EU Referendum: The result and aftermath...

[Senex]

Theresa May said on Marr on Sunday that there will be £4bn extra a year going to the NHS for the next 5 years, some of which will be funded by a 'Brexit dividend' and the rest by tax increases. She refused to say how much of the £4bn a 'Brexit dividend' would provide. If it's £35 per year and the rest comes from tax increases then she'll have met her vague promise!

Indeed she will. And on BBC1's "Sunday Politics" Paul Johnson from the IFS reminded people that there will be no savings at all at first as we shall still be paying in to the EU. Interesting that shne is being very coy about where the tax increases will fall, though there have been rumours about the threshold for the 40% rate. I wonder if it will end up being a case of middle-earning Middle England paying whilst the Tories pose no extra burdens on their friends at the top or on all those who do not pay income tax but still use NHS provisions.

 

[fowler9]

Maybe he thinks it’s bad law. If so, as an MP, he’s well within his rights to object. I couldn’t possibly comment. I haven’t read the draft bill myself. Have you?

Surely it’s a good thing that an elected MP can delay the passage of a private members bill?! All that will happen is that parliament will debate it at a later date and then pass it into law if duly voted.

What’s wrong with that, exactly?

It’s very strange indeed to me that members of this forum criticise the workings of our mature parliamentary democracy, yet are apparently happy to hand over our sovereignty and governance to the EU.

It was a joke mate. Clearly not a good one.

 

[Bromley boy]

It was a joke mate. Clearly not a good one.

Still better than most of my jokes on this forum .

 

[fowler9]

Still better than most of my jokes on this forum .

Ha ha.

 

[NSEFAN]

Indeed she will. And on BBC1's "Sunday Politics" Paul Johnson from the IFS reminded people that there will be no savings at all at first as we shall still be paying in to the EU. Interesting that shne is being very coy about where the tax increases will fall, though there have been rumours about the threshold for the 40% rate. I wonder if it will end up being a case of middle-earning Middle England paying whilst the Tories pose no extra burdens on their friends at the top or on all those who do not pay income tax but still use NHS provisions.

It is funny to see the papers wibble about a "stealth tax" for the NHS and how we should "reduce NHS waste instead". The reality is that the people are getting older and cost more to look after. There's only so much that "efficiencies" can deliver before the service becomes cut. If the people want the NHS to survive then they need to bloomin well pay for it.

Or maybe we need to import some more youthful workers to pay NI on their behalf.

 

[AlterEgo]

It is funny to see the papers wibble about a "stealth tax" for the NHS and how we should "reduce NHS waste instead". The reality is that the people are getting older and cost more to look after. There's only so much that "efficiencies" can deliver before the service becomes cut. If the people want the NHS to survive then they need to bloomin well pay for it.

Or maybe we need to import some more youthful workers to pay NI on their behalf.

Or we could do what most countries with better public health do and move to an insurance model while retaining universal healthcare.

 

[Senex]

Another aspect of this. We are told that the NHS needs 4% real extra funding year on year in order, effectively, just to stand still. May is offering 3.4%. Total public expenditure to April this year, central and local government, is estimated at £814bn and expenditure on health £146.8bn (https://www.ukpublicspending.co.uk/). That health figure will double in about 21 years and double again in another 21 years, and it won't be that long till it accounts for the whole of government spending (at its present level). The argument is always that this sort of growth can be met by growth in the economy as a whole rather than simply by massive extra taxation, but the economy has not been doing that well in recent years and if some of the forecasts for the future are to be believed, it will not be doing that well for a good few years to come. How far is a tax model for the NHS sustainable, especially for governments that want to "punch above our weight" on the world stage by keeping world-deployable armed forces, atomic weapons and the means of delivery, large commitments to overseas aid, and so on? How far can the NHS be allowed to consume more and more of the GDP at the expense of other areas such as education and so on? Or has the time come to do as Alter Ego indicates, and move to an insurance model while retaining universal healthcare? And, on the basis that yhou only properly value something that you know is costing you something, should everyone make some sort of direct financial contribution to their healthcare?

