Best Of

In the end I think Leon is right, the mood music in the country has turned decisively against immigration and asylum seekers, it is only going to get more negative towards it as Labour are unable to deport the illegal immigrants or stop the boats so of Reform don't have the stomach then the public will inevitably vote in a party that does or the Tories will step in and become that party.

The prevailing view when the modern experiment in mass migration began was that people might be a bit angry in the short term, but they'll get over it and we'll all be better off in the long run, so any opposition should just be ignored or managed. It's proving to have been a terrible mistake.

I think if immigration had been limited to people with earnings over the higher rate threshold then this might have been the case. As it is with millions of people arriving on unskilled, student and dependent visas who contribute far, far less than they receive in state services it has been an unmitigated disaster since about 2005. Wrt illegal immigration the current or next government will need to get a Rwanda style agreement up and running, clear any and all legal hurdles with primary legislation, abrogating treaties and agreements if necessary and just putting people on planes and deporting them to somewhere not the UK or giving them a chance to self deport if they don't want to do that (see the illegal immigrants in the US self deporting rather than risk ending up in El Salvador).

Make clear that there is no chance of staying in the UK under any circumstances so it's go home on a commercial flight or go to Rwanda, if they've burned their passports etc... then it's go to Rwanda by default unless they can arrange for a new passport to be issued by their home country.

There is an argument that high-skilled migration crowds out the current population from the best paying jobs. Instead of having a half-decent education system or allowing people to progress from the bottom rung to the top, just get some foreign graduate in to do the job instead.

Both my grandfathers did not have degrees yet ended up in relatively senior positions in international firms. One literally started washing windows aged 16, the other on the factory floor. Both were trained up by their firms, sent abroad to get some experience, had their childcare and sometimes housing paid for etc etc. That must be pretty rare nowadays.

Wages are far too crude a measure anyway. I like the idea of a visa that allows people to install solar panels for four years. That won't be particularly well-paid, but it will mean we get over the hump of the Green transition more quickly and cheaply than otherwise. Then we can have a smaller workforce of technicians who replace them when need or fix any problems for the next 30+ years.

Which is why you'd set a much higher bar than graduate salaries. I'd have put the £38.9k up to £55k nationally and £75k for jobs in London already to ensure that companies still have an interest in upskilling and training for juniors rather than just hiring someone from overseas.

I'm not opposed to temporary single time or seasonal work visas for specific projects, however they shouldn't be allowed to import labour for the whole thing even if it makes the project or company unviable. Fundamentally what's the point in having an industry or company if it's low margin, employs and entirely foreign workforce of temporary visa holders and creates little wealth beyond that of the owners/shareholders who are likely to also be foreign.

Wages are market pricing of value, it's the fairest way to measure who should or shouldn't come to the UK. There may be some outliers in some industries but I doubt it's worth it.

As an employer of around 80 mixed skill staff I have a pretty good perspective on the jobs market. There are a large number of young UK graduates who get paid relatively little on an international scale. These graduates are competing with a vast quantity of mostly Indian and African recently arrived graduates on variable quality. We recently hired a recent graduate in Birmingham area. Over 300 applications with 90% of foreign heritage. Ended up hiring Indian recent graduate. Note their salary will be less than 10% above minimum wage. There appear to be large number of UK local graduates who are not really trying to get a job. They apply and don't turn up for interviews or respond to emails.

For non skilled workers recruiting UK workers is becoming very difficult. Many of them have chaotic lives which sooner or later impact on their work. For many the differential between benefits and paid work is marginal. In addition with all the recent changes the pressure on them to perform is huge to justify their wage plus NI plus pension etc. The majority of our unskilled staff are now East European.

The jobs market was in trouble and is now completely broken. Labour ramped up salary costs dramatically, For us this was the equivalent of losing 2 staff members, We have also like many others looked to both increase automation and outsource labour internationally. I recently listened to the head of Reed on LBC who was explaining we are in the worst job recession for his 30 years experience. Private sector has shed 250,000 jobs in the last year, This at a tine where the country is awash with new labour. Maybe 100,000 graduates have gone onto PIP in last year and others on UC. Others are becoming perpetual students. The chance of following your grandfather route is close to zero.

The Government has to stop worrying about supply of labour which is already too much and focus on the creation of good quality jobs in large numbers within the private sector. I see no evidence of this and so the resentment will continue to grow,

The NHS is just broken for ordinary people it seems. If you fit into one of the “pathways” (cancer, stroke, heart disease) then you get treated in a timely fashion (most of the time), but those are mostly the diseases of old people. For the young, the NHS is a failure that pretends to treat them & then keeps them dangling with the hope of treatment that might manifest itself sometime, maybe.

I'm currently awaiting eye surgery for the second time. First it was the left eye which took three years from initial referral to surgery. Now with the right eye I'm told it's likely to be over a year just to get an initial consultation and two and a half to three years after that for surgery.

So in total I'll likely have spent seven or more years partially sighted because of a condition that is easily treated with a fairly minor, if delicate, procedure. I'm lucky, I've always had one functioning eye and can keep on working. But I wonder just how much of our bloated benefits bill is due to people who can't work because the NHS is incapable of fixing their problems in any reasonable time frame.

It's time to outline £100bn in spending cuts and tax rises, split 75% towards spending cuts with the majority coming from welfare and entitlements. If the government doesn't do this and continues to borrow like a drunken sailor we're heading for a bond vigilante strike and another bout of QE which will push inflation up and destroy people's disposable incomes.

