A damning forecast by the IMF is accurate, but fails to be honest about the WHO report that there is no NHS. Each Region and Post Code will have different forms of rationing, and no “Noticeboard” warning citizens what they need to plan for …. Even Mr Stevens thinks rationing has to happen – without mentioning the word it seems! The unreal denial in the RCGP and Prescription Charges Coalition documented in the Times is delaying the inevitable, but worse, it stops rationing being planned. Is this a conscious or unconscious collusion of politicians and leaders?
Taxes will have to rise if the government is to balance the books by the middle of the next decade and the NHS may have to be privatised, the International Monetary Fund has warned.
Property taxes, the removal of preferential VAT rates for goods such as pasties, and higher national insurance contributions by the self-employed need to be considered if Britain is to have any chance of eliminating its budget deficit by 2025 because spending cuts have gone about as far as they can, the global economic watchdog said in its annual review of the UK.
Weak productivity and the increasing care demands of an ageing population will make deficit reduction harder. Public services such as the NHS may have to be scaled back or privatised, it added.
The warnings are a reminder of the persistent problem of Britain’s public finances almost a decade after the financial crisis caused borrowing to soar. National debt is 87 per cent of GDP and spending on public services exceeds revenue from taxes by more than 2 per cent of GDP.
“Continued deficit reduction is critical to create further room to respond to future shocks,” Christine Lagarde, managing director of the IMF, said. “There is not much space for additional spending cuts and the revenue side of the equation has to be looked at.”
Britain is already forecast to be paying 34.3 per cent of GDP in tax by 2022, more than at any time since the 1950s, but economists estimate that at least £20 billion of extra austerity will be needed to hit the government’s target of balancing the books.
Ms Lagarde said population changes were adding to the problem. “Population ageing is expected to lead to material increases in spending on healthcare, pensions and long-term care, while productivity growth has been slow. And a slowly growing economy means fewer resources will be available to meet increased spending,” she said.
The public spending burden will soon make Britain face some hard choices, the IMF added. “The UK may face difficult decisions about the desired size of its public sector, as well as the mode of delivery and financing of public services. Brexit-related effects may exacerbate the challenge.”
To address the problem, Britain needs to boost productivity. Ms Lagarde welcomed the chancellor’s £31 billion fund for infrastructure investment and focus on technical qualifications because “the UK underinvests in infrastructure and falls short in human capital development”. But she said that more needed to be done “such as easing planning restrictions and reforming property taxes to boost housing supply”.
As well as introducing a land tax, the government should harmonise VAT for goods that get preferential rates and better “align the tax treatment of employees and the self-employed”. Both proposals have proved a poisoned chalice for chancellors. George Osborne tried to harmonise VAT rates for hot food in his “omnishambles budget” and Philip Hammond had to backtrack this year on raising national insurance for the self-employed. The IMF also recommended “reducing the tax code’s bias towards debt” and scrapping the triple lock on state pensions.
John McDonnell, the shadow chancellor, said: “The IMF has played the role of the ghosts of Christmas past, present and future to remind the chancellor that seven years of Tory failure is undermining our economy.”
Scrapping NHS prescriptions for anti-dandruff shampoo and indigestion tablets could fund thousands of cataract operations and hip replacements, health chiefs say.
Ending routine treatment for coughs, ulcers, piles and other conditions that will get better by themselves could save up to £136 million a year to spend on other care, NHS England calculates.
Simon Stevens, the head of NHS England, signalled the crackdown on over-the-counter remedies last month as part of cost-cutting plans and began consulting on the practicalities of the changes yesterday.
“To do the best for our patients and for taxpayers it’s vital the NHS uses its funding well,” he said. “This consultation gives the public the opportunity to help family doctors decide how best to deploy precious NHS resources, freeing-up money from the drugs bill to reinvest in modern treatments for conditions such as cancer, mental health and emergency care.”
The NHS spends £4.5 million a year on anti-dandruff shampoo, which Mr Stevens said could fund 4,700 cataract operations or 1,200 hip replacements. The £5.5 million cost of treating mouth ulcers could pay for 1,500 hip replacements and the £7.5 million spent on indigestion and heartburn could fund 300 community nurses…..
…Some over-the-counter remedies are cheaper than the cost to the NHS of prescribing, including £2.18 travel sickness tablets that cost taxpayers £35 once the costs of dispensing, administration and a GP’s time are included.
Helen Stokes-Lampard, chairwoman of the Royal College of GPs, said: “Where patients can afford to buy medication over the counter, we would certainly encourage them to do so. There are also many minor, self-limiting conditions for which patients don’t often need to seek medical assistance, or prescribed medication. What remains imperative — and we will be making this clear in our consultation response — is that no blanket bans are imposed, and GPs will retain the right to make clinical decisions.”
Matina Loizou, co-chairwoman of the Prescription Charges Coalition, added: “NHS England has decided to play the role of Ebenezer Scrooge this Christmas by launching this cruel consultation. If seen through, these proposals would be a catastrophic blow to some of the country’s most vulnerable and unwell people who rely on a variety of medication and treatments to live, work and be well.