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Chris Bell

The call for a separate tax to fund the NHS



Sir, Daniel Finkelstein invites alternative suggestions to a “hypothecated tax” to pay for increased spending on the NHS (“It’s time for a separate tax to fund the NHS”, Mar 8).

The alternative I have proposed would build on the distinction the public makes between tax and contributions. Recent polling found that while 42 per cent of voters would support an increase in tax to pay for a larger NHS budget, this figure climbed to 53 per cent once voters were asked about an increase in national insurance contributions.

Public support for this reform would be cemented if the contributory base was made more progressive. Likewise the inclusion of pensioners’ incomes would make it a serious runner for the longer term.

A national mutual that consulted the electorate regularly on the costs of health, and the level of contributions required to meet those costs, accompanied by a continuing efficiency programme, could see the NHS through the next generation.

Frank Field MP

House of Commons

Sir, A hypothecated NHS tax would not change the terms of the debate on the NHS as Daniel Finkelstein hopes. The “pressure for more spending”, as he rightly identifies, would continue regardless. Governments could still raise extra funds from the NHS from other taxes or areas of income. Little, in fact, would change.

More importantly, the creation of a dedicated tax would distract ministers from the essential task of reorganising the health service so that it works more productively. At long last the NHS is genuinely trying to shift its centre of gravity from relatively expensive hospitals to primary care, and indeed to care in the home. The creation of a new funding system would send the contrary message that the government sees funding, not productivity, as the solution to the NHS’s problems.

Andrew Haldenby

Director, Reform

Sir, There is already a separate, identifiable health tax: national insurance. A portion, 19 per cent this year, is allocated to the NHS with the remainder going towards contributory benefits such as the state pension. That no real relationship exists between spending on these items and national insurance receipts shows what a sham hypothecation is.

It is unrealistic to believe that ministers will resist the temptation to spend a surplus from a health tax on other politically popular items. And if they can top up the health budget with the proceeds from other taxes should health tax revenues disappoint, why bother with a health tax in the first place? This is precisely what happens with national insurance.

Setting health budgets according to how much a particular tax raises will invariably lead to a misallocation of resources. Hypothecated taxes have always been a bad idea, and the fact that the NHS is failing a bit more than usual doesn’t change that.

Alex Wild

Research director, TaxPayers’ Alliance

Sir, Daniel Finkelstein’s closing paragraph goes to the heart of one of the main causes of NHS expenditure: the elderly, who he says should “chip in too”.

There are many of us pensioners with reasonably generous private pensions (and in many cases considerable assets) sufficient to pay national insurance quite easily.

When advocating this (I am 70) I have often received a stony response, along with the usual mantra about having paid into it all my working life then I should be entitled to free care until death. Closed minds, in other words. The same principle applies to the bus pass, heating allowance and TV licence.

James Finlay

Bicester, Oxon

BUDGET’S BOOST FOR GRAMMAR SCHOOLS

Sir, We were delighted to see the provision of £500 million of additional funding for education in the budget. This is exactly the boost that state education in this country needs after years of inadequate and unequally distributed funding.

What a shame, therefore, that the government plans to spend 65 per cent of that amount on free schools, including unnecessary new grammar schools. At a time when a further reduction is forecast in school revenue funding, of 8 per cent over the next three years, this seems a highly irresponsible and retrograde step.

Continuing underfunding of state education means that head teachers and governors across the country are already being faced with unacceptable choices between increasing class sizes, reducing staff and curriculum options, or cutting back on basic services. If the UK is to flourish post-Brexit, the government needs to rethink this plan and invest all available education funding in existing state schools for the benefit of all students.

Alison Mayne

Chairwoman of governors, Perins School, New Alresford, Hants

ENGLISH OR BRITISH?

Sir, Melanie Phillips (Mar 7) says that Englishness came to stand proxy for all the communities of the British Isles, citing as evidence the fact that Edmund Burke described himself as an Englishman rather than as British. Burke, of course, was a member of the Anglo-Irish elite. Whether Irish people who worked the land and paid the rents shared his sentiments is doubtful. In the long run the United Kingdom failed to win the loyalty of the majority of Irish Catholics.