The only way out is to cut welfare spending and get people back into work. We can't afford to pay the lazy to sit at home doing nothing on benefits.

'Benefits' according to the OBR are £150bn on Pensioners; £88bn on UC; and £74bn on other benefits. Where would you axe to get the £100bn?

Should we get pensioners back into work?

£20bn each out of UC and "other" benefits.

Cut the triple lock entirely.

£20bn out of the state pension by tapering above £40k, spend half of the saving on increasing the state pension for those who don't have any or significant private income in retirement.

NI payable on all income types/merge NI and income tax.

50% haircut on defined benefit public sector pensions for amounts over £40k (so a £60k DB pension becomes £50k).

Freeze thresholds for a further 3 years.

Cut at least 500k public sector jobs within two years, ban use of agency staff and severely limit the use of consultants and contractors. Use half of those savings to offer competitive salaries for technical roles.

I think that would probably make a £100bn worth of closing the deficit, the resulting fall in bond yields and inflation would probably add another £20bn saving per year on the interest bill.

And means test the NHS for the wealthy

Define wealthy.

Otherwise people like me will either die because they can't afford treatment (and I am already at high risk of early death because of the NHS's failures to spot stages 1, 2 or 3 of my cancer) - and I can't - or be bankrupted and made homeless.

As for the state pension, it gets taxed if the pensioner has other income.

One of the reasons for the deficit is the amount spent on furlough during Covid - money largely spent on those in jobs and to keep them in jobs. It was about £140 billion. They too should contribute.

- 1p on income tax.
- Extend VAT to food, books/newspapers & children's clothes.
- NI for everyone who works.
- Limit or abolish tax relief for those giving to charity and place an upper limit on the tax saved by those contributing to charity whether alive or after death.
- Limit tax relief for pension contributions to the basic rate.
- Extend VAT on education to all education providers, including universities.
- Freeze thresholds.
- Place a limit on public sector pay increases (the amount shovelled at train drivers by Reeves never gets mentioned here but it was a stupid move).
- Abolish the WFA and other pension-specific benefits. Aim for the state pension to be the same as the tax free income as and when we can afford it.
- Abolish the triple lock.
- Those with assets should contribute something towards social care.
- Introduce council tax bands for higher value houses.
- Increase or widen the charges for council services beyond the basic.
- Ensure that overseas visitors pay for the NHS. Other countries manage this. So can we.
- Limit tax relief for private equity companies loading companies up with debt, taking dividends and asset stripping. (Thames Water and other companies in a similar position should be allowed to go bust and then nationalised for a £. Too often asset stripping has been presented as overseas investment. It is a gigantic con.)

And so on.

There is a nasty streak among some of the commentary on here. Everyone seems to want others to pay taxes and those who work on here seem to think that they should be exempt from any measures to help pay down the deficit, thinking it must all be done by the poor and the old. It also gives the impression that some welcome AD because they will be able to pressure the old and sick into killing themselves to save money or withhold treatment so that they suffer. It is disgustingly frankly. I am surprised to see @Big_G_NorthWales among their number

Can I just say that wealthy to me include celebrities and multi millionaires who can contribute to the NHS

As far as your list is concerned I agree with each and every one and it needs a government to accept we cannot continue borrowing, spending and taxing and think the unthinkable

I want the NHS available to all but those with the broadest shoulders should contribute as indeed should the pension be reviewed as to just who should receive this very expensive benefit

They do contribute - as indeed have I - through taxes. In my case for decades. But there is no justification for denying the NHS to people who are seriously or terminally ill. You are advocating for a US style system which will harm the sick. I am one of their number and I think it disgusting that you should wish to deprive me of the NHS when I need it most. You do not define what wealthy means - name a figure and let's see what this actually means.

Indeed, means testing the NHS and barring the wealthy just seems like an odd and very mean spirited thing to do. From a practical sense I doubt it would save very much money given that the "wealthy" that BigG mentions are likely to have private health insurance and it breaks the idea that all British citizens/residents get treated equally by the health service, rich and poor alike get the same (sometimes not very good, sometimes excellent) treatment.

The comment about those with the broadest shoulders contributing is also very off colour for BigG, I think he's been watching too much Jez on Tiktok or something. At my peak earnings a few years ago my net rate of tax was 43% and I paid well into six figures per year in tax, to suggest that the "wealthy" don't already make a huge contribution is factually incorrect. Indeed it is this anti-wealth attitude among those who call themselves conservative that resulted in the previous government just ceding the subject of wealth creation to the left.

No one ever suggests giving a tax rebate/benefit to anyone who has private health insurance which helps take the pressure off our sainted NHS.

Generally the choke point is the same pool of consultants and specialists that you have to see, before (and often during) getting private treatment that also give a proportion of their time to the NHS, with the private patients essentially paying to jump the queue. If there was incentive for a significant batch of people to switch to private, either private waiting times would increase dramatically, or consultants would do more private work and less NHS, making the NHS position worse.

The governments approach of using the over capacity in the private sector to deal with the NHS backlog is the more sensible one. Continuing what the Tories were doing before.

The absurd rationing of testing continues.

I know more and more people who pay private facilities to get MRIs etc. XRays seem to be easier in the NHS system.

Early detection of problems is cheaper.

Indeed, my dad just had this issue (hence my suggestion in the previous comment). He has had a knee problem for about 15 years, it's suddenly got a lot worse so he went to see the doctor. Long story short, after about 6 months of hearing nothing back from the NHS on getting a scan he went private and got a scan done - they said his right knee is basically completely deteriorated and he needs surgery.

