before the deal is made.

    • eeyore
      Posted March 22, 2018 at 6:22 pm | Permalink

      A recent poll on public attitudes to the NHS produced a surprising result. It turns out that, so long as they get medical care, people are not much bothered whether it is from a nationalised service or any other provider.

      The NHS is Westminster’s great sacred cow but I wonder if the public may not have moved on and left their leaders behind.

      The noble beast costs us almost £2000pa each. It is an effective monopoly, in that few can pay that sort of money and afford health insurance too. Other monopolies are wisely discouraged by the state. What’s so special about this one?

    • Lifelogic
      Posted March 22, 2018 at 7:22 pm | Permalink

      Not their money so what do they care? Piss poor organisation and management and no sensible direction from cowardly ministers either. Customers are non paying so a nuisance to them not vital as they should be.

      Perhaps Management were dealing with May’s gender pay reporting, gender neutral loos, ethnic background surveys, workingvout how to fiddle the waiting figures or some other vital matters. While the patients wait for hours in A&E or years waiting for angioplasty, cancer tests, scans or HIP/knee opps.

    • Mark B
      Posted March 22, 2018 at 8:23 pm | Permalink

      Sorry Colin to hijack your post.

      I see my comment did not make it at all this morning. Could not have been the link to a national newspaper highlighting the high numbers of people obtaining UK Citizenship. And it could have nothing to do with a solution that I have proposed here before, without censorship I might add. And it could not be the length, the fact that no names were mentioned or any defamatory remarks etc.

      Truth should never be put in fear in the presence of power. Because if it is, sooner or later it will be power that will become the victim.

  2. Dave Andrews
    Posted March 22, 2018 at 7:09 am | Permalink

    Company Medical Insurance Policies
    Rather than being taxed as a benefit, these should be encouraged with credits against the company’s NI contributions.
    This should come with safeguards, like the schemes must include all employees who choose to join and be comprehensive in their scope, so no exclusions that require recourse to NHS services.
    Individual employees may choose to include members of their family in return for a contribution.

    • Lifelogic
      Posted March 22, 2018 at 7:24 pm | Permalink

      Why just company ones and why the 12% IPT from Hammond on top to. They have already paid for the Nhs they are not using after all.

    • Narrow Shoulders
      Posted March 23, 2018 at 8:06 am | Permalink

      Quite, if open to all employees why is this a benefit rather than a necessity?

      The NI credits for the business is a good idea.

  3. jerry
    Posted March 22, 2018 at 7:12 am | Permalink

    “Taxing work more is not the way to do this.”

    Tax is tax, be it paid on income or expenditure! The only difference being who might be taxed and by how much. Tax breaks can be given for start-ups or true R&D, perhaps on the same principle as JSA/UB is, a contract between govt. and client, if the latter can not prove that they have done (success would not be necessary) what they said they would then the govt. would have to be refunded.

    “Someone visiting the UK should be welcome to register with a GP and have access to our hospitals if they need it, but there should be a full charge of the costs to them or their insurance company.”

    Indeed but the problem there is many will see the opportunity for ‘mission creep’, that is why so many dislike the idea and others would positively welcome it as the first step in all needing some kind of Health insurance -as I’m sure some comments to this debate will testify! In any case the amount owed by non UK nationals is but a small sum of the total NHS budget, a distraction to the real problems the NHS has faced for far to long now.

    “The Treasury accepts the theory that above a certain rate a tax collects less, not more”

    The Laffer curve in other words, a theory on how tax avoidance (and worse) works, but if govt. tie-off those loop-holes….

    • jerry
      Posted March 22, 2018 at 8:16 am | Permalink

      Off-topic. British (made) passports for British nationals please!

    • Bob
      Posted March 22, 2018 at 7:01 pm | Permalink

      “if govt. tie-off those loop-holes….”

      Which “loopholes” would you tie off Jerry?
      Perhaps people who receive over the tax free threshold in bennies should pay tax and NI? (after all if they were working for the money they’d have to pay tax).

    • Narrow Shoulders
      Posted March 23, 2018 at 8:09 am | Permalink

      One road to large savings is to identify as many small incidental savings as possible Jerry.

      If it is a distraction then why not address it and remove the distraction to focus on other issues?

      • jerry
        Posted March 23, 2018 at 12:43 pm | Permalink

        @NS; “If it is a distraction then why not address it and remove the distraction to focus on other issues?”

        Because the collateral damage will perhaps cost more, do we really want non UK nationals walking about transmitting (perhaps serious) communicable infectious illness/diseases for fear of being billed for such treatment even though the treatment would likely not be charged. Thus the NHS saves on the cost of treatment of one non UK person but ends up having to treat many UK nationals who succumb to the infection!

        The problem within the NHS is not front line services, nor who pays, but the top heavy management structures that have grown like topsy.

    • Edward2
      Posted March 23, 2018 at 10:21 am | Permalink

      That’s not what the Laffer theory is about.
      It shows how people alter their behaviour and actions as governments change tax rules and rates.
      It helps explain why governments are surprised when higher rates sometimes bring in less revenues.

      • jerry
        Posted March 23, 2018 at 12:28 pm | Permalink

        @Edward2; “[the Laffer curve] shows how people alter their behaviour and actions as governments change tax rules and rates.”

        Exactly! By using tax avoidance measures to minimise their tax bill, how else can they both keep the same salary and pay less tax, or are you seriously suggesting that whole swaths of high rate tax payers either take a pay cut (enough to drop a tax bracket) or give up their jobs completely?!

        • Edward2
          Posted March 24, 2018 at 5:18 pm | Permalink

          Laffer is really about behavioural economics.
          We can argue about the meaning of the word avoidance but it tries to explain that people alter their behaviour when tax changes.
          By not selling their house or their shares or by home brewing beer or altering their will.
          Avoidance?
          Perhaps
          But the Treasury seems to refuse to consider that there is a reaction.

  4. sm
    Posted March 22, 2018 at 7:15 am | Permalink

    A cousin is a senior physiotherapist at a major English District General Hospital. She has just told me about the massive sums of money recently wasted on an IT innovation pilot scheme for monitoring in-patients that had not been discussed with staff before implementation.

    Because staff had not been consulted, operating issues had not been noted; the system has now been scrapped, but has also left major structural repairs to be done, where floors, walls and ceilings had been altered to allow for wiring and machinery insertion. So, tens of £thousands down the drain, plus the cost of repairs, estimated at several £thousand.

    Before spending more money in whatever way on the NHS, there should be a cold, hard look at the appalling management of many primary, secondary and tertiary resources.

  5. acorn
    Posted March 22, 2018 at 7:20 am | Permalink

    What’s missing from the Laffer Curve chart? Numbers! In other words, the actual tax rates and the percent increase in revenue generated. If Laffer had put numbers on the diagram, the government could say, “Hmm, let’s increase the tax rate from 24 percent to 25 percent to get a 2 percent increase in the tax base.” If you look at the chart, it appears that the “Prohibitive Range” starts at about a 50 percent tax rate. If that were the case, then the chart would be useless today. Why? The federal government hasn’t taxed anyone at 50 percent (or higher) since 1986. (The Balance)

    • Edward2
      Posted March 22, 2018 at 5:50 pm | Permalink

      When top rate income tax was reduced to 45% years ago the ever so reliable Treasury predicted a loss of revenue of many millions.
      Result…big increase in revenues.
      When Capital Gains tax was increased from 18 to 28% the Treasury predicted increases in revenues.
      Result..large fall in revenues.

      • acorn
        Posted March 23, 2018 at 3:50 pm | Permalink

        These tax changes are flagged up several months before they become active. Hence “forestalling” is the name of the game, and the Treasury knows it will happen.

