Spring budget - what tax to cut?

[Bluenose]

Also the approx. 2/3 marginal income tax rate on the £100k - £125k bracket due to the loss of the personal tax free allowance.
Highly unfair, reduces productivity through avoidance by any means including by working less.
Not great if we need more doctors.

The peeps on the Spanish Visas will be cheering as its 24% flat rate Spanish income tax and another UK NI cut.

[Zigenare]

Not sure the original assumption is valid - should we be cutting any tax when services like the NHS will be taking a massive income cut due to inflation?

Of course we need efficiency/productivity improvements such as getting the NHS away from paper patient notes hanging on the bed and towards go anywhere notes on integrated systems and tablets.

Always promised, but never delivered.

If I had to choose a couple of dodgy taxes, I'd get rid of stamp duty which is a huge drag on labour mobility, downsizing etc. Problem is house prices would probably just go up by the same amount and the exchequer would need to get that money somewhere else, handing the value to existing homeowners.

Also the approx. 2/3 marginal income tax rate on the £100k - £125k bracket due to the loss of the personal tax free allowance.
Highly unfair, reduces productivity through avoidance by any means including by working less.
Not great if we need more doctors.

You could throw all the money in the world at the NHS and you still wouldn't fix it.

[malvolio]

You could throw all the money in the world at the NHS and you still wouldn't fix it.

Absolutely. The NHS being underfunded is a total myth, they have around 10% of GDP. What they can't do is spend it properly, mainly caused by long running support contracts via PFI, pension commitments and utterly stupid compartmentalisation of areas like procurement (localised competitive tendering guarantees the worst outcome) and recruitment (average two months to hire a basic lab assistant).

I read recently that less then 40% of their income goes on patient care. When a senior clinical lab manager can't make £50k while they are advertising for non-productive roles at £70k you know something is wrong.

The French model - low cost primary care supported by effective insurances - is the one to aim for, much better outcomes on roughly the same GDP spend. It will never happen though - too many political roadblocks.

[sreed]

Absolutely. The NHS being underfunded is a total myth, they have around 10% of GDP. What they can't do is spend it properly, mainly caused by long running support contracts via PFI, pension commitments and utterly stupid compartmentalisation of areas like procurement (localised competitive tendering guarantees the worst outcome) and recruitment (average two months to hire a basic lab assistant).

I read recently that less then 40% of their income goes on patient care. When a senior clinical lab manager can't make £50k while they are advertising for non-productive roles at £70k you know something is wrong.

The French model - low cost primary care supported by effective insurances - is the one to aim for, much better outcomes on roughly the same GDP spend. It will never happen though - too many political roadblocks.

Like a lot of other public services (including elderly care which is closely linked to NHS capacity), it’s all down to extremely short sighted command and control planning by the revolving-door ministers in charge implemented by spreadsheet warriors in middle management.

They just throw money on opex at the NHS when it throws up headlines on the popular/tabloid press - War hero OAPs lying in hospital corridors! Winter emergency! Waiting Lists! A&E waiting times at record highs! - and ignore proper reform which takes decades not months or years. You get these sticking plaster solutions like mass importation of medical and care staff from overseas that don’t address the core issues. And what counts for ‘capital investment’ is funnelling millions of taxpayer pounds to parasites like Michelle Mone.

But ultimately, they’re is only able to do this because the electorate are equally short-sighted, have a weird way of putting the NHS on a pedestal and would never vote for a root and branch reform of Our NHS.

We’d never go for the hyper expensive US model but like you rightly mention, there are so many models on the continent to choose from and adapt to our needs but that requires political backbone, a long term vision and most importantly an electorate that will vote for it.

[sreed]

I see that ‘Raise taxes on everyone but me’ is as popular as ever…

[malvolio]

I see that ‘Raise taxes on everyone but me’ is as popular as ever…

Tl;DR

Obvious, but they are looking at the wrong question. Perhaps if they examined the proportion of taxes paid to the exchequer by the various groupings, you might get a more realistic response...

Personally, as someone who won't be affected by a cut in NIs, the level of tax I pay is tolerable (it could always be lower) but the freezing of the thresholds is the real iniquity.

[Smartie]

Absolutely. The NHS being underfunded is a total myth, they have around 10% of GDP. What they can't do is spend it properly, mainly caused by long running support contracts via PFI, pension commitments and utterly stupid compartmentalisation of areas like procurement (localised competitive tendering guarantees the worst outcome) and recruitment (average two months to hire a basic lab assistant).

I read recently that less then 40% of their income goes on patient care. When a senior clinical lab manager can't make £50k while they are advertising for non-productive roles at £70k you know something is wrong.

The French model - low cost primary care supported by effective insurances - is the one to aim for, much better outcomes on roughly the same GDP spend. It will never happen though - too many political roadblocks.

I didn't suggest that the NHS is underfunded, but rather that the funding is decreasing significantly in real terms.
There does need to be reform to improve efficiency, particularly in the use of nationally integrated systems rather than the local 'we have special requirements' rubbish that happens at the moment.

As far as the French system goes, if we had a time machine and could properly fund and invest in our system as they have for decades, maybe that would work.
I'm certainly in favour of a part-insurance based system.

We should remember though that even as our taxes rise to 38% of GDP, the French pay 46%.

[Snooky]

The peeps on the Spanish Visas will be cheering as its 24% flat rate Spanish income tax

Spain has a flat rate tax system? That's news to me, I thought it was a progressive system. Perhaps I misunderstood what you were saying.

[malvolio]

I didn't suggest that the NHS is underfunded, but rather that the funding is decreasing significantly in real terms.

Again, untrue. The figures as a percentage of GDP are compared to 2020/21, when there were significant extra funds ploughed in. Generally the actual budget has grown in real terms for quite a while. Obviously recent high inflation will have had an impact - but only a short term one.

There does need to be reform to improve efficiency, particularly in the use of nationally integrated systems rather than the local 'we have special requirements' rubbish that happens at the moment.

As far as the French system goes, if we had a time machine and could properly fund and invest in our system as they have for decades, maybe that would work.
I'm certainly in favour of a part-insurance based system.

We should remember though that even as our taxes rise to 38% of GDP, the French pay 46%.

[Smartie]

Again, untrue. The figures as a percentage of GDP are compared to 2020/21, when there were significant extra funds ploughed in. Generally the actual budget has grown in real terms for quite a while. Obviously recent high inflation will have had an impact - but only a short term one.

The IFS disagree with you: https://ifs.org.uk/articles/health-s...ing-top-likely

High inflation has more than a short term impact on budgets where it is not compensated for, much like a below inflation pay rise will affect all your pay rises in the future.

Finally, given we have currently have population growth of over half a million people per year, that budget needs to increase if the per/head value is to be maintained.