He wanted to make sure that this was necessary so he arranged finally got an appointment with the NHS specialist a few months down the road who looked at the scan and said words to the effect of "we wouldn't recommend surgery at this stage because the degradation doesn't meet our requirements for it, basically you can still walk around for up to a mile or so before it starts really hurting". He then asked if he could go private would that advice change and the specialist said "yes, get this done ASAP because it will seriously improve your life quality and in 10 years when this gets to the point where the NHS will consider it degraded enough to operate you may not be eligible due to age and poor likelihood of recovery". It's a completely mental situation. They're knowingly saying no/delaying huge life improving surgery to people knowing that 10 years down the road it will cause huge issues for these people, well at least for those people who can't afford to go private.

This is the kind of stuff that I really think is low hanging fruit for the NHS, cheap preventative care today reduces our future liability by huge amounts and that's where I would be looking for gains. They may not show immediately but in 2-3 years there would be a noticeable drop in resource demand.

It's time to outline £100bn in spending cuts and tax rises, split 75% towards spending cuts with the majority coming from welfare and entitlements. If the government doesn't do this and continues to borrow like a drunken sailor we're heading for a bond vigilante strike and another bout of QE which will push inflation up and destroy people's disposable incomes.

The only way out is to cut welfare spending and get people back into work. We can't afford to pay the lazy to sit at home doing nothing on benefits.

'Benefits' according to the OBR are £150bn on Pensioners; £88bn on UC; and £74bn on other benefits. Where would you axe to get the £100bn?

Should we get pensioners back into work?

£20bn each out of UC and "other" benefits.

Cut the triple lock entirely.

£20bn out of the state pension by tapering above £40k, spend half of the saving on increasing the state pension for those who don't have any or significant private income in retirement.

NI payable on all income types/merge NI and income tax.

50% haircut on defined benefit public sector pensions for amounts over £40k (so a £60k DB pension becomes £50k).

Freeze thresholds for a further 3 years.

Cut at least 500k public sector jobs within two years, ban use of agency staff and severely limit the use of consultants and contractors. Use half of those savings to offer competitive salaries for technical roles.

I think that would probably make a £100bn worth of closing the deficit, the resulting fall in bond yields and inflation would probably add another £20bn saving per year on the interest bill.

And means test the NHS for the wealthy

Define wealthy.

Otherwise people like me will either die because they can't afford treatment (and I am already at high risk of early death because of the NHS's failures to spot stages 1, 2 or 3 of my cancer) - and I can't - or be bankrupted and made homeless.

As for the state pension, it gets taxed if the pensioner has other income.

One of the reasons for the deficit is the amount spent on furlough during Covid - money largely spent on those in jobs and to keep them in jobs. It was about £140 billion. They too should contribute.

- 1p on income tax.
- Extend VAT to food, books/newspapers & children's clothes.
- NI for everyone who works.
- Limit or abolish tax relief for those giving to charity and place an upper limit on the tax saved by those contributing to charity whether alive or after death.
- Limit tax relief for pension contributions to the basic rate.
- Extend VAT on education to all education providers, including universities.
- Freeze thresholds.
- Place a limit on public sector pay increases (the amount shovelled at train drivers by Reeves never gets mentioned here but it was a stupid move).
- Abolish the WFA and other pension-specific benefits. Aim for the state pension to be the same as the tax free income as and when we can afford it.
- Abolish the triple lock.
- Those with assets should contribute something towards social care.
- Introduce council tax bands for higher value houses.
- Increase or widen the charges for council services beyond the basic.
- Ensure that overseas visitors pay for the NHS. Other countries manage this. So can we.
- Limit tax relief for private equity companies loading companies up with debt, taking dividends and asset stripping. (Thames Water and other companies in a similar position should be allowed to go bust and then nationalised for a £. Too often asset stripping has been presented as overseas investment. It is a gigantic con.)

And so on.

There is a nasty streak among some of the commentary on here. Everyone seems to want others to pay taxes and those who work on here seem to think that they should be exempt from any measures to help pay down the deficit, thinking it must all be done by the poor and the old. It also gives the impression that some welcome AD because they will be able to pressure the old and sick into killing themselves to save money or withhold treatment so that they suffer. It is disgustingly frankly. I am surprised to see @Big_G_NorthWales among their number

Can I just say that wealthy to me include celebrities and multi millionaires who can contribute to the NHS

As far as your list is concerned I agree with each and every one and it needs a government to accept we cannot continue borrowing, spending and taxing and think the unthinkable

I want the NHS available to all but those with the broadest shoulders should contribute as indeed should the pension be reviewed as to just who should receive this very expensive benefit

They do contribute - as indeed have I - through taxes. In my case for decades. But there is no justification for denying the NHS to people who are seriously or terminally ill. You are advocating for a US style system which will harm the sick. I am one of their number and I think it disgusting that you should wish to deprive me of the NHS when I need it most. You do not define what wealthy means - name a figure and let's see what this actually means.

Indeed, means testing the NHS and barring the wealthy just seems like an odd and very mean spirited thing to do. From a practical sense I doubt it would save very much money given that the "wealthy" that BigG mentions are likely to have private health insurance and it breaks the idea that all British citizens/residents get treated equally by the health service, rich and poor alike get the same (sometimes not very good, sometimes excellent) treatment.

