Government should raise taxes to fund NHS and social care, say experts

BMJ 2017; 356 doi: (Published 17 March 2017) Cite this as: BMJ 2017;356:j1381
  1. Gareth Iacobucci
  1. The BMJ

A group of healthcare experts has urged the government to consider various options for raising taxes to provide extra funding for the NHS and social care in England.

In an interim report published on Thursday 16 March, the expert panel, assembled by the Liberal Democrats’ shadow health secretary, Norman Lamb, to suggest solutions for tackling the current funding crisis, said it was “unanimously of the opinion that it is necessary to raise additional revenue for health and care through taxation.”1

The 10 strong panel, which includes the former NHS England chief executive David Nicholson and the former chair of the Royal College of General Practitioners Clare Gerada, said that three options should all be on the table for discussion; raising income tax, increasing national insurance contributions, and introducing a dedicated health and care tax.

The panel said that a 1% increase in income tax would raise just over £4.6bn in 2017-18, while a 1% rise in national insurance contributions would generate a similar amount.

It said that the current mechanism for funding health and social care was not fit for purpose and that the government could not continue to expect health and care services to close the current funding gap through efficiency savings alone. The experts urged that any additional investment should be ringfenced for spending on strengthening primary care, mental healthcare, social care, and community services for at least three years.

Alongside this, the report recommended the establishment of an independent body to make health and care budgetary recommendations to the government, providing a similar function to the Office for Budget Responsibility.

Though convened by the Liberal Democrats, the panel emphasised that it is non-partisan and that its recommendations “are informed by our own professional backgrounds and experiences.” It intends to publish a full report later this year in which it will recommend which method of taxation it believes would be preferable to use to increase health and care funding.

Katherine Murphy, chief executive of the Patients Association and a member of the panel, said that there was “a clear and pressing need to re-evaluate how we fund health and social care.”

She said, “Today’s interim report is a valuable addition to the debate. It states hard truths about the shortcomings of current arrangements, which have long been obvious but are too seldom recognised in mainstream politics.

“The Patients Association believes that more money is needed and that the best way of securing it is to pool risk across the whole population. In other words, the most efficient way of doing it is for everyone to chip in, rather than a shift to large scale reliance on self funding as and when people fall ill.”


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