        When you know the rate is coming down you forestall bonus payments dividend payouts etc. That’s when it appears the tax yield goes up at the start of the lower tax period.

        You do the opposite when rates are going up, you cash in early under the old rate. The yield appears to drop when the new higher rate comes in.

        • Edward2
          Posted March 24, 2018 at 6:11 pm | Permalink

          Hmm..I remember the top rate reduction by How as being a bit of a shock.
          Short term I would agree with you but years later the figures still stand up

  6. Bryan Harris
    Posted March 22, 2018 at 7:30 am | Permalink

    With such dire agreements associated with BREXIT, Ms May is either going to stitch us up completely as a vassal state, or pave the way for an abrupt exit, because the EU will still not agree to terms despite getting far more than they deserve – I hope it is the latter…
    If that is the case, then more money can be spent on our priorities, but the NHS is not the only claimant.
    1. taxes should be cut to encourage growth… even if its only a couple of percent;
    2. a thorough review needs to be imposed on the NHS as to how it can be managed better, and with less costly exec’s, – while putting in place a means to charge appropriate people;
    3. I don’t regard fertility and most cosmetic surgery as best use of NHS funds – we should use the NHS for real health related issues – anything else should be chargable;
    4. stop giving priority to immigrants and visitors;
    5. once the NHS can show it is fully effective, and is collecting fees appropriately then it could get more money, but only where it is shown to be required.

    • Hope
      Posted March 22, 2018 at 5:59 pm | Permalink

      May stated in her last capitulation speech at the Mansion House she would not walk away or resort to WTO, therefore she informed the EU she had no bargaining chip before negotiates were complete. Who negotiates like that?

  7. GLifelogic
    Posted March 22, 2018 at 7:34 am | Permalink

    I do not support an NHS financed by taxation and free at the point of need. We see that very often it is not delivered at all at the point of need with endless delays rationing and incompetence. Delays on 999 call are an outrage as are delays on seeing a gp, having a HIP or eye operation.

    The system creates a dire virtual state monopoly a lack of supply and kills more efficient competitiom. Anyone who can pay should we need only a safety net for the few who really cannot.

    Ken Clark the other day said we cannot have US levels of taxation and a European system of health care. Well in the UK we have appalling health care and tax levels that are way too high. We have the worst of both worlds. Plus taxation, even in the USA, is far too high.

    We need to charge and have tax breaks or vouchers for people who go privately. Not as we have now 45% income tax, 23% NI and 12% IPT plus you pay for the Nhs too if you make your own provision. Why should these people pay 3 times over. It kills competition. It is economic insanity John. We have the same idiotic distortions with education too.

    The UK state Services are so bad they can only compete by creating a virtual monopoly and forcing people to pay three times over if the dare to make other provision.

    • Iain Gill
      Posted March 22, 2018 at 6:00 pm | Permalink

      correct.

      treatment I needed when in dire need was not provided, and I had to spend more money to go private otherwise I would have died.

      I think we should copy from the best of the rest of the world, have a state backed medical insurance scheme, get the state out of owning and running providers of care, and allow patients to take their insurance payouts to any provider they choose. force commercial pressure from empowered patients to change and optimise providers of care.

    • Adam
      Posted March 22, 2018 at 8:13 pm | Permalink

      Our Govt used to assist those who paid for NHS & state education without using those services. Contributions to private health insurance enabled tax relief on the charges. Parents of lowish incomes who paid to have their offspring educated privately were entitled to the Assisted Places Scheme (which Labour abolished on ideology).

      Nations spending high sums on health services are regarded as having healthier citizens, however a nation of the healthiest citizens on earth would need Zero expenditure to make them better.

  8. Mike Stallard
    Posted March 22, 2018 at 7:34 am | Permalink

    Please do not give any more money to the NHS before it is purged. The bureaucracy is staggering.

    This has two effects:
    1. It weighs down the people who actually turn out to work, to heal, to investigate, to clean, to feed, to diagnose. They soon get fed up and leave and the remainder get severely overworked. These front line workers need respect. At the moment they are right at the bottom of the system. Patients ought to be right at the top. Then the workers. The managers ought to be subsidiary and paid accordingly.

    2. It increases costs. Already “senior nurses” are appearing on telly complaining that the rise is not enough and they have had to wait too long for it. I wonder when they last mopped the floor? I also wonder if the burgeoning Managerial Staff will get a little morsel of this new pay package too? 6% of a lot is an awful lot.

  9. eeyore
    Posted March 22, 2018 at 7:36 am | Permalink

    Lifestyle diseases are an immense burden to the NHS. By weakening people’s responsibility for their own health it encourages unhealthy living. Are those who wilfully indulge self-damaging lifestyles much different, morally, from benefits cheats?

    One understands the reluctance of politicians to raise the subject, but having devised the means to make everyone’s health everyone else’s responsibility, don’t they have a duty to denounce and penalise unhealthy habits as well as encourage healthy ones?

    • Ed Mahony
      Posted March 22, 2018 at 5:34 pm | Permalink

      I agree.

      Lifestyle diseases is huge. HUGE. If we could eradicate this, we would save the NHS 10’s of billions of pounds per year. And taxes would drop drastically.

      But it’s not just the NHS. Lifestyle diseases also affects mental health and work productivity, family life and general social well-being.

  10. GLifelogic
    Posted March 22, 2018 at 7:39 am | Permalink

    So a year after the Westminster Bridge attack have they sacked the people responsible for not arming the police on the gate to the HoC yet? Who probably cost this policeman his life?

    Do we still rely on having a ministers protection officer just passing by chance at the time?

  11. GLifelogic
    Posted March 22, 2018 at 7:54 am | Permalink

    The only way to get better paid jobs is far less government, fewer parasitic jobs, lower simpler taxes, cheap reliable energy, easy hire and fire and fewer misguided government regulations. Some real competition in banking, health and education too.

    Idiotic things such as May’s gender pay reporting drivel, the renewable drivel, the work place pension, the poor apprentice scheme, the minimum ways laws or Gove’s idiocy on electric dog collars.

  12. Narrow Shoulders
    Posted March 22, 2018 at 8:06 am | Permalink

    Four – reduce public sector pension entitlements especially for higher paid staff and MPs

  13. Hope
    Posted March 22, 2018 at 8:07 am | Permalink

    Your party already increased our taxes by adding on another sum for adult social care to our council tax bills! Rudd invited all family members to EU citizens no matter their age! May has agreed an extension to freedom of movement with ECJ oversight for years while taxing us more! All these people entitled to health care eduction housing and welfare whether they live here or not. Tell us this is not a bad deal. Poor unskilled immigrants estimated to cost the UK taxpayer £3.5 billion.

    You state £40 billion the sum not disclosed but the principles estimated, this not does include add ons such as EDF, it does not disclose our assets estimated at £56 billion. It is over £100 billion that May and Davis originally claimed would not be paid. They lied.

    EU will continue to collect tax and tariffs from the UK for another two years and will benefit another £2-3 billion from pillaging our fish from our seas. EU states the U.K. Has no rights beyond 2019, why does May accept being a vassal state for nothing in return? May’s last capitulation speech stated she ruled our WTO or walking away. Having declared she has no bargaining chips why do idiots like Gove claim the EU were tough negotiators! Why would they do anything else if May declared in advance she was not going to walk or revert to WTO terms! Incompetence does not begin to describe the traitorous behaviour of this govt. Oust May is your only option to leave on good terms for the UK taxpayer.

