The Secretary of State for Health and Social Care (Matt Hancock)
Yesterday’s Budget proved the time-honoured truth that careful stewardship of the economy, taking difficult decisions, creating the environment for enterprise and generating growth will lead to better days, not just for those with the dignity of employment, now in record numbers, who did not have it in the past, but for the provision of the public services on which we all depend. This Budget reported record jobs, unemployment lower than in a generation, more full-time jobs, the lowest proportion of low-paid jobs for two decades and rising real pay, with the fastest rises in real pay among the lowest paid in our society, thanks to our national living wage.
We have just seen the big difference between the two Front Benches. While we are delivering more jobs, more opportunity and more prosperity, those on the Opposition Front Bench promise more borrowing, more taxes and more debt. We have just heard it again from the shadow Chancellor: no ideas for the future; just talking Britain down. There is a big difference in this Parliament between a party that believes in the future and an Opposition Front Bench that would only take us back. Wherever it has been tried in the world, the programme that the right hon. Member for Hayes and Harlington (John McDonnell) proposes has led to bankruptcy and misery for millions, and we cannot fund public services on that. Without a strong economy, we cannot fund an NHS that everyone can turn to in their hour of need, whether that involves a life-threatening condition or falling over some fly-tipping. We are able to put record funding into our NHS only because there are millions more people in work who are earning more and paying their taxes.
James Morris (Halesowen and Rowley Regis) (Con)
On that point, may I thank the Secretary of State for his work on securing the public capital for the Midland Metropolitan Hospital in Sandwell, which had some difficulties following the collapse of Carillion? His work with the chief executive and the board of the trust has secured the future of that hospital, which is now on track to be built. It will be a vital resource for my local area of Rowley Regis.
Matt Hancock
I pay tribute to my hon. Friend, who has worked so hard to get that hospital back on track. It is now being built because we have put in the capital—it is in the NHS budget. We had to rescue it from the failed private finance initiative that was invented by the Labour party. It is only because we have a strong economy that we can give the NHS the longest and largest cash injection ever in its history—
Matt Hancock
If the right hon. Gentleman will welcome that injection, I will give way to him.
Sir Edward Davey
The right hon. Gentleman is talking about the rise in health spending. He is Secretary of State for Health and Social Care, so can he tell us by how much social care expenditure is going to rise over the next five years?
Matt Hancock
Yes, I am going to come on to social care. Yesterday, we put a further £650 million into social care, and we are coming forward with reforms to social care to put it on a sustainable footing for the long term.
Chris Bryant (Rhondda) (Lab)
I want to ask the Secretary of State about acquired brain injury. We save so many lives now, but if we put in significant investment up front to ensure that everyone got the right neuro-rehabilitation, we could save vast amounts of money for the taxpayer. Is that not rather a good model for us to pursue?
Matt Hancock
Yes, and the constructive approach that the hon. Gentleman has taken on this subject with me over many months, and for years before that, shows the progress that we can make. We are putting £20.5 billion extra into the NHS, and making an uplift like that means that we can turn resources towards preventing ill health in exactly the way that he describes. I pay tribute to the work that he has done on this subject.
Wes Streeting (Ilford North) (Lab)
Yesterday, the Chancellor boasted of a “jobs miracle”. If there is a jobs miracle, why is the chemotherapy unit at King George Hospital in my constituency closing because of a shortage of chemotherapy nurses?
Matt Hancock
We have a plan to improve the cancer workforce and to try to solve some of these problems. Maybe the hon. Gentleman should come over to this side and work with us to put record funding into the NHS. We can only have record funding for the NHS if we have a strong economy.
Mr Jayawardena
Is it not critical that every single penny put into the NHS is well spent if we are to tackle waste and bureaucracy, unlike what happened when Labour was in charge, when almost half was not spent on patient care?
Matt Hancock
My hon. Friend is absolutely right. People want to see more funding for our NHS, and they are going to get it, but they also want to see all the money being well spent.
