14-01-2017, 13:11
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#106
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Inactive
Join Date: Apr 2004
Posts: 63
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Re: Crisis in the NHS
Quote:
Originally Posted by heero_yuy
Best way here IMHO would be to roll NI into income tax. This would have several benefits: The starting threshold for NI clobbers the very low paid, making this the same as income tax would help them. Those who contract their work and avoid paying NI could be bought into the system particularly if the amount they can pay themselves by dividends is limited.
Then there's no upper ceiling to income tax unlike NI (£150K IIRC) so some extra revenue could be generated from those on higher pay to put toward the NHS.
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Scrapping NI has been discussed for as many years as I have been working in the payroll industry (I teach it)
You need to take into account Employers NI and the other classes of NI where people are paying extra to cover gaps in their employment and self employed people.
All employees get an NI allowance.. An employee on NI Table letter A would be: (There are others for under 21s and Apprentices under 25 but these help the employer not the employee)
Primary Threshold: £155 per week £672 per month £8,060 per year (This is where the employees start paying NI at 12% on everything above this)
Secondary Threshold: £156 per week £676 per month £8,112 per year
(This is where the Employers start paying NI at 13.8% above this)
One people get to the UEL they pay 2 % on all earnings above that... this is because they have contributed enough for a full state pension. It used to be 0%, then 1%
If we compare the NI threshold to the personal allowance of 1100L employees can earn appox £916 a month before paying tax at 20% (rising to 1150L / £958.33 in 17/19) This means people pay NI before they start paying tax but at a lower rate.
There is one big discrepancy with NI which I think should be removed.. If you have more than one job you get the same allowance in both jobs (unlike tax where you can split the personal allowance or go onto a BR / 0T) unless you earn up to the UEL in one job.. you can get a certificate of deferment and just pay 2% in the 2nd job.
One more thing.. the LEL (lower earnings limit) is used to determine if an employee is entitled to statutory payments like SMP or SSP. NI is also used in the calculation of the Employment Allowance and the Apprenticeship Levy (Which starts in 2017/18).
National Insurance is more complicated than Tax (in my opinion) .. but has been simplified in recent years.
Last edited by nidave; 14-01-2017 at 13:19.
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14-01-2017, 13:17
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#107
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laeva recumbens anguis
Cable Forum Team
Join Date: Jun 2006
Age: 67
Services: Premiere Collection
Posts: 42,229
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Re: Crisis in the NHS
Quote:
Originally Posted by Mr K
Hire more GPs ? yes, but it'll cost ( and take years).
Non emergency appointments at weekends,? nice but it will cost.
This would be on top of the extra money required to maintain the status quo.
Question keeps coming back to are we prepared to pay? Although most say yes, they do say different when it comes to voting/affecting their take home pay. Buck stops with us all.
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If only we had started training more doctors in 2008...
http://www.bmj.com/content/337/bmj.a748
Quote:
Delegates at the annual BMA conference voted by a narrow majority to restrict the number of places at medical schools to avoid “overproduction of doctors with limited career opportunities.” They also agreed on a complete ban on opening new medical schools.
David Sochart, from Manchester and Salford, warned that in the current job climate allowing too many new doctors into the market would risk devaluing the profession
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And this was only 9 years ago...
http://www.bmj.com/content/337/bmj.a...J_UK_TrendMD-0
Quote:
“Large numbers” of trainee GPs are finding a lack of jobs to apply for when they qualify, representatives at the BMA’s annual meeting heard on Monday.
Members agreed to press the association to carry out an immediate investigation into the number of trainees in this situation, the number retiring, and the supply of substantive posts.
They also called for a media campaign to highlight the “plight of unemployed, fully qualified general practitioners.”
Alex Smallwood, from the Junior Doctors Committee, said that about 2300 trainee GPs were coming through each year and that this was set to rise to 3100. But anecdotal evidence indicated that the number of jobs advertised was 400-500 short of this figure.
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(Waits for Mr K to find a reason why this was the current Government's fault...)
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14-01-2017, 14:26
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#108
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cf.mega poster
Join Date: Jun 2003
Location: Kairdiff-by-the-sea
Age: 68
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Posts: 9,845
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Re: Crisis in the NHS
Our local GP's were paid to "extend their opening hours"
They did, but just had a longer patient-free period between the morning and evening sessions.
Morning sessions are at a set quota "first in, first seen, up to a maximum of 15". But if you are number 15 and a more "serious case" appeared you get told to come back the next day (no weekends of course). Triage by admin staff, not someone medical! And the 15 will one day be divided between a lone GP, the next it could be 2 or even 3.
Evening sessions have strictly limited numbers too, by appointment only.
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14-01-2017, 18:09
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#109
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[NTHW] pc clan
Join Date: Jun 2003
Location: Tonbridge
Age: 56
Services: Amazon Prime Video & Netflix. Deregistered from my TV licence.