    I am being fleeced 5.6 percent increase in council, tax twice the rate of inflation, for your govt stupidity o the EU environment policy that creates flooding, and now paying for their citizen adult social care while they paid nothing in the pot!

    • Hope
      Posted March 22, 2018 at 8:08 am | Permalink

      This not a transition it is an extension, it is still not known what trade agreement will be reached. Based on performance to date nothing to write home about.

  14. Endo
    Posted March 22, 2018 at 8:08 am | Permalink

    A simple way to help the NHS is to cancel Brexit, which is causing a huge economic downtrn as well as reducing supply of nurses and doctors

    • getahead
      Posted March 22, 2018 at 5:36 pm | Permalink

      Endo, you would lose the £350 million a week if you did that. EU membership is far too expensive.

  15. ian parkinson
    Posted March 22, 2018 at 8:32 am | Permalink

    I would also look not just at how much we spend but what we get for the money. If I have a small procedure that needs doing the choices are: NHS (eventually, maybe), UK private (astonishingly expensive), or when I am in France I can pay for the same treatment and it will be 20% of the UK private cost (and this doesn’t involve a subsidy as the french doctors are charging full fare on the expectation that most people will be claiming the cost back on their state insurance). If private UK treatment cost the same as walk-in French prices that would probably take a decent amount of pressure off the NHS.

  16. VotedOut
    Posted March 22, 2018 at 8:35 am | Permalink

    “move to spending our money on our own priorities”

    Well, this on the day that De La Rue lost a government order to make the new blue passports… to a FRENCH company.

    I know you folks in Whitehall have contempt for the people you govern, but you could at least have tried to be subtle about this.

    We are a global joke !

    • Anonymous
      Posted March 22, 2018 at 6:02 pm | Permalink

      Well you will keep voting Tory.

      • VotedOut
        Posted March 23, 2018 at 5:34 pm | Permalink

        You clearly prefer subjugation to a foreign power. In this case you are also wrong.

  17. Bob
    Posted March 22, 2018 at 8:39 am | Permalink

    Employ fewer managers, on lower pay rates.

    IVF should NOT be included free at the point of delivery.

    The NHS needs to properly charge out for services provided under the EHIC system.

    Overseas visitors should be required to carry adequate health insurance as a requirement of entry. Many heavily pregnant women often come to the UK for the sole purpose of free maternity services and a British passport for their kid. If this automatic entitlement were removed it would reduce the demand on the NHS.

    • Ed McEvoy
      Posted March 22, 2018 at 8:11 pm | Permalink

      There is no entitlement to British citizenship for the children of foreigners who happen to be born in the UK. The British Nationality Act 1981 requires birth in the UK plus having a parent who is a British Citizen, or a parent who has settled immigration status. But you are right about the use of maternity services by visitors – notably from West Africa. The Home Office, which issues visitors visas and sometimes monitors the boarding of aircraft, must take the blame..

    • juter
      Posted March 23, 2018 at 8:37 am | Permalink

      We pay for: abortions before 24 weeks; neonatal care for those born before 24 weeks; and IVF for those that can’t conceive. Madness.

  18. Richard1
    Posted March 22, 2018 at 8:46 am | Permalink

    Outrage over a French firm winning the contract to print blue passports. Why? Changing the passports strikes me as a waste of money anyway, but the govt should certainly take the best offer for production, if that’s in France, or the US or India so be it. Then all the silly outrage over fish as the current arrangements will continue for another two years – including even from the SNP who presumably were perfectly happy for the current arrangements to continue indefinitely given they are in favour of EU membership! I suggest Brexiteers focus on the important issues not on these trivia.

    • Leslie Singleton
      Posted March 22, 2018 at 5:36 pm | Permalink

      Dear Richard–I think considerably otherwise–we have no honour left as a country and using the French doesn’t help at all. We are doing it solely because of the ghastly EU Procurement Rules and I wonder how much thought was given to the British jobs lost–none by the looks of it.

      • Endo
        Posted March 22, 2018 at 8:37 pm | Permalink

        You are profoundly ugnorant. They are WTO rules, not EU rules. And Mr Redwood insists we must follow WTO rules

        • Leslie Singleton
          Posted March 23, 2018 at 2:48 pm | Permalink

          Dearest Endo–The profounder the better on this sort of rubbish–But what was that EU, I’m fairly sure, “Journal” of some kind that I had to do some work on once (I do not claim, and do not want, to be any kind of expert) in which I understood all EU public (?) contracts had to be advertised for tenders. Enormous effort involved with contracts ending up often being given against the advertisers’ better judgement. Heavy EU prescription of the whole thing as usual, as it seemed to me. It was the “principle” of having to do this that I could not stomach and I really care not who or what is the original source. Any and all insults welcome. Let me guess–does “Endo” relate to “In”??

    • Briton
      Posted March 22, 2018 at 6:01 pm | Permalink

      The French should produce our passports. Someone like us needs to check their work carefully to make sure it is up to standard.

    • Denis Cooper
      Posted March 22, 2018 at 6:44 pm | Permalink

      It seems to be an article of Conservative faith that fishermen are dispensable. They were dispensable in 1972 with Edward Heath and now they are dispensable with Theresa May. She doesn’t seem to recognise how much damage this did to the cohesion of the United Kingdom, she says it is our “precious” United Kingdom but this doesn’t look that way at all.

    • Ed Hirst
      Posted March 23, 2018 at 9:30 am | Permalink

      The extinction of fish stocks around the UK owing to the Common Fisheries policy is not in my view a trivial matter Richard1.

  19. Andy
    Posted March 22, 2018 at 8:50 am | Permalink

    The overall cost to the NHS of ‘health tourism’ is very low. The political cost of health tourism is, however, very high. I understand that is easy to blame foreigners – even if it is not accurate to do so.

    A friend of mine, an American, had an accident in London and he needed immediate NHS care. He was, literally, asked for a credit card before they would treat him. So it is entirely wrong to say foreigners do not pay. It depends on the foreigner and the hospital and treatment.

    The highest estimate I have seen is that, overall, foreigners costs the NHS £1.8b – out of a budget of around £100b. So 2%ish. Some of this is recovered and, obviously, we should try to recover the rest.

    But the real issue here though is not the NHS at all. It is tax avoidance. HMRC estimates the tax gap to be around £34b. This is UK money which is never collected. People paying for jobs cash in hand, buying goods on the black market, not declaring income etc.
    Multinationals alone avoid £6bn. The EU is taking on these multinationals – the UK is not.

    The Tories need to tackle tax avoidance. Though, I suspect, a quick glance down the list of big Tory donors and a quick glance down the list of tax avoiders – and a comparison or both – would provide the answer as to why they don’t.

    This should be our money which should be used to fund hospitals, roads, school meals for poor children. It is actually being used to wine and dine top Tories at swish London restaurants – with the balance being spent on yachts, chalets and private jets. Labour is no better.

    Drain the swamp.

    • Know-Dice
      Posted March 22, 2018 at 5:42 pm | Permalink

      The highest estimate I have seen is that, overall, foreigners costs the NHS £1.8b

      Apparently “social care” in the UK is short of £2.4 billion, so by your figures a good proportion of that shortfall could be covered by recovering costs from those not entitled to free NHS treatment.

    • Edward2
      Posted March 22, 2018 at 5:58 pm | Permalink

      I wonder where these estimates for lost tax come from.
      Multi nationals are allowed (under EU single market rules) to define one HQ nation as an accounting centre.
      They often choose Ireland or Luxembourg or their home nation in the case of China India and USA.
      If you ran a multi national Andy this is a sensible solution ie one accounting HQ.
      Imagine trading in 50 or more nations and having to produce accounts and pay tax in every one.
      So the claim of lost tax is abstract.
      The UK would only get one fiftieth in my example of the total tax as all other nations demanded their fraction.

