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Former RCN leader among experts calling for ringfenced health and care tax to fund NHS

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A panel of 10 health experts, including a former Royal College of Nursing leader, have called for a shake-up in the way that the NHS in England is funded in future.

A new tax earmarked solely for the NHS and social care is among the recommendations from the panel of 10 experts in a report commissioned by the Liberal Democrats and published on Monday.

“This report looks at ways we can tackle these deep seated challenges right across the system”

Peter Carter

The new report – titled Health and Social Care: Delivering a Secure Funding Future – will form the blueprint of the political party’s ongoing healthcare policy, it said in a statement accompanying the document.

The panel included figures such former NHS England chief executive Sir David Nicholson, former RCN chief executive Dr Peter Carter, and Professor Clare Gerada, former chair of the Royal College of GPs.

It concluded that the NHS in England needed a real terms funding increase of £4bn in 2018-19 and further real terms increases of £2.5bn in each of the following two years.

In the short-term, the NHS funding gap could be bridged by an income tax increase, the report noted in its report. But, for the longer-term, the panel recommended bringing together health and care funding in a single, ring-fenced tax which would replace National Insurance.

This should be combined with social care funding, which is currently raised through council tax, to raise the amount needed to sustain good quality services, it said.

“We will all rely on our NHS and social care to treat and support us at one time or another”

Judith Jolly

Other recommendations included creating an Office for Budget Responsibility for Health and introducing incentives to encourage people to save more towards adult social care.

Additional revenue for local authorities to invest in public health and reinstating the cap on the costs of adult social care were among the panel’s ideas.

The group also argued that consideration should be given to scrapping the total exemption from National Insurance Contributions for people who work beyond the age of 65.

Dr Peter Carter, who was RCN chief executive from 2007 to 2015, said: “Our NHS has tens of thousands of staff vacancies and is billions of pounds short of the funding it needs.



Peter Carter

“It is clear that we cannot carry on like this,” he said. “There is a desperate need for an injection of extra funding, but we must also look at longer term solutions to put services on a more sustainable footing.

“Whether this is enabling services to modernise and innovate, and encouraging prevention and more out of hospital care, this report looks at ways we can tackle these deep seated challenges right across the system,” he added.

Liberal Democrat health spokeswoman Judith Jolly said: “We will all rely on our NHS and social care to treat and support us at one time or another.

“These services, and the hard working staff who run them, deserve more than to be left to struggle through another crisis, barely able to make ends meet,” she said.

She added: “The introduction of an ‘OBR for Health’ would mean independent, reliable and long-term forecasting of exactly what resource is needed to carry on providing the high quality care we all have the right to expect. I whole heartedly welcome this recommendation.”

The panel comprised:

  • Sir David Nicholson, former chief executive of NHS England
  • Dr Peter Carter, former chief executive of the Royal College of Nursing
  • Katherine Murphy, former chief executive of the Patients Association
  • Professor Clare Gerada, former chair of the Royal College of General Practitioners
  • Professor Dinesh Bhugara, emeritus professor of mental health and cultural diversity and president of the World Psychiatric Association
  • Sir Stephen Bubb, chief executive of Charity Futures and former chief executive of the Association of Chief Executives of Voluntary Organisations
  • Amna Ahmad, health campaigner and NHS policy expert
  • Professor Paul McCrone, health economist
  • Cllr Richard Kemp, leader of Liverpool Liberal Democrats and deputy chair of the Local Government Association’s Community Wellbeing Board
  • Professor Nick Bosanquet, professor of healthcare policy at Imperial College
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