The Budget confirms that the NHS is the Government’s No. 1 spending priority, just as it is the British people’s No.1 spending priority. This Budget places the Government four-square in the centre of British politics. It is progressive and optimistic and focused on the future, not just for the many but for the whole country that we serve.
Dr Sarah Wollaston (Totnes) (Con)
I absolutely welcome the uplift to NHS funding, but will the Secretary of State answer a small technical question, please? In the Red Book, there are separate entries for the increases in the resource departmental expenditure limits for health and for NHS England? Can he confirm that the difference—£6.3 billion versus £7.2 billion—will not result in a transfer from Public Health England, from Health Education England or from capital budgets to fund the discrepancy? That has happened in the past.
Matt Hancock
Yes, I can confirm that. The £20.5 billion real-terms funding for the NHS in the Budget is for the NHS itself and will be channelled through NHS England. Of course there are budgets in the Department that are outside the NHS envelope, and they will be settled in the spending review. This is exactly as has been planned, and it was made clear in June. I can tell the House that the £20.5 billion is both the longest and the largest settlement for any public service in the history of this country.
Grahame Morris
We need to be precise and accurate about this, and I have just googled the settlement. In fact, the biggest ever increase in NHS funding happened between 1997 and 2008 when the budget went up from £55 billion to £125.4 billion—
Grahame Morris
Well, I am talking about being factually correct. The biggest ever funding increase came under a Labour Government. Let us be honest about this.
Matt Hancock
This is a single settlement for a five-year period so that the NHS can plan again.
Several hon. Members rose—
Matt Hancock
I want to make some progress.
I received some representations about what we should do on NHS funding. One was from a John from Hillingdon, who called for a 2.2% increase in funding. John said that would make the NHS the “envy of the world”. Others may preach a gospel of envy, but we are getting on with building the NHS to be there for us all. The £20 billion increase I have talked about is not a 2.2% per year increase—it is 3.4% a year more over the next five years.
Mr Adrian Bailey (West Bromwich West) (Lab/Co-op)
I acknowledge the Secretary of State’s contribution to funding the Midland Metro Hospital, which is very important to people in the Black country. However, given that NHS hospital trusts have cumulative debts of around £7.5 billion plus a further £5 billion or so of other debts, can he reassure us that the £20.5 billion will be used not just to pay debts but to provide extra services?
Matt Hancock
The £20.5 billion is just for day-to-day running costs—the resource costs. Of course there is a capital budget, too, which includes £4 billion of taxpayers’ money. That goes towards ensuring that we can get the capital built. The critical point is that we have not only that £20.5 billion uplift in running costs but a capital budget. We will make further announcements on the allocation of the capital budget later in the autumn.
Karin Smyth (Bristol South) (Lab)
I am grateful to the Secretary of State for clarifying the £20.5 billion figure, which does not include training or capital. Of course, that contradicts the unhelpful briefing from Downing Street during the summer that it was something like £84 billion. Will he confirm that that £84 billion figure, which has been repeated in the media, is, as the Health Service Journal says, a fib, and that we are talking about £20.5 billion purely for resources in the NHS in England and Wales?
Matt Hancock
No. The £84 billion is the cash figure. The £20.5 billion is the real-terms increase by the end of the five years. If we add up all the extra money, we get £84 billion. It is there on page 36 of the Budget, if the hon. Lady wants to look. The biggest single cash increase comes next year, in 2019-20. It is all there in the Red Book.
Nicky Morgan (Loughborough) (Con)
I thank the Secretary of State for more good news for the midlands in the form of £70 million for the Defence and National Rehabilitation Centre just outside my constituency to help civilian rehabilitation. Can he share further details of that with us?
