Labour spending plans

Following on from a couple of meetings I had prior to going on holiday, I have 3 appointments next week for senior engineers and surveyors who are planning to leave the UK to work in Saudi/Dubai on extendable contracts of between 2 and 3 years. They believe that tax here is going up and by moving overseas they will have several years of untaxed salary and large bonuses which will allow them to come back to the UK in the future, miss the mayhem coming and buy a house outright and live debt free. One Director was seriously pissed off that his salary of £120K only netted him about £500/mth more than a manager earning under £100K who had none of his responsibility and worked far fewer hours. When I explained that his earnings between £100K and £120K were being taxed at 67.5% in Scotland, he got even angrier and said that this had now made his mind up. He was going!!

I think Labour might find, very quickly, that all these wonderful theories they have about collecting more tax might end up doing exactly the opposite.

Me too. However Breakfast TV this morning was saying that the NHS is now treating fewer people than it did before, whilst receiving more money than ever. They need to speak to the Doctors and Consultants in hospitals because every time I speak to senior people they complain about the waste and stupid decisions made by people who aren't medically trained, together with the interference by politicians looking for a positive headline which ends up of little practical use in the day to day operations but creates cost and wastes resources. Another issue is the hugely inflated cost of many of the drugs and treatments which not only means that the NHS will not buy the drugs but it means that people suffer or die when they might otherwise have lived. There needs to be a better way for this to be managed and controlled. And maybe, just maybe we will have to accept the fact that not everything can continue to be totally free. If everyone who attended a Doctor or hospital had to pay £5, how much would that raise?

100% this, although I guess the administration of fines will probably make it loss making rather then adding to the NHS coffers. But anything that stops wasted time and opens up more appointments would be good. 

Maybe charge people £10 per doctors appointment? It would certainly cut down on usage but I guess that isn't the point. 

£10 refundable deposit for all appointment's, no deposit, no appointment.


But don’t spend £billions on a payment system and a new department to manage it all……

Therein lies the problem. And I have no interest in yet another department full of wasters to "administer" such a scheme either!

Not just the NHS but the whole of government spending, especially at the scale I am exposed to in Major Programmes, is beset with the same problem: the panic of who is to blame. Decisions that should go through maybe two Boards if the delegation levels are set correctly go though several pre-boards (LOD they call it - “Line of Defence” , a title which tells you all you need to know about the mentality) so that no one has the ability to point the finger at a single group or individual of senior personnel. By the time the person with the adequate delegated authority and ability to make a decision is given the opportunity to do so the proposal is so far advanced and they are so far removed from it that it is senseless to involve them. That this takes several months on massive budget projects means that there is shock and surprise when the proposed final value increases and the out turn cost is up to 50% more - something very evident in the period of high inflation of the last 18-24 months.

When slave driving private companies built the railways and roads of the past they just got on with it because they needed a return on it as soon as possible. There is zero financial accountability in the public sector until it comes to the taxpayers contribution. Then the public purse needs all your money to not be accountable for.

Agree, a refundable deposit would be the first sensible step as it should be low on administrative burden…but I would make it £25

Next step would be to not refund those who don’t get free prescriptions.

To be fair to Starmer and Streeting, they are being reported as making some of the right noises (telling the NHS they can’t have even more tax payer cash, telling the BMA to stop holding us to ransom, etc). However let’s see the walk to match the talk. It’s going to take some massive trouser potatoes to drive meaningful reform and they well get hammered from every corner….so they will probably do bugger all apart from ban Mars Bars and biscuit adverts

How can they tell the NHS they can't have more taxpayer cash, when the doctors were just given a huge payrise? The nurses (understandably) said they wanted the same, and so on...

Agreed the Labour party are the only ones that can reform this without civil war - unless the whole thing is going to hell on a handcart like in 2009, when global financial armageddon and a Labour election loss meant the coalition managed meaningul cuts. But New Labour under Blair said they would sort out the accelerating spending on public sector pensions, again something only that party can address without massive problems. Then totally bottled it. So I'm not holding my breath this time, and we will be paying for whatever they do....

The healthcare models used in Europe do cost most users some money but they are not US style unaffordable and they appear to be considerably better funded and efficient than the NHS.

When we were in San Francisco we met up with my friend who now lives there. He retired a couple of years ago and is currently paying over $900/mth for his healthcare policy. He was telling me that due to an operation he had about 8 years ago, he has an excess of $50,000 if he has to get the same/connected treatment again. There are also lots of different policies, some which cover you for prescriptions, some which don't and others which provide varying levels of cover for different ailments. He says it is a bit of a lottery which policy is best for a person at a particular time and once you have had a claim you can guarantee that you will be faced with increased premiums, increased exclusions, increased excess etc etc.
Given where we are coming from with the NHS the US model is a complete non starter but some contribution needs to start to come from the users otherwise we will lose "working" healthcare provision in the UK.

Not sure EDF is a good example since the UK Government doesn’t pay a penny for Hinckley Point. All costs are borne by the French taxpayer (EDF has been nationalised) and their Chinese partner.

I thought EDF were getting massive bungs from UK Government?
Is it simply that they're being guaranteed a huge price per unit when they finally start producing?

After the last couple of years I'm not sure that "huge" price per unit is looking that daft for baseload generation. Particularly on an asset that will operate for 80+ years - about 3 to 4  times the lifespan of a windfarm. EDF don't get bungs - in fact they paid £800 million in taxes last year. 

Is the 13.8% employer's NI not effectively the same as the EU model for employers paying towards healthcare? US employers do pay it as well but as you state, they are paying it in to a profit making private healthcare system whereas the EU model avoids the profit making trap.

The 13.8% is paid by the employer over and above your salary. As an employee you currently pay 8% employee's NI between £12,570 and £50,240 and 2% thereafter (rumoured to be 3% or 4% after the budget)