What does healthcare and social care cost?

The danger of associating one tax with one item of spending is people might believe that item of tax paid for that item of spending. This will not  be true with the NHS or with social care and the new levy by a very large margin.

According to the Treasury Budget document issued in March they plan to spend £230 billion on health this year, and another £40 bn on social care. The new proposed levy is a bit over 4% of those totals. People ask me if the Council Tax precept for social care will go when the Care Levy comes in. Of course it will not as the Care Levy  is only 23% of current social care spending plus the extra from the levy. This assumes they will remove all the Care Levy money from the NHS as currently proposed. The Levy otherwise will pay a smaller percentage of the care budget if some is still needed for waiting lists.

If we wished to have hypothecated taxes to cover the cost of health then it would take all of Income Tax  (£198 bn), all of Capital Gains Tax ,all  Inheritance Tax, all  Stamp Duty and all the Property transaction tax to reach the £230bn figure.  Maybe we should rename all these taxes as the Health taxes to show people how income and wealth is currently taxed extensively to pay for healthcare.

If we wanted a tax to hypothecate for social care why not choose the Council Tax which this year is forecast to be that same £40bn figure as the costs of social care.

The debate about waiting lists and about social care needs to start with the current budget figures. The health  budget has risen from £166bn for 2019-20  (Treasury forecast in Budget 2018) to £230bn (Budget forecast 2021). It is true the pandemic imposed additional costs and needs on the system, but as these decline we still have much larger  budgets than before the pandemic struck. I will look in a future blog at the management issues posed with such large sums of money. I will also return to the issues around social care which I have discussed before.

257 Comments

  1. oldtimer
    September 10, 2021

    Thank you for summarising the extraordinary sums now committed to running the health service. The £64bn or 38% increase between the forecasts for 2018 and 2021 means there must be colossal waste in the system. The NHS did not give the impression of being a sharp, well-run operation when it was spending £166bn a year, itself a mind boggling sum. Nothing in the measures voted on by the HoC earlier this week suggests that any thought has been given to how this extra £64bn a year is going to be managed and spent efficiently – that is more than £1bn a week! Such thought that has been expended on the issue appears to have been focussed on how best to bounce the HoC into voting for ill-conceived taxes under the cover of the pandemic. The Times reports today the latest poll with the Tories down to 33%, below Labour at 36%, as Johnson ditches his election promises not to raise tax rates. Johnson and the NHS will bankrupt the nation and destroy the Conservative party.

    Reply
    1. Oldwulf
      September 10, 2021

      Yep – eyewatering sums of money.

      Whom do we trust to ensure it is properly spent.

      A conundrum.

      Reply
      1. Timaction
        September 10, 2021

        Indeed. How much do the 9 million foreign nationals cost us and the 1 million illegal citizens? When is Priti Useless going to actually take action not words with the boat people National security issue!

        Reply
        1. Hope
          September 10, 2021

          JR, this is the hallmark of the chaotic misfit in charge of your party and govt. Your party helped to fund holidays and decorate his rent free gaffe way beyond his own means, like a socialist he spends other people’s money! Who said that phrase?

          Your party and govt. are complicit with wrecking our economy, continuously raising taxes far higher than Labour, wasting hundreds of billions without any value in return!

          Reply
    2. Peter from Leeds
      September 10, 2021

      According to the Commonwealth Fund (4th August 2021 – available online) the UK comes out not too bad – either in terms of quality of service or proportion of GDP cost with the Netherlands, Australia and Norway leading. Perhaps we should study what they are doing better. In terms of spending the UK has been comparatively modest!

      As ever the worst healthcare in terms of shear cost and worst quality is the US (of the wealthy nations considered). So we clearly don’t want to go down that road!

      Obviously all the cards have been thrown in the air by the pandemic.

      We Brits do tend to do ourselves down (not heard much about our Olympic successes) we moan endlessly about the weather and just about all our services. But I absolutely agree with Sir John that we also tend not to have any handle on the true costs of the various services that are provided by our taxes and therefore no understanding of the political choices available.

      Reply
  2. turboterrier
    September 10, 2021

    What does it cost?
    Too much far too much.
    The waste is obscene and the nursing staff are upset about pay rises in view of aĺl the affects of the pandemic. One can argue that in all walks of life or career path you know what your signing up for, hope it never materialises but sometimes the unthinkable happens.
    The NHS has got to put itself through a seismic change, remove all these layers of management and explore new technology and processes to then enable the front line nursing staff to be paid the wages they deserve.
    Hiving off elements to the private sector is not the answer as the latest private hospital scandal hits the airwaves.

    Reply
    1. oldwulf
      September 10, 2021

      @turboterrier
      Maybe incompetence in the private sector can be sorted out more quickly than it can in the public sector – and it may well be less expensive ?

      Reply
    2. John Hatfield
      September 10, 2021

      “The (private) consultant sent me for an MRI scan. I was offered an appointment the next day, at 7.40pm. When I turned up at the diagnostic centre, the place was practically deserted. Given the late hour, I assumed I was their last patient.
      ‘You must be rushed off your feet right now,’ I remarked to the nurse
      ‘Not at all,’ she said. ‘We’ve been sitting here twiddling our thumbs all day.’
      Why then, I wondered, hadn’t I been offered an earlier time slot?
      She explained that the NHS had booked the facility for the duration but hadn’t bothered sending along any patients.
      When I mentioned this to my consultant, he said it was par for the course. He told me that the NHS bureaucracy was ideologically opposed to using private healthcare. So while NHS hospitals were dealing exclusively with Covid cases, patients with other ailments were being denied treatment which was available elsewhere — even though it was bought and paid for.”
      Courtesy Richard Littlejohn.

      Reply
  3. Sea_Warrior
    September 10, 2021

    May I ask, Sir John, that you post, soon, an article on alternative models for funding ‘welfare’?

    Reply
    1. Andy
      September 10, 2021

      By far the biggest chunk on ‘welfare’ is state pensions – which no doubt you receive. My suggestion is to scrap this massive chunk of welfare, to give us hard working taxpayers a break.

      Reply
      1. a-tracy
        September 10, 2021

        Andy, state pensions are contributory, people have had national insurance paid by them and their employer to fund their state pension promise. There is a national insurance fund for this purpose. Now go away. If you want to stop people’s pension credits who haven’t paid in national insurance, or haven’t paid sufficient national insurance, or have been women raising children I hope you are prepared to go on tv personally to tell them why you want to remove their pension credits and social security.

        Reply
        1. acorn
          September 10, 2021

          The word “Fund” is a misnomer, there is no big pot of investments paying interest and dividends. This years NICs pay for this years benefits. The NIF is allowed to invest its accumulated surplus (£37 billion last year) at the Debt Management Office, in government bonds from which it got £0.23 billion in interest last year.

          Boris hasn’t mentioned the £37 billion surplus in the NIF as far as I know; that is about two years of his “levy” sting.

          Of the £144 billion NICs collected last year, HMRC skimmed off, Mafia style, about £27 billion and bunged it straight to the NHS. What’s left went into the NIF account. All perfectly legal and approved by our MPs after they had undoubtedly forensically investigated the accounts.

          Reply
        2. Dave Andrews
          September 10, 2021

          No, the NI payments just went into the government spending the year they were collected, and partially paid for the pensions of the day. Nothing was put by, otherwise it would have shown up as a surplus in those years. The government just spent it, and very likely even then had to borrow yet more to make up the difference between taxes and spending.
          Your pension is paid out of the taxes and borrowing the government raises today. It’s a Ponzi scheme.

          Reply
          1. a-tracy
            September 10, 2021

            Dave, I never said it wasn’t a Ponzi scheme I agree it is and always was. I don’t understand why Labour was lorded over its Madoff style creation. It was never going to work and it never has. Each government is left making bigger and bigger promises with less money and it’s all about to go boom. The Public sector workers pensions are an even bigger scam, most have no pots of investment they are even more reliant on the taxpayers of today as their promises are massive at least 3 times the basic state pension if they worked 35 hours per week for 39 years if not more if they were higher earners.

            However, we were promised a state pension if we and our employer’s paid in for 39 years. That promise has been reneged on over and over again. Yet has the public sector workers been put back or reduced as their Ponzi scheme is even more in the red. Just check out the big top ups our local councils have to put in their pots. And housing association (ex Council Housing works department) use more for their pensions than they spend on services or indeed building new properties to rent.

        3. Fedupsoutherner
          September 10, 2021

          Perhaps he could start with those that don’t pay a penny but still get it.

          Reply
      2. Fedupsoutherner
        September 10, 2021

        Andy, so good to read your joke of the day again. Could do better.

        Reply
        1. John C.
          September 10, 2021

          I think he’s becoming feeble. His joke Leftie persona is becoming silly. I used to snort at his nonsense ; now I yawn.

          Reply
      3. acorn
        September 10, 2021

        Pensions were £113 billion and personal care services were £36.8 billion out of the £297 billion social protection (cofog 10) spend last year. Health spend was £219 billion (cofog 7). Half of government spending in the pandemic year.

        BTW. If you want to know a 9.22 minute consultation with a GP costs the NHS £33 and the GP costs the NHS £217 per hour of patient contact, have a look at https://www.pssru.ac.uk/wp-content/uploads/2020/12/unit-cost-of-health-and-social-care-staff-2019-20.xlsx

        Reply
        1. a-tracy
          September 10, 2021

          Acorn, is this £113 billion just basic state pensions or does it include pension credits, public sector workers pensions?

          Thanks for sharing the link to GP costs. Do they still charge the same for none physical contact and substitute nurses contact. I even had a receptionist give me a diagnosis.

          Reply
          1. acorn
            September 11, 2021

            a-t. Just the old age state pension (cofog 10.2). Public Sector pension are separate at about £41 billion in payment with £39 billion coming from contributions. For the GP, the £33 drops to £28 for a 9.22 minute consult.

          2. a-tracy
            September 12, 2021

            Thank you acorn, do you know ‘is the public sector pension paid in the same way as State pensions from today’s contribution by the public sector workers in the scheme plus an employer’s contribution today (do you know what % of pay that the State employer contributes to this £39bn and what % of the £39bn collected is the employer’s contribution? I’d guess it would have to be 20-25% of pay and 2/3 of the £39bn) rather than an investment pot? Who pops in the extra £2 billion per year required to cover the outgoing pensions?’

            I wonder how many people are getting the public sector workers defined benefits pension compared to the number in the ‘old age state pension’ when they are actually in both pots.

        2. dixie
          September 11, 2021

          thanks for the link, the PSSRU looks a useful source of info, particularly as it is paying attention to unpaid carers as part of it’s research.

          Reply
      4. Sir Joe Soap
        September 10, 2021

        I’m actually in favour of scrapping state pensions Andy. It seems crazy that many pensioners who don’t need it are paying tax and being given it back as state pensions. Either work or go on benefits if you need to.

        It would have to go hand in hand with reducing public sector pensions to the average for similarly paid folk in private industry though, and I doubt you’d accept this.

        Reply
      5. Micky Taking
        September 10, 2021

        I don’t know how you fit in the ‘hardworking’ when you contribute such crap all day to this site.
        I wish our generation knew the secret when we worked all day, but then we didn’t have internet to play games on….like you?

        Reply
        1. ukretired123
          September 10, 2021

          Agree 100% with Mickey Taking – How true that Andy’s fantasy economics and time wasting would not be tolerated years ago when work really meant stressful times and smoking a packet of cigarettes per day was how most folks coped when they could afford them.
          Pity children are not taught economics.
          I once attended a seminar given by professional UK head-hunters who noted that the most successful high-fliers invariably had studied Economics…..unsurprisingly!

          Reply
      6. John Hatfield
        September 10, 2021

        Pensioners have paid for their pensions Andy. As well you know.

        Reply
        1. Andy
          September 10, 2021

          Most now take out more than they ever paid in. So, no, they haven’t.

          Reply
          1. Enrico
            September 10, 2021

            Andy where is your evidence for this ridiculous statement of yours.

          2. a-tracy
            September 10, 2021

            Andy, it is not the fault of the people and their employers who paid in for their State pension but the fault of the custodians of the subs that were duly paid the required sums.