    • Anonymous
      Posted March 22, 2018 at 6:07 pm | Permalink

      It’s like an estate agent charging you £5k to sell your house and telling you it’s OK.

      “Ah. But it’s only 100th of the price of your house.”

      Worse. The NHS is losing this amount every year.

  20. Christine
    Posted March 22, 2018 at 8:51 am | Permalink

    We are taxed enough already. All your suggestions have been voiced for years but nothing ever happens to improve the NHS. This Government seems to put the welfare of foreigners above that of hard working British people. I’ve never been to another country where I expect to receive health care without paying for it. It’s the Government that has allowed the NHS to become the WHS. I know for a fact that there is a lot of waste within the NHS and this should be cut before putting more burden on the tax payer.

  21. percy openshaw
    Posted March 22, 2018 at 9:06 am | Permalink

    Do you really support a tax funded health service, Mr Redwood? Why? Would you support a tax funded food service, so that meals are “free at the point of delivery”, with all groceries, supermarkets, restaurants and taverns under the direction of the state? No? Because it would be cumbersome, restrictive and inefficient; quite. So how does health differ from food? Indeed, the two are intimately connected as the issue of obesity suggests. Perhaps people allow themselves to balloon precisely because they know that there is no necessity to pay for the consequences of their gluttony. Were their health insurance premiums to rise as a result of those extra pounds, they might exert some self discipline and turn their lives around. And is there not abundant evidence that other health services serve their people better than ours? We pretty close to the bottom of the league when it comes to cancer survival rates, aren’t we? Perhaps transitioning to a completely free market in medicine would be a shock, but we could benefit from social health insurance surely?

  22. Ian wragg
    Posted March 22, 2018 at 9:14 am | Permalink

    Is there no end to the rank stupidity of this government. Please John get your researchers to tell us who makes German, French, Italian and Spanish passports.
    Please explain why we have to continue following EU procurement rules after we have left. You really do deserve to lose the next election.
    You’ve certainly lost my vote.

  23. margaret
    Posted March 22, 2018 at 9:15 am | Permalink

    John perhaps you yourself could clarify what you mean or alternatively ,what is meant at the ‘point of need’. Every intervention in the process of health care is one of need. Whether it is primary or secondary care, whether it is physiotherapy , or occupational health , whether it is emergency services , whether it is Nursing services in general practice or Ward Nursing services ; they are all there because of need. Myself I function running a minor illnesses service (amongst many other things)and these include chest infections , tonsillitis and other emergency problems . These are a point of need, but if you mean, as some do, simply accident and emergency , the services would collapse.

  24. Adam
    Posted March 22, 2018 at 9:17 am | Permalink

    If the EU seeks to charge us £40bn for a service, they should submit an itemised invoice, with supporting evidence detailing how those costs are calculated. We, then, as the recipient can assess what is charged & pay only for the items that are valid.

  25. formula57
    Posted March 22, 2018 at 9:19 am | Permalink

    Back in the 1970’s the NHS was supposedly attempting to devise a system to see that charges were made on non-UK citizens, so a family member reminded me recently. Having failed for c. 40 years to implement procedures to do this, let us attribute the government’s present enthusiasm to policies as espoused not policies as practised.

  26. ChrisS
    Posted March 22, 2018 at 9:22 am | Permalink

    PASSPORTS

    If it is indeed true that the outcome of the open tender process to produce our new, blue UK passports has been won by a Franco/Dutch company, it will have to be reconsidered, otherwise Mrs May and the Conservative Party will be a laughing stock.

    This outcome is yet another reason why the Government should take an axe to the Civil Service and reform it from top to bottom.

    What on earth could have possessed Whitehall to put the contract for the very first and most prominent Brexit icon out to international tender ? It looks suspiciously like those at the top of the Civil Service wanted to deliberately insult those that voted to leave the EU.

    As I understand it, the French insist their passports are produced in France for reasons of National Security so the decision to go to international tender can’t be blamed on EU rules.

    However much De La Rue may have lost out by, if you take into account the taxes returned to the Treasury from the company, its sub-contractors and its workforce, a decision to place the contract with a foreign company must mean higher costs than if it were awarded to De La Rue. Now that we are going back to being a fully independent country, the net financial cost to the Country and strategic/security issues should form part of any tendering process for public works.

    If this rumoured outcome over passports proves to be true, the decision is utterly perverse. The contract cannot possibly be allowed to go abroad.

    • ChrisS
      Posted March 22, 2018 at 11:45 am | Permalink

      PS if the contract is worth £500m, the return to the treasury from the total taxes raised from the company, its sub-contractors and its workforce from making the passports in the UK rather than in the EU must be in the order of £50m.

      • Know-Dice
        Posted March 23, 2018 at 10:29 am | Permalink

        Excellent point ChrisS,

        The UK Government should always factor in the potential UK employment and tax return when deciding on any procurement…

    • Endo
      Posted March 22, 2018 at 8:41 pm | Permalink

      They are WTO rules. Which mr redwood supports

  27. Epikouros
    Posted March 22, 2018 at 9:23 am | Permalink

    Whilst we are not prepare to alter how healthcare is provided and funded then improving the quantity of provision(quality and value for money will never be adequately improved under the current system) then year after year the government will have no other recourse than to call on the taxpayer to give more. Using some of the savings from no longer having to contribute to the EU budget post Brexit will help to reduce that demand. How much will depend on how much of those saving will not have to be diverted to other causes. Your suggestions on how to make the best of a bad job(considering there are better ways to provide and fund an NHS, which I have already stated nobody wants) are helpful but not a long term solution.

  28. Iago
    Posted March 22, 2018 at 9:26 am | Permalink

    million

  29. Know-Dice
    Posted March 22, 2018 at 9:40 am | Permalink

    Transition only works if on 29th March 2019 all trade deals etc. are in place.

    To go in to a transition phase without knowing the “end game” is exceedingly foolish, but as many have been saying on your blog since the Referendum – Our Prime Ministers (both Cameron & May) wish to remain in the EU, this is just a delaying tactic to the detriment of the UK and its citizens…

    • Hope
      Posted March 22, 2018 at 6:09 pm | Permalink

      It is not a transition, nothing changes. It is a vassal state without a voice.

  30. Denis Cooper
    Posted March 22, 2018 at 9:42 am | Permalink

    Off-topic, I’ve just seen the CEO of De La Rue on TV saying that the first he knew that his firm had been unsuccessful in its bid for the production of the new UK passport was when he woke up this morning and saw it on the news.

    I will leave aside questions about the nature of the change and which firm should be awarded the contract and instead I will point out that at the very least it can be seen as discourteous for the government to inform newspaper journalists of the result before informing one of the competing firms, and I will ask whether there is any confidential government information which will not be leaked by disloyal civil servants who are intent upon disrupting and if possible preventing Brexit and who correctly calculate that they can do this without facing criticism let alone any kind of disciplinary action.

    • forthurst
      Posted March 22, 2018 at 8:52 pm | Permalink

      The stench of rotting fish from this terminally incompetent Tory government has now become overwhelming.

  31. English Pensioner
    Posted March 22, 2018 at 9:55 am | Permalink

    I agree with the need to ensure that all non UK citizens pay for their use of the NHS, I liked a sign at the reception desk of a hospital in Sydney which my wife had to visit whilst we were on holiday “Show your entitlement to treatment or produce your credit card”.

