Would you cancel HS2 to invest in the NHS?

Bletchleyite · 21 Feb 2017

najaB said:
The theory is that local control actually saves money since services can be tailored to the needs of local communities.

I have a friend who is a civil servant in the area of health management (not NHS) and he fairly strongly believes he'd go further than the CCGs - he believes it should be a local authority matter, subject to some specific minima, and funded through local taxation.

I would rather see it a bit more like the Bank of England - long-term and apolitical, but equally well defined.

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stut · 21 Feb 2017

Enough with these false dichotomies. Can HS2 to fund the NHS. Can foreign aid to help homeless ex-servicemen. Can green energy subsidy to fund schools.

None of these are either-or. Budgets simply don't work like that. If there's a strong business case for HS2, do it. If not, don't. It has jack all to do with the NHS.

The NHS's main problem now is that it's being primed for selling off, bit by bit. You can be sure that whatever happens, it will cost us more, earn its employees less, and have a bunch of people sat in the middle creaming off the difference. That's how it works round here...

pemma · 21 Feb 2017

I would like to see the costings for a viable alternative to boosting capacity on the rail network without building HS2. So for example, an additional route between Manchester and Crewe, Liverpool and Crewe, Milton Keynes and London, Wolverhampton and Birmingham and line speed improvements and electrification across the XC network. Then if that's significantly cheaper than HS2 the savings could be invested elsewhere.

najaB · 21 Feb 2017

jcollins said:
Then if that's significantly cheaper than HS2 the savings could be invested elsewhere.

It won't be. Building a railway is expensive, building a high-speed railway is slightly more expensive.

al78 · 21 Feb 2017

I heard that one of the main issues with the NHS is that it is not so much the amount of money it receives, it is a combination of an aging population and that as people age, they require regular care long term. If we could set up local centers that specialised in treating people with long term conditions which require frequent treatment, and invest more in social care which can help people live at home, rather than keep returning to hospital, that may free up hospital beds and reduce the pressure a bit. It may be the case that in 20 years or so, the problem will ease somewhat, as the baby-boomers will be approaching the end of their life by then, and as they die off, that will result in at least a temporary drop in the number of elderly/infirm. Yes I would support raising taxes to pay for this, in combination with analysis of how our tax money is spent, and whether there is dead wood that can be pruned away.

Bletchleyite · 21 Feb 2017

al78 said:
It may be the case that in 20 years or so, the problem will ease somewhat, as the baby-boomers will be approaching the end of their life by then, and as they die off, that will result in at least a temporary drop in the number of elderly/infirm.

Despite the impression the media give the generations are a continuum, not a cut-off. There will be no such sudden drop, though it might reduce a bit as younger generations had fewer children (which itself will create a funding crisis in its own right).

najaB · 21 Feb 2017

al78 said:
I heard that one of the main issues with the NHS is that it is not so much the amount of money it receives, it is a combination of an aging population and that as people age, they require regular care long term.

That problem can be solved in two words: Solyent Green.

misterredmist · 21 Feb 2017

as the WCML is creaking at the seams and needs a helluva lot of TLC then we must have additional capacity somewhere.....and hopefully, HS2 will provide that.

As for the NHS, unfortunately, it is a basket case money pit. I think we'll have to accept contributing privately to the system very soon and may be we have to look at some Health Services elsewhere to get some idea as to how to run the NHS properly as I don't think we have a clue.

Bletchleyite · 21 Feb 2017

misterredmist said:
As for the NHS, unfortunately, it is a basket case money pit. I think we'll have to accept contributing privately to the system very soon

We already do - dental and optical.

and may be we have to look at some Health Services elsewhere to get some idea as to how to run the NHS properly as I don't think we have a clue.

As above I nominate the European insurance-based systems as a better option, specifically because they will allow entitlements to be clearly defined and standardised nationally to remove the postcode lottery.

By the way - who didn't know that the main window they have into the NHS, the GP surgeries (and for that matter dental surgeries), are all private, for-profit businesses as they were never nationalised in the first place?

miami · 21 Feb 2017

Neil Williams said:
No, I'd increase taxes (specifically income tax) so we can fund both properly.

I would increase tax, but not income tax. That's far too easy to avoid, and it sends the wrong message - taxing productivity rather than hoarding. I would fund the immediate shortfall in NHS and Social Care via a windfall tax on property and pensions, then institute a land tax to continue the funding - something that is hard to avoid, and also ensures that properties are not left empty or unused. I'd also reinstate the tax breaks on mortgage interest on buy-to-let properties and remove all stamp duty too.

Schools are losing funding, libraries are closing, bins aren't being collected, and council tax is going up by 5%{2}, all due to an elderly population that are the richest they have ever been{1}, while needing more financial support than ever before.