            To achieve a £9500 pa pension, the pot would need to be £220,000. Most people 90%+ prior to the 90’s started work at 16-18 years of age and were demanded to pay in to the national insurance pension scheme for 50 years, once you’ve paid in the 39 years you don’t stop paying in you carry on and if you work over 65 your employer still pays in the national insurance element.

      7. No Longer Anonymous
        September 10, 2021

        With a rebate on all contributions over a lifetime.

        Reply
      8. Sea_Warrior
        September 10, 2021

        Yawn. I receive a service pension, which I earned. My pay, as a commander, on leaving the RN was a little less than one relative earned working in the City within a year of leaving university. I refuse to feel guilty for taking my deferred pay. And I doubt that you ever regularly notched up eighty hours a week – without ‘overtime’.

        Reply
        1. a-tracy
          September 13, 2021

          SW, if your comment is to me I regularly worked an 80 hour week for many years. Even after having children I worked a 48 hour week with additional hours on the weekend on-call. I earn less than City workers didn’t stop Brown raiding my pension, moving my pension age up and stealing my deferred earnings that I’ve saved from the age of sixteen because my father believed in always putting money in a pension even when I started on a YTS 10% went into a pension.

          Reply
      9. Jane
        September 10, 2021

        What a terrible comment. All those on pensions have worked throughout their lives and contributed to society. You know, we paid for your education, unemployment, health cover etc. Older people I know saved hard to buy a house, had no car or holidays, did not eat out etc to secure their futures. Now you think that should be taken away from them. Shame on you.

        Reply
      10. NickC
        September 10, 2021

        Andy, The IFS (report) stated: “Education spending is the second-largest element of public service spending in the UK behind health, representing about £91 billion in 2018–19”.

        Why should current 66+ year olds have their state pensions removed merely on your (unjustified) whim? Existing pensioners have worked, earned and paid taxes to support previous generations of pensioners. That’s the contract. Break that, and no contract is safe in the UK. That alone would destroy the UK.

        By contrast the vast majority of young people up to 18 years have (by definition) contributed nothing. And they are subsidised for longer than pensioners, too. So if the sole aim is a massive and sudden cut in state spending then removing “free” education is a simpler and more justifiable route. And it could start from 2027 without breaking contracts.

        Reply
      11. Mike Wilson
        September 10, 2021

        Fair enough. Pay me back all the money I contributed to other people’s state pensions and retrospectively invest it at ‘pension fund rates’ and give me the money to buy an annuity. After all, you can’t seriously suggest it would be fair for me to pay taxes and NI for 48 years to fund state pensions and now that I am of state pension age I should suddenly get none? Is that what you are suggesting?

        Reply
      12. Peter2
        September 10, 2021

        How would you deal with elderly people who have no other income other than the State pension andy?
        Would you like to see millions of old people living on the street destitute and homeless?
        Have you thought through the effect of your desired policy?
        I don’t think it is a vote winner

        Reply
  4. BW
    September 10, 2021

    With respect for all those working at the sharp end The NHS is not fit for purpose. As it stands it will never have enough money. It is top heavy with managers. As the population increases and technology, it will need ever increasing amounts of money. The NHS can no longer be fixed with tinkering around at the edges. I read with dismay that one the governments solutions is to employ numerous new executives on £270,000 salaries, plus their expenses plus pensions plus extra admin staff etc etc. Now that we are treating the world that arrives at our shores plus over £300,000 net immigration “treating the many paid for by the few” will never ever work.

    Reply
    1. Andy
      September 10, 2021

      Foreigners have to pay for NHS treatment.

      Reply
      1. Donna
        September 10, 2021

        No, foreigners requiring non-emergency NHS treatment are given a bill after they’ve had the treatment. There is no enforcement and most don’t pay up.

        Reply
      2. oldwulf
        September 10, 2021
        Reply
      3. bigneil - newer comp
        September 10, 2021

        They are supposed to – but AFAIK do NOT

        Reply
      4. a-tracy
        September 10, 2021

        Andy, No, they don’t and their countries aren’t all billed back for every treatment the government and the NHS have admitted this google it, we don’t bill for GP services, NHS dental services or A&E either for every treatment [EU countries do bill the UK – we do not offset]. This does need to change immediately.

        If you dispute this send us your proof that all NHS treatment is billed back to foreigners, please.

        Reply
        1. a-tracy
          September 10, 2021

          full fact 2018 – WHAT WAS CLAIMED
          The UK paid out £674 million in health costs to European countries, but received only £49 million in return. Addressing this could “transform the financial situation of the NHS”.

          OUR VERDICT
          The figures are broadly correct for 2015, although addressing this situation would in itself only have a marginal impact on the financial situation of the NHS.

          MY VERDICT £600 million approx per annum is a big contribution and if healthcare costs more in the UK then it needs rebilling at the correct cost.

          Reply
          1. hefner
            September 11, 2021

            According to kingsfund.org.uk ‘The NHS budget and how it has changed’ 24/03/2021, the NHS core funding in 2020/21 is £159 billions, so £600 millions would be about the whole of …. 0.4%.

            Reply I have quoted the figure for health from the Treasury budget document

          2. a-tracy
            September 12, 2021

            Hefner the amount claimed by the EU countries was significant enough for them to do it. Plus all the travel insurance we Brits take out for treatment abroad because of restricted treatment, even when in the EU my son’s university insisted all the students on a field trip took out private travel insurance for illness cover. Perhaps if we started charging more for treatments visitors and none U.K. citizens would take out medical insurance and we could treat them in private hospitals as Spain do with our visitors thus not taking up resources and spaces within the NHS unless paid for fully at the correct cost.

      5. Fedupsoutherner
        September 10, 2021

        No they don’t Andy..

        Reply
      6. matthu
        September 10, 2021

        Immigrants aren’t foreigners.

        Reply
      7. Martyn G
        September 10, 2021

        Yes, but only if the hospital bills them, which almost never happens. Which is why so many foreigners beat a path to the NHS – commonly, to give birth, to have the care needed and then back to whence they came. Hospital admin processes to reclaim money from them are very rarely implemented and if they are, the ‘patient’ is no longer in the UK.

        Reply
      8. Ian Wragg
        September 10, 2021

        Even channel dodgers, I don’t think so.

        Reply
        1. Ian Wragg
          September 10, 2021

          Just checked on gridwatch and wind is supplying 1.5 gigawatt or 4.4% of demand. To make up for the deficit we are running open circuit gas turbines, Importing maximum on interconnected, have 2 coal fired plants online.
          Net Zero anyone.
          The NHS has been paying private hospitals 400 million a month but not using them during the pandemic. Then they demand more money.

          Reply
          1. glen cullen
            September 10, 2021

            I have a dream

          2. Sakara Gold
            September 10, 2021

            @Ian Wragg
            You persist in misrepresenting the renewable eectricity figures from the Gridwatch website. “Wind” is the power from wind farms and does not include unmetered wind turbines. The output from windfarms fluctuates with the wind. There are currently over 6500 wind turbines in wind farms.

            For most of today electricty demand has been in the range 30-35 GW. Renewbles at ~16% and carbon neutral sources at ~28% totalled ~44% or ~15 GW of supply. During the winter we can expect wind to contribute up to 45% of demand. In June solar contributed ~11% alone. Wind and solar are free energy sources – which we don’t have to import.

            At no point today did the various interconnectors contribute more than 11%. The contribution from solar is now past its summer peak and wind strength across the UK has been unseasonally weak so far this month. This is why we need new nuclear to reduce the contribution from burning gas. Of which currently we only have 3 days supply stored.

          3. Micky Taking
            September 10, 2021

            REPLY to S.GOLD.
            Only 11% ….hands up the people and businesses that will give up their 11%.
            And by the way organisations like Hospitals (not surpringly) have first call on dwindling electricity supplies. Might be a good idea for us all to move near them to hope we keep the juice when shortages inevitably happen.

      9. Reggie
        September 10, 2021

        Untrue. NHS does not take payment in advance or request any guarantee so abuse is rife. How can it recover thousands of pounds from those unable to pay?

        Reply
        1. glen cullen
          September 10, 2021

          Proof of health/medical insurance with visa upon entrance to UK
          I never go aboard without it and many others countries demand it…so should we

          Reply
      10. Mark
        September 10, 2021

        Only some of them. Not anyone with indefinite leave to remain, or who has rights from our days in the EU, asylum seekers, and anyone the NHS fails to bill.

        Reply
      11. Micky Taking
        September 10, 2021

        Barely 1% because the NHS won’t set up a system to charge like the other countries, EU for example.

        Reply
      12. BW
        September 10, 2021

        No they don’t.

        Reply
      13. glen cullen
        September 10, 2021

        Correct they ‘have to’ but don’t

        Reply
      14. No Longer Anonymous
        September 10, 2021

        They are meant to pay but do they ?

        Other countries demand payment/security up front.

        Reply
      15. NickC
        September 10, 2021

        Andy, You don’t half talk some tripe. From the NHS (PHE) video about entitlements to treatment: “Anyone in England . . . can receive primary care services free of charge irrespective of their nationality or immigration status.” Full PHE NHS care is available to anyone who is “ordinarily resident” in England, and that includes all EU citizens who took up residence up to 1st Jan 2021. Bilateral health care agreements cover many temporary foreign (inc EU) visitors as well.

        Reply
      16. John C.
        September 10, 2021

        They don’t HAVE to. Many go home and ignore it. Can’t say I blame them. A soft nation like ours deserves a pummelling, to be honest.

        Reply
      17. Mike Wilson
        September 10, 2021

        No, they don’t. They have to provide contact details but, despite employing 1.4 million people, they don’t have the desire, or system, to chase payment. In other countries I have had to get a credit card out or be refused treatment.

        Reply
      18. Micky Taking
        September 10, 2021

        in your dreams.

        Reply
  5. DOM
    September 10, 2021

    This entire debate is pointless until we address it from a completely different angle. This entire issue is not about healthcare, nor is it about patient welfare, nor it is about the taxpayer. This is pure bred Client state parasitism and party political interest. This is all about POLITICS

    The cost of rebranding the Tory party is costing the nation hundreds of billions of pounds. That is the cost the taxpayer must take on board to finance previous, this and future Tory governments pathological desperation to appease the now political and exploitative NHS and its Labour allies who have the ability to damage Tory party and portray them in the media and on the pro-Labour BBC still as ‘the nasty party’ and all the other lefty lies they use to demonise Tory party MPs

    The taxpayer is financing not the provision of healthcare but a bottomless shit-pit of Client State parasitism, political party interest and a government in both colours who now see the taxpayer not as a means of financing State run provision of important public services but as a method of financing political and electoral focused public policy.

    This entire NHS and other other laughably termed public services charade is comic but more sinister since at some point access to such services that we have paid for will be used as a political weapon to impose compliance. This will happen

    This Tory government should be reforming and in many cases dismantling Labour’s and the unions public sector that is now a source of powerful unelected power. Instead as an act of destructive and cynical appeasement they are building upon it and that doesn’t bode well for freedom, for liberty and for the taxpayer

    Reply
    1. Sir Joe Soap
      September 10, 2021

      They’re definitely doing Labours job for them. That’s the whole point. They know there’s nowhere else to go. The only was is down, as the song goes.

      Reply
    2. Jim Whitehead
      September 10, 2021

      DOM, +1! To the point once more.
      NHS and BBC are being used to blatantly undermine all aspects of conservative thinking and all that was worth voting for in a Conservative Party. Tolerating both with weakness will be to lose what the NHS and BBC already know is a fight to the death.

      Reply
    3. Nota#
      September 10, 2021

      @DOM +1, I agree with every nuance there. You get the feeling that (and sorry to paint everyone the same) the whole of the HoC and pointless HoL is so lacking in basic managerial ability they should all be sacked and we get to start over. The problem there is it would be the Political Class that would see themselves as the new shapers and we would be back to square one.

      Reply
      1. turboterrier
        September 10, 2021

        Nota#
        Exactly. The whole problem is the calibre of the new generations of career politicians. They can’t manage they can’t lead and have qualified in the art of double speak which adds up to three fifths of nothing. It’s so obvious it’s embarrassing.