 

[HSTEd]

Or has the time come to do as Alter Ego indicates, and move to an insurance model while retaining universal healthcare? And, on the basis that yhou only properly value something that you know is costing you something, should everyone make some sort of direct financial contribution to their healthcare?

And where will the money magically come from to pay everyones insurance contributions?
The only way insurance-models reduce costs is if the poor are simply left to die.

The same number of doctors and other staff will still have to be paid, the same medications dished out and the same equipment purchased.
Indeed you will require more because you will need to create a huge new bureaucracy to manage the insurance system and prevent those without insurance from receiving treatment etc etc.

The fact remains that the NHS's costs are expanding primarily because of the aging population - but the population will eventually reach a new equilibrium and the NHS budget will stop increasing.

This is not an unbounded exponential increase.

 

[Senex]

The fact remains that the NHS's costs are expanding primarily because of the aging population - but the population will eventually reach a new equilibrium and the NHS budget will stop increasing.

This is not an unbounded exponential increase.

It isn't just people growing older, it's massively expensive new treatments and new drugs — and the medics themselves are not talking about the budget stopping increasing. They are the ones who are asking for something like 4% per annum growth in real terms ad infinitum so that they can use all the modern developments. Someone is going to have to make hard choices about just what the NHS can be expected to take on and what total share of the national budget it can have. Also, if the burden goes on income tax at the standard and 40% rates, at what point will the payers of the tax start objecting and registering their votes accordingly? (You presumably heard the news today that Computer-Game Addiction has now been recognised as an illness and therefore the NHS is likely to have to start paying for treatment ...)

 

[greyman42]

It isn't just people growing older, it's massively expensive new treatments and new drugs — and the medics themselves are not talking about the budget stopping increasing. They are the ones who are asking for something like 4% per annum growth in real terms ad infinitum so that they can use all the modern developments. Someone is going to have to make hard choices about just what the NHS can be expected to take on and what total share of the national budget it can have. Also, if the burden goes on income tax at the standard and 40% rates, at what point will the payers of the tax start objecting and registering their votes accordingly? (You presumably heard the news today that Computer-Game Addiction has now been recognised as an illness and therefore the NHS is likely to have to start paying for treatment ...)

If there has to be tax rises to pay for the better NHS that a lot of people seem to be demanding then so be it. If any of that money raised by higher taxes is spent on treating people with "computer game addiction" then I would object to that. There are far more important thigs to spend the extra money on than that.

 

[HSTEd]

It isn't just people growing older, it's massively expensive new treatments and new drugs — and the medics themselves are not talking about the budget stopping increasing. They are the ones who are asking for something like 4% per annum growth in real terms ad infinitum so that they can use all the modern developments. Someone is going to have to make hard choices about just what the NHS can be expected to take on and what total share of the national budget it can have. Also, if the burden goes on income tax at the standard and 40% rates, at what point will the payers of the tax start objecting and registering their votes accordingly?

So the voters will simultaneously demand massively expensive new treatments, and refuse to pay the money for them?
That absurdity can be pointed out to the voters at the time.

Whilst technologies will make more expensive new treatments, it also tends to make them cheaper over the time.
DNA sequencing used to cost a million dollars a time, now it costs a few hundred.

At the moment the taxpayers are perfectly willing to pay more taxes to obtain better care, and NHS spending remains some of the lowest government health spending per capita in the world.

(You presumably heard the news today that Computer-Game Addiction has now been recognised as an illness and therefore the NHS is likely to have to start paying for treatment ...)

Good job mental health treatments pushed by the NHS are really cheap then - why do you think Cognitive Behavioural Therapy is so common now?

 

[Senex]

At the moment the taxpayers are perfectly willing to pay more taxes to obtain better care, and NHS spending remains some of the lowest government health spending per capita in the world.

Has there been any polling of those who actually pay income tax and national insurance, or is it simply opinion polls that just ask the general population whether they're in favour of higher taxes for the NHS that we hear about? You seem to think we should just fund whatever the medics think they would like to have and do whether all that is really what society as a whole wants, particularly in their officiously striving to keep alive at the beginning and end of life, no matter what the costs being incurred. I think that (a) the aspirations of the medics should be controlled, and (b) all people have some responsibility to look after their own health and moderate their demands on a state health system. And I certainly don't accept that whoever thinks he has a need has a right to unlimited support from the rest of us. But I'm pretty certain you and I shall never agree on this subject, as we clearly come at it from very different sets of principles, so I'll say no more.

