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Rescue Our Health Services Through A NHS Tax

20/02/2017 12:27
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It's no surprise to you or to me that the NHS is at breaking point, right now. Only last month, 43 acute hospital trusts across the UK could not cope with the demand for urgent care and were forced to divert patients to alternative emergency departments. Critical operations such as hip replacements have been canceled because of a shortage of beds and staff.

At the heart of this crisis, there is a supply and demand issue. We simply don't have the scale of infrastructure we need to treat everyone in a timely manner. The tragedy of this situation is that we can't get vital services that we need to get on with our lives, or in many cases, to even survive.

So what has been the Conservative Government's answer to this? Another reorganisation, ministers are pushing forward a set of reforms introduced by Sir Simon Stevens in his "Five Year Forward view" plan. Which aims to bridge the divisions between health and social care, through the delivery of 44 sustainability and Transformation Plans (STPs) developed by local authorities and NHS organisation across England.

With the potential to reduce demand on A&Es by massively expanding community services, there could be real long term benefits. But it won't help solve the crisis now, or in the medium term. Because of the Government's insistence on focusing on the STPs they are not focusing on the here and now.

The BMA calculated that £9.5 billion will be required to launch STPs, with many clinicians such as the GP, Dr. Kailash Chand arguing that STPs are a way of covertly rationing healthcare.

The reality is that if we want to mend the NHS right now, instead of waiting for another generation to do so, we need to tackle the underfunding. Last week, it was revealed that 24 A&E units have been targeted for closure or downgrading, despite the fact that demand for urgent care is increasing.

NHS England predicts that the NHS will face a funding gap of up to £30 billion by 2021, if this is not plugged, there will be more forced hospital closures. Placing immense pressure on the remaining hospitals to treat a wider population of patients.

But the government is not facing the reality. STPs might work in the long term, but it won't succeed in scaling up to the point that it will help plug the imminent funding hole in four years. Instead of admitting the limits on how quickly the STPs can succeed, the Conservative Government continues to freeze funding and push efficiency measures to save money, leaving swathes of the UK population in chronic danger.

So how do we deal with the underfunding? Rather than hoping the reorganisation will save the NHS on time, the government should introduce a dedicated NHS tax or a National Insurance (NI) increase to alleviate the financial pressure on the NHS. This would ensure that the NHS has the money it requires to provide the highest quality of care.

One of the main objections to a dedicated tax for the NHS is the argument that spending on the NHS should be linked to need rather than a specific tax. To tie spending on the NHS to revenue from a single tax would mean that healthcare spending would be vulnerable to macroeconomic factors out of the government's control, not linked to the population's health needs.

However, it is clear that the government's current approach of efficiency savings and reorganisation is not working. A rise in revenue through a hypothecated tax or increase in NI specifically aimed at funding NHS may help to rapidly reduce the funding gap.

In 2015 around 8% of UK GDP was spent on health, while France and Germany's spending as a percentage of GDP were around 9%. Currently compared to other countries with a similar level of income, Britain spends less on healthcare as a percentage of gross domestic product.

To add to this opinion polls indicate consistently that the public welcome more spending on healthcare, there is a strong case for increasing spending through raising revenue. Endless sets of reorganisations will not solve the root cause of the problems the NHS currently faces. The NHS simply needs more funding, stat!

Dr Maritn Edobor is an Associate Director at the New Century Institute and Junior Doctor.

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