        Reply
    4. Everhopeful
      September 10, 2021

      That makes so much sense.
      I’d always wondered why a health service should be so terrifying and bullying at the point of “care”and yet why it appeases and flatterers certain groups beyond any medical reason. Then I read that the NHS is the darling of the Left because it is seen as a social leveller. A dustman in the same ward as a duke! (Except of course in reality the duke would pay for good care elsewhere and the NHS staff would have to make do with bullying an unfortunate lower middle class pensioner).
      I wonder if MPs realise how incredibly vicious the empowered and emboldened Left has become ( thanks Johnson)?

      Reply
    5. Donna
      September 10, 2021

      Correct. They are raising taxes on the working population and businesses already hammered by their idiotic Covid policy to prove that the Conservative Party loves the NHS and the claim made by the Labour Party at every General Election “the NHS isn’t safe in Tory hands” isn’t true.

      It’s pure politics. It will not reduce the waiting lists by much; and it will do nothing for social care. They’re buying votes with our money.

      Reply
      1. John C.
        September 10, 2021

        Donna, they’re not buying votes. They’re losing them.

        Reply
    6. oldwulf
      September 10, 2021

      @Dom

      When Mr Starmer said that the Tories are no longer the party of low tax – I was both surprised and amused.

      His implication is that the Tories are now as bad as Labour…. hardly an endorsement of his party 🙂

      Reply
    7. No Longer Anonymous
      September 10, 2021

      Richard Littlejohn reports today that the NHS block buys private health wards and doesn’t send patients to them. The idea is to stop people getting private care as the managers in the NHS are ideologically opposed to this method of funding.

      It is part of the reason as to why we have such a backlog of treatment.

      If true then this is a wicked waste of opportunities to make people better.

      Reply
    8. Mark B
      September 11, 2021

      The first job of any politician is to keep themselves in a job. With that in mind no wonder we are where we are.

      Reply
  6. Mark B
    September 10, 2021

    Good morning.

    As highlighted by others both here and elsewhere it seems that there has been quite a growth in ‘non-jobs’ in the healthcare system. One typical example is, Diversity Officers. Whilst I do not pretend that getting rid of them and other such drains on resources will magically resolve this issue, if one follows the maxim that, “if you look after the pennies, the pounds will take care of themselves.”

    The situation we have found ourselves has been created because successive government for literally decades have kinked this particular can of worms down the road and into the next county. It also has not helped that successive governments, of all hues, have dipped into people pockets (ie pensions) to pay for various projects / spending. The Conservative governments of the 1980’s created personal pensions because, I believe, they knew that the State Pension and ultimately personal care, could not be met by successive governments. I know of a man who told me recently that he and his wife had a pension pot of over half a million pounds. This sum of money was accumulated by an individual who was one would consider a ‘high earner’. This is what individuals can do for themselves when generally left alone to do so. Now he fears that the government might steal some of that money. I ask you, where is the incentive ? There is none ! The governments, through their own greed and ineptness have made saving worthless through low interest rate and inflation. So naturally as people become less self sufficient they fall into the realms of government care and this another reason why we are where we are.

    Perhaps, as I have suggested many time before, it is time for employers to be encouraged to offer FREE Health Insurance (not taxable) as a benefit. This would, I believe, help the NHS as there would be investment in healthcare releasing money for Social Care.

    Reply
    1. Nota#
      September 10, 2021

      @Mark B – a Diversity Officer, is a signal that the senior managers is god and needs to send political signals to others that they like Government know how to waste taxpayer money. Whichever way you shape it a Diversity Officer is a political statement by organisations that see the money the taxpayer is throwing at them is for their own personal politicizing “I don’t know what I am doing, I have a lousy movement ability but I support the ‘me-to’ virtue siginal and political gestures of Socialisms”

      Reply
      1. Mark B
        September 11, 2021

        They are the equivalent of the old Commissar.

        Reply
    2. a-tracy
      September 10, 2021

      Half a million pension pot sounds massive Mark B but what will that buy the individual in an annuity with spousal transfer on death annually. Age 66 Each £100,000 buys around £3,800 – £4,500 pa (without transfer). An income of around £20,000 pa so if he was a ‘high earner’ and by that, I’d guess you mean someone on around £50,000 pa his final salary pension is about 40%. Now go and compare that to protected final salary public sector and ex-public sector workers pensions (council, British Gas, Housing associations) all the other people now considered private sector but with protected public sector type pension guarantees. It’s all going to go boom, too many of them without the pots invested out of current taxation. We’re never told the total cost of those are we!

      Reply
    3. Old person
      September 10, 2021

      Mark B, your post raises interesting points and I would like to add that the £64bn can provide 320,000 hospital administrators on £200,000 a year.
      More to the point, what has happened to the money from raising the pension age? Where was it spent and by which departments. That must be an awful lot of money denied to retirees. Now the workers are hit again with the NI increases. Government very quiet on CGT and IHT tax rates.
      As regards paying for healthcare in your twilight years, there is no way the government will get me into a nursing home, thank you, unless I go suddenly gaga. I will make my own arrangements. Live in isolation, talked down as if you were a child, refused visitors, and pay more for the same care that the local council pays. And, after your money runs out, be suicided with Mizadolam.
      By sending untested hospital patients into nursing and care homes the government and opposition surrendered any legitimate right to govern.
      The heath insurance issue has problems. People insured with self-inflicted sports injuries tend to distort the claims, and unemployed/retired old people cannot afford to self-insure. Once insurers become involved the small print issues debase the insurance. Eg. is pregnancy a natural event.

      Reply
    4. Jane
      September 10, 2021

      I would dismantle the organisation and have a system similar to France. Insurance cover by employee and employer. Different levels of cover. State support and the same level of care for those who are poor and unemployed. Competition exists – if you do not like a doctor you go to another one. Appointments with consultant arranged in two days, same as hospital. Public in France very happy with their system and their clinical outcomes far superior to those of the NHS.

      Reply
      1. Mike Wilson
        September 10, 2021

        How do you dismantle the system. It is not possible. 5 million waiting for an operation. Who would pay? How could insurance be arranged now? No-one could take on the risk.

        Reply
    5. NickC
      September 10, 2021

      Mark B, An interesting contribution, thank you. Further to your suggestion of more employers health insurance here, many are surprised to learn (I was, too) that the USA spends about the same (pro rata) on state (and states) funded health care as we do – but they spend a whole lot more on private health care on top. Such private additional health care is not denigrated there as it is here.

      Reply
  7. turboterrier
    September 10, 2021

    How many millions will it cost to provide health care to all these illegal dingy invaders and others when they integrate into our society?
    Sooner or later they will need some form of health care, and eventually social care.
    The rules and laws have to be tightened up or repealed. The hard working tax payer struggling to provide a home and a reasonable life style for themselves and their family will find the demands being made on them unsustainable.

    Reply
    1. Everhopeful
      September 10, 2021

      I’m off to Denmark!

      Reply
      1. MWB
        September 10, 2021

        Is it possible to move to Denmark ?
        As I understand it, even when we were in the EU, buying Danish property was not allowed.

        Reply
        1. Everhopeful
          September 10, 2021

          I’ve no idea!
          I was joshing.
          We can’t travel at the mo anyway can we?
          No..it was just that this morning I heard how very sensible they are being!
          Unlike our govt.

          Reply
      2. glen cullen
        September 10, 2021

        The only sane country in the whole continent of europe

        Reply
        1. Everhopeful
          September 10, 2021

          +1
          Absolutely.

          Reply
    2. BW
      September 10, 2021

      +1

      Reply
    3. glen cullen
      September 10, 2021

      +1
      I watched the head of MI5 being interviewed on the BBC this morning…..he mentioned a lot of differing threats to the UK but didn’t once mention the channel boat people

      Reply
  8. MPC
    September 10, 2021

    A truly Conservative government would have used its large parliamentary majority to fundamentally review the quality, cost and financing of health and social care services with reference to good practice overseas, followed by a gradual introduction of such good practice – yes probably including obligatory personal insurance comparable to the introduction of pension auto enrolment. After all, no other nation has copied the UK approach of ever increasing income taxation without fundamental reform of services. But Mr Johnson is more interested in a legacy of HS2 and Net Zero.

    Reply
    1. SM
      September 10, 2021

      +10

      Reply
    2. Nota#
      September 10, 2021

      @MPC – ‘YUP!’ we voted for the Conservatives and received a far left Socialist Kabul, that deceived us in their speeches and manifesto. They still deceive us today, they want the glory, they want to stroke their egos’ so assumed to micro management of everything – only to be failing at every turn, destroying those that are able to respond to the situations in case they get shown up for what they are. ‘The Great Reset in Action’

      Reply
    3. John Hatfield
      September 10, 2021

      Time for all good men to cross the floor to the Reform Party.

      Reply
      1. Fedupsoutherner
        September 10, 2021

        +1 I would if I thought they would get in.

        Reply
    4. Jane
      September 10, 2021

      You are absolutely right. MPs run scared of such a suggestion – not because they do not agree but they worry about their electorate who have been fed unwarranted stories of the NHS being the envy of the world. MPs know for example that we have far too many large hospitals – cannot say so as people are attached (goodness knows why)to their local hospital regardless of its performance. Witnessed this in local press with removal of services when the hospital involved has been in special measures for years. Yes of course the MP got involved – must keep those pesky ignorant constituents happy.

      Reply
    5. Rhoddas
      September 11, 2021

      +10 too

      Reply
  9. PeteB
    September 10, 2021

    “What does care cost?” Flippant but true answer – as much as you are prepared to spend.

    I believe the original justification for spend when the NHS was created in the 50’s went along the lines of “spending will reduce over time as people will be healthier”. Reality – the longer people live, the more it costs.

    As you say, will be interesting to see how the extra money is managed. I’d argue a body which is in the top 10 IN THE WORLD by employee numbers is already too big to be efficient.

    Reply
    1. turboterrier
      September 10, 2021

      PeteB
      All so very true. Nearly every body who works in the NHS are adamant that the NHS is not a business. But it’s an organisation where health is its business.
      If it was a private industry it would be calling in the receivers year on year.
      Richard Branson loathe or love him, has a vision a business idea, sets up a company, as soon as the staffing levels reach a 100+ he recognises there is an opportunity to start another company similar but different and so his empire grew. I have long advocated departments should be trained into Self Directed Work Teams where the whole process is driven bottom up. Pick any one hospital not a Trust and change it into a self sufficient unit delivering patient service excellence managed by them, to meet the demands of the district they actually serve. Rocket science it is not.
      Push has to go to shove and quickly.

      Reply
      1. Nota#
        September 10, 2021

        @turboterrier & @PateB – so true. There is no management at the top in Government or down stream at local command level. There is just Political posturing and personal ego. The taxpayer pays in hard cash and those at the functioning end pay with the disruption of providing and efficient and effective service.

        Reply
      2. Mockbeggar
        September 10, 2021

        Hospitals used to be run by medical staff. Then it was decided that doctors were trained to be doctors and not administrators so we’ll have non medicals doing the management. This seemed to be logical. However, the easiest way for a manager to increase his/her grade is to recruit more staff and presenting a good case showing how much more work is being/can be done is what works. By this means, the manager’s job becomes more important and merits a higher grade. But every new recruit has a knock-on effect in other pats of the organisation: e.g. Human Resources, Salary and Pensions administration, Accommodation, Equipment, Training, Security and so on.
        In business this goes on until at Director level they realise that the ‘bottom line’ is being affected and so a cull of middle management takes place. Either that, or the business goes out of business altogether. In public organisations where the taxpayer is picking up the bill the pressure to improve productivity is much lower as ‘the Government’ can be easily persuaded that more money is required ‘just to keep their heads above water’ and the ‘business’ can never go out of business.

        Reply
      3. NickC
        September 10, 2021

        Well said, TT (and PeteB). I would like to see hospitals run by boards of (unpaid) trustees as self sufficient units. Of course there would still be cooperation with other hospitals, universities and GP practices, as now. We must replace the NHS’s top-down 1950s soviet style “push” management, with the bottom up “pull” management pioneered by the car companies.

        Reply
    2. Andy
      September 10, 2021

      You probably wouldn’t qualify to go to Denmark. The Danes have tough immigration rules and you are unlikely to reach the criteria.

      Reply
      1. NickC
        September 10, 2021

        How could you possibly know, Andy?

        Reply
      2. No Longer Anonymous
        September 10, 2021

        You make that sound like a good thing, Andy. So why can’t we have it ?

