Will Heaven

A special NHS tax would be bonkers or a total fraud

Some very clever people are rallying around the idea of a specific NHS tax partly because of what has been called a ‘winter crisis’ in hospitals. It’s an idea that has been around for yonks, but Nick Boles’s book, Square Deal, has kick-started the debate again. He argues for National Insurance to be repackaged as National Health Insurance. This would ‘give the NHS what it needs while removing it from running financial battles in Whitehall,’ he says. Boles makes a strong case, not least as someone who has survived two bouts of cancer thanks to NHS treatment.

The key to his piece, I think, is this bit:

Currently, we spend 7.3% of GDP on publicly-funded healthcare and a further 1% GDP on publicly-funded social care… The taxpayer is therefore currently spending 8.3% of national income on the public provision of health and social care. In 2014, an independent Commission set up by the King’s Fund recommended some reforms which would extend the free provision of social care to more people. They argued that we would need to spend 11-12% of GDP on the public provision of health and social care by 2025.

There seems to be momentum building around an NHS tax, since it might force taxpayers to face up to the true cost of their health care. And it might allow NHS funding to be fully protected, now and in the decades ahead.

The Treasury’s former chief mandarin, Nick Macpherson, tweeted the following earlier this month:

Which is interesting mainly because of his background. Treasury types have always tended to oppose hypothecated taxes, to give them their technical name.

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