The half-truth as you quote Tim Farron as saying about paying for the NHS is that the money has to come out of people’s pockets (Editorial, 21 September). This is not as difficult as it may sound at first if we work out the value to the community of the services provided by the NHS and compare it with the costs. The consistent increase in longevity since 1948 must owe a great deal to its existence, and the addition to the national income year by year must run into billions of pounds if we put a proper value on such things as enabling people to return to work after injury or illness after a shorter absence, or even at all. Reduction in pain and anxiety runs into many more billions, as well as the benefits from improved drugs, new and simpler methods of surgery, treating conditions in outpatients departments, or regular visits to GP surgeries (instead of hospitalisation).
If a monetary value were to be put on these and many other of the NHS’s activities, this would produce a “profit”, year by year. Part of this could then be ploughed back into the service in a similar way to part of commercial and industrial profits being used to finance expansion. It is time to stop nit-picking on the cost side of the NHS and get down to working out just how much we owe it.
Harvey Cole
Winchester, Hampshire
• Raising sufficient revenue to finance our currently strained NHS shouldn’t be a problem economically. When a private company employs more people to produce more goods or services that people clearly need and demand, an appropriate price has to be levied to pay wages and other costs, reimburse lenders and reward shareholders. A private insurance company has to levy premiums on its new customers. In no case is such pricing felt to be an undue imposition with adverse economic effects. Indeed, economists generally consider any such move to have positive multiplier effects on the rest of the economy, as the initial new workers increase demand for general consumer goods.
The same logic surely applies in the case of public services. Provided people really need and demand the services (obviously very much the case) and more service is indeed given (which should be the case if quality workers are employed), then raising revenue through tax or social insurance should have unambiguously good effects. And we can both safely expand essential services and employ good people in well-paid professional and semi-professional public jobs providing these services, more or less to the point that public need and demand is met. If so, this is a massively important (hitherto insufficiently recognised) point that all political parties need to take on board.
Bernard Cummings
Erith, Greater London
• I stopped paying national insurance contributions when I reached the state pension age 12 years ago. Since then I have needed to make increasing use of the NHS. I have two suggestions for increasing funding for the NHS.
First, require state pensioners to make NI contributions according to their ability to pay. If abolition of the exemption were to be considered ill-advised by political parties fearful that such a measure would lose them votes, then NI contributions could instead be phased out and merged into the income tax system. This approach, less damaging politically, would enable pensioners to contribute to the funding of state pensions and benefits and the NHS fairly, according to their means.
Second, the public need to be better informed about the costs of the NHS, so that we might be more willing to pay for its services. The real cost of a “free” visit to a GP and of “free” common operations such as hip replacements, cataract removals and heart bypasses should be displayed boldly in surgeries and in pharmacies. More of us might then recognise that the NHS provides excellent value for our money – and needs more to meet its understandably rising costs.
Alan Baker
Cambridge
• The Labour leadership have not been as forthcoming as they might about their views on the NHS. Tim Farron sees them as supporting “renationalisation”, which means the current version of the NHS reinstatement bill awaiting its second reading in November. If it were passed into law, £10bn more annually would become available without any increase in taxation, because the current marketised system costs that much more in administration than did the public service model NHS which preceded it (admin costs are now over 14% of the NHS budget instead of the previous 5%).
Jeanne Warren
Oxford
• Your editorial suggests that Jeremy Corbyn’s campaign has failed to provide detail on how he would finance an expanded NHS. This omission is understandable. On the day of his innovative health policy launch in August, the media chose to focus on “traingate” (Report, 25 August). This ludicrous non-news story, which successfully blew away Corbyn’s attempt to publicise his excellent health policy details, involved Richard Branson, whose Virgin Healthcare has a strong commercial interest in eradicating the NHS. What a coincidence.
Catharine Sadler
Little Birch, Herefordshire
• Join the debate – email guardian.letters@theguardian.com
The cost of the NHS is a matter of perspective | Letters
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