        Reply
      3. John C.
        September 10, 2021

        Members of the EU do not have tough immigration rules. It’s part of the deal, Andy. If I’m a Bulgarian peasant and fancy shivering in Aarhus, then off I go. Great, you must agree.

        Reply
      4. Mike Wilson
        September 10, 2021

        I wonder why the Danes have tough immigration rules? Don’t they want to be ‘global Denmark’? Don’t they want high immigration? Are they racists?

        Reply
    3. Christine
      September 10, 2021

      “the longer people live, the more it costs” – Is this really true?

      People are expected to work longer but the average death age has hardly risen in decades.
      The government is raking in huge amounts of money from increasing the state pension retirement age.
      Workers stop paying NI contributions once they reach retirement age, so by increasing the age to 67 the government automatically rakes in extra tax.

      On top of this many working women have lost over £65k each in state pension payments by having their retirement age raised from 60 to 67 and working men over £18.5k each by having their retirement age raised from 65 to 67.

      Add to this the changes to the state pension scheme whereby any old contributions where the employee was contracted out to their employer’s scheme no longer count as contributory years towards the state pension and we see another stealth tax. Many workers are yet to realise that although they have worked all their lives they won’t be able to get a full pension. Yet those who have lived a life on benefits including people who have never even set foot in this country will get a full pension.

      If I compare what I have paid into the system and received back with that of my mother the difference is vast.

      Blaming increased costs on an aging population is a fallacy the government likes to perpetuate.

      Where are all this extra tax money and pensions savings going I ask?

      Reply
      1. PeteB
        September 11, 2021

        “Average death age has hardly risen in decades”. FALSE

        See attached link from our Office for Notional Statistics. Life expectancy has been rising for decades
        https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/lifeexpectancies/articles/howhaslifeexpectancychangedovertime/2015-09-09

        Plus 7-10 years between 1970 and 2010. That is sizeable.

        As an aside the C-19 deaths are estimated to have reduced average life expectancy in the UK by 1 month.

        Reply
  10. Lifelogic
    September 10, 2021

    The danger of associating one tax with one item of spending is you do not then have the flexibility to spend government money sensibly. Just as when you pass laws saying we will spend x% of GDP on overseas aid or on the moronic climate change act or net zero CO2. You tie the hands of future governments preventing them making sensible judgements. More to the point these massive tax increases will damage the recovery, destroy jobs and raise less not more by reducing the size of the productive economy.

    The NHS is a dire a very inefficient, state monopoly health rationing system. The more money they get the more they will waste on overpaid bureaucrats, diversity officers, rebranding and similar. David Starkey on Iain Dale/Talk Radio (with Paul Mason, Anneliese Dodds and David Davis) on Wednesday in a lively debate had it right. At one point Dodds said she would not be lectured to on economics by Starkey. If anyone needed educating on economic (and reality in general) by Starkey it is the dopes A Dodds and Paul Mason.

    Thank goodness we have delightful Emma Raducanu to cheer us all up!

    Reply
    1. Nota#
      September 10, 2021

      @Lifelogic +1. The Ego of this Government is they must direct, they are entailed to pour money down the drain – its the ‘grandstanding’ the political message of being the master of all you see that makes them feel good. That’s why they and in particularly Boris are not fit for purpose – any reshuffle is really the boss saying I am not fit for purpose

      yes it is good to see in Emma the ability of achievement from the young is still there as opposed to the whining entitlement the MsM picks up on

      Reply
    2. NickC
      September 10, 2021

      As a nationalised top-down soviet-style organisation, the NHS is in the happy (?) position of being able to claim that every failure isn’t something to be ashamed of, but simply demonstrates how difficult their job is. The NHS structure guarantees failure. There just isn’t any incentive to do better with less. It’s almost national blackmail.

      Reply
      1. Lifelogic
        September 11, 2021

        +1

        Reply
  11. Lifelogic
    September 10, 2021

    The main reason Sunak wrongly think these new taxes are needed is that this government have borrowed £billions to piss away by hugely over reacting to Covid. Thus pissing billions away on lockdowns, test and trace and other foolish and very major errors.

    The best solution by far is to cancel the tax grap, cancel the £ Trillion net zero, cancel HS2, cull loans for duff degree, fire the 50% of government that does more harm than good and get real and fair competition in to health care and education. Simple really.

    Reply
    1. NickC
      September 10, 2021

      Lifelogic, It’s funny how the government thinks it’s perfectly possible to get “net zero” CO2, but spectacularly fails to achieve net zero immigration.

      Reply
      1. Lifelogic
        September 10, 2021

        +1

        Reply
      2. Mike Wilson
        September 10, 2021

        @NickC

        The government most emphatically does not fail to get net zero immigration. It does not want it! On the contrary- high immigration is a deliberate policy. Allow a load of young people to move here – they’ll work and pay tax and, hopefully, not need the NHS much. Economy grows, tax take goes up, public spending goes up a bit less than economy grows – result? The government keeps the plates spinning and carries on borrowing.

        High immigration is quite deliberate. Which, when you think about it, is perfectly obvious. The government could easily limit immigration if it wanted to.

        Reply
  12. Everhopeful
    September 10, 2021

    Whatever the cost, we the public, have no control over what is spent and on what.
    Perhaps the NHS should not have subsumed every single twig of medicine? There were excellent private provisions before it raised its ugly head.
    Anyway, since March 2020, do we have much access to it? And all alternatives wiped out.
    Undeniably our tax money is taken, supposedly for the purpose of providing us with healthcare.
    Thus far the government has failed abysmally.
    The recent plague outbreak is no excuse as all governments should have been fully prepared since that other plague in 2009 ( not to mention at least one other attempt) and also alerted by the “ Global Vaccine Action Plan” 2010-2020.

    Not pigs nor birds but….BATS!!

    Reply
    1. Nota#
      September 10, 2021

      @Everhopeful – +1, tax money spent without accountability comes to mind. It is not taken for health care, but so as a poor performing Government can make political statements

      Reply
      1. Everhopeful
        September 10, 2021

        +1
        Exactly.
        Someone told me that the Tory strategy is to out-Labour Labour in order to render the country a one party state. Heaven help us!!
        So Labour in power WOULD have to raise taxes to fund their beloved NHS. Tories have preempted them?
        Sounds a barmy enough plan.
        But no one will forget and possibly not forgive what Johnson has done.

        Reply
    2. NickC
      September 10, 2021

      Government “services” cost more and more, yet become less and less usable.

      Reply
    3. Hat man
      September 10, 2021

      Everhopeful, the government WAS prepared – prepared to hide the truth, for a start. The outcome in 2016 of Exercise Cygnus investigating NHS capability was kept secret from the public. It predicted shortages of ICU beds and PPE. Then the number of hospital beds was further reduced, with the result that there would be a real crisis in the next respiratory disease wave.

      I don’t buy the idea that the government stumbled blindly into an inadequate Covid response. The NHS went up to a level 4 alert at the end of January 2020. On 10th February Hancock gave the authorities the power to arrest and isolate suspected Covid carriers. At the beginning of March, he told Andrew Marr that ‘closing down cities’ was among measures the government was considering. The problem was, British people were thought to be less inclined to give up their freedoms than in many other countries. It took massive pressure from the media softening up the public for the removal of civil liberties before the government could ‘get away with’a Chinese style approach (to quote Neil Ferguson). I think the government was for several weeks very deliberately shifting from the 2019 pandemic response plan, to preparing lockdown restrictions instead. It will be interesting to see what the Covid inquiry comes up with.

      Reply
  13. Everhopeful
    September 10, 2021

    Social care = huge social cost.
    No compassion or dignity.
    The absolute apotheosis of cultural Marxism.

    Reply
  14. SM
    September 10, 2021

    May I give one example of NHS management stupidity experienced 7 years ago:

    a major District General Hospital in Essex rebuilt its main entrance some years ago. It is very grand to look at, but it’s not possible to park sufficiently close to the doors to enable an out-patient to access them easily, because there are a flight of stairs or a long ramp leading from the road upwards. If a patient is too disabled or weak to walk to the hall where wheelchairs are kept, the driver must temporarily park illegally and attempt to deal with the issue. There is utterly insufficient parking, with many cars that are forced to park at random on patches of grass or close to uncared-for bushes. Yet within yards of the main gateway to the hospital there was an abandoned Council multi-storey car park, which the hospital had apparently made no attempt to commandeer. There are residential roads immediately surrounding the hospital grounds, and their residents were understandably upset by the takeover of their parking space by hospital visitors and patients.

    Complaints about the problem both from staff and patients were met with a stony silence.

    Reply
    1. Peter
      September 10, 2021

      I used to work on the capital budgets for what was then a PCT. Because of the strict financial year if budgets weren’t spent in the year they were lost for the next year also, rather than being carried over in the normal way. It is not the one you are talking about, but I had to authorise a completely unsuitable new hospital main entrance following the collapse of a proposed new hospital extension. The project was the only one ready to go and have spent the money in the financial year. It made sense for the PCT but to no one else!!

      Reply
    2. Original Richard
      September 10, 2021

      SM : Your example of NHS management stupidity reminds me of another :

      Every 3, 4 or 6 months qualified doctors on their specialist training courses rotate their position and start work at a new hospital, known as changeover.

      I heard a report of one hospital where a doctor arrived at 07.30/08.00 hrs on the first day to begin work attending to patients for a surgery list starting at 08.30 hrs.

      The doctors were allowed to park in the hospital car park provided they paid for the privilege and first obtained a car park pass.

      On this first day the doctor had no car park pass as it was not posted to them in advance.

      Upon arrival they were told by the car park attendant that they could not park without a pass. So the doctor told the attendant they would go quickly to reception to collect their pass.

      The receptionist said they were not allowed to give out the car parking passes until after 09.00 hrs even though they had already been prepared and were laying on the reception desk!

      Apparently this farce takes place at every changeover.

      Reply
  15. Sir Joe Soap
    September 10, 2021

    We’re in the field of church taxes of 1000 years ago. Who would argue against a tax to support the ministry? Later, taxes to fight the French. Who’d argue against that? No matter that much was lost through waste and corruption. The actual cost didn’t matter. The principle did, and at least the French were kept at bay.
    Today the NHS is that religion. Poorly run, utterly disorganised – yesterday a relative arrived on time for a paediatric appointment but had to sit on the pavement outside a clinic with one year old twins to protect the staff inside from COVID- the NHS is the excuse to gouge taxes.

    Reply
    1. oldwulf
      September 10, 2021

      @Sir Joe Soap

      Maybe someone should set up a blog – where we can all post our experiences with the NHS.

      Probably wouldn’t lead to change – but it might at least improve our mental health if we can tell someone about it ?

      Reply
      1. SM
        September 10, 2021

        It would be overwhelmed in hours, oldwulf.

        Reply
    2. NickC
      September 10, 2021

      “A government dollar is worth 50 cents”.

      Reply
  16. Hat man
    September 10, 2021

    Where is the money going, that’s spent on social care? Part of the answer seems to be found in financial reports. I see 2020-21 was the most profitable for quite some years for the biggest UK care provider CareTech PLC, and probably for other private providers in this sector. No doubt another lockdown would do their cashflow a power of good.

    A neighbour of mine couldn’t see his family, friends or neighbours for months thanks to government lockdown orders during the Covid crisis. Instead, he had very frequent visits from care workers, needing to be paid for, of course.

    Just shows every crisis is an opportunity.

    Reply
  17. Andy
    September 10, 2021

    You cannot seriously talk about his subject without talking about old people. Figures the Nuffield Trust produced in 2016 found healthcare for a man in his late 80s costs the state SEVEN times what healthcare for man in his 30s does. A man in his 30s is far more likely to be earning and paying proper taxes too.

    The number of old people in this country is a ticking time bomb. The vast sums spent on their health care, social care, pensions and other old age perks is simply unaffordable for everybody else. The elderly mostly have not paid as much into the system as they now take out – so who funds the difference? And with more people living longer this problem is only going to get worse.

    My wife and I pay a vast amount of income taxes. Around a quarter of a million pounds each year. I estimate more than £100k of this is spent on services for the elderly. All of you are costing me close to £10k a month. It is outrageous.

