Should we pay more tax to increase funding for the NHS?
Dr Clare Gerada, medical director of the NHS Practitioner Health Programme and former chairwoman of the Royal College of GPs, says YES.
The NHS is our most treasured national institution. But it is clear that current funding is not keeping pace with need.
Year on year, the NHS is treating more patients, for longer, with more innovative technologies and advanced medicines than ever before. And this costs money which it doesn’t have.
There is an old adage that “you get what you pay for”, and if we want to continue our world class, cost-effective, accessible and fair service, then it will cost us and continue to cost us more – the King’s Fund estimates four per cent more a year.
It’s not realistic to rely simply on cost savings or eliminating waste – our health system already performs extremely well on measures of efficiency. If we are serious about our NHS, we have to be prepared to take tough decisions. A new tax, ring-fenced specifically for the NHS, would be a good start. This would be the best seventieth birthday present for our health service, and the best gift to us all.
Dr Kristian Niemietz, head of health and welfare at the Institute of Economic Affairs, says NO.
The government spends just under eight per cent of GDP on healthcare. By international standards, that is a completely mid-range figure. It is true that total healthcare spending – i.e. the sum of public/statutory spending and private/voluntary spending – is considerably higher in several of our neighbour countries. But that difference is not due to higher taxes, hypothecated or otherwise.
First, many other systems demand substantial co-payments from patients who can afford it.
Second, more market-based systems make it easier for patients to top up, or upgrade, statutory healthcare spending voluntarily. Patients can, for example, request single room accommodation in a hospital, and pay for the extra cost themselves, either out of pocket or via supplementary insurance.
If we strengthened such mechanisms, we could easily match out neighbour countries in terms of total healthcare spending without the need for additional taxes. It would probably also raise efficiency, and make the system more consumer-focused.