 

[HSTEd]

Has there been any polling of those who actually pay income tax and national insurance, or is it simply opinion polls that just ask the general population whether they're in favour of higher taxes for the NHS that we hear about?

Given that we don't really have hypothecated taxes in the UK, and the vast majority of Government income is not raised by either of those two methods, why should it matter if the polling is of the general population or of people that pay those two particular taxes?

The polling doesn't include sub 18 year olds who pay VAT after all.

You seem to think we should just fund whatever the medics think they would like to have and do whether all that is really what society as a whole wants, particularly in their officiously striving to keep alive at the beginning and end of life, no matter what the costs being incurred.

I most certainly don't think that, but I don't see any current problem with increasing NHS funding as it has done historically.
I fully support a system in which the NHS budget is controlled from the bottom up by adjusting the tolerable cost of treatment per QALY.

I think that (a) the aspirations of the medics should be controlled, and (b) all people have some responsibility to look after their own health and moderate their demands on a state health system.

And they do - people who do unhealthy things (primarily smoking and alcohol because those things are by far the worst avoidable health problems in our society) tend to pay a lot more tax and duties.
Tobacco smokers subsidise the healthcare of non-smokers as the cost of treating smokign related diseases pales compared to the Tobacco duty income.

And I certainly don't accept that whoever thinks he has a need has a right to unlimited support from the rest of us. But I'm pretty certain you and I shall never agree on this subject, as we clearly come at it from very different sets of principles, so I'll say no more.

I never said unlimited support - but insurance systems are often used as a Trojan Horse for the principle of abandoning poor people to early deaths for no other reason than because they are poor.
And I have not seen any demonstration that they are more efficient in terms of outcomes per pound spent.

 

[AlterEgo]

So the voters will simultaneously demand massively expensive new treatments, and refuse to pay the money for them?
That absurdity can be pointed out to the voters at the time.

The first thing is already happening but the second is political anathema in a state which historically defines one of its greatest achievements as the introduction of socialised medicine.

 

[WelshBluebird]

So the voters will simultaneously demand massively expensive new treatments, and refuse to pay the money for them?
That absurdity can be pointed out to the voters at the time.

Yes voters are that stupid.
That is why they vote for things like tax cuts, and then act surprised when that means public services have to be cut.
You see it with Brexit too. Acting surprised when leaving the EU means giving up the good things aswell as the bad.

 

[muddythefish]

Why does there have to be tax rises on ordinary folk when tax evasion by wealthy individuals is still a huge problem, there are more than 1,200 measures people can use to avoid paying tax (up from 900 in 2010) and multinationals avoided paying as much as £5.8bn in UK corporate taxes last year by booking profits in overseas entities ?

https://www.ft.com/content/00de4f00-b754-11e7-8c12-5661783e5589

 

[NSEFAN]

Why does there have to be tax rises on ordinary folk when tax evasion by wealthy individuals is still a huge problem, there are more than 1,200 measures people can use to avoid paying tax (up from 900 in 2010) and multinationals avoided paying as much as £5.8bn in UK corporate taxes last year by booking profits in overseas entities ?

https://www.ft.com/content/00de4f00-b754-11e7-8c12-5661783e5589

The government could simplify the tax system in an effort to recover more money. However right now they need to be seen to be encouraging businesses to come to the UK and employ people, to bring some stability to the country whilst Brexit is being sorted out. They may not pay much tax on the profits by declaring them overseas, but they're still employing taxpayers in the UK.

 

[yorksrob]

Maybe he thinks it’s bad law. If so, as an MP, he’s well within his rights to object. I couldn’t possibly comment. I haven’t read the draft bill myself. Have you?

Surely it’s a good thing that an elected MP can delay the passage of a private members bill?! All that will happen is that parliament will debate it at a later date and then pass it into law if duly voted.

What’s wrong with that, exactly?