    I don’t mind paying taxes for education. Children need the best start in life. I don’t mind paying for transport and infrastructure. We need good roads and railways and reliable sewers and power grids. But I majorly object to funding whinging old people so they can go on yet another cruise. If you need social care pay for your own. And if you can’t afford it: tough. That is what charity is for. Your care should not be my problem. I have insurance should I need care. Why don’t you?

    reply The 80 year old was a 30 year old once. Of course Health care costs are concentrated in old age, whilst tax to pay it is collected throughout our lives.

    Reply
    1. Richard1
      September 10, 2021

      what a foolish and unpleasant post. its like saying ‘99% of NHS spending goes on ill people. i am healthy (at the moment) I dont want all my taxes going to ill people’.

      Anyway keep it up. this is just the sort of thing we need to hear from the left. given the incompetence and missed opportunities of this govt, we’re only going to win again next time by saying the other lot will be worse (should work, its been a reliable – and justified – line).

      Reply
      1. NickC
        September 10, 2021

        Richard1, Exactly so. Andy’s perpetual whining that old people are . . . well . . . old, and sometimes need more care than 30 year olds, is so odd it’s mechanistic. It’s as though he does not understand that humans are helpless at both the beginning and end of their lives. Next he’ll demand that 6 month old babies wipe their own bottoms.

        Reply
    2. Wonky Moral Compass
      September 10, 2021

      Thanks are due to you and your wife for your tax contributions, Andy. I’m amazed that you find the time to post as much as you do while holding down such a high-paying job. What’s your secret?

      Reply
      1. John C.
        September 10, 2021

        Andy is a fantasist who likes to stir up genuine Conservatives. I suspect he lives in an attic.

        Reply
    3. Glenn Vaughan
      September 10, 2021

      Another attack of detestation aimed against the elderly that oozes hatred from every pore. Why he is allowed a public platform daily by the moderator to preach his hatred I’ve no idea and I also wonder what on earth can be regarded as “hate crime” if it’s not this sad individual’s daily diatribe.

      His message like most of his others on this website qualifies as an excellent example of the 3Rs i.e. repellent, repulsive and repugnant! UGH!
      p.s. I wonder if my contribution will pass moderation or am I also required to attack the elderly as a condition for approval?

      Reply
    4. oldwulf
      September 10, 2021

      @Andy

      You both seem to be paid as much as a public sector manager.

      Good luck to you 🙂

      Reply
    5. SM
      September 10, 2021

      Andy, I am going to try to ignore your infantile and offensive descriptions of the elderly and deal with the issue:

      It has been said (by some of us) time and again for many, many years – when we were your age, in fact – that the NHS/Care/Pension systems were either introduced by politicians living in La-La Land or by utter incompetents.

      Aneurin Bevan, who pushed through the NHS Act in 1948, was criticised by senior members of his own Party (Labour, by the way) because insufficient thought had been given to its funding system. However, he had major ambitions to become Party Leader and used his powerful personality to get it enacted. Within 2 years, the NHS was in financial trouble, and charging had to be introduced. Politicians on all sides have constantly succumbed to its pleadings because they are unwilling to enter the complex argument/public relations arena on behalf of a better system. Bevan of course never achieved his ambition.

      Lloyd George (Liberal, by the way) introduced the State pension [Ponzi] scheme, on the economic basis that there were far more workers than pensioners, and when the average male life expectancy was 74yrs. Politicians on all sides have been unwilling to explain to the electorate that conditions have irremediably changed, and another way must be found to deal with the issue of caring for and subsidising the increasing number of elderly people.

      Last point: it may not happen in your wealthy family, but most of the pensioners I know, including myself, spend a lot of their time and effort – and money – caring for their families (whether grandchildren, close relatives within the same generation, or those in their 90s kept alive by modern medicine), not going on cruises.

      Reply
    6. Christine
      September 10, 2021

      You seem to have a rather cushy job that allows you so much time to read and comment on John’s diary. What is it you actually do, you never tell us this? What makes you so much more worthy than the elderly people who you criticise?

      I would never have had this much spare time during my years of working full-time and raising a family.

      Your hatred of old people is a constant theme in your posts and you need to get some help to manage this problem you clearly have.

      Reply
    7. Peter Parsons
      September 10, 2021

      I was a 30 year old once and I hope to make it to be an 80 year old. I have no problem paying towards the pensions and health care of those who funded my education, just as I hope that those whose education I am paying for now will be willing to do the same when I get to my latter years.

      The problem/question is this – as the older population grows in number due to increased life expectancy, better healthcare etc., what does that mean for the working age tax base? Either it needs to grow at a similar rate so that the burden on each tax payer remains broadly constant, or, if it grows at a slower rate, the burden on each individual working age tax payer will increase.

      So, how do you grow the working age tax base at the same rate as the older population is growing? There are only two sources – you breed them (having children) or you import them (net migration). The UK birth rate falls way short of what is needed to grow the working age tax base at the same rate as the retired population is growing, so the only other solution (apart from cutting spending on the retired population) is a level of net immigration to plug the gap.

      Reply
      1. a-tracy
        September 10, 2021

        Peter, what has actually happened is you make them work another six to seven years (women) and two – three years (men). Many are working over retirement age and their employer’s continue to pay the employers NI contribution.

        Too many employer’s have had enough of SSP, SSP holiday pay, SMP, SMP holiday Pay, national insurance contributions nest etc and have made workers self-employed!

        Reply
    8. Sharon
      September 10, 2021

      JR

      I agree with your comments. Let’s hope Andy lives to be 80, then perhaps he’ll understand…

      Reply
    9. No Longer Anonymous
      September 10, 2021

      Reply to reply

      Andy has a blind spot for the amounts paid in by individuals but I do feel that the NHS is a victim of its own success. It is very good at keeping sick people going rather than helping them not to get sick in the first place.

      Not eating crap and moderate exercise can change outcomes dramatically.

      Reply
    10. Beecee
      September 10, 2021

      If you think an OAP living off a State Pension can afford a Cruise then you are an idiot.
      Oldies with private pensions plus State Pension totalling over c. £12,500, pay tax.

      The basis of the information you use needs to be extended beyond soiled toilet paper!

      Reply
    11. No Longer Anonymous
      September 10, 2021

      Andy

      Average male life expectancy UK 79.4 years (below 80)

      So your point is ?

      I lost another mate two weeks ago, aged 56. Not covid but likely to be a victim of lockdown and NHS neglect (as the other – now 5 – non covid deaths in my circles in this pandemic.)

      Reply
    12. Cliff. Wokingham
      September 10, 2021

      Andy
      Are you talking about public sector pensions as well as ordinary pensions for ordinary, NI paying workers?
      The unfunded liability for public sector pensions in Feb this year stood at £1.2 trillion. Do you wish to deprive nurses, soldiers, bin men and council employees of their occupational pensions too or are you just talking about every other older person’s pension?
      If you really are paying as much tax as you say you are, then you need to employ a new accountant.
      Did you not say a couple of years ago that you own a translation business?
      Thanks for my pension old chap, keep paying because I really do appreciate it . XXX

      Reply
    13. NickC
      September 10, 2021

      Actually current pensioners must have paid in (in total) vastly more than they’re now taking out, Andy.

      Reply
      1. Dave Andrews
        September 10, 2021

        In average terms they can’t have done, otherwise the national debt would have just about vanished. Instead it has grown just about every year since the 60s. Whatever current pensioners have paid in has long been spent, by the borrow and spend governments they helped to elect.
        I’m not averse to the state pension concept by the way, just this delusion that pensioners are getting back what they paid in. That only applies to private pensions.

        Reply
        1. NickC
          September 11, 2021

          There are many more things the state spends money on, in addition to state pensions, Dave. Almost all of it is funded by taxation. Therefore current pensioners must have paid in (in taxation) vastly more than they are now receiving in state pensions.

          There is a discussion to be had about all state benefits – the NHS, care, education, pensions, etc – my objection to Andy is that he is solely hostile to “old” people; it’s almost pathalogical.

          Reply
    14. Cheshire Girl
      September 10, 2021

      Im sure you’ve got the Final Solution, Andy.

      One day you will be old yourself. Just make sure you decline any health care from the NHS.

      What goes around, comes around. Remember that.

      Reply
    15. alan jutson
      September 10, 2021

      Andy

      Are you and your partners parents and grandparents still alive by any chance ?

      Reply
    16. Dave Andrews
      September 10, 2021

      Who funds the difference? Well, borrowing does of course, so that is a problem passed on to the next generation. How kind!

      Reply
    17. Mike Wilson
      September 10, 2021

      Thank you so much. If you really earn the money you claim, it is astonishing that you have so much time to post on here. Maybe you’re a buy to let parasite.

      Reply
  18. alan jutson
    September 10, 2021

    Thank you JR for outlining the costs of the NHS, I was certainly aware it was a very large budget, but not aware of the scale of the increase in recent years, and how it consumes so much of our taxes.

    Perhaps it is now time for the Government to issue an annual, but simple, income verses expenditure chart each year, rather similar to what we get with our Annual Council Tax demands, so we are all rather better informed as to exactly where the Governments money (tax payer income) comes from, and where it is spent.
    I assume most Councils operate the same as in Wokingham with Pie charts and income and expenditure lists.

    If for no other reason it would show everyone that the Government has no money of its own, everything is taken from the taxpayer/population.

    The first part of every discussion is knowledge and facts, which seem to get lost in any political debate.

    I wonder how many MP’s are aware of the costs outlined in your post today ?

    Reply
    1. Nota#
      September 10, 2021

      @alan jutson – taxpayer money? surely you mean Boris’s money, that’s why there is no responsibility or accountability placed on the spend

      Reply
    2. acorn
      September 10, 2021

      You can find what the government spent £1,094.386 billion on in Table 5.2 PESA 2021, and where the £726 billion in central government receipts (plus £38 billion in Council Tax etc) came from in “Public sector finances, UK: April 2021”, which includes in Sec 5 “Borrowing”.

      Reply
      1. alan jutson
        September 10, 2021

        acorn

        Aware it can be found, but I would guess 99% of people do not bother, if it was sent to them each year in a much more simple form with their tax code number, perhaps they may just look at it and wonder !.

        Reply
  19. `m on about the bus )
    September 10, 2021

    It is a real pleasure to see the Redwood brain exerted for good . This blog , for you newbies, used to be full of this sort of beautifully composed and clear thinking material. Quite why Nationalism rots the brain I don`t know, but for some reason one the infection is acquired the sternest realist seems incapable of telling Fact from Fairy Tale.
    What I like about this post is not just the point but the whole subject. There should be far more public clear discussion of what big items the State provides how they are paid for and whether they can be afforded . Once the numbers are on the table , just possibly, we might have a National Conversation more like boardroom and less like a Football Stadium.
    By the way the welfare budget is only slightly less than the Health budget but health spending even prior to Covid was growing as part of GDP from 5.49% in 2000 to 7.79%in 2019 (10.43% in 2020 ).
    Good stuff, more please, and I join you in condemning all, those who hypothecate paltry sums , worse still , with, pure inventions , against huge dynamic costs so as to mislead people .
    Where is that bus …now ?

    Reply
    1. Newmania
      September 10, 2021

      oops tis me ..not sure what happened there

      Reply
      1. Everhopeful
        September 10, 2021

        +1
        Thank goodness.
        That’s a very strange handle! 🤭

        Reply
    2. NickC
      September 11, 2021

      You think nationalism “rots the brain”, Newmania. I think “internationalism” (ie disrespecting national roots) rots the brain. Especially the sort of internationalism that European thinkers impose on the world such as Communism, Nazism (no respecters of nationalism they), and the EU ideology. Its “anywheres” vs “somewheres” again.

      Reply
  20. Shirley M
    September 10, 2021

    The NHS tries to be all things to all people. It is an impossible task as there isn’t enough money in the whole world to achieve that outcome. Sad to say, but it is time to restrict the expectations of what the NHS can do for them. It is no different for insurance led health care. They also have restrictions.