{1} http://www.telegraph.co.uk/finance/...an-the-rest-and-we-should-celebrate-that.html + http://www.telegraph.co.uk/finance/...tax-bracket-than-those-in-their-thirties.html
{2} http://www.bbc.co.uk/news/uk-38982643

Bletchleyite · 21 Feb 2017

paulweaver said:
Schools are losing funding, libraries are closing, bins aren't being collected, and council tax is going up by 5%{2}, all due to an elderly population that are the richest they have ever been{1}, while needing more financial support than ever before.

Of course Council cuts are partly because Councils are capped by central Government - basically meddling in the local democratic process.

My strong view, as noted above, is that Councils should be funded solely from local taxation with the Government having no control over the amount of this, only the structure to keep things simple. Local democracy can decide what the Council priorities are.

LNW-GW Joint · 21 Feb 2017

yorksrob said:
You could make an argument that new trains are a one off capital investment (at least for the next forty years), particularly if they significantly increase capacity.

The capital investment in new trains is mainly by Roscos/suppliers (eg IEP), not HMG.
That's like PFI in hospitals.
Currently the NHS can build new hospitals, but can't afford the staff to run them year on year.

Similarly Network Rail projects are capitalised, but the resources to run them aren't (eg signallers, maintenance staff etc).
There's always the interest bill on the capital, but that is at historic lows at the moment.

pemma · 21 Feb 2017

najaB said:
It won't be. Building a railway is expensive, building a high-speed railway is slightly more expensive.

But HS2 will be 225 miles of track for £56bn. I'm suggesting something like 100 miles of new track and upgrading existing track. Even the WCML upgrade which went grossly over budget only costed a fifth of what HS2 will cost (obviously inflation needs to be taken in to account) but we're yet to see if HS2 can be done within budget.

Comstock · 21 Feb 2017

Moonshot said:
How many voters would vote for that (a rise in income tax) ?

Sadly probably not very many. I say sadly because IMHO income tax is the only truly fair and progressive tax, and it has an inbuilt mechanism (the personal allowance) to protect those at the bottom of the pyramid. No one earning less than £220 a week would be affected at all by an income tax rise. Everyone else would only be affected on what you earn above that. So for example if income tax was raised by 2% someone on £300 a week would only pay £1.60 a week.

Geezertronic · 21 Feb 2017

I believe the OP is mistaken if he/she believes that there is a big pot of money that will be released if HS2 was cancelled. It seems typical as a while ago I saw "NHS not HS2" posters springing up near Burton Green and I do not believe it is in any way correct to assume that the HS2 money can be used for NHS or other rail projects if not used for HS2. Other rail projects are certainly not affected by HS2 funding so HS2 is not robbing from the coffers

al78 · 21 Feb 2017

Neil Williams said:
Despite the impression the media give the generations are a continuum, not a cut-off. There will be no such sudden drop, though it might reduce a bit as younger generations had fewer children (which itself will create a funding crisis in its own right).

Yes I am aware of that, but in addition the birth rate is not constant with time. The 20 or so years after WWII corresponded to a rise in birth rate which then dropped back down again. When the people that were born during this period of birthrate rise reach the end of their life, the idea is that the population of elderly will drop, since the numbe of people reaching retirement in 20 years time will be lower than the number of retirees dying off.

zaax · 21 Feb 2017

For the NHS - find a new tax stream, like they have in few USA states by leaglising marijuana. Colorado collected almost $70 million in marijuana taxes in 2015

pemma · 21 Feb 2017

Comstock said:
Sadly probably not very many. I say sadly because IMHO income tax is the only truly fair and progressive tax, and it has an inbuilt mechanism (the personal allowance) to protect those at the bottom of the pyramid. No one earning less than £220 a week would be affected at all by an income tax rise. Everyone else would only be affected on what you earn above that. So for example if income tax was raised by 2% someone on £300 a week would only pay £1.60 a week.

If, for instance, a party said we propose a small tax rise but the tax rise would mean free dental check ups and essential dental treatment then I'm sure some people would vote for them as it would mean they would pay around the same but not get any unexpected bills.

pemma · 21 Feb 2017

Geezertronic said:
I believe the OP is mistaken if he/she believes that there is a big pot of money that will be released if HS2 was cancelled.

Yes but a lot of people believed 'Vote Leave' that if we stopped paying a contribution to the EU budget that a big pot of money would be available for the NHS so it's not surprising people believe the same thing could happen if other expenditure was cancelled.

work-traveller · 21 Feb 2017

One of the 'catchy' lines generated by the anti-HS2 lobby was 'NHS not HS2' which worked marvellously. It takes full advantage of the (on this topic) unknowledgeable general public to conflate NHS operational funding and HS2 capital funding. The fact that the entire HS2 capital budget would fund the operation of the NHS for a mere 6 months, is completely unknown to most people. In essence, the anti-HS2 lobby needed something warm and fuzzy that they could put up against HS2, and the NHS makes for a catchier headline that 'Milk & Honey not HS2'.