    I think the other problem of the NHS is inefficiency with non-medical staff numbers. Unlike private industry, a merger of two local hospitals did not appear decrease the number of “back room staff” or administrators. But when it came to the A&E, one hospital had its facilities downgraded but the other does not appear to have been expanded to cope with the extra work.

  32. Peter
    Posted March 22, 2018 at 10:06 am | Permalink

    “The first thing to improve is to remind everyone this is a National health Service, not a World Health Service. The government and NHS need to get better at collecting the money from patients who are not UK citizens for all non emergency treatment.”

    Absolutely. The use of ID before treatment is offered might help. People might grumble but if it was made clear why this was being done most would understand. Also no entry to the UK without proper health insurance. Thirdly simply refuse treatment to those who do not meet the first two criteria. Harsh initially but word would spread that the UK is no longer a soft touch.

    As for transition period, well we are getting that anyway, since nobody in parliament will take the necessary action to replace the current prime minister with a capable and resolute head of state.

  33. Edward2
    Posted March 22, 2018 at 10:10 am | Permalink

    Another thing that could be done is to encourage employers to provide private health insurance for their staff by making it tax deductible for both.

    PS interesting comments from ceo of one of the UK’s biggest house builders who said in the 70’s moving from outline planning to gaining permission to start building took six weeks now it can take 18 months.
    He said the planning system wasn’t fit for purpose.

  34. Andy
    Posted March 22, 2018 at 10:38 am | Permalink

    Perhaps before you get treatment you should have to show your passport.

    The NHS could accept both burgundy ones and the new foreign made blue ones.

    (That went well too! I’d say Brexit is a triumph so far).

    • Anonymous
      Posted March 22, 2018 at 6:14 pm | Permalink

      “Brexit is a triumph so far.”

      Because Remain are in charge of it and such as Redwood are on the back benches.

      So. Prepare for Corbyn.

      He dislikes the type of education you have chosen for your children.

  35. nigelR
    Posted March 22, 2018 at 10:54 am | Permalink

    – “the second is to have not have a transition period” etc..well Mrs May and DD are over in Brussels today and by this afternoon we’ll know full well about the transition period..there will be talks to the press, handshakes and smiles all round.. so I don’t know why we are still banging on about transition periods. Just the same as the 40 billion that was already agreed at the December meeting? so why go on about it? What has not been covered yet is about passporting for our financial services going forward post brexit? and as regards the Fisheries, we can forget about it, information coming from Europe is that what we are claiming is EU economic zone waters..if push comes to shove we’ll get back the waters that includes for the UK territorial limits out to twelve miles from the coast, which is the same as we had prior to joining the EEC in 1973.. makes you wonder..just where are we headed?

  36. graham1946
    Posted March 22, 2018 at 10:57 am | Permalink

    We don’t necessarily need vast increases in spending, though we are well below first world standards in spending on our health and certainly need some. What we do need reductions in the waste.

    Foreign patients. How can we have a Health Service with more pen pushers than clinicians and still not have a system for charging? It is ludicrous and another Andrew Lansley cock-up. Anyway, this is shirt buttons compared to the real waste.

    Get rid of the internal market where health professionals are set against each other and all the rest. Doctors and nurses need to care, not become business managers and most are not capable of it or even wanting it. Stop the Whitehall interference – in fact get rid of the Health Minister, he seems to serve no useful function. (Same could also be said for Education)

    It would surely be more efficient to let doctors prescribe what they think is best for their patients and be trusted as professionals instead of having pen pushers, not qualified in anything much on 50 grand a year trying to save tuppence. Get a central buying operation that gets the best prices for all with immense buying power instead of the ludicrous situation where some Trusts pay 10 times what others do for the same products. Get tough with the drugs companies – probably one of the most profitable businesses on earth and pay only prices that can be backed up and tested.

    Trouble is that the Tories having said they would not re-organise the NHS, promptly did it, and made a complete mess, allowing one man to do it because the PM was lazy and had no interest in it. Being politicians, they cannot possibly now say they were wrong and undo it all so we continue to suffer the consequences and pour endless amounts into a bottomless bucket. It will never come right this way even if we use all the EU money.

  37. Know-Dice
    Posted March 22, 2018 at 11:12 am | Permalink

    Off topic 🙁
    Apparently the contract to manufacture the New/Old Blue British passport has been award to a French company…

    “Under EU procurement rules, the Home Office had been required to throw open the bidding process to European firms”

    As these will not be required until we leave the EU, surely extra weighting should have been given to a UK based company?

    Not only that, from a security point of view ALL of these type of documents etc. should in future be produced in the UK regardless of cost.

  38. Walter
    Posted March 22, 2018 at 11:14 am | Permalink

    I know it’s early days but I would love to know what part Cambridge Analytics had to play in our own referendum..given Robert Mercers involvement in the whole thing..

  39. Rien Huizer
    Posted March 22, 2018 at 11:19 am | Permalink

    Mrt Redwood,

    For someone who is not British, it is very hard to understand why a conservative (or economic liberal social conservative like many UK Conservatives) would be in favour of having the public sector providing health care. There is a proper role for government in health care, but it should be limited to oversight (regulation) in order to prevent abuse, infectious diseases and unsafe practice. There is no reason why the government would not run auto repair shops but would be involved in healt care to the point of actually providing the service.

    Of course it is polically im[possible to change this completely and suddenly. May I recommend the Australian model, as a transition to fully private (but with compulsory insurance, no age or prior condition discrimination and very aggressive, hostile regulation) service provision. That would improve quality, promote efficiency and relieve the public use of a burden no modern capitalist government carries. The NHS assets could ne monetized in the future and modern, efficient facilities could be built on much cheaper land. Hospitals (or larger cooperatives) would buy products and services from domestic and foreign providers and not be at the mercy of cartels of consultants and politicians.

    Anyway, this is probably well known in Conservative (as well as Labour) circles but impossible to do because of public entrenchment and the simple fact that the experts available for the treansition are beneficiaries of the status quo. Just start by a hypothecated tax (like the Australian Medicare Levy) and watch the public awareness grow that healthcare cannot be “free”.

  40. Ed Mahony
    Posted March 22, 2018 at 11:43 am | Permalink

    And this brings me back to how important religion / culture / education (and psychology) is in making our people happy and our country great.

    And this isn’t just abstract philosophy. There’s lots of data from scientists to prove how important all this is to our economy and general welfare as a society. And moving away from clinical psychology to culture, history and religion show us how important, for example, work ethic is over greed – look at the brilliant companies the Quakers set up (Quakers only a small % of the country) and how they grew our economy. And then look at how religion has inspired the arts and education which in turn makes people happier and increases patriotism and so on.

    (And i haven’t even touched the subject whether religion makes us happier on an individual level – not talking about that here, although i believe it does, profoundly – what I’m talking about is how religion / culture has a profound effect on the happiness of a nation in general – and this is something i think our political leaders should look at really hard – and not just for utilitarian reasons, but also because it’s an interesting thing to do and very fulfilling!).

  41. behindthefrogs
    Posted March 22, 2018 at 11:59 am | Permalink

    What is needed is for NI contributions to be removed for the low paid, particularly those who do not earn enough to pay income tax

    • juter
      Posted March 23, 2018 at 8:41 am | Permalink

      Why shouldn’t low paid workers contribute towards the NHS?

  42. Tad Davison
    Posted March 22, 2018 at 12:11 pm | Permalink

    I can’t find much wrong with that, if anything at all, so how come we still have the highest offices in the land filled with people who just don’t get it?

    Why do we get a relentless procession of politicians who are just not up to the job, or who are incapable of seeing things the way any logically-minded person does?