It’s very strange indeed to me that members of this forum criticise the workings of our mature parliamentary democracy, yet are apparently happy to hand over our sovereignty and governance to the EU.

I've read of one MP (can't remember which, sorry) who has admitted deliberately philibustering private members bills because he believes that they are not part of the governing party manifesto that the electorate has voted for.

Personally I think that such a member should be permanently barred from parliament and imprisoned for perverting the parliamentary process, but it does seem arcane that our system allows him to get away with it in the first place.

As far as the NHS is concerned, we should be benchmarking our spend per head of population against that of other Western countries. In a system where health resources are truly allocated according to need, I can't see by what mechanism an insurance based system would save costs, given that state funding is effectively insurance with the widest possible base of contributors.

 

[Senex]

As far as the NHS is concerned, we should be benchmarking our spend per head of population against that of other Western countries.

I think there's an interesting general point here. Pretty well all those other western countries do have an insurance-based system, at least in part, so that people feel there is a direct relationship between what they pay and what they get. Could it be that when people feel they are (to some extent at least) in control, they are willing to pay significantly more, and that is at least part of the reason for those higher levels of expenditure per head? In our system you just get what some remote bureaucracy chooses to allow you, with no real sense of personal control in what goes on at all (and not just in health matters, of course). With health, it does seem both interesting and relevant so that very few other advanced states have chosen to follow the NHS model.

 

[yorksrob]

I think there's an interesting general point here. Pretty well all those other western countries do have an insurance-based system, at least in part, so that people feel there is a direct relationship between what they pay and what they get. Could it be that when people feel they are (to some extent at least) in control, they are willing to pay significantly more, and that is at least part of the reason for those higher levels of expenditure per head? In our system you just get what some remote bureaucracy chooses to allow you, with no real sense of personal control in what goes on at all (and not just in health matters, of course). With health, it does seem both interesting and relevant so that very few other advanced states have chosen to follow the NHS model.

That may well be the case, however I just worry that allowing competing private sector insurance providers into the process would just introduce a whole new layer of burocracy which has to be paid for from the same pot and that this would be a completely unnecessary waste of resources.

I'm reminded of one of the states in Australia which never bothered with a type of insurance (may be motor), instead relying on state compensation, and as a result its residents pay a lot less than would do through an insurance based system.

I do have some sympathy with the view that an element of taxation, maybe national insurance, should be ring fenced and dedicated to health and perhaps social care so that it could increase or decreased visibly for that purpose of controlling funding forhealth and perhaps social care.

 

[AM9]

... Well they did have better railway systems, until the EU legislated in the latest set of railway directives to require competitive tendering for all subsidised and public service services.
Which together iwth the other "reforms" essentially locks in the British model.

Back now, I can report that those travelling on DSB (over the last 7 days) were quite content at the service and quality of accommodation they were paying for. The prices were no more expensive than thay would be here and apart form a hioccup on the Oresund line where there was a delay behing a short terminated train, everything seemed to run as planned. Of course nobody complained about the competitive tendering forced on their national railway and as ticket interavailability, interchanges and timekeeping all went smoothly, the experience didn't seem to reflect the troubles that a fragmented operation like here in the UK normally suffers from. So that's another EU red herring dismissed.

 

[HSTEd]

Back now, I can report that those travelling on DSB (over the last 7 days) were quite content at the service and quality of accommodation they were paying for. The prices were no more expensive than thay would be here and apart form a hioccup on the Oresund line where there was a delay behing a short terminated train, everything seemed to run as planned. Of course nobody complained about the competitive tendering forced on their national railway and as ticket interavailability, interchanges and timekeeping all went smoothly, the experience didn't seem to reflect the troubles that a fragmented operation like here in the UK normally suffers from. So that's another EU red herring dismissed.

I wasn't aware it was December 2019 yet.

And given that Denmark has had its own fair share of issues with failed franchisees for rail operations - I would hardly say its a paragon of how the EU regulations are actually perfect and cannot be improved on.
And the railways would be far more expensive than they have to be because of the shear number of lawyers that must be employed for such systems.