    Reply
  21. BW
    September 10, 2021

    The question is, What does my household cost. I find out the my energy bills are going up by £400 pa. Yes I have shopped around. I have no doubt the Council tax, which I have no say on, based on the size of your house and not your income, (so lets call it what it is a poll tax) will rise again, with more for the “elderly care” add-on, more for the garden waste add-on. more for every other add-on that seems fit. More for the police who I never see and have closed the police station. No doubt more for the inevitable councillors pay increase. every single bill I will get next year will increase. That is before the April tax grab. The increase in the State Pension next year has already been wiped out and more.
    What I believe is making everybody angry is the massive waste that is clearly visible to all, The entire public sector is a mess of waste and the government thinks it is fine to dip into my pocket every time.
    So lets bring in the HK Chinese, Lets bring in Afghanistan, lets welcome the boats at Dover. Its ok just send me the bill. That’s appears to be fine as well. I think all in all as a pensioner I will be taking more than £1000 pay cut in real terms. But don’t worry about that. Not until the next election anyway!

    Reply
    1. Andy
      September 10, 2021

      Councillors do not get paid.

      As a pensioner you cost me far more than any asylum seeker ever will.

      Reply
      1. BW
        September 10, 2021

        So Andy you don’t see a difference between a person who has paid in all his life and an illegal economic migrant. That is really sad. Don’t forget nobody is forcing them to leave France so they are not in anyway refugees or asylum seekers.

        Reply
      2. No Longer Anonymous
        September 10, 2021

        Andy

        I know you’re miffed that pensioners took away your kids rights to work on French ski resorts in the winter.

        Mine were too busy as members of research teams for brain tumours and diabetes to have time for that sort of thing.

        This (soon to be) pensioner has certainly done his bit for the country.

        Reply
      3. BW
        September 10, 2021

        I know what you mean about tax payers money Andy. When I was paying tax I didn’t mind so much paying for pensioners who had contributed. What I did mind was paying people to have as many kids as they wanted. I also resented paying to educate those kids, some of it obviously wasted, who would then go on to resent paying the small pensions to the very people who were taxed to bring them to adulthood.

        Reply
      4. NickC
        September 10, 2021

        Yes, Councillors do get paid, Andy. You have no means of knowing that BW, as a pensioner, will cost more than “any asylum seeker ever will”. Even when this mythical asylum seeker (more likely an economic migrant) reaches state retirement age? Hardly! You’re becoming more irrational with every comment, Andy.

        Reply
      5. SM
        September 10, 2021

        They don’t get a salary but they get allowances, variable by council, and there are special responsibility allowances which can amount to tens of thousands of £s. I believe they also can get pensions.

        Reply
      6. IanT
        September 10, 2021

        “As a pensioner you cost me far more than any asylum seeker ever will.”

        So Asylum Seeker go back home when they get old do they Andy??
        Wonderful – almost as good as your income tax porkie!

        Reply
      7. Peter2
        September 10, 2021

        Councillors do get paid.
        Attendance allowances, travel expenses, office expenses and many other payments.
        Especially those now called Cabinet ministers, as some in my local authority have redefined their titles, , who have given themselves a nice big salary on top.

        Reply
      8. Peter2
        September 10, 2021

        Councillors do get paid.
        Check it out.
        Stop posting nonsense Andy.

        Reply
    2. oldwulf
      September 10, 2021

      @BW

      “Not until the next election anyway”

      I hope we will have more choices then, than we have now.

      Reply
    3. SM
      September 10, 2021

      +1

      Reply
    4. Ian Wragg
      September 10, 2021

      Wait till you start getting priced out of the energy market when taxes are raised on gas to force you into buying a heat pump.
      When petrol and diesel are so expensive that only BBC employees and politicians can afford it.
      Wait until the country is all electric and there are major power cuts when the wind don’t blow and the sun doesn’t shine.
      Net Zero, you’ve seen nothing yet.

      Reply
  22. Denis Cooper
    September 10, 2021

    Off topic, I have a little letter in the Belfast News Letter:

    https://www.newsletter.co.uk/news/opinion/letters/one-of-the-uups-protocol-proposals-is-actually-three-years-old-3377456

    “One of the UUP’s Protocol proposals is actually three years old”

    “Studying the alternative Protocol proposals made by the Ulster Unionist Party, I note that the first on the list is not the establishment of a cross-border body – which clearly has touched some very raw nerves – but the passage of a UK law to prohibit the export to the Republic of goods which do not comply with EU requirements.

    This was first suggested to Prime Minister Theresa May in February 2018; then, in a more developed form, it was proposed by a former EU official in August 2019; and at last it has found its way into the UK government’s recent Command Paper.

    So why is the government not just going ahead and drafting the legislation?

    Whatever else happens, such a UK law will be necessary, and moreover it would make redundant some of the more obnoxious provisions of the protocol.”

    Of greater and more immediate practical significance, DUP leader Sir Jeffrey Donaldson has announced that his party will no longer go along with checks being made on the goods entering Northern Ireland from Great Britain, and he will pursue that course to the bitter end:

    https://www.newsletter.co.uk/news/politics/in-full-sir-jeffrey-sets-out-battleplan-against-protocol-in-long-awaited-speech-3377934

    “Sir Jeffrey sets out battleplan against Protocol in long-awaited speech”

    This is thanks to those who decided to make a mountain out of a molehill on the Irish land border.

    Reply
    1. Sayagain
      September 10, 2021

      Sir Jeffrey may huff and puff but he is not going to change the fact that the protocol is in place and we have now left effectively leaving NI behind in the EU Single Market – It is not the Protocol which was freely negotiated but the Brexit itself that is the problem and there is no other way around this unless the Government decides that GB should rejoin the Single Market. Sir Jeff

      Reply
      1. NickC
        September 10, 2021

        Sayagain, We voted in a single issue national Referendum, to Leave the EU – of which the EU’s single market is part. As was made explicit time and time again before our vote.

        Being outside the EU’s single market is not a problem for the rest of the world, so it should be no problem for the UK. If the EU is worried about goods from the UK crossing the border illegally, I’m sure we’ll help the EU if it asks nicely.

        Reply
      2. Denis Cooper
        September 11, 2021

        The only genuine rationale for Northern Ireland to be left behind in the EU Single Market was that some of the goods crossing the land border into the Republic will have been produced within Northern Ireland and so will not be would caught by the EU’s preferred checks and controls on the goods brought into the province. Change from those daft EU import controls to sensible UK export controls and that rationale disappears.

        Reply
    2. Denis Cooper
      September 10, 2021

      Incidentally our local newspaper the Maidenhead Advertiser has printed the last letter that I sent in, floating the possibility that Boris Johnson and Lord Frost were off their rockers:

      https://johnredwoodsdiary.com/2021/09/05/shortages/#comment-1257439

      Plus a letter from a local member of the European Movement who quotes the EU take on the protocol:

      https://johnredwoodsdiary.com/2021/09/07/do-we-fight-too-many-wars-2/#comment-1257801

      However the EU’s stated “presumption that all goods entering Northern Ireland … are at risk of moving on to the Union” is clearly irrational, indeed absurd, given that the volume of goods entering Northern Ireland from other places is so much higher than the volume moving to the Republic. For example in 2017 goods worth a mere £3 billion were exported from Northern Ireland to the Republic, versus £17 billion imported into Northern Ireland from the rest of the world including the rest of the UK. And even some of that £3 billion would be goods produced in Northern Ireland, rather than goods imported and passed on down, which is why the EU has insisted that Northern Ireland must remain under its rules.

      Reply
    3. NickC
      September 10, 2021

      Again, well done, Denis – keep up the good work the government should be doing, but isn’t.

      Reply
  23. Nota#
    September 10, 2021

    I don’t think any one is unaware of the size of the problem and its costs. Government however is in the dubious untenable position which is seemingly based on ‘ego’ that thinks it can stand there and orchestrate, command and control everything in its minute detail from its lofty seat.

    The ‘care sector’ primarily in private hands, now has No 10 in control. The Government could of course Nationalize it – but what a waste of money.

    There is the problem, the NHS is a massive monolithic operation run on a one size fits all by central command. The Government has to get it in its ‘head’ they are not business leaders, they have proved they don’t understand money as a resource, then add in they are not remotely qualified for the position they have given themselves. The desperation to be the single egotistical man that solves everything is the fly in the ointment.

    Things need to be broken down so that those on the Ground who do the ‘actually’ work no were they stand, not just sitting there waiting for the next command from central office

    Reply
  24. Lisa
    September 10, 2021

    What’s a few billion here or there? This government has squandered more money than any other British government in history (whilst making sure a good lot of it went to them and their friends).

    Reply
    1. glen cullen
      September 10, 2021

      Did someone just mention HS2

      Reply
  25. Nota#
    September 10, 2021

    The NHS employing WOKE Managers, to assess diversity etc. Is an insult to all hardworking staff and actually defines the upper management and its style of operation as being out of control and lacking in the acumen to be fit for purpose.

    Taxpayer money should not be squandered on Political Messaging, making Political Statements when it was directly directed to providing a service. That should also go to all institutions that are funded and subsidised by the taxpayer – there political masters HoC, Government already own and get paid for that function. You could reason that the management of any business that thinks in needs to ‘virtue signal’ at any level is not fit for purpose and should be removed

    Reply
  26. Sea_Warrior
    September 10, 2021

    May I suggest that the NHS is wasting a fortune on COVID testing? Looking at the figures, it appears that we have all been tested five times or so – and some 97% of the expensive tests come back negative. So shouldn’t backbenchers be pushing Javid to target testing better, make savings and use those funds to pay for the ‘catching-up’? Or does no-one in the Commons care about value-for-money anymore?

    Reply
    1. Lester_Cynic
      September 10, 2021

      SW

      I’ve not been tested once and I don’t intend to be, the man behind the PCR test said that it was never intended to be a diagnostic test, I recently spent an afternoon in A&E and a nurse approached me with a swab and I refused to allow it to be inserted into my nostril much to her surprise, the test is totally unreliable and is used to inflate the numbers and frighten everyone!

      Goering said in the early 1930’s that if you frighten people enough you can get them to believe anything and the same principle is being applied now

      There a 99.95% survival rate from the virus and it affects people who have pre-existing conditions and the average age of death from the virus is higher than the normal avg age of death, the ones dying have already been vaccinated, you only have to look at Israel to see the truth

      The number of people continuing to wear masks defies belief but it suits Johnson perfectly, he’s already destroyed the Conservative party and the country with his loony ideas!

      Who will rid us of this troublesome PM?

      Reply
      1. Lester_Cynic
        September 10, 2021

        I’m sure that when I left my reply to Sea Warrior there were relatively a few posts?

        It’s very odd that some comments seem to remain in a Time Warp and await Moderation for an eternity!

        Reply
        1. Mark B
          September 11, 2021

          Yes, and some of them have been known to completely disappear. Haven’t they, Sir John ?

          😉

          Reply
    2. glen cullen
      September 10, 2021

      Spot On

      Reply
    3. Micky Taking
      September 10, 2021

      ‘does no-one in the Commons care about value-for-money anymore?’
      Did they ever?

      Reply
    4. Mark
      September 10, 2021

      Test and trace is indeed a farce. Tracing and isolation are only potentially effective in reducing spread if they operate rapidly, within 24 hours. Otherwise you might as well not bother. Limiting testing to suspected cases and perhaps inbound travellers would allow for a huge reduction in spending.

      Reply
      1. glen cullen
        September 10, 2021

        I still can’t get my head around the fact that they’ve spent £37bn….37 billion

        Reply
        1. Micky Taking
          September 10, 2021

          Do you want to reconsider the term ‘spent?’

          Reply
  27. ChrisS
    September 10, 2021

    The only way to bring the cost of the NHS under control is for its customers (us) to realise what it is costing them and they will demand improvements. While Governments allow gullible members of the public to think that the NHS is “Free” at the point of delivery, the near-religious admiration for the organisation will persist and the demand for ever more resources will continue ad nauseam and politicians wander round wearing little NHS badges and dare not criticise “our NHS.”

    We could go to a German-style mix of state and insurance provision where users can chose the level of care they want to pay for. That works very well, (we lived there for five years and our first son was born there).
    It is far from the socialist principles the NHS works on, yet the reality is the same here : I know that if I have a medical problem that would mean a long uncomfortable wait for treatment, I can buy the necessary treatment from the same Consultant privately.
    That is an option available to most people who have savings or own their own home where they could remortgage or use equity release, so what is the difference between that and the German model where one chooses which level of insurance cover to buy ?
    You were right to vote against Boris’s dog’s dinner of a proposal and I’m pleased to say my own MP, Christopher Chope, voted with you.