Posts: 21,950
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Re: Crisis in the NHS
That BBC documentary that I linked to a couple of pages back showcased a GP surgery where they reduced the number of patients coming in and seeing a GP by 70%!
I'll say that again.....by working 'smarter', they reduced their workload by 70%
Imagine if all GP practices did the same......
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14-01-2017, 18:43
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#110
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Sad Doig Fan!
Join Date: Aug 2007
Location: Barry South Wales
Age: 68
Services: With VM for BB 250Mb service.(Deal)
Posts: 11,677
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Re: Crisis in the NHS
Quote:
Originally Posted by Ramrod
That BBC documentary that I linked to a couple of pages back showcased a GP surgery where they reduced the number of patients coming in and seeing a GP by 70%!
I'll say that again.....by working 'smarter', they reduced their workload by 70%
Imagine if all GP practices did the same......
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Is that because the 70% went to A&E instead?
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14-01-2017, 19:15
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#111
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cf.mega poster
Join Date: Jun 2003
Location: Kairdiff-by-the-sea
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Re: Crisis in the NHS
Quote:
Originally Posted by Ramrod
I'll say that again.....by working 'smarter', they reduced their workload by 70%
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They slam the doors shut once their daily quota has entered the building?
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14-01-2017, 19:18
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#112
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Woke and proud !
Join Date: Jun 2004
Services: TV, Phone, BB, a wife
Posts: 9,186
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Re: Crisis in the NHS
Quote:
Originally Posted by Hugh
(Waits for Mr K to find a reason why this was the current Government's fault...)
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Although the last Labour government wasn't blameless, continuing to blame them after 7 years is wearing a bit thin Hugh.
A more open and honest way is to throw this back to the public and how much they are prepared to contribute to the increasing demands on the NHS. (sorry another referendum...)
Something along the lines of:-
- contribute no more. The NHS only to provide emergency care, you need private care for anything else (I suspect this is where the Govt. wants to go)
- 1p in the pound more tax. Try and maintain the status quo, with the NHS cutting some non-life threatening treatments.
- 2p more, status quo
- 3p more. More GP's and out of hours service
- 4p more. All singing and dancing 7 days a week NHS providing all care.
Not pretending these are the real figures or level of funding needed but an example of the choice we as the public, not politicians, need to make. Then we couldn't whinge because we'd made the choice.
It would certainly be a more honest approach than the current Govts. i.e. just let the NHS rot, blaming Junior Dr's, GPs, immigrants etc etc. When it collapses bring your private sector mates to the rescue...
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14-01-2017, 19:21
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#113
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[NTHW] pc clan
Join Date: Jun 2003
Location: Tonbridge
Age: 56
Services: Amazon Prime Video & Netflix. Deregistered from my TV licence.
Posts: 21,950
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Re: Crisis in the NHS
Quote:
Originally Posted by pip08456
Is that because the 70% went to A&E instead?
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Nope. Listen to the program
---------- Post added at 19:20 ---------- Previous post was at 19:19 ----------
Quote:
Originally Posted by Taf
They slam the doors shut once their daily quota has entered the building?
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As above
---------- Post added at 19:21 ---------- Previous post was at 19:20 ----------
Quote:
Originally Posted by Mr K
Although the last Labour government wasn't blameless, continuing to blame them after 7 years is wearing a bit thin Hugh.
A more open and honest way is to throw this back to the public and how much they are prepared to contribute to the increasing demands on the NHS. (sorry another referendum...)
Something along the lines of:-
- contribute no more. The NHS only to provide emergency care, you need private care for anything else (I suspect this is where the Govt. wants to go)
- 1p in the pound more tax. Try and maintain the status quo, with the NHS cutting some non-life threatening treatments.
- 2p more, status quo
- 3p more. More GP's and out of hours service
- 4p more. All singing and dancing 7 days a week NHS providing all care.
Not pretending these are the real figures or level of funding needed but an example of the choice we as the public, not politicians, need to make. Then we couldn't whinge because we'd made the choice.
It would certainly be a more honest approach than the current Govts. i.e. just let the NHS rot, blaming Junior Dr's, GPs, immigrants etc etc. When it collapses bring your private sector mates to the rescue...
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Listen to the program I linked to. the NHS doesn't need more money. It just needs to work properly and also not waste the money we give it.
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Step by step, walk the thousand mile road...
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14-01-2017, 20:15
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#114
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laeva recumbens anguis
Cable Forum Team
Join Date: Jun 2006
Age: 67
Services: Premiere Collection
Posts: 42,229
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Re: Crisis in the NHS
Quote:
Originally Posted by Mr K
Although the last Labour government wasn't blameless, continuing to blame them after 7 years is wearing a bit thin Hugh.