Matt Hancock
I pay tribute again to my right hon. Friend, who has worked tirelessly in support of that project. The Defence and National Rehabilitation Centre in Loughborough will link world-class military medical facilities with our NHS. That means lessons learned in the medical field from treating our brave troops who come back from the frontline can be brought into the NHS—for instance, surgical techniques that were learned in battle can be adapted to help civilians here. I pay tribute to her and others for the work they have done.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
Here is a representation from a Jonathan from Leicester. Further to the question from the Chair of the Select Committee on Health and Social Care, the hon. Member for Totnes (Dr Wollaston), can the Secretary of State confirm that, in next year’s spending review, the cuts to capital budgets and the £700 million-worth of cuts to public health budgets will be reversed, and that there will be real-terms increases in funding for capital, training and public health? Can he guarantee that?
Matt Hancock
The spending review is next year. What I can guarantee is a £20.5 billion increase in NHS spending. That is the biggest increase in any spending commitment for any public service in the history of this country. [Interruption.] It is a pity that the Leader of the Opposition is not interested and does not want to hear about it. If he stayed, he could also hear about the reforms we are going to make. He should hear this more than anyone. We are acutely aware on the Conservative Benches that this is not Government money or NHS money but the hard-earned money of taxpayers, and we need to ensure that it is spent wisely. When he sprays his commitments around, Opposition Front Benchers would do well to remember that this is money from taxpayers.
Mr Jayawardena
I welcome the fact that taxpayers’ money will be spread across the whole country, including £10 million to support air ambulances, which provide vital services in rural areas.
Matt Hancock
So many of us know just how important air ambulance services are and the countless lives they save. I am delighted that, on top of the £20.5 billion for the NHS—the biggest ever, longest ever cash settlement for any public service in history—there was £10 million for air ambulances.
Neil O'Brien
If my right hon. Friend will excuse another Leicestershire-based health intervention, I am incredibly grateful for the creation of the new Cottage Hospital in Market Harborough, the gleaming new A&E ward at Leicester Royal Infirmary and the decision to save the brilliant children’s heart unit at Glenfield Hospital. Does he agree that that is a more welcome record than the Labour party’s record of bankrupting the country, giving us the biggest recession since the second world war and putting 1 million people on the dole?
Matt Hancock
It is true that the Labour party in office has always left unemployment higher than it found it; it is true that, while Labour left the deficit higher, we are bringing it down; and it is true that inequality, too, is coming down. Page 8 of the distributional analysis shows that, contrary to what we heard in that paean of gloom from the shadow Chancellor, the biggest rises in full-time employee gross weekly real earnings over the last three years have been among the 10% least well paid in our country. That is what this Conservative Government are doing—delivering for everybody in our country.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
On inequalities, does the Secretary of State recognise that life expectancy is stalling under his Government? In some regions it is getting worse. For women, it is getting worse. Perhaps he can answer the question he could not answer last week—why, for the first time in 100 years, do four babies in 1,000 not reach their first birthday?
Matt Hancock
As the hon. Lady knows, life expectancy is increasing, and we are forecast to see an increasing number of people live to a good old age. Indeed, the number of people aged 75 and over is set to double in the next 30 years. That is a brilliant achievement, which is in part down to the hard work of our NHS. Cancer survival rates are at a record high, strokes are down by a third and deaths from heart failure are down by a quarter. Of course, those successes have brought new challenges. The biggest health challenge we face is that people are living longer, often with multiple chronic conditions. The money is only one part of the plan to safeguard the NHS and ensure it is fit for the 21st century. The Budget delivers the funding, and later this year we will deliver the plan for how we will set the NHS fair for the future.
Rachael Maskell (York Central) (Lab/Co-op)
I have very little hope for the older people of our country given that the Government have cut £7 billion from the social care budget and replaced it with only £240 million. How is that safeguarding our old people for the future?
Matt Hancock
Of course, in Scotland social care is devolved, so—[Interruption.] And in York, the amount of money for social care is going up thanks to the decisions announced yesterday.