The comment about those with the broadest shoulders contributing is also very off colour for BigG, I think he's been watching too much Jez on Tiktok or something. At my peak earnings a few years ago my net rate of tax was 43% and I paid well into six figures per year in tax, to suggest that the "wealthy" don't already make a huge contribution is factually incorrect. Indeed it is this anti-wealth attitude among those who call themselves conservative that resulted in the previous government just ceding the subject of wealth creation to the left.

No one ever suggests giving a tax rebate/benefit to anyone who has private health insurance which helps take the pressure off our sainted NHS.

Generally the choke point is the same pool of consultants and specialists that you have to see, before (and often during) getting private treatment that also give a proportion of their time to the NHS, with the private patients essentially paying to jump the queue. If there was incentive for a significant batch of people to switch to private, either private waiting times would increase dramatically, or consultants would do more private work and less NHS, making the NHS position worse.

The governments approach of using the over capacity in the private sector to deal with the NHS backlog is the more sensible one. Continuing what the Tories were doing before.

The absurd rationing of testing continues.

I know more and more people who pay private facilities to get MRIs etc. XRays seem to be easier in the NHS system.

Early detection of problems is cheaper.

Indeed, my dad just had this issue (hence my suggestion in the previous comment). He has had a knee problem for about 15 years, it's suddenly got a lot worse so he went to see the doctor. Long story short, after about 6 months of hearing nothing back from the NHS on getting a scan he went private and got a scan done - they said his right knee is basically completely deteriorated and he needs surgery.

He wanted to make sure that this was necessary so he arranged finally got an appointment with the NHS specialist a few months down the road who looked at the scan and said words to the effect of "we wouldn't recommend surgery at this stage because the degradation doesn't meet our requirements for it, basically you can still walk around for up to a mile or so before it starts really hurting". He then asked if he could go private would that advice change and the specialist said "yes, get this done ASAP because it will seriously improve your life quality and in 10 years when this gets to the point where the NHS will consider it degraded enough to operate you may not be eligible due to age and poor likelihood of recovery". It's a completely mental situation. They're knowingly saying no/delaying huge life improving surgery to people knowing that 10 years down the road it will cause huge issues for these people, well at least for those people who can't afford to go private.

This is the kind of stuff that I really think is low hanging fruit for the NHS, cheap preventative care today reduces our future liability by huge amounts and that's where I would be looking for gains. They may not show immediately but in 2-3 years there would be a noticeable drop in resource demand.

Our youngest had an ingrown toenail a couple of years ago. After going through the initial stages of treatment with our NHS GP (which consisted understandably of “give it a couple of weeks to see if it sorts itself out”) the GP referred him to get it looked at by a specialist. By the time the letter from the specialist dept had arrived to tell us we had been booked for an initial appointment another four months later we had already given up on the NHS & taken him to a private specialist who had diagnosed it as needing surgery & carried that surgery out that week - removing an impressively large chunk of toenail that had grown off sideways into the depths of his big toe in the process!

The specialist said the likely time from initial diagnostic appointment to actual surgery on the NHS was between 9-12 months in his experience.

The NHS is just broken for ordinary people it seems. If you fit into one of the “pathways” (cancer, stroke, heart disease) then you get treated in a timely fashion (most of the time), but those are mostly the diseases of old people. For the young, the NHS is a failure that pretends to treat them & then keeps them dangling with the hope of treatment that might manifest itself sometime, maybe.

We need to get back to the idea that the NHS sees getting working age people back into work as quickly as reasonably possible a priority.

We looked at this quite closely in terms of private health care for our staff at the Faculty. The staff got private health care as a part of their package of employment. It wasn't cheap and when things got tough in the period during Covid we looked at it. The conclusion was that although it was not cheap having staff off sick waiting for NHS treatment would cost us even more and it was good value.

When you get to that point the NHS is simply not delivering for working people, unless you fit into one of the categories that they care about, basically women's cancers. And it employs over 1.5m people and costs almost a third of all public expenditure. Something has gone very seriously wrong.

It's time to outline £100bn in spending cuts and tax rises, split 75% towards spending cuts with the majority coming from welfare and entitlements. If the government doesn't do this and continues to borrow like a drunken sailor we're heading for a bond vigilante strike and another bout of QE which will push inflation up and destroy people's disposable incomes.

The only way out is to cut welfare spending and get people back into work. We can't afford to pay the lazy to sit at home doing nothing on benefits.

'Benefits' according to the OBR are £150bn on Pensioners; £88bn on UC; and £74bn on other benefits. Where would you axe to get the £100bn?

Should we get pensioners back into work?

£20bn each out of UC and "other" benefits.

Cut the triple lock entirely.

£20bn out of the state pension by tapering above £40k, spend half of the saving on increasing the state pension for those who don't have any or significant private income in retirement.

NI payable on all income types/merge NI and income tax.

50% haircut on defined benefit public sector pensions for amounts over £40k (so a £60k DB pension becomes £50k).

Freeze thresholds for a further 3 years.

Cut at least 500k public sector jobs within two years, ban use of agency staff and severely limit the use of consultants and contractors. Use half of those savings to offer competitive salaries for technical roles.

I think that would probably make a £100bn worth of closing the deficit, the resulting fall in bond yields and inflation would probably add another £20bn saving per year on the interest bill.

And means test the NHS for the wealthy

Define wealthy.

Otherwise people like me will either die because they can't afford treatment (and I am already at high risk of early death because of the NHS's failures to spot stages 1, 2 or 3 of my cancer) - and I can't - or be bankrupted and made homeless.

As for the state pension, it gets taxed if the pensioner has other income.

