Richard Murphy – 2023 Comments on NHS Funding and Sajid Javid’s Proposals

The comments made by Richard Murphy, the Professor of Accounting Practice at Sheffield University, on Twitter on 21 January 2023.

Sajid Javid says we need to pay £20 for a GP appointment and £66 to go to A&E as a way to solve the NHS funding crisis. He’s wrong because there are so many better options in my new report on funding the NHS.

There are 367 million GP appointments in the NHS each year. Assuming everyone had to pay (and I bet children and pensioners would not) at £20 a time that would raise £7.3bn in extra revenue.

In England there are roughly 27 million A&E appointments a year, which at £66 each, assuming everyone paid, would raise £1.8 billion a year.

So, Javid wants to raise £9.1 billion a year by imposing a sickness tax on those wanting to see a doctor. But that’s before exemptions and before the massive cost of actually collecting this money, which can’t be ignored. So, let’s guess it’s £6 billion after exemptions.

In my new report on NHS funding out today I suggest the NHS needs £30 billion extra a year to function properly. So Javid is not proposing anything that will make any big difference to its fortunes. But he is going to hit the poorest hardest.

I have suggested how to find the £30 billion required to pay for the NHS we need. Half would come from extra taxes paid simply as a result of spending the extra money on the NHS or by making people well enough to work again. In the real world that’s what happens.

But that stills leaves £15 billion to find. That could come from halving the tax reliefs given to the wealthiest 10% in the UK on their pension and ISA accounts which cost a staggering £30 billion a year in total. Wouldn’t that be better than charging the sick?

Or we could double the rate of capital gains tax and collect maybe £15bn a year. It is absurd that right now this tax, paid almost entirely by the wealthiest, is charged at half the rate of income tax. Wouldn’t that be better than charging the sick?

Alternatively, we could invest £1 billion in HM Revenue & Customs to tackle tax abuse. It is reckoned they collect £18 for every £1 spent. So that could also raise the money needed. Again, wouldn’t that be better than charging the sick?

And there are other tax options as well on top of which the government could simply run a deficit to pay for this or do QE to fund the NHS as the Tories did for other crises.

But what we do not need to do is charge the sick what is, in effect, a new tax when being sick is already a good indicator of being on lower than average income and Javid’s sole aim in doing this is to pave the way for NHS privatisation, and his scheme raises insignificant money.

We need a debate on NHS funding but crass ideas from Sajid Javid and his like on NHS charging need to be dismissed out of hand when vastly better options from taxing the best off more fairly or from borrowing are available.

My report is at https://www.taxresearch.org.uk/Blog/2023/01/21/the-nhs-funding-crisis-and-how-to-solve-it/.