A more open and honest way is to throw this back to the public and how much they are prepared to contribute to the increasing demands on the NHS. (sorry another referendum...)
Something along the lines of:-
- contribute no more. The NHS only to provide emergency care, you need private care for anything else (I suspect this is where the Govt. wants to go)
- 1p in the pound more tax. Try and maintain the status quo, with the NHS cutting some non-life threatening treatments.
- 2p more, status quo
- 3p more. More GP's and out of hours service
- 4p more. All singing and dancing 7 days a week NHS providing all care.
Not pretending these are the real figures or level of funding needed but an example of the choice we as the public, not politicians, need to make. Then we couldn't whinge because we'd made the choice.
It would certainly be a more honest approach than the current Govts. i.e. just let the NHS rot, blaming Junior Dr's, GPs, immigrants etc etc. When it collapses bring your private sector mates to the rescue...
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Please show me in the post where I blamed the Labour Government - I, in fact, pointed out that the BMA had voted against training more Junior doctors...
btw, it takes around 10 years from beginning medical training to being a GP, so there are no quick and easy answers, but if the BMA had supported more training, half of those qualifying would have been GPs next year, which would have been helpful...
__________________
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If only we’re brave enough to be it.
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14-01-2017, 20:54
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#115
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The Dark Satanic Mills
Join Date: Dec 2003
Location: floating in the ether
Posts: 12,072
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Re: Crisis in the NHS
Quote:
Originally Posted by Mr K
A more open and honest way is to throw this back to the public and how much they are prepared to contribute to the increasing demands on the NHS.
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a big fat Zero.
Quote:
Something along the lines of:-
- contribute no more. The NHS only to provide emergency care, you need private care for anything else (I suspect this is where the Govt. wants to go)
- 1p in the pound more tax. Try and maintain the status quo, with the NHS cutting some non-life threatening treatments.
- 2p more, status quo
- 3p more. More GP's and out of hours service
- 4p more. All singing and dancing 7 days a week NHS providing all care.
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????
Quote:
Then we couldn't whinge because we'd made the choice.
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What if we went for the 8p option? But then that proved not to be enough either, could we moan then?
more money isn't the answer, it's a little bit of the answer but I wouldn't give it more money unless the whole concept of the NHS was completely reimagined.
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The wheel's still turning but the hamsters dead.
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14-01-2017, 21:18
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#116
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Woke and proud !
Join Date: Jun 2004
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Posts: 9,186
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Re: Crisis in the NHS
Quote:
Originally Posted by Pierre
more money isn't the answer, it's a little bit of the answer but I wouldn't give it more money unless the whole concept of the NHS was completely reimagined.
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You're beginning to sound like a management consultant mate....
Which one of these 'concepts' do you want to 'reimagine'?
Quote:
that it meet the needs of everyone
that it be free at the point of delivery
that it be based on clinical need, not ability to pay
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http://www.nhs.uk/nhsengland/thenhs/...rinciples.aspx
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14-01-2017, 23:08
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#117
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The Dark Satanic Mills
Join Date: Dec 2003
Location: floating in the ether
Posts: 12,072
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Re: Crisis in the NHS
Quote:
that it meet the needs of everyone
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No.
Quote:
that it be free at the point of delivery
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Yes
Quote:
that it be based on clinical need, not ability to pay
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Depends on the situation. The "Clinical need" is a good one. Certain elective procedures for example, may not have a pressing clinical need. Also those certain procedures without a pressing clinical need could be charged for.
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The wheel's still turning but the hamsters dead.
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15-01-2017, 10:40
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#118
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Perfect Soldier
Join Date: Mar 2009
Location: Worthing West Sussex
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Re: Crisis in the NHS
Quote:
Voters believe the NHS is better off under the Tories than Jeremy Corbyn and Labour, an opinion poll suggests.
It comes despite intense pressure on the prime minister over the state of the health service.
The ComRes poll, for the Sunday Mirror and the Independent, found 43% thought Theresa May would make a better job of managing the NHS this winter - while 31% backed Labour.
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Source
So much for Labour "weaponising" the NHS. Looks like that backfired.
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15-01-2017, 10:50
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#119
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Inactive
Join Date: Oct 2006
Location: Right here!
Posts: 22,316
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Re: Crisis in the NHS
Quote:
Originally Posted by heero_yuy
Source
So much for Labour "weaponising" the NHS. Looks like that backfired.
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Yep, they shot themselves in the foot with their own 'weapon'.
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15-01-2017, 11:20
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#120
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Woke and proud !
Join Date: Jun 2004
Services: TV, Phone, BB, a wife
Posts: 9,186
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Re: Crisis in the NHS
We've all 'shot ourselves in the foot' by not funding the NHS properly. Even cancer operations are now being cancelled.
https://www.theguardian.com/society/...y_to_clipboard
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