One of the reasons for the deficit is the amount spent on furlough during Covid - money largely spent on those in jobs and to keep them in jobs. It was about £140 billion. They too should contribute.

- 1p on income tax.
- Extend VAT to food, books/newspapers & children's clothes.
- NI for everyone who works.
- Limit or abolish tax relief for those giving to charity and place an upper limit on the tax saved by those contributing to charity whether alive or after death.
- Limit tax relief for pension contributions to the basic rate.
- Extend VAT on education to all education providers, including universities.
- Freeze thresholds.
- Place a limit on public sector pay increases (the amount shovelled at train drivers by Reeves never gets mentioned here but it was a stupid move).
- Abolish the WFA and other pension-specific benefits. Aim for the state pension to be the same as the tax free income as and when we can afford it.
- Abolish the triple lock.
- Those with assets should contribute something towards social care.
- Introduce council tax bands for higher value houses.
- Increase or widen the charges for council services beyond the basic.
- Ensure that overseas visitors pay for the NHS. Other countries manage this. So can we.
- Limit tax relief for private equity companies loading companies up with debt, taking dividends and asset stripping. (Thames Water and other companies in a similar position should be allowed to go bust and then nationalised for a £. Too often asset stripping has been presented as overseas investment. It is a gigantic con.)

And so on.

There is a nasty streak among some of the commentary on here. Everyone seems to want others to pay taxes and those who work on here seem to think that they should be exempt from any measures to help pay down the deficit, thinking it must all be done by the poor and the old. It also gives the impression that some welcome AD because they will be able to pressure the old and sick into killing themselves to save money or withhold treatment so that they suffer. It is disgustingly frankly. I am surprised to see @Big_G_NorthWales among their number

Can I just say that wealthy to me include celebrities and multi millionaires who can contribute to the NHS

As far as your list is concerned I agree with each and every one and it needs a government to accept we cannot continue borrowing, spending and taxing and think the unthinkable

I want the NHS available to all but those with the broadest shoulders should contribute as indeed should the pension be reviewed as to just who should receive this very expensive benefit

They do contribute - as indeed have I - through taxes. In my case for decades. But there is no justification for denying the NHS to people who are seriously or terminally ill. You are advocating for a US style system which will harm the sick. I am one of their number and I think it disgusting that you should wish to deprive me of the NHS when I need it most. You do not define what wealthy means - name a figure and let's see what this actually means.

Indeed, means testing the NHS and barring the wealthy just seems like an odd and very mean spirited thing to do. From a practical sense I doubt it would save very much money given that the "wealthy" that BigG mentions are likely to have private health insurance and it breaks the idea that all British citizens/residents get treated equally by the health service, rich and poor alike get the same (sometimes not very good, sometimes excellent) treatment.

The comment about those with the broadest shoulders contributing is also very off colour for BigG, I think he's been watching too much Jez on Tiktok or something. At my peak earnings a few years ago my net rate of tax was 43% and I paid well into six figures per year in tax, to suggest that the "wealthy" don't already make a huge contribution is factually incorrect. Indeed it is this anti-wealth attitude among those who call themselves conservative that resulted in the previous government just ceding the subject of wealth creation to the left.

No one ever suggests giving a tax rebate/benefit to anyone who has private health insurance which helps take the pressure off our sainted NHS.

Generally the choke point is the same pool of consultants and specialists that you have to see, before (and often during) getting private treatment that also give a proportion of their time to the NHS, with the private patients essentially paying to jump the queue. If there was incentive for a significant batch of people to switch to private, either private waiting times would increase dramatically, or consultants would do more private work and less NHS, making the NHS position worse.

The governments approach of using the over capacity in the private sector to deal with the NHS backlog is the more sensible one. Continuing what the Tories were doing before.

The absurd rationing of testing continues.

I know more and more people who pay private facilities to get MRIs etc. XRays seem to be easier in the NHS system.

Early detection of problems is cheaper.

Indeed, my dad just had this issue (hence my suggestion in the previous comment). He has had a knee problem for about 15 years, it's suddenly got a lot worse so he went to see the doctor. Long story short, after about 6 months of hearing nothing back from the NHS on getting a scan he went private and got a scan done - they said his right knee is basically completely deteriorated and he needs surgery.

He wanted to make sure that this was necessary so he arranged finally got an appointment with the NHS specialist a few months down the road who looked at the scan and said words to the effect of "we wouldn't recommend surgery at this stage because the degradation doesn't meet our requirements for it, basically you can still walk around for up to a mile or so before it starts really hurting". He then asked if he could go private would that advice change and the specialist said "yes, get this done ASAP because it will seriously improve your life quality and in 10 years when this gets to the point where the NHS will consider it degraded enough to operate you may not be eligible due to age and poor likelihood of recovery". It's a completely mental situation. They're knowingly saying no/delaying huge life improving surgery to people knowing that 10 years down the road it will cause huge issues for these people, well at least for those people who can't afford to go private.

This is the kind of stuff that I really think is low hanging fruit for the NHS, cheap preventative care today reduces our future liability by huge amounts and that's where I would be looking for gains. They may not show immediately but in 2-3 years there would be a noticeable drop in resource demand.

Our youngest had an ingrown toenail a couple of years ago. After going through the initial stages of treatment with our NHS GP (which consisted understandably of “give it a couple of weeks to see if it sorts itself out”) the GP referred him to get it looked at by a specialist. By the time the letter from the specialist dept had arrived to tell us we had been booked for an initial appointment another four months later we had already given up on the NHS & taken him to a private specialist who had diagnosed it as needing surgery & carried that surgery out that week - removing an impressively large chunk of toenail that had grown off sideways into the depths of his big toe in the process!