Mr Jayawardena
Is not it true that Labour talk the talk but do not walk the walk? They failed to deliver an effective long-term solution for social care when they were in government. They had 13 years to sort it and they did not. Is not it also true that, even though they said they would use the comprehensive spending review to address that, they left office without delivering? That is what they do time and again.
Matt Hancock
My hon. Friend is absolutely right. The long-term plan needs to ensure that we address the challenges of today and of tomorrow, including dementia, obesity and the rise in mental ill health. It will set out how we are going to address and deliver these changes. The Government believe in an NHS that is free at the point of use for everyone, for the long term.
Vicky Ford (Chelmsford) (Con)
The A&E in my local hospital is deeply loved and I am very grateful that it is staying, but it is still under huge pressure. When I have been out at night with the emergency services, I have seen that emergency services personnel have to stay with someone who has an acute mental illness and needs a mental health bed, which means that they cannot get on with other roles. Does the Secretary of State agree that the Government’s strong announcement of more funding for mental health will help the whole NHS to do more?
Matt Hancock
My hon. Friend is absolutely right, and we can only have a sustainable NHS if the social care system is also properly supported.
The social care Green Paper to be published later this year will set out the options to meet the unprecedented demographic challenge—and what a challenge. Some 70% of people in residential care homes now have dementia. The number of people with dementia is set to rise from 850,000 today to over 1 million in less than a decade. The number of people of working age in need of care is rising and is set to increase by almost half by 2035. Yet, despite these pressures, 83% of adult social care settings are now rated good or outstanding by the Care Quality Commission. That is the highest level since assessments began. As a society, we need to address the pressures on social care so that everyone can live in dignity and we can have a situation that is sustainable for the long term.
The Green Paper will bring forward a range of proposals to reform our social care system. I pay tribute to the excellent cross-party work of the Health and Social Care Committee and the Housing, Communities and Local Government Committee, which are helping to build a consensus behind potential solutions. This is exactly the sort of long-term cross-party work that we need to see, when fair-minded people from across the House come together to address the challenges of the future, and I will work with anyone from any party to get this right.
Sir Geoffrey Clifton-Brown (The Cotswolds) (Con)
I listened with care to my right hon. Friend’s very welcome remarks on yesterday’s “Today” programme about having parity of esteem between mental health and physical health, and I welcome the announcement in the Budget of £250,000 for children’s crisis centres. Sadly, people in society now have complex mental health problems at a younger and younger age. In order to make these policies work, will the Secretary of State ensure that there is a sufficient number of well trained staff in the NHS to deal with these mental health problems?
Matt Hancock
My hon. Friend is absolutely right; he has put his finger on an incredibly important point. As we spend £20 billion extra on the NHS, we are going to ensure that we train up and attract the people who are going to do the caring.
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
On the issue of mental health support and services for children, I was quite disappointed that mental health support for schools was missing from the Budget. A lot of money was promised for child and adolescent mental health services but, as the Secretary of State will know, the Education Committee produced a joint report with the Health and Social Care Committee entitled “The Government’s Green Paper on mental health: failing a generation”, in which we outlined that we were really keen to see additional funding for mental health support in schools. Is there anything that the Minister can do to look again at that issue?
Matt Hancock
Yes—part of the £2 billion of extra mental health funding that we announced yesterday is to ensure that there is support in schools, particularly for young people. That is one of the elements of the funding that we announced in the Budget yesterday, and I am very happy to talk to the hon. Lady about the details.
The social care Green Paper will address the question of long-term funding reform for social care and how we can help people to plan sensibly so they do not have to fear the risk of losing everything. But the Green Paper will not just look at funding; it will also look at the role of housing, at how we can combine a home with high-quality care, and at the links between the care of children and of the elderly. I have seen how such links can benefit both groups, helping children’s development and tackling the scourge of loneliness that elderly people too often face. The Green Paper will of course also look at how we can better integrate the NHS and the social care system. What matters is what works, so we will look at things such as auto-enrolment, and how and if reforms elsewhere can be applied to social care. Like the NHS, the future of our social care system rests not just on funding, but on reform, and we are determined to rise to this challenge.