 

[radamfi]

Franchising is an extreme left-wing philosophy, practically on a par with communism.

According to the "Buses & coaches" section.

 

[EM2]

This is not good news for the UK.
https://www.thetimes.co.uk/article/...ness-from-britain-over-brexit-fears-f6jnc7x2j
Airbus prepares to move business from Britain over Brexit fears
●Aerospace giant on brink of abandoning British investment ●Tens of thousands of manufacturing roles at risk over Brexit

The European aerospace company Airbus is set to become the first big manufacturer to pull investment from Britain after losing patience with Theresa May’s stalled Brexit negotiations.

Airbus, which generates £1.7 billion in tax revenues, is preparing to abandon plans to build aircraft wings at its British plants and move production to China, the US or elsewhere in Europe. It is making a series of investment decisions this summer because of worries that EU safety certifications will not apply from March next year and uncertainty over customs checks.

“In the absence of any clarity, we have to assume the worst-case scenario,” Tom Williams, the chief operating officer of Airbus, told The Times.

The rest of the article is paywalled

 

[Senex]

This is not good news for the UK.
https://www.thetimes.co.uk/article/...ness-from-britain-over-brexit-fears-f6jnc7x2j
Airbus prepares to move business from Britain over Brexit fears
●Aerospace giant on brink of abandoning British investment ●Tens of thousands of manufacturing roles at risk over Brexit

The rest of the article is paywalled

But should anyone really be surprised?

 

[WelshBluebird]

But should anyone really be surprised?

Anyone who has a brain isn't.
Sadly a lot of the Brexiteers are already shouting "project fear" etc etc.

 

[Western Lord]

It would take Airbus years to set up from scratch a new wing building facility elsewhere (and cost a fortune). Remember that they would have to continue full production at the existing facilities in order to meet their delivery schedules, so they couldn't transfer equipment or personnel from the existing plants. A break in production and consequent delivery delays would cost them hundreds of millions of dollars in compensation to airlines (and probably loss of business to Boeing). The shareholders of Airbus would have no desire to have to go to this expense (and the expense of closing the existing facilities) and there could not be any government aid under EU rules (as this would not be a new product which would qualify under the repayable launch aid rules).

 

[Groningen]

When the Brexit is in place than the Netherlands will have 900 new bordercontrol personel in the harbours at the Northsea ports.

 

[WelshBluebird]

It would take Airbus years to set up from scratch a new wing building facility elsewhere (and cost a fortune). Remember that they would have to continue full production at the existing facilities in order to meet their delivery schedules, so they couldn't transfer equipment or personnel from the existing plants. A break in production and consequent delivery delays would cost them hundreds of millions of dollars in compensation to airlines (and probably loss of business to Boeing). The shareholders of Airbus would have no desire to have to go to this expense (and the expense of closing the existing facilities) and there could not be any government aid under EU rules (as this would not be a new product which would qualify under the repayable launch aid rules).

And at the same time, because of the way Airbus operates, if we do actually end up with a "no deal" Brexit, then they won't really have much choice but to move from the UK (or move everything from the other EU countries to the UK, which isn't going to happen). That is the reality. Airbus is a company that relies on moving items (parts, fully or partly assembled components and planes etc) easily, quickly and cheaply between EU countries. If we end up getting in the way of that (with additional customs checks, with no agreement about air safety standards etc) then how on earth can anyone expect them not to leave?

You say shareholders won't have any idea to go through additional expenses. But at the same time shareholders do not like the current uncertain and risk that is at play because Airbus simply do not know what the landscape will be when we leave the EU (and the "transition period"). They cannot make accurate predictions because any made right now will likely be blown out of the water when the reality of whatever Brexit we end up having ends up being clear. Are we going to have additional customs checks or not? Are there going to be extra costs (apart from time) because of that? Will any "electronic" customs system (that the government have mentioned a few times) be good and reliable enough (if it even ends up existing). Who knows.

 

[Groningen]

A dutch article says that directly 14.000 people work for Airbus in England and an extra 100.000 related jobs. If things go to Hamburg and Toulouse than the lines would be shortened. Yes; high cost to replace things, but Airbus does not want to make new argreements with the government.