The specialist said the likely time from initial diagnostic appointment to actual surgery on the NHS was between 9-12 months in his experience.

The NHS is just broken for ordinary people it seems. If you fit into one of the “pathways” (cancer, stroke, heart disease) then you get treated in a timely fashion (most of the time), but those are mostly the diseases of old people. For the young, the NHS is a failure that pretends to treat them & then keeps them dangling with the hope of treatment that might manifest itself sometime, maybe.

We need to get back to the idea that the NHS sees getting working age people back into work as quickly as reasonably possible a priority.

I know of people waiting over two years to get access to CAMHS in Edinburgh.

Two years is quick, for most.

The rape case I did last week involved a young woman whose legal guardian claimed had a mental age of 6. She was in residential care but had freedom of movement. She was raped and enormously distressed. Medical evidence said, remarkably, that she understood enough about sex to consent or withhold her consent.

Her guardian contacted Social work the night it happened who did ...nothing. When the guardian got back from her holiday she took her to the police but it was too late to get medical support for the claim. The man was convicted by the evidence of the distress and what was said to the guardian hours after the assault. It was close, a majority verdict.

The lack of care of such an obviously vulnerable young woman frankly made me incandescent. So many jobsworths are paid to look after people and just don't give a damn. This case involved an indigenous Scot but it demonstrated all so clearly how the victims we are not supposed to talk about get taken advantage of.

We are spending a fortune on these services. We are not getting results.

That's absolutely shocking and glad the jury came back with the correct decision, even by majority verdict. These are the kinds of cases why people like me suggest that burning it all down and starting again can't be worse than what we have now. People are being failed by the state at an alarming rate, whether that's cases like these which are absolutely awful, the NHS in lots of areas, the police are failing the public at large on crime, the judiciary are failing the public in deportations, politicians are failing us on all fronts.

The UK is getting closer and closer to becoming a failed state so maybe some tough medicine is what the state needs, not more of the same.

I have recently started ‘Who dares, win’ by Dominic Sandbrook on the early Thatcher years. The opening chapters have laid bare the state of the nation in 1979 and the radical approach that Thatchers government took, including the realisation that there would be pain for some but it would be worth it in the end.*

There is no sense that any political party is prepared to undertake policies that might have short term pain for long term gain. Take Labour. They wanted to slash WFA soeniding and failed to hold their nerve. And again on PIP. I am not commenting on the right or wrong of either more the lack of political guts to suffer even a tiny bit of kick back from policy.

We have to start living more within our means. Increase tax, reduce spending and find a way to economic growth. And we need to accept that it will hurt for some. No one wants to punish people unfortunate to be unable to work or look after themselves. But we risk being taken for mugs when ‘feeling a bit sad sometimes’ elicits money for free.

Someone in the room needs to tell the country hard truths. And it’s about time we listened to them. The party is over, now it’s time to pay the bills and tidy up.

*Opinion is divided on this.

I think also that Britain probably needs a Prime Minister who is willing to say that they aren't going to try and fix every problem in the country, because such a task is not something that government can do alone.

I'm not old enough to remember in detail what it was like before Blair, but Blair always gave the impression that he was going to personally intervene to fix every problem - hence czars and the PM's office monitoring targets.

That doesn't work. When the centre tries to run everything not only is that a problem when a complete nutter takes over the centre, but it leads to the centre promulgating set procedures for workers to follow, and targets to ensure that they are. This creates legions of people afraid to think for themselves and use their own judgement, and working only towards the target, following procedure, and blind to the negative consequences to the real people involved.

Britain needs a leader who will inspire people to work hard to improve things, who will delegate power to allow them to do so.

I can understand Max's frustration, but I think he's very wrong to think that it can't get worse. What is happening in the US should demonstrate that it can get a lot worse indeed. My impression is that there are a lot of things that are only just holding together due to the efforts of a minority of committed people. If you sweep those people aside with a year zero plan then you'll really see how bad they can get.

Well said. Things can almost always get worse. I was young and furious at George W Bush who I saw as the worst possible leader for America. Now I'd take him in a heartbeat over Trump. I was angry at David Cameron who seemed awful to me. But clearly in retrospect a much better leader than Johnson or Truss.

It's time to outline £100bn in spending cuts and tax rises, split 75% towards spending cuts with the majority coming from welfare and entitlements. If the government doesn't do this and continues to borrow like a drunken sailor we're heading for a bond vigilante strike and another bout of QE which will push inflation up and destroy people's disposable incomes.

The only way out is to cut welfare spending and get people back into work. We can't afford to pay the lazy to sit at home doing nothing on benefits.

'Benefits' according to the OBR are £150bn on Pensioners; £88bn on UC; and £74bn on other benefits. Where would you axe to get the £100bn?

Should we get pensioners back into work?

£20bn each out of UC and "other" benefits.

Cut the triple lock entirely.

£20bn out of the state pension by tapering above £40k, spend half of the saving on increasing the state pension for those who don't have any or significant private income in retirement.

NI payable on all income types/merge NI and income tax.

50% haircut on defined benefit public sector pensions for amounts over £40k (so a £60k DB pension becomes £50k).

Freeze thresholds for a further 3 years.

Cut at least 500k public sector jobs within two years, ban use of agency staff and severely limit the use of consultants and contractors. Use half of those savings to offer competitive salaries for technical roles.