    Reply
  28. John Miller
    September 10, 2021

    We need to scrap the NHS. It is an old Socialist idea and like all Socialist ideas, doesn’t work.
    Even the left wing Grauniad admits, the NHS biggest failing is keeping people alive.
    It is also a bottomless pit, absorbing every penny paid to it.
    Strange, that no other country that I know of has copied that model that is “the envy of the world”.

    Reply
  29. Donna
    September 10, 2021

    Google supplies the information that in 2009 there were 42,000 Managers working in the NHS. Now there are 77,000.

    That already inflated number is due to be increased by an influx of Integrated Care Managers each on £quarter of a million salaries – plus all their administrative staff.

    Oh and the NHS obviously “needs” dozens of Inclusion and Diversity Managers as well.

    As with all Public Sector institutions, the NHS is operated for the benefit of the people it employs, particularly at the senior level. It will continue bleeding this country dry …. because there is no-one prepared to do anything to try and stop it. This is now a country run and taxed for the benefit of NHS/Public Health Bureaucrats.

    A very wise and competent Conservative Prime Minister once said “the problem with socialism is that eventually you run out of other peoples money.”

    The current CON and his cowardly MPs have, as Allistair Heath wrote in the DT this week, ensured that this country will become and remain a socialist one.

    Reply
    1. glen cullen
      September 10, 2021

      Yeah but every NHS employee is a ‘manager’, thats how they can justify the big bucks

      Reply
    2. NickC
      September 10, 2021

      Donna, That is so, unfortunately. Johnson has to go. Ever since he got covid19 he is a changed man.

      Reply
  30. Richard1
    September 10, 2021

    Good article in the Telegraph by Jeremy Warner today on how the govt are squandering the opportunities of brexit. 18 months of incompetence and now sustained leftism, no attempts to realise the advantages of Brexit claimed by Leave in the referendum. an example is massive passport queues as the service hasn’t been digitised (despite all these public employees having had nothing else to do for 1 1/2 years!).

    Labour should kick out Starmer, get Burnham in and stand on a platform of joining the EEA, Norway-style. At this rate there will be no defence to the question ‘what was the point of ‘hard’ brexit, what have you done that you couldn’t have done while maintaining smoother relations with the EU?’

    Reply
    1. NickC
      September 10, 2021

      Apart from it being not what people actually voted for, you mean, Richard1? If the rest of the world can manage outside the EU, then I’m sure we can.

      But we do have to get a government and establishment who believe in the UK, stop wasting money, stop micro-managing, and stop using behavioural propaganda to cover up their own timidity and incompetence.

      Reply
  31. Ex-Tory
    September 10, 2021

    Not only that, but every new tax complicates our already ridiculously complicated tax system.

    Reply
  32. bigneil - newer comp
    September 10, 2021

    Why did PP make the “Stopping all the boats and sending them back to France” comment? – then within hours it gets weaker and weaker. The world can turn up here – – and get for free – – what WE have to work and PAY for. 1000+ a week??? – – housed, fed and bed, benefits, NHS, education, TIME AND MONEY – – to get what WE pay for – but then CAN;T GET.
    How many millions more will get here? Free everything. Clearly what the plan was if we had stayed IN the EU. Merkel said many times – no borders = she wanted this island destroyed by millions of immigrants – and BoJo is doing it RIGHT NOW.

    Reply
  33. Nota#
    September 10, 2021

    YouGov. 10th September 2021 – Conservative 33% Labour 35%

    Looks like Johnson wants to beat Trudeau to the biggest instant slump and ego for a polatician

    Reply
    1. glen cullen
      September 10, 2021

      We’re not going to see a snap election soon nor reform of the Fixed-Term Parliaments Act 2011

      Reply
  34. a-tracy
    September 10, 2021

    These figures can appear too big to comprehend in relation to each person/contributor.

    The NHS budget alone (just healthcare) how much is this per registered taxpayer? How much is this per person registered in the UK right now? What is the gap between people paying in and funding healthcare for people not contributing?

    This weekend I’m going to try to find the amount received by the government each year from Employee’s NI, Employer’s NI, Class 1A NI, Self-employed NI, IR35. Is there any other receipt that I have forgotten that we are told is towards Healthcare? Then there is an amount the government saves by people paying for private healthcare, private dental cover, etc. that otherwise would fall upon the NHS to treat.

    How does this compare with how much is spent per head, like for like comparison, for healthcare, including private payments for private treatments and hospitals, dentistry, opticians, podiatrists, pharmacy charges, parking charges (a blood test costs £3.50 in parking fees where I live) with a similar Country like Germany or France?

    Dividend taxation also includes part of the national insurance element.

    Reply
  35. Reggie
    September 10, 2021

    Untrue. NHS does not take payment in advance or request any guarantee so abuse is rife. How can it recover thousands of pounds from those unable to pay?

    Reply
  36. Everhopeful
    September 10, 2021

    They were “Reconfiguring” the “Health Service” last summer whilst plague laid waste the land.
    Goodness knows what that means…it won’t be good ….or cheap!

    Reply
  37. Original Richard
    September 10, 2021

    The Tories may find, as Labour have, that continually and contemptuously treating taxpayers as an endless source of money by increasing taxes without any matching curbs on vanity project spending or efforts to improve the efficiency of major spenders such as the NHS, the Civil Service and Quangos, to be electorally damaging.

    Reply
  38. Maylor
    September 10, 2021

    Get rid of some of the faceless administrators and replace them with experienced nursing or medical staff who really understand how the system works.

    Reply
    1. glen cullen
      September 10, 2021

      I employ welder/fabricators & specialist engineers, either would make good administrators…..I wouldn’t want my highly paid senior engineer sitting at a desk all day trying to purchase the best value toilet rolls

      Reply
      1. Micky Taking
        September 10, 2021

        Nobody in the NHS sits at a desk trying to purchase anything ‘best value’.

        Reply
        1. glen cullen
          September 10, 2021

          My mistake

          Reply
    2. Mike Wilson
      September 10, 2021

      Where will you find ‘experienced nursing staff’?

      Reply
  39. glen cullen
    September 10, 2021

    What does it cost…it will cost the conservative the next election

    Reply
    1. NickC
      September 10, 2021

      Yes.

      Reply
    2. Micky Taking
      September 10, 2021

      possibly the one after that. The electorate might wake up and smell better coffee than they had been used to. And the deluge of lies emanating from No 10. might stop. Could be refreshing?

      Reply
  40. The PrangWizard of England
    September 10, 2021

    Referring to the Treasury and government decision makers as ‘they’ disguises the fact that it is the Tory party and Tory leaders who make the money available, and enable the policies and practises at the heart of which is waste and abuse; waste of taxpayers money, my money and everyone else’s. There may be some who are happy to be impoverished and don’t mind waste but I am not one of them.

    The problem is that no member of the Tory party and particularly no Tory MP can pretend they are innocent. Every member follows the move to socialist practices which include authoritarian control of our daily lives; objections can be recorded and views published which take a different practical line but all the time people are members the party can rest secure. The party has moved Left relentlessly and now has now taken a determined lurch; no claim that a true Conservative party exists can be justified. The leader takes the view he is untouchable and thus can get away with anything – ‘doubling down’ could be a phrase to apply to his activities to achieve his Leftist solution. I do not believe the PM understands the meaning of honesty, truth or integrity.

    Just how many Tory MP’s can remain loyal to the party now? If they do they are deceivers of the voters. But then we know that the whole point of the Tory party is to put the party first, before people and the nation. They are happy to let the sovereignty and freedom of the country and people be destroyed, economically, culturally and spiritually as long as the party survives.

    Therefore, the only thing before us is to do everything we can to destroy the party and everyone in it. I would like to see one or two MPs resign but I am not holding my breath.

    I am sure I am not the only one who will not tolerate betrayal any more. We must get people’s heads out of the sand over what is going on.

    Reply
    1. glen cullen
      September 10, 2021

      Good words

      Reply
  41. Jane
    September 10, 2021

    I do not hold the NHS in great esteem. Yes there are pockets of excellence but also poor clinical service and outcomes throughout the country. My local hospital has been in special measures for years – not that it matters as there is no comeback. Trust has had so many CEO-s over the past ten years I have lost count. I am appalled at the cost of the service which puts its own interests before its customers. I have never required treatment but have accompanied elderly relatives and neighbours and all I can see is waste, some staff overloaded and others idle. I read of shocking services, procurement issues, high salaries, Senior Managers resigning on huge pensions when a negative report about their oversight is due. Huge payoffs for inefficient managers who then turn up at another trust. Billions paid out for clinical errors, lack of management at Ward Level. Today it was reported that a nurse who took a doctor to its regulating authority disliked being told what to do. Medical staff frightened of bullying allegations, etc etc. I can say honestly that most older people I know fear having to go into hospital as they think it will end their lives. We all have read about hospital acquired infections which are lethal for the elderly as well as one in five hospital covid cases were acquired within hospital.

    For all the praise it seems interesting that no other developed country has adopted the NHS model. I have lived in several countries in Europe and have experience different systems. I can tell you they are more ruthless in terms of costing – items such as swabs costed. You certainly know how much everything costs. In France insurance costs as little as 40 Euro a month for an individual – of course you can pay more for a higher degree of cover. I do accept that premiums will also be raised because of Covid. There, if your doctor is not up to what you expect, you go to another. You see a consultant within 2 days etc etc. You wait whilst a letter is typed not the 6 week wait for a NHS letter following an appointment. In other words there is competition – a good thing. there are also much better clinical outcomes.

    Everyone knows that the NHS is not fit for purpose. I feel very sorry for those staff on the front line who genuinely care about their patients and work very hard. No leadership, tough trade unions, Medical Associations purporting to be health bodies but who are in reality tough trade unions etc etc. Reform is a dirty word as is more patient involvement. Why cannot we have access to our records online – unions blocking of course.

    Start again. I know that in our country that we will always look after those in need and who cannot afford insurance. We need a mixture of private and public such as the systems in Europe. It is time MPs actually told the truth about this never ending additional funding without any oversight. I am paying for this and i resent doing so.

    Reply
  42. paul
    September 10, 2021

    That all very well that NHS is spending 230 billion but how much is private health care coming to, are you spending as much as the USA when put together.

    Reply
  43. J Bush
    September 10, 2021

    Having put over 37 years contributions into the system and for a considerable period of time, this was amounted to just under £2,000 a month IT & NI, I learn the hip replacement I have been waiting 2 years for, is not likely to happen, as it is now classed a ‘non-essential’!

    To top it all, the moronic Johnson regime are toying with the idea of making pensioners continue to pay NI! What the hell for? If you are not going to provide medical care that pensioners need, just why the hell should they, after decades of paying into the system, be expected to carry on paying for something they are denied?

    Meanwhile hundreds of illegal migrants land here daily and are not only getting free health care, but also free dental care, something denied to the taxpayer! And, on the top of this, the illegals are put to the top of the list!

    I am not surprised to read the Johnson regimes tax grab has resulted in the polls sthowing a serious drop in support. Is Johnson on a suicide mission, or is he really as myopically blinkered, naive and stupid as I think he is?

    I wonder if all the politicians who are currently blindly following and voting for everything he suggests will continue to do so, when, eventually, it dawns on them, by doing so, they are likely to lose their own cushy number?

    Reply
  44. Nota#
    September 10, 2021

    “risen from £166bn for 2019-20 to £230bn (Budget forecast 2021).” Thats a massive 38% increase and the pleading for more and not enough goes on.

    The Governments 10% hike in the NHI take might have been understandable, if at the same time it devoted time to the overall econamy and addressed it own continual creation of taxpayer funded ‘black holes’

    Reply
  45. Rhoddas
    September 10, 2021

    9 out of 10 people admitted to hospital with Covid have not had their vaccinations, despite all adults being offered jabs. This refusal costs us, the taxpayer, far more than if they had been vaccinated at the right time.
    So my thoughts are why not double the employee NI increase of 1.25% –> 2.5% for these vaccine refuseniks?
    NHS have records of those vaccinated, so easy to check and for each employee to show certificates to their manager and payroll. Welcome comments, thank you!

    Reply
    1. Philip P.
      September 10, 2021

      Rhoddas – you don’t say where you got your information from. I couldn’t find it on the ONS site under Covid hospitalizations in England and Wales. However, Public Health Scotland does make the corresponding figures available:- https://publichealthscotland.scot/media/9030/21-09-08-covid19-publication_report.pdf.

