The Regressive NHS

The National Health Service, in its own words, ‘was born out of a long-held ideal that good healthcare should be available to all, regardless of wealth’. Whether you support the provision of healthcare by the state or not, the concept is a somewhat noble cause. Certainly, the UK possesses widespread great pride and protective instincts regarding this institution. Our ability to rally behind and protect a service that is such a prevalent part of all our lives is nothing short of true magnificence.

However, is it also a contributing force in its ever-looming privatisation?

Before I risk polarising the readership, a brief explanation of the regressive and progressive forms of tax. Regressive tax is non-discriminatory, meaning everyone pays the same, regardless of any affecting factor and so has a greater effect on the poor. For example, if income tax was made a flat 10% across the board, those with very little income would be required to forgo that 10% of their income and it may decrease their quality of living substantially. Fortunately, the UK has implemented a progressive tax system, so called due to its apparent equality. Those who make minimum wage pay no tax up to £11,000 whilst those who make more must pay 20% tax on any income made above this figure but below £43,000, and so the “bands of tax” continue (more up-to-date information is available at, insuring that those on lower incomes don’t have to sacrifice the essentials just to pay tax whilst revenue is still made for nationally provided services.


But what if those services were banded too?


Whilst I agree that no one should be denied emergency treatment and that the NHS would by far be the best provider of these services, it has become clear that our nation’s Health Service cannot operate at the optimal rate that is required. Our Nurses and Doctors are continually stretched beyond their limits trying to provide the best possible care under ever-shrivelling budgets and ever expanding patient numbers. The government continues to look to the private sector to pick up the slack by slowly transforming the NHS into a hybrid of public service and private organisation. Whilst the NHS clearly needs help, there should always be a clear separation of private entities from the provision of state healthcare. Whilst the NHS is available to all, private companies will continually pressure the government to stop ‘stifling’ the market with a free alternative to their product. Furthermore, those who can afford the bills of a private doctor for many things will quite often not use private care but will take full advantage of a free service available to them. What if it were possible for private health companies to be involved in picking up the slack without seeing those who are at the mercy of the NHS as customers?


If it were possible to separate those who were truly in need of a national service as opposed to those who are simply taking advantage of a system that they have access to, then we could ensure that the NHS had the means to provide care that wasn’t letting the most vulnerable slip through the net whilst still having a completely medically covered populace.


The unfortunate reality is that we do not have the resources to know where to draw a line, where to cut people off from the NHS or even if we could at all. To fully cover those who truly need free healthcare, a significant proportion of the population would be left without, which no doubt would cause pandemonium whilst anything less would be a waste of time. Surely this unconventional system would not be feasible, or accepted by much of the outraged public.  


We are, as always, limited by our government’s organisational incompetence. I merely hope that our pride in the NHS won’t be what’s holding it back from adapting, and ultimately surviving.


Written By: James King


Author: alternativefactsuk

Current Affairs and Economics from Loud Voices

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