I think that would probably make a £100bn worth of closing the deficit, the resulting fall in bond yields and inflation would probably add another £20bn saving per year on the interest bill.

And means test the NHS for the wealthy

Define wealthy.

Otherwise people like me will either die because they can't afford treatment (and I am already at high risk of early death because of the NHS's failures to spot stages 1, 2 or 3 of my cancer) - and I can't - or be bankrupted and made homeless.

As for the state pension, it gets taxed if the pensioner has other income.

One of the reasons for the deficit is the amount spent on furlough during Covid - money largely spent on those in jobs and to keep them in jobs. It was about £140 billion. They too should contribute.

- 1p on income tax.
- Extend VAT to food, books/newspapers & children's clothes.
- NI for everyone who works.
- Limit or abolish tax relief for those giving to charity and place an upper limit on the tax saved by those contributing to charity whether alive or after death.
- Limit tax relief for pension contributions to the basic rate.
- Extend VAT on education to all education providers, including universities.
- Freeze thresholds.
- Place a limit on public sector pay increases (the amount shovelled at train drivers by Reeves never gets mentioned here but it was a stupid move).
- Abolish the WFA and other pension-specific benefits. Aim for the state pension to be the same as the tax free income as and when we can afford it.
- Abolish the triple lock.
- Those with assets should contribute something towards social care.
- Introduce council tax bands for higher value houses.
- Increase or widen the charges for council services beyond the basic.
- Ensure that overseas visitors pay for the NHS. Other countries manage this. So can we.
- Limit tax relief for private equity companies loading companies up with debt, taking dividends and asset stripping. (Thames Water and other companies in a similar position should be allowed to go bust and then nationalised for a £. Too often asset stripping has been presented as overseas investment. It is a gigantic con.)

And so on.

There is a nasty streak among some of the commentary on here. Everyone seems to want others to pay taxes and those who work on here seem to think that they should be exempt from any measures to help pay down the deficit, thinking it must all be done by the poor and the old. It also gives the impression that some welcome AD because they will be able to pressure the old and sick into killing themselves to save money or withhold treatment so that they suffer. It is disgustingly frankly. I am surprised to see @Big_G_NorthWales among their number

Can I just say that wealthy to me include celebrities and multi millionaires who can contribute to the NHS

As far as your list is concerned I agree with each and every one and it needs a government to accept we cannot continue borrowing, spending and taxing and think the unthinkable

I want the NHS available to all but those with the broadest shoulders should contribute as indeed should the pension be reviewed as to just who should receive this very expensive benefit

They do contribute - as indeed have I - through taxes. In my case for decades. But there is no justification for denying the NHS to people who are seriously or terminally ill. You are advocating for a US style system which will harm the sick. I am one of their number and I think it disgusting that you should wish to deprive me of the NHS when I need it most. You do not define what wealthy means - name a figure and let's see what this actually means.

Indeed, means testing the NHS and barring the wealthy just seems like an odd and very mean spirited thing to do. From a practical sense I doubt it would save very much money given that the "wealthy" that BigG mentions are likely to have private health insurance and it breaks the idea that all British citizens/residents get treated equally by the health service, rich and poor alike get the same (sometimes not very good, sometimes excellent) treatment.

The comment about those with the broadest shoulders contributing is also very off colour for BigG, I think he's been watching too much Jez on Tiktok or something. At my peak earnings a few years ago my net rate of tax was 43% and I paid well into six figures per year in tax, to suggest that the "wealthy" don't already make a huge contribution is factually incorrect. Indeed it is this anti-wealth attitude among those who call themselves conservative that resulted in the previous government just ceding the subject of wealth creation to the left.

No one ever suggests giving a tax rebate/benefit to anyone who has private health insurance which helps take the pressure off our sainted NHS.

Generally the choke point is the same pool of consultants and specialists that you have to see, before (and often during) getting private treatment that also give a proportion of their time to the NHS, with the private patients essentially paying to jump the queue. If there was incentive for a significant batch of people to switch to private, either private waiting times would increase dramatically, or consultants would do more private work and less NHS, making the NHS position worse.

The governments approach of using the over capacity in the private sector to deal with the NHS backlog is the more sensible one. Continuing what the Tories were doing before.

The absurd rationing of testing continues.

I know more and more people who pay private facilities to get MRIs etc. XRays seem to be easier in the NHS system.

Early detection of problems is cheaper.

Indeed, my dad just had this issue (hence my suggestion in the previous comment). He has had a knee problem for about 15 years, it's suddenly got a lot worse so he went to see the doctor. Long story short, after about 6 months of hearing nothing back from the NHS on getting a scan he went private and got a scan done - they said his right knee is basically completely deteriorated and he needs surgery.

He wanted to make sure that this was necessary so he arranged finally got an appointment with the NHS specialist a few months down the road who looked at the scan and said words to the effect of "we wouldn't recommend surgery at this stage because the degradation doesn't meet our requirements for it, basically you can still walk around for up to a mile or so before it starts really hurting". He then asked if he could go private would that advice change and the specialist said "yes, get this done ASAP because it will seriously improve your life quality and in 10 years when this gets to the point where the NHS will consider it degraded enough to operate you may not be eligible due to age and poor likelihood of recovery". It's a completely mental situation. They're knowingly saying no/delaying huge life improving surgery to people knowing that 10 years down the road it will cause huge issues for these people, well at least for those people who can't afford to go private.

This is the kind of stuff that I really think is low hanging fruit for the NHS, cheap preventative care today reduces our future liability by huge amounts and that's where I would be looking for gains. They may not show immediately but in 2-3 years there would be a noticeable drop in resource demand.