      In the last fortnight of data (21st Aug.-3rd Sept) there were 543 hospital admissions ‘with Covid’. Of these, 472 were double-vaxxed against Covid – 87%. But only 75% of the Scottish population have taken the vaccine. So the double-vaxxed represent a higher proportion of hospital admissions than you’d expect on average.

      On this basis, your assertion is mischievous, hateful nonsense.

      Reply
      1. Rhoddas
        September 10, 2021

        Figs have been reported in MSM for several weeks and here is the link (sorry Sir J) for the source too.
        https://www.covid-arg.com/post/how-many-covid-admissions-are-vaccinated.

        For the older population who are more susceptible to covid due to AGE (whether vaccinated or not) their ratio of admissions are higher as their majority are vax’d, but the point here is their numbers OVERALL are lower than if NOT vax’d.

        Hope this helps Phillip.

        Reply
        1. Philip P.
          September 11, 2021

          Your figures are out of date. They are also cumulative, thus reflecting just the statistical biases you mention in your post.

          Unless you think Scotland got a whole lot of dud vaccines, you need to explain the clear evidence there that there is no advantage to the double vaxxed in terms of hospitalizations.

          Reply
          1. Rhoddas
            September 13, 2021

            https://www.express.co.uk/life-style/health/1490664/office-for-national-statistics-ons-covid-deaths-vaccinations

            This is pretty persuasive imvho. and certainly not hateful nonsense but thanks for the cackhanded comment, I fear it reflects badly on you …. plenty of ONS evidence that jabbing is highly beneficial in reducing hospitalisation and death.

            QED

    2. NickC
      September 10, 2021

      Rhoddas, I doubt very much that in the UK “9 out of 10 people admitted to hospital with Covid have not had their vaccinations”. It certainly isn’t true in Israel with 78% vaccinated and one of the current highest levels of hospital admissions (pro rata) in the world for covid19.

      But why politicise the choice of vaccination in the first place? After all, the vaccines do not prevent either infection or transmission, so for other people, the unvaccinated pose no additional risk. And don’t forget that the vaccines have demonstrated a high level of serious side-effects which cost us, and the victims, a lot too.

      Reply
      1. Micky Taking
        September 10, 2021

        Nonsense – a very high percentage of Covid ICU patients are totally unvaccinated.
        This should be treated as declining medical assistance.

        Reply
        1. Fedupsoutherner
          September 10, 2021

          Micky exactly

          Reply
        2. NickC
          September 11, 2021

          Micky and Fed-up, Then please explain why Israel (78% vaccinated) currently has one of the highest incidences (pro rata) of covid19 hospital admissions in the world? There are certainly people in hospital (and dying) directly as a result of the vaccines, and others with covid19 who have been vaccinated. The situation is a lot more complex than the MSM or the government are telling you, and the vaccines are less effective and more dangerous too.

          Reply
      2. Fedupsoutherner
        September 10, 2021

        Nick C. We’ll it’s certainly true on Shrewsbury. Most Covid patients have not been inoculated.

        Reply
        1. NickC
          September 11, 2021

          Are you sure you’re not being misled, Fed-up? How come last summer (2020) covid19 died down (fewer deaths than flu or pneumonia) without the vaccines, yet now in late summer 2021, after 65.3% (Dame Sarah Gilbert’s figure) of the entire UK population has had two jabs there are so many in hospital? The government and the MSM has told so many porkies (eg covid19 not originating at the Wuhan virology lab) about covid19 that I begin to doubt everything they say.

          Reply
    3. Mike Wilson
      September 10, 2021

      Sounds like an administrative nightmare. How is an employer supposed to know whether an employee is vaccinated or not? And, even if the employee is happy with their employer knowing their vaccination status, the payroll software would need to be modified.

      Reply
  46. Bored..
    September 10, 2021

    Therese Coffee’s Prisoner jacket. I want one.
    Had one 50 years ago !!
    Can you get the Mail to do a fash piece ?

    Reply
    1. Never Bored
      September 12, 2021

      Fab Fash Prog on BBC World Sevice Sunday about 4am.
      “The Cultural Frontline”
      About various businesses already up and running abroad mostly dealing with
      Renting/altering old high end clothes.
      Transhumanism and AI.
      Genderfluid clothes ( Apparently you can put them on, inflate them and you “magically” alter.
      It’s” magic ” how I so luckily woke up at the right time to hear this prog.

      Reply
  47. Pauline Baxter
    September 10, 2021

    Sir John.
    Surely the problem with the NHS is glaringly obvious. Too many Chiefs and not enough Indians!
    It is overburdened by administrators and their ‘expert’ hangers on.
    Much the same applies to the Care systems run by local authorities.
    Mandatory Covid Vaccinations are a gross infringement of personal liberty and will force many care workers to leave. May be even some doctors and nurses.
    Mass vaccination campaigns have probably also cost the NHS money and also the side effects from those jabs.
    While it is fine to boast about how clever we were to be at the forefront of developing the vaccines the whole mania has gone way too far. Also the test and trace scheme which is an expensive way to disrupt supply chains.
    However, back to the problem of chiefs and indians. It is the problem that affects all nationalised industries.
    That is what the NHS is, a nationalised industry.
    It has another problem. It has been virtually taken over, by Global Pharmaceutical Companies.
    I’m sorry Sir John but personally I do not believe your Leader, or even your Party has a clue about tackling any of those problems.

    Reply
  48. Sam
    September 10, 2021

    £230b or £3,450 per person each year is substantial but maybe not excessive when compared to other comprehensive healthcare systems.

    The brokenness of our system comes not from the providers but from the bureaucracies, targets and reorganisations the NHS is subjected to.

    19 years in the health service and I have seen over 7 reorganisations. Yet it is the same people being shuffled around as there isn’t another workforce waiting to takeover.

    As for targets, in a GP surgery we have to:

    – reserve so many appointments for nhs 111 to use
    – reserve so many appointments for before 8am/after 8.30
    – reserve appointments for on-the-day
    – reserve appointments for face to face encounter
    – reserve appointments for telephone encounters
    – reserve appointments video/econsults
    – reserve appointments for consulting with patients seen in hospitals (the new funding for backlog will have a significant impact on appointments)
    – reserve appointments for amber drug monitoring
    – reserve appointments for housebound and vulnerable
    – reserve appointments for patients with a learning disability
    -reserve appointments for patients with any number of chronic diseases that exists
    – reserve appointments for urgent cases
    – reserve appointments for patients presenting with sepsis
    – reserve appointments for home visits
    – reserve appointments for covid vaccinations
    – reserve appointments for patients requiring a sick note
    – reserve appointments for patients needing a medical report
    – reserve appointments for safeguarding concerns
    – reserve appointments for… etc

    In addition, patients call and also want to be seen for their own reasons…

    It is too complicated and it means the focus is on adhering to targets each with an income stream (hence ‘reserving’) rather than viewing all of the above as a core general practice and allowing surgeries to provide care without the hoops.

    If general appointments are difficult to obtain, it is most likely because they are reserved. Without reserving them, income disappears and general practice collapses.

    For individuals who think that GPs should work harder then targets would not be needed forget that targets are often politically motivated and GPs don’t go to work and have nothing to do. They have lots to do, but targets and demands are so complicated and impenetrable in regards to general understanding that the assumption is always lazy gp’s.

    Now apply all of the above to community, mental health, and hospital providers.

    Too many remote senior managers directing the focus of people on the ground without comprehensive knowledge of delivery.

    Population growth and immigration is not to blame. Spending grows with GDP.

    The NHS is an enormous entity that no single person can run.

    Reply
    1. glen cullen
      September 10, 2021

      and thats why you need so many administrators

      Reply
    2. alan jutson
      September 11, 2021

      Thank you Sam

      You have highlighted what many of us have thought for years, Our Health service has completely lost the plot and has made itself totally unmanageable.

      Time for a complete and total rethink.?

      What are your thoughts and would be your solution to get it moving sensibly again to make it fit for purpose.

      Reply
    3. kb
      September 11, 2021

      The fact that you can write this tells us volumes:

      “In addition, patients call and also want to be seen for their own reasons…”

      So is it correct to say that spending and budgets for GPs are based only on estimated number of appointments needed under those headings you list?

      Reply
  49. Diane
    September 10, 2021

    Bigneil – Yes, social care continues in Kent today, as usual, until the weather breaks, with hotel expenditure rapidly increasing. Kent county council however is now in a better position, after the June capacity crisis, to again accept, as of yesterday, unaccompanied children into their care, which I assume is being funded. For anyone who has worked in travel, tourism / transport, just knowing the cost of the multiple coach movements, vehicles which are lined up daily in Dover alone, to transport arrivals all over the country on an ongoing basis is mind boggling. BBC reports: 06 SEP: 785 / 27 boats. 07 SEP: 458 / 17 boats 08 SEP: 301 / 9 boats ( Not just Kent coast / Sussex also reported for this day ) There is a recent French authorities announcement too that it has been discovered that traffickers have been hiding dinghies in the blockhouses on French beaches…. Sources all available on line.

    Reply
  50. dixie
    September 10, 2021

    What metrics are used by government to assess the effectiveness and efficiency of the NHS in terms of medical outcomes and financial performance?

    Reply
  51. Lester_Cynic
    September 10, 2021

    Everyone else’s comments seem to be moderated without trouble, soon you won’t have anywhere to hide because the chickens are coming home to roost and your disgusting government will be no more, and it can’t come soon enough for me

    Reply
    1. alan jutson
      September 10, 2021

      Lester we all suffer delay with moderation from time-time, it could be for a number of reasons, JR’s first priority is surely to complete his obligations as an MP for his Constituants first, other matters come second, third or even last.

      Just be thankful that he will read all comments eventually, even if they are not posted until later, and that in itself is a dam site better than the service you will get from most MP’s.

      Reply
      1. Shirley M
        September 12, 2021

        +1 – I wish all MP’s gave the electorate a chance to air their thoughts, even if not all are published.

        Reply
  52. Peter2
    September 10, 2021

    I’m not certain my maths is correct, but if as Sir John says £270 billion is the cost of health and social care and then if you assume 70 million people, then each person pays £3857 per annum in taxes for these services.
    I wonder if it needs a radical rethink and a move to a part insurance part state system such as France and Germany have.

    Reply
  53. Fedupsoutherner
    September 10, 2021

    No wonder there is a long waiting list to get into hospital for routine operations. I’ve just been told by someone who works at Shrewsbury hospital that they are nearly full with Covid cases and guess what????? Most havent been inoculated so they are unecessarily taking up a bed which could be used.

    Reply
    1. NickC
      September 11, 2021

      So presumably in Shewsbury, Fed-up, they are prioritising covid patients over non-covid patients? Have you asked why? How do think it’s possible that Shrewsbury hospital is “nearly full up” with covid patients when 65.3% of the UK population has had two jabs, when last year – without vaccines – Shrewsbury hospital was not overwhelmed? How many beds are taken up by patients who have had side effects to the covid jabs?

      Reply
  54. rose
    September 10, 2021

    Decades ago my husband told me the NHS could be given the entire GNP and it wouldn’t be enough. It is coming true. But I want our Navy back, and our army. I want our police force back. I want our libraries back and our parks and public gardens maintained. I want the public realm to look as nice it does on the Continent and in the Far East. I want worthy public transport. And much else. Too much has been sacrificed for the NHS, long before we shut the country down to save it.

    Reply
  55. ukretired123
    September 10, 2021

    Preventive health maintenance for all ages is encouraged in China such as public displays of “Tai chi” but I cannot see that happening here as young people are encouraged to go for easy street and Uni expecting others to do menial tasks sadly by all parties devoting much time wasting to polishing their ego on social media.

    Reply
  56. Lindsay McDougall
    September 11, 2021

    “If we wanted a tax to hypothecate for social care why not choose the Council Tax?”

    Now you’re talking. And keep the NHS out of it.

    Reply
    1. kb
      September 11, 2021

      This would be much more logical. Social care is provided by the Local Authorities. There is already a Social Care precept listed on my council tax bill, why not simply increase that?

      Reply
  57. Iain Gill
    September 11, 2021

    thanks for this post John

    your best post of recent times

    this needs saying, and saying clearly, time and time again

    Reply

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