Intended for healthcare professionals


The health and social care levy won’t be a quick fix

BMJ 2022; 377 doi: (Published 12 April 2022) Cite this as: BMJ 2022;377:o948
  1. Sally Warren, director of policy
  1. King’s Fund, London, UK
  1. s.warren{at}

Politicians should level with the public or face even deeper dissatisfaction

The health and social care levy has finally arrived, and this month employers and employees will see and feel the increase in national insurance contributions. What might they start to see improving in the NHS and social care as a result, and when might they expect to see it?

The levy is expected to raise £39bn (€47bn; $50bn) for the UK over the next three years. The amount raised has changed because of recent improvements in economic forecasts and changes to the threshold at which people start paying national insurance. Crucially though, the spending commitments for the NHS and social care remain unchanged—showing that ringfencing the levy is more a political tool than a true hypothecation of the tax proceeds.1

In England, most of the funds, around £25bn over three years, will go to the NHS or to the Department for Health and Social Care for other spending related to healthcare, such …

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