Ms Phillips goes on to question Ireland’s claim to nationhood on the ground that it seceded from the UK only in 1922. If she compares the map of Europe now with that of 1922, she will see that many nations have come into existence since then — and many more if one thinks of Africa and Asia.

Whether Scotland will follow Ireland’s example is uncertain. Fortunately the SNP, unlike the IRA in 1919-21, eschews violence. Anglo-Scottish relations are likely to be amicable whatever happens. However, the Union might be stronger if people like Ms Phillips would re-examine their Anglo-centric assumptions. She could make a start by asking why the Conservative and Labour parties hold only one Scottish seat each in Westminster.

Professor George Peden

Callander, Stirling

TALK ABOUT DEATH

Sir, Alice Thomson (Comment, Mar 8) rightly points out we have lessons on sex education, careers advice and pre-natal classes “but rarely mention the end”. More needs to be done by employers, and by schools and colleges, to help us all to plan for, and deal with, death. Lessons on death and grief should be part of the national curriculum, and training and policies to support bereaved staff and people providing care for terminally ill relatives should be standard for all employers. If we don’t talk and support each other, people will be left feeling isolated and abandoned at a time of great need.

Claire Henry

CEO, National Council for Palliative Care and the Dying Matters coalition

Sir, How appropiate that Alice Thomson should write about death and grieving. Five years ago today [March 8] my eldest son died unexpectedly. A card from dear friends telling us of their thoughts and prayers was a good start to the day. Later as a family we will meet and speak his name. Grief is a long-term business and in my experience we all react in different ways, but the support of others is vital in the healing process.

Christine Edgar Bromlei

Forward Green, Suffolk

EMPIRE STRIKES BACK

Sir, If the government is keen to revive trade with Commonwealth countries from the former British Empire (“Ministers aim to build ‘empire 2.0’ with Commonwealth after Brexit”, Mar 6), perhaps it could revive the Empire Marketing Board, a successful organisation in the 1920s. The board produced 72 reports over ten years extolling trade with Britain, many aimed at “housewives”. Every house apparently needed a “Book of Empire dinners”, and a “Calendar of fruits and vegetables from the Empire”, not to mention “The King’s Empire Christmas pudding”, which was made entirely from ingredients sourced from the Empire. There may be more opportunities to trade with the Commonwealth, although about 31 of the 52 countries still have populations of fewer than 1.2 million people. But at least we may get a few currants and raisins from them.

Sally Tomlinson

Emeritus professor, Goldsmiths, University of London

BLASTED ESSEX

Sir, While it is commendable that the residents of Brondesbury Park acted with good humour for 24 hours while their unearthed bomb was swiftly defused and whisked down to MoD Shoeburyness to be blown up (report, Mar 4), neighbours around Foulness Island in Essex are constantly under fire. Monday to Friday we endure repetitive reverberation, vibration and pollution. Explosions sometimes start as early as 8am. Furthermore, when on the water, we are no longer able to beach our boats, walk the shores and most annoyingly sail under Havengore Bridge when red flags fly (signalling firing and testing in progress), which is most of the time. In addition, our four-legged friends are gibbering wrecks most of the time.

Diana Bailey

Burnham on Crouch, Essex

CALL OF THE RED BOX

Sir, Patrick Kidd’s piece on Norman Lamont keeping a bottle of whisky in his red box (Mar 8) reminds me of a solicitor colleague who always packed a telephone directory plus the Yellow Pages in his briefcase when he appeared in court. It gave him some gravitas, he felt, to be seen lugging the heavy bag. Clients’ instructions, of course, were written on the inside of a cigarette packet. He usually won.

Robert S Lyttle

Londonderry

YOMPING CITROËN

Sir, Further to the correspondence on makeshift car repairs, when our 2CV got into difficulties while we were driving cross-country in the Falklands, we simply picked it up and carried it.

Anne Johnston

Dornoch, Sutherland

CHALLENGING TIMES

Sir, Could the reason for there being fewer women then men in the teams competing in University Challenge be that the women feel less need to parade their intellectual prowess on television (report, Mar 8)? Perhaps they have more confidence in their own abilities and don’t have as great a compulsion to prove themselves.

Or perhaps they have just got better things to do.

Liz Hayto

Arnold, Notts


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