Funding reforms for health and social care
Sir, The much-needed reform programme in health and social care must extend beyond the remedy you suggest (“National (Health) Insurance”, leader, Mar 22). Analysis I commissioned from the Commons library indicates that, in 2020, the combined deficit for health and social care in England will reach £9.1 billion.
A fourfold revolution in the national insurance system is required to meet both the immediate and the longer-term funding challenge. First, a penny increase in national insurance contributions would eliminate the short-term deficit. Second, that initial tranche of new funding must herald the creation of a national health and social care mutual that sets future contribution levels, governs the long-term financial framework for those services, and educates contributors on the costs of health and social care.
Third, extending national insurance contributions to people of pensionable age who are still in work would meet part of the funding gap in social care. Finally, the system should become more progressive. Those earning less than £11,000 a year should gain exemption from national insurance, with a starting rate of 10 per cent for middle earners and higher rates further up the scale.
Frank Field, MP
House of Commons