Our youngest had an ingrown toenail a couple of years ago. After going through the initial stages of treatment with our NHS GP (which consisted understandably of “give it a couple of weeks to see if it sorts itself out”) the GP referred him to get it looked at by a specialist. By the time the letter from the specialist dept had arrived to tell us we had been booked for an initial appointment another four months later we had already given up on the NHS & taken him to a private specialist who had diagnosed it as needing surgery & carried that surgery out that week - removing an impressively large chunk of toenail that had grown off sideways into the depths of his big toe in the process!

The specialist said the likely time from initial diagnostic appointment to actual surgery on the NHS was between 9-12 months in his experience.

The NHS is just broken for ordinary people it seems. If you fit into one of the “pathways” (cancer, stroke, heart disease) then you get treated in a timely fashion (most of the time), but those are mostly the diseases of old people. For the young, the NHS is a failure that pretends to treat them & then keeps them dangling with the hope of treatment that might manifest itself sometime, maybe.

We need to get back to the idea that the NHS sees getting working age people back into work as quickly as reasonably possible a priority.

I know of people waiting over two years to get access to CAMHS in Edinburgh.

Two years is quick, for most.

The rape case I did last week involved a young woman whose legal guardian claimed had a mental age of 6. She was in residential care but had freedom of movement. She was raped and enormously distressed. Medical evidence said, remarkably, that she understood enough about sex to consent or withhold her consent.

Her guardian contacted Social work the night it happened who did ...nothing. When the guardian got back from her holiday she took her to the police but it was too late to get medical support for the claim. The man was convicted by the evidence of the distress and what was said to the guardian hours after the assault. It was close, a majority verdict.

The lack of care of such an obviously vulnerable young woman frankly made me incandescent. So many jobsworths are paid to look after people and just don't give a damn. This case involved an indigenous Scot but it demonstrated all so clearly how the victims we are not supposed to talk about get taken advantage of.

We are spending a fortune on these services. We are not getting results.

That's absolutely shocking and glad the jury came back with the correct decision, even by majority verdict. These are the kinds of cases why people like me suggest that burning it all down and starting again can't be worse than what we have now. People are being failed by the state at an alarming rate, whether that's cases like these which are absolutely awful, the NHS in lots of areas, the police are failing the public at large on crime, the judiciary are failing the public in deportations, politicians are failing us on all fronts.

The UK is getting closer and closer to becoming a failed state so maybe some tough medicine is what the state needs, not more of the same.

I have recently started ‘Who dares, win’ by Dominic Sandbrook on the early Thatcher years. The opening chapters have laid bare the state of the nation in 1979 and the radical approach that Thatchers government took, including the realisation that there would be pain for some but it would be worth it in the end.*

There is no sense that any political party is prepared to undertake policies that might have short term pain for long term gain. Take Labour. They wanted to slash WFA soeniding and failed to hold their nerve. And again on PIP. I am not commenting on the right or wrong of either more the lack of political guts to suffer even a tiny bit of kick back from policy.

We have to start living more within our means. Increase tax, reduce spending and find a way to economic growth. And we need to accept that it will hurt for some. No one wants to punish people unfortunate to be unable to work or look after themselves. But we risk being taken for mugs when ‘feeling a bit sad sometimes’ elicits money for free.

Someone in the room needs to tell the country hard truths. And it’s about time we listened to them. The party is over, now it’s time to pay the bills and tidy up.

*Opinion is divided on this.

I think also that Britain probably needs a Prime Minister who is willing to say that they aren't going to try and fix every problem in the country, because such a task is not something that government can do alone.

I'm not old enough to remember in detail what it was like before Blair, but Blair always gave the impression that he was going to personally intervene to fix every problem - hence czars and the PM's office monitoring targets.

That doesn't work. When the centre tries to run everything not only is that a problem when a complete nutter takes over the centre, but it leads to the centre promulgating set procedures for workers to follow, and targets to ensure that they are. This creates legions of people afraid to think for themselves and use their own judgement, and working only towards the target, following procedure, and blind to the negative consequences to the real people involved.

Britain needs a leader who will inspire people to work hard to improve things, who will delegate power to allow them to do so.

I can understand Max's frustration, but I think he's very wrong to think that it can't get worse. What is happening in the US should demonstrate that it can get a lot worse indeed. My impression is that there are a lot of things that are only just holding together due to the efforts of a minority of committed people. If you sweep those people aside with a year zero plan then you'll really see how bad they can get.

I just laid Rupert Lowe to be next PM at 29/1 on Betfair. I honestly couldn't believe what I was seeing. Surely the true odds should be a million to one?

It's a bit like David Miliband, who wasn't even an MP, was favourite to be next Labour leader and in the top five to be next PM.

There's some really dumb/wishcasting punters out there.

There must be!

Lowe is the same price as Boris. Obviously Johnson isn't an MP, but if he did become one, he would likely also be LotO, and more chance of being PM than Badenoch now, so I guess that has to be a factor. I can't see that either though

But Lowe? I just can't believe anyone could think he was a 3% chance of next PM. It's almost impossible

I have a theory.

Betfair puts those bets into the system, because people like you will take them as you - correctly - ajudge that the right price for Lowe is probably 1,000 to 1.

But here's the thing. You've now trapped some of your Betfair balance. If you keep your bet for two years, you will have made 3%. But Betfair will have made 7% on the interest, plus taken a small chunk of your winnings.