    I have never understood how some politicians get it so wrong, when the problems are so often so easy to comprehend, pointing the way towards an effective and amicable solution.

    Were we talking about an insane asylum, where the hapless inmates couldn’t tell chalk from cheese, not being able to come down on the side of common sense would be forgivable. But we are talking about this nation’s very future. To compound the injustice, there are some very good people in parliament who could take the place of the incompetent and the inane in a trice, so why isn’t it happening?

    All the time, the clueless contingent of politicians continue to flap and flounder, and wonder why the people hold them in utter contempt! Maybe they would be well advised to read this blog more often.

    Tad Davison

    Cambridge

  43. Anonymous
    Posted March 22, 2018 at 12:32 pm | Permalink

    Anyone who comes without insurance must have their medical costs paid by deducting it from foreign aid.

    The sad fact is that our establishment quite likes its World Health Service and quite hates its own people.

  44. Gary C
    Posted March 22, 2018 at 12:44 pm | Permalink

    Going by this it is obvious the public do not trust the Conservatives and are fed up with voting for the best of the worst.

    https://www.independent.co.uk/news/uk/politics/labour-london-local-elections-2018-win-best-results-party-poll-a8221081.html

    The size of bunny TM has to pull out of the hat is now too big for her to manage!

  45. rose
    Posted March 22, 2018 at 1:20 pm | Permalink

    The worst thing yesterday was not the BBC sneering at the trawler in the Thames – we expected that – but when Mark Francois, historian, soldier, and former whip, asked a straight question at PMQs about the fate of our fisheries after the “implementation period” is over. The wriggling weasel at the despatch box was unable to give a straight answer and it was the first time I have ever seen Oliver Letwin look worried.

  46. JJE
    Posted March 22, 2018 at 2:01 pm | Permalink

    Does anyone know what proportion of the NHS clinical pay bill is spent on expensive emergency agency staff because the regular staff are leaving in droves? I think it’s shockingly high. And how much the extra cost could increase base wages instead to the benefit of staff and patients alike?

  47. Not well, OVER done!
    Posted March 22, 2018 at 2:01 pm | Permalink

    “Our health service is the best in the world” ( applause, clapping, cheering, YES!!! )
    Are we the richest country in the world? Are we the largest country in the world? Are we the most powerful country in the world? Then use most of this year’s NHS budget to get government’s heads tested.

  48. Denis Cooper
    Posted March 22, 2018 at 2:09 pm | Permalink

    Off-topic:

    https://www.ft.com/content/4199d63e-2d2b-11e8-9b4b-bc4b9f08f381

    “Whitehall begins talks on dismantling Brexit ministry”

    So it seems that there will be one change during the “status quo” “standstill” “nothing will change” “it will all be predictable” oxymoronic “transition period” after we have formally left the EU, and that will be the closure of the Department for Exiting the EU.

    But what about all those negotiations on our future relationship with the EU? How will there be any chance of continuity if the staff who dealt with our formal withdrawal are then dispersed around various government departments? Is this another cunning ploy by civil servants to muck up our withdrawal because they are against it and they know best, better than all those plebs who foolishly voted to leave?

  49. rose
    Posted March 22, 2018 at 2:28 pm | Permalink

    A very, very good speech on the Economy today. No notes, and right in every detail. If only you were Chancellor.

  50. piglet
    Posted March 22, 2018 at 2:32 pm | Permalink

    Right on all three counts.

  51. Clever Clogs
    Posted March 22, 2018 at 2:37 pm | Permalink

    Build many more hospitals outside London and demolish hospitals inside London over a period of time ( short ).
    It costs the tax-payer far far too much employing health and ancillary workers in London.
    You can literally employ three people or more in many places north of London for the price of one in London.

    It should not be a requirement that hospital beds and services except in accident and emergency…at the first instance are in the locality of the accident/ emergency.

    If you were making rubber ducks and it cost you three times as much to make them in London then the population of London would be all unemployed. Why isn’t the population of London already largely unemployed? Good question. It is because of political meddling, madness and pseudo-democracy which is making our nation increasingly ill and poorer by the day.

  52. Beecee
    Posted March 22, 2018 at 2:53 pm | Permalink

    We could stop subsidising the Scottish NHS.

    After all they are not grateful and continuously complain that they are being hard done by

  53. Hope
    Posted March 22, 2018 at 4:03 pm | Permalink

    Tories quietly announce it will open the borders for (the EU ed) in June until the end of the extension and citizens will be entitled to stay here permanently! When did May or Hunt complete the costed survey that the UK could afford unlimited (people ed) emigrating here at any age permanently?

    JR, please explain how May has control of our borders? How many more can the Words Health Service cope with and why should I pay for them to come and have treatment?

    May has sold the country out. Oust her now.

  54. Ken Moore
    Posted March 22, 2018 at 4:09 pm | Permalink

    What happened to the drive for efficiency. The businessman Gerry Robinson looked at the NHS trust structure and found huge levels of inefficiency.

    https://en.wikipedia.org/wiki/Can_Gerry_Robinson_Fix_the_NHS%3F

    ‘I think what the NHS needs to learn is that actually you don’t solve problems by throwing money at it, and not every problem actually needs money to solve it. That’s the first lesson. Secondly, to get out of their heads the idea that things have to take three years to do and get into the idea that there is a series of objectives that we need to do now, and that we’ve got months, not years to do it’.

  55. BrexiteerwivMusket
    Posted March 22, 2018 at 4:12 pm | Permalink

    Since announcing the two year transition with absolutely nothing changing, the FTSE100 has gone down 1.5% just today. Business does not like the uncertainty of staying in the EU

    • hefner
      Posted March 23, 2018 at 7:02 am | Permalink

      Brilliant analysis: Any impact of the USA-China exchange of tariff threats on the FTSE, by the way?

  56. BrexiteerwivMusket
    Posted March 22, 2018 at 4:16 pm | Permalink

    Bloomberg TV says Mrs May has gone to the EU and is telling them we should all unite as Russia does not respect borders. Just the right place the EU for complaining about not respecting borders. Mrs May is a Beauty.

  57. hans chr iversen
    Posted March 22, 2018 at 4:27 pm | Permalink

    John,

    Why start talking about a non-transition period with the EU, when the transition has already been agreed.

    What is the point of that exercise?

    Reply Because nothing is agreed until everything is agreed, and because we need to carry on planning for No Deal in case there is no acceptable deal.

    • hans chr iversen
      Posted March 23, 2018 at 7:39 am | Permalink

      John,

      this is a load of rubbish the idea is to give business time to prepare for what the final deal will look like and preparing for no deal is not an option, as we will not be able to prepare separate trade deals in the time available. And doing trading only on WTO rules and an electronic border in Northern Ireland, (that you have advocated) doe not exist.

      So, your alternative is really not viable

  58. ale bro
    Posted March 22, 2018 at 4:52 pm | Permalink

    Using the new wealth confiscation orders on London’s Russian mafia would be a good place to start finding new income for the Treasury.

  59. Denis Cooper
    Posted March 22, 2018 at 5:06 pm | Permalink

    Off-topic:

    http://www.bbc.co.uk/news/uk-politics-43126719

    “Local businesses are beginning to get more used to the idea of operating outside the single market, especially after the government of Gibraltar revealed that roughly 90% of its financial services trade within the single market is actually with the UK.”

    Well, much the same is true of the UK itself, a very high percentage of its financial services trade within the EU Single Market is actually within the UK and has nothing at all to do with external trade.

    http://johnredwoodsdiary.com/2016/10/05/the-imf-forecast/#comment-835073

    “… the Tory MP Mark Garnier stated that although 2.2 million people are employed in financial services in the UK no more than “tens of thousands” would be involved in selling anything to the rest of the EU … ”

    and taking that as 22,000 out of 2.2 million it would be 99% of personnel having nothing to do with the EU apart from having to obey every one of its thousands of diktats.