physics34 · 21 Feb 2017

scrap it and invest in advanced signalling to increase capacity

quantinghome · 21 Feb 2017

physics34 said:
scrap it and invest in advanced signalling to increase capacity

What advanced signalling would that be? ERTMS Level 2 is already planned to be installed on some lines before HS2 is open. Or do you have in mind some even more advanced signalling system, ERTMS Level 3 perhaps? If so, you may want to read up on the Jubilee line extension and Railtrack's plan for the West Coast Main Line Upgrade.

quantinghome · 21 Feb 2017

jcollins said:
I would like to see the costings for a viable alternative to boosting capacity on the rail network without building HS2. So for example, an additional route between Manchester and Crewe, Liverpool and Crewe, Milton Keynes and London, Wolverhampton and Birmingham and line speed improvements and electrification across the XC network. Then if that's significantly cheaper than HS2 the savings could be invested elsewhere.

jcollins said:
But HS2 will be 225 miles of track for £56bn. I'm suggesting something like 100 miles of new track and upgrading existing track. Even the WCML upgrade which went grossly over budget only costed a fifth of what HS2 will cost (obviously inflation needs to be taken in to account) but we're yet to see if HS2 can be done within budget.

The new lines you propose are the most expensive parts of HS2 so you would see little saving. For example, an additional route between Milton Keynes and London would still require tunnelling from the M25 to central London and rebuilding/expanding Euston. Those are the really expensive bits. Putting new track through a field is cheap.

sonorguy · 21 Feb 2017

Pinza-C55 said:
I had to vote "other" because I would cancel HS2 regardless of whether any more money went to the NHS. As for the NHS I believe the answer to its problems is to strip out the various attempts at pseudo privatisation and fat cat bosses who have no medical experience. Return it to what it was supposed to be - a service available to British citizens, free at the point of use.
The rail network should also be renationalised immediately.

My bold and a little off topic, as someone who has worked as a clinically qualified senior manager in the NHS and private sector, some of the very worst managers I've seen are medically or nurse qualified, and some of the very best came from non-healthcare related environments.

The two job types require very different competencies that don't often align and there are many senior NHS jobs, particularly around finance, estates and commissioning of services that don't require clinically qualified managers, as long as they listen to the senior doctors/nurses/OTs/radiographers etc who understand the clinical need properly.

devonexpress · 21 Feb 2017

Yes I would, I would give a proportionate amount to the NHS, with the rest going to reopening the Paddington to Birmingham line, and improvements to the West Coast & East Coast train lines to improve speeds.

HS2 is NOT needed, we have plenty of domestic flights such as Easyjet, Flybe which are quicker, 55 minutes average flight time, compared to saving 20 minutes off a journey from Birm NS to Euston on HS2!! And before anyone says aircraft produce worse emissions, I can tell you that is a load of rubbish by idiots like Greenpeace, airlines are looking to save money, especially on expensive fuel, they only carry the minimum fuel needed, and budget airlines have some of the newest aircraft in the world, purely because they are more efficient and therefore save money!

daccer · 21 Feb 2017

I dont believe the argument for HS2 stacks up and I think it should be put on hold regardless.

Bletchleyite · 21 Feb 2017

devonexpress said:
HS2 is NOT needed, we have plenty of domestic flights such as Easyjet, Flybe which are quicker

You misunderstand completely what HS2 is for.

It is about capacity. It just might as well be high speed as it costs little more than a 125mph line.

pemma · 21 Feb 2017

quantinghome said:
The new lines you propose are the most expensive parts of HS2 so you would see little saving.

Rubbish. A new line for ordinary trains between Manchester and Crewe would cost a fraction of what HS2 would cost. Almost all of it could be built through fields or even using existing track which currently has no or limited passenger services. However, the same doesn't apply if you want to find new track to run 250mph trains on as upgrading a 50mph route to 250mph isn't economically viable and it's cheaper to start with a new route.

The cost of HS2 are so huge that even a 5% saving would be a saving approaching 3 billion pounds.

and rebuilding/expanding Euston.

A new route doesn't have to go to Euston. Just because rebuilding Euston is the most economically viable option if HS2 is built doesn't mean it would be the most economically viable option for a non-HS route.

Bletchleyite · 21 Feb 2017

jcollins said:
A new route doesn't have to go to Euston. Just because rebuilding Euston is the most economically viable option if HS2 is built doesn't mean it would be the most economically viable option for a non-HS route.

As the purpose of HS2 is to relieve capacity on the south WCML, the high speed benefit being a side benefit, where on earth else do you propose it should go?

Xenophon PCDGS · 21 Feb 2017

physics34 said:
Scrap it and invest in advanced signalling to increase capacity

That is a very ruthless solution that you propose to happen to the NHS....or have I grasped the wrong end of the proverbial stick?

Would you cancel HS2 to invest in the NHS?

Would you cancel HS2 to fund our NHS?

Yes

Yes - but splitting the funding to fund NHS and upgrade existing railway infrastructure

No

No - but delaying HS2 to prioritise NHS spending

Other

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