NHS Tax Hack: an idea

The idea
The NHS is in crisis. We know this. That’s why 70% of us say that we would pay more tax to fund the NHS. So what’s stopping us?
A 1% NHS tax has already been suggested. But the government have stated emphatically that they will not raise taxes on the highest earners.
So here’s the question: would you voluntarily pay the extra 1% to a trustworthy third party if you were confident they could get it directly to the NHS? As part of a sort of ‘coalition of the willing tax-hack’.
The idea would be to build this to such a scale that the government would eventually have to apply the tax for real.
If this sounds interesting and you’ve got a spare 3 minutes, I’d really appreciate you taking this quick survey to share your thoughts:
An experiment
This feels like a feasible thing. And it’s possible to start small, prove the concept, then scale.
For example, if 70 people on salaries similar to mine paid 1% of their income, it would be enough to fund a full time nurse. That feels very tangible. There are a lot of hospitals out there cutting front line nursing posts to save money. And as a result they often end up spending on more expensive agency staff to plug gaps instead of employing nurses full time.
If 70 of us wanted to try this, would it be possible to find a hospital willing to take our money to directly fund a nursing post? There are precedents for this work-around, with cancer charities funding full time NHS cancer nurses. So why not? (MacMillan Cancer Support were already funding over 3,000 NHS specialist nursing posts in 2010)
What might this look like
Imagine being able to subscribe to the NHS Tax Hack like you would to an online service, like Netflix or Spotify. You’d set up an account, put in your card details, and every month some money would come out. Perhaps there would be a feedback loop that keeps you informed about the impact the money is having.
Where might the money go
In the short term it feels like it would make most sense to try and get this money directly to hospitals. And doing so (initially at least) with the request that it’s directly spend funding nursing salaries.
But I’m not sure what this would actually look like. If you turned up with a briefcase full of cash, gave it to the Finance team and said ‘this is for nurse salaries’ would they be able to take it? How might that work?
Would you need to be a charity? Or at least to use a charity as an intermediary? One idea might be to work with a charity like the Red Cross, who have run a high profile campaign declaring a Humanitarian Crisis in the NHS.
As a person who might be interested in doing this tax hack, I’d be interested to hear what you would be comfortable with. If you’ve got a spare 3minutes, I’d really appreciate you taking this quick survey to share your thoughts:
Scalability
Say we were able to prove the concept and we got a growing number of people doing this. Theoretically the basis of this model (getting people to set up their monthly payments to a third party) is infinitely scalable. The bit that isn’t scalable is what you do with that money.
Initially you could scale the basic ‘nurse funding’ model. But if you started to have real scale and potential for impact you would need to start asking serious questions about who gets to decide where this money goes. Perhaps a steering group of healthcare leaders could allocate the funds. But you wouldn’t want to get into the business of building a replica Department of Health. And the thing would become too politically charged.
Presumably there’s a trigger point in the scale of the tax hack where you start to legitimise and normalise the hack. There’s a point at which you’d start trying to give the money directly to the Department of Health so they can decide how it’s spent through normal democratic mechanisms.
And that would be the flashpoint for change. Either the government would have to accept the money on an ongoing basis from (say) 50% of the population, which would make them look pretty silly, or they’d have to implement the tax rise for real.
The other option would be for them to not take the money. Which would also make them look pretty silly. In which case we’d have to continue trying to give the money directly to the front line in the most fair and democratic way that we can. Probably in collaboration with the Colleges of Nursing and Medicine and leaders of struggling hospitals.
Initial traction
I started by running this idea past a small group of politically minded friends. There was some challenge and a lot of helpful feedback. But the general consensus was positive.
So I put together a quick landing page and posted a few lines about the idea to my Facebook friends. I wanted to see if the idea had traction beyond my politics geeks. There’s a ‘join the mailing list’ bit on the landing page, and on the first day, to my surprise, a bunch of people joined it. What was really exciting was that as well as my friends (thanks guys) there were people I didn’t know.
That was a couple of weeks ago. This post is my next step.
The CALL TO ACTION
If you’ve been reading this and thinking any of the following:
- Hmm that sounds interesting…keep me posted
- Interesting idea but there are loads of obvious problems…
- This is exciting, how can I help?
Then I’d love to hear from you. I’ve set up a quick survey on Google Forms so you an tell me what you think and share your email if you’re up for hearing more. To get started, click HERE
What I’m planning next
A proof of concept experiment:
- Find 69 other people who are up for trying this
- Agree a way to collect the money
- Find a hospital up for having a crowd funded nurse
- Join the dots