  60. Ron Olden
    Posted March 22, 2018 at 5:18 pm | Permalink

    Putting up NIC would be disaster. It needs to be cut, not raised.

    Almost every other tax available is a more suitable candidate for raising money than NIC. NIC solely taxes earned income, taxes jobs, and adds to the cost of things we try to export.

    All other sorts of incomes, and windfall gains etc, are exempt, and NIC is disproportionately charged on people who’s income falls in to the basic rate for tax, at times in their lives when they can least afford it.

    The NIC system is also responsible for widespread tax avoidance in the gig economy.

    The simplest way for the NHS to raise money for patient care is to stop wasting it in the first place.

    The amount it spends on useless and/or overpriced drugs and contracts to do things like change light bulbs is ludicrous, and PFI contracts should be bought out.

    The NHS should also make people who can’t be bothered to pay £5 or £10 for a flu vaccine at Tesco or Morrisons etc pay for their flu treatment.

    A GP told me that 2/3 of those who are entitled to the vaccine free don’t even bother take it up, but there they are queuing at the surgery or complaining that the hospital is overburdened when they, and a vast army of people like them, all catch flu at the same time.

    The NHS has one of the lowest capital and labour productivity rates in the world, parts (not all) of it are grossly overmanned, and it’s the fifth biggest employer in the world. It could soon be the third biggest, behind the Chinese and US Military.

    There are umpteen things seriously wrong with the NHS, from its’ overgenerous final salary pension scheme, to its’ ridiculous absenteeism from work rates, which money cannot cure.

    It even pays its’ staff full pay to go off and do Trade Union (i.e. often Labour Party) business, and its’ payroll departments collect Trade Union subscriptions from people’s wages (i.e. donations to the Labour Party).

    The thing is run for the benefit of everyone who encounters it, apart from the patients themselves.

    • Peter D Gardner
      Posted March 23, 2018 at 8:46 pm | Permalink

      people don’t value what they don’t pay for. There is a general lack of awareness of costs throughout the health system in UK. You get income, as a GP not from providing good service but getting people in upir postcodes onto your register. That’s it. that alone defines your earnings. It is quite risible. Pharmacy is the same. I asked once what the actual cost of a prescription medicine was. Not a clue they said.

  61. GilesB
    Posted March 22, 2018 at 5:28 pm | Permalink

    Everyone seems to agree that global companies with significant UK revenues and relatively few UK employees should pay more tax. And that UK companies employing people in the UK should pay less tax.

    This shift can be realised overnight by increasing VAT and eliminating National Insurance. The global companies can pay the VAT themselves, or increase their prices and lose market share. On average for UK companies the VAT increase can be paid for by the NI reduction.

  62. Daniel Thomas
    Posted March 22, 2018 at 5:29 pm | Permalink

    Solving foreign nationals getting NHS care they are not entitled to is surely easy. Make health insurance a criteria for entry into the UK for any purpose.

    Every foreign national entering the UK would have to demonstrate valid insurance to be allowed entry. Anyone not having insurance would have to purchase insurance at entry at market rates. Anyone who refuses to do so is not allowed entry.

    Problem solved. If this causes problems at ports/airports make it a requirement that the airlines/ferry companies have to have verification of health insurance before allowing transport with punitive fines if they allow people in without it.

    Anyone who enters avoiding the main entry routes who does not have insurance, the cost is deducted from foreign aid/billed to the country of origin, plus the person is deported immediately after treatment with permanent no right to return.

    • Peter D Gardner
      Posted March 23, 2018 at 9:30 pm | Permalink

      I would guess that most non-EU visitors have travel insurance so could easily afford to pay, and that most EU visitors do not. The NHS just doesn’t bother because its has no motive to do so. Its mentality is that it is funded by the government and so its efforts to raise funds are directed almost entirely at the government.

  63. mancunius
    Posted March 22, 2018 at 6:05 pm | Permalink

    “I am not sure it is being implemented properly in each hospital and surgery.”
    No, and it never will be, for quite subtle, mixed reasons of political and cultural motive and collectively induced disincentive, that become obvious if you visit any urban hospital a few times.

    I am all for the pooling of risk insofar as for public health reasons it is essential to have some basic health treatment for all who fall ill. I’m against a socialist system (the NHS is a classic postwar socialist coup based on 1945 Labour government propaganda) that demands ever-higher tax-funding for medical treatment, physio and medicines, from those who take sensible, prophylactic measures to maintain their health, to pay for those who smoke, drink, drug and indulge themselves with overeating, and take no exercise at all.

    These are not of course the direct causes of e.g. cancer, and cancer treatment needs to be available to all citizens. But an insurance based system would be fairer and more effective at pooling risk.

    As for the BBC belief that ‘Everyone wants to pay more tax to fund the NHS’ – I suspect that everyone is happy for taxes to rise to fund the NHS – as long as they are not their own taxes, but someone else’s.

    At present we see mass abuse of our health system. That must stop: it is not a free buffet.

  64. mancunius
    Posted March 22, 2018 at 6:45 pm | Permalink

    Also, I hope and asssume that someone on here has already pointed out that NIC is an irrelevance, as it is neither N nor I nor a C, but an unhypothecated tax that goes into the general pot and serves merely to make it look as if income tax is lower than it actually is.

  65. Denis Cooper
    Posted March 22, 2018 at 7:09 pm | Permalink

    Off-topic, yesterday I mentioned an IFS study which downplayed the potential benefits of removing EU tariffs from our imports:

    http://johnredwoodsdiary.com/2018/03/21/more-jobs-rising-wages-and-lower-inflation/#comments

    but now has been a riposte:

    http://brexitcentral.com/ifs-tariffs-study-misses-biggest-benefits-leaving-customs-union/

    “The IFS tariffs study misses the biggest benefits of leaving the Customs Union”

    The problem I have with this is much the same problem that I have with studies which predict entirely disproportionate economic damage from leaving the EU, that the major effects – “the biggest benefits” here, like the greatest losses in the pessimistic studies – depend upon highly speculative long term “dynamic” factors.

    That is how a marginal “static” economic gain or loss can unrealistically be amplified up to something more significant.

    • Original Richard
      Posted March 23, 2018 at 8:50 pm | Permalink

      The IFS receives funding from the EU so I wouldn’t expect them to produce a positive report on leaving the EU/SM/CU.

  66. Denis Cooper
    Posted March 22, 2018 at 7:32 pm | Permalink

    Mrs Clegg was on Sky News, using her maiden name, pointing out that the EU Commission was fining the UK for allegedly having failed to collect all the EU customs duties which the EU thinks it should have done. However she didn’t bother with the “allegedly” bit.

  67. Original Richard
    Posted March 22, 2018 at 10:12 pm | Permalink

    “The first thing to improve is to remind everyone this is a National health Service, not a World Health Service.”

    Agreed, but will the Government ever do anything to prevent this misuse of our NHS ?

    Secondly, we need to cut the rates of immigration down to “tens of thousands” each year as promised in the Conservative Party’s manifesto.

    • Original Richard
      Posted March 22, 2018 at 10:43 pm | Permalink

      I have just read that from July 1st this year Croatians will be able to come and work in the UK without needing a visa or other permission and will have full citizen’s rights including the permanent right of residence and the same family reunification and other rights.

      This lifting of restrictions to Croatians will not be made by three other EU countries, – Austria, the Netherlands and Slovenia.

      What is our Government playing at ?

  68. miami.mode
    Posted March 22, 2018 at 11:08 pm | Permalink

    One point where I agree with Jeremy Corbyn is in the inequity of land purchased fairly cheaply becoming many multiples of the cost price when planning permission is given.

    Notwithstanding the fact that local councils sometimes make it incumbent on developers to provide funding for a particular project, a substantial percentage of the sale price of the land with planning permission should be paid up front by the seller to the local council and the local health authority to provide some compensation for the extra infrastructure needed to cater for the increased population.

    • ChrisS
      Posted March 23, 2018 at 11:11 am | Permalink

      There is invariably an infrastructure charge on land zoned for housing. This will include the provision of roads and drainage to be built by the developers and can extend to other items of public works as well. The roads etc built by the developer will be inspected before being adopted by the council after the development is completed.

      They are made under what is called a section 52 agreement, named after the relevant section of the Town and Country Planning Act 1971. The quote below is from :
      http://www.legislation.gov.uk/ukpga/1971/78/section/52/enacted

      As you can see, the powers granted to levy a charge are wide ranging :

      52. Agreements regulating development or use of land

      (1)A local planning authority may enter into an agreement with any person interested in land in their area for the purpose of restricting or regulating the development or use of the land, either permanently or during such period as may be prescribed by the agreement; and any such agreement may contain such incidental and consequential provisions (including provisions of a financial character) as appear to the local planning authority to be necessary or expedient for the purposes of the agreement.

  69. anon
    Posted March 22, 2018 at 11:22 pm | Permalink

    Well… you know we could like ..er .. leave the EU and stop contributing massive amounts of funds via any and all means.

    Otherwise you could end the favorable tax treatment of public and defined pensions versus the private sector.

    I think you could just dispense with an entire upper tier of the (eu)civil service based in the UK. HOL and reduce MP numbers considerably , say 50%.

    The cap is irrelevant for most people, but it should still apply to the public sector schemes using the same accrual rates as the private sector money purchase plan.

    Public service pensions should be capped at the average salary in the UK.

    Anything else should be money purchase plans, which should be protected from conflicts of interest , e.g, if where inside information is available.

  70. Prigger
    Posted March 23, 2018 at 12:02 am | Permalink

    BBC Question Time sounded less silly tonight. Though proper Evidence is required if you’re a stickler when you put up the idea that Russia should be brought back into a “rules based” system of international dialogue as put awkwardly by James Cleverly MP.

    Russia may be as guilty as hell but what amounts to “feelings” about the truth of the matter become absurd and unacceptable in lockstep with the greater intelligence of the utterer. And James Cleverly is obviously far too intelligent to make such nonsenses publicy or should be. But then politicians who actually disagree with certain party lines/ points sometimes do a set piece in regurgitating nonsense thus using the fake and frail positive to win through the real negative.
    But it is not a get-out to indicate “we are awaiting international scientific non-partisan verification” It is our Trump card.

    • rose
      Posted March 23, 2018 at 12:18 pm | Permalink

      This QT really cheered me up – all those young people, the audience packed to be under 30 and completely diverse, giving the wrong answer every time: “I don’t know anyone who voted remain”; “All my friends voted to leave”; “The old people knew what they were doing and they were right”; “We knew exactly what we were voting for: we voted to come out of the single market, to come out of the customs union, and to take back control of our laws…” etc or words to that effect.

      • Times Dark Force
        Posted March 24, 2018 at 8:09 pm | Permalink

        Rose I don’t live a thousand miles away from that Leeds’ audience. Locally,the only Remainers I’ve heard of are Labour MPs Benn, Jarvis, Angela Smith and Mary Creogh but no-one speaks to them.

  71. JM
    Posted March 23, 2018 at 9:06 am | Permalink

    On the subject to tax. Fuel duty according to the IFS raises £28 billion (https://www.ifs.org.uk/publications/9178). The RAC tells us that the Highways Agency spends somewhere between £600 and £800 million with local councils spending a further @1.1 billion odd (https://www.racfoundation.org/wp-content/uploads/2017/11/economics_of_road_maintenance-an_racf_view-june_2013.pdf). That means that the motorist is paying £26 billion in tax on fuel duty alone (VAT is paid in addition on fuel including on fuel duty adding a further £5.6 billion at least), which is not being spent on the roads. Why are our roads in such an appalling state? The money is being raised from the road users.

    • miami.mode
      Posted March 23, 2018 at 2:13 pm | Permalink

      JM. The money is being used for the NHS. I’m not sure whether the NHS claims from motor insurance the cost of treatment of crash victims. If not, then obviously that is another source of income.

  72. Peter D Gardner
    Posted March 23, 2018 at 8:19 pm | Permalink

    “The first thing to improve is to remind everyone this is a National health Service, not a World Health Service. The government and NHS need to get better at collecting the money from patients who are not UK citizens for all non emergency treatment. …. I am not sure it is being implemented properly in each hospital and surgery.”

    I can assure you from my own experience as a dual citizen of Australia and UK it is not being implemented. On several visits to UK I have been treated for severe influenza. I have never been charged. In at least one case in a ‘treatment centre” I offered to pay and was told there was no mechanism for me to do so. the facility had no forms, no EFTPOS facility.
    While resident in UK any overseas visitors who needed treatment in hospital were not charged. As far as I can recall my GP at the time had no means of receiving payment.
    There are other rorts going on. The Australian Medicare and UK’s NHS have reciprocal arrangements for emergency treatment so that each gets paid by the other or at least the costs are balanced out over a period. Yet travel insurance companies take no account of it in setting premiums and policy conditions.
    We know too that the NHS does not claim what it should from other EU member states for treatment of EU citizens.
    I disagree with John Redwood that the NHS should be funded out of general taxation and be free at the point of use. There are much better ways of funding public health services. It is rigid adherence to this principle that underlies everything that is wrong with the health service in UK.

  73. Ron Olden
    Posted March 26, 2018 at 8:19 am | Permalink

    I’m absolutely horrified to see Jeremy Hunt in the papers today demanding a ‘ring fenced tax’ for the NHS.

    He already has a more reliable source of, ‘ring fenced’ income, in the form of a ‘ring fenced’, budget commitment, which in recent years has not merely been delivered in full, but added to, year in year out, in response to every extra demand made of it by NHS Unions and Management.

    Unless Hunt is proposing a fixed escalating cash sum charged as a Poll Tax, any ‘ring fenced tax’ will fall apart as soon as we get a single year in which the tax fails to deliver the amount of Revenue the NHS expects, whereupon it will demand yet more on top.

    We won’t however get a reciprocal response in any year in which the tax delivers more than expected. They’ll just pour the windfall down the NHS bottomless pit of waste.

    If anyone deserves ring fenced taxes it’s all the other services and essential benefits, which relentlessly have their budgets cut, or held back, in order to fund the rapacious, cash guzzling, money wasting, demands of NHS Management and Unions.

  • About John Redwood


    John Redwood won a free place at Kent College, Canterbury, and graduated from Magdalen College Oxford. He is a Distinguished fellow of All Souls, Oxford. A businessman by background, he has set up an investment management business, was both executive and non executive chairman of a quoted industrial PLC, and chaired a manufacturing company with factories in Birmingham, Chicago, India and China. He is the MP for Wokingham, first elected in 1987.

  • John’s Books

  • Email Alerts

    You can sign up to receive John's blog posts by e-mail by entering your e-mail address in the box below.

    Enter your email address:

    Delivered by FeedBurner

    The e-mail service is powered by Google's FeedBurner service. Your information is not shared.

  • Map of Visitors

    Locations of visitors to this page