Every Member of this House will have their own personal story of the NHS. Whether it was the first few breaths of a child or the final few moments of a loved one, from cradle to grave that care is ever present, whatever the shade of Government. This Government want to ensure that that care will always be there for whoever needs it, and that the NHS remains free at the point of delivery. That is why we are putting the extra £20 billion into the NHS. It is only because our economy is strong, employment is rising and we believe in a free market economy that we can fund this increase, for just as there can only be truth when there is freedom of speech, so can there only be prosperity to fund public services when there is freedom of enterprise. It is a great sadness that, in stark contrast with the greats of his party in the past, the shadow Chancellor opposes both. It is now a combination that we can only get under a progressive, optimistic, future-focused Conservative Government. That is what this Budget delivers. I commend it to the House.
Kirsty Blackman
Absolutely; it is clear that remaining part of the UK is bad for Scotland’s economy. The comparators in the Budget information documents show that the UK economy is growing slower than the EU economy is set to grow in every but one of the next five years.
Matt Hancock
May I just ask whether the hon. Lady has ever seen the result of a referendum that she likes?
Kirsty Blackman
Do you know what? The reality is that we have argued for a very long time—I have argued for my entire adult life—against the current democratic system, because it does not work for the people of Scotland. We do not get the Governments we vote for and we do not get the result that we voted for in the EU referendum. If the democratic system meant that Scotland’s votes were reflected in reality, we would be in a very different situation today.
On a serious note, every week in our communities and at our surgeries MPs from both sides of the House are faced with the consequences of Westminster’s poor decisions. We see working mothers forced to go to food banks. We see and hear about the Home Office-enforced separation of families. We meet young men struggling with mental health problems who have been sanctioned yet again because they are unable to jump through the unreasonable hoops put in their way by the Department for Work and Pensions. I do not know how anybody, even in this Westminster Government, can believe that their policies are having a positive benefit. The tears and desperation with which we are all faced on a regular basis give the lie to that notion.
The Chancellor has failed adequately to fund our public services in this Budget. He has failed to undo the devastating social security cuts, he has failed to legislate for a real living wage and he has failed to provide adequate support for businesses facing the impending cliff edge of Brexit.
The Budget should have included decisions to help support all those who have been hit by a decade of austerity, and all those who will be hit by the forthcoming Brexit. The roll-out of universal credit should have been halted. A third of working-age households will be entitled to some universal credit. Of those, around a third will be at least £1,000 a year worse off than under the legacy system.
The Financial Secretary to the Treasury (Mel Stride)
May I begin by associating myself and Government Members with the pertinent comments made by the hon. Member for Leicester South (Jonathan Ashworth) in respect of the terrible tragedy that has befallen Leicester City football club in his constituency?
In 2010, we inherited an economy in disarray. It has been the discipline of a Conservative Government that has brought that back on track, combined with a monumental national effort on the part of millions of determined people in our country. Together we have turned the economy around. We now have near record levels of employment and near record levels of women in employment. Unemployment is at its lowest level since 1975, and we have halved youth unemployment since 2010. Debt is falling, and of course the deficit has been reduced by no less than 80%. Those points were all quite rightly made by my hon. Friends the Members for Harborough (Neil O’Brien), for Sleaford and North Hykeham (Dr Johnson) and for Berwick-upon-Tweed (Mrs Trevelyan).
In yesterday’s Budget, we showed the British people that their hard work has paid off, because the people of this country now deserve the rewards that are available in our strengthened economy. This Budget is a demonstration that we are coming out of austerity and into a brighter future. Today we have had a full and thoughtful debate on health and public services, and this Budget provides significant additional investment in our precious national health service, our carers, our schools and our police—those serving on the frontline, helping and caring for our families and communities, and working to build a better, safer and healthier Britain.
This Government have ensured an increase in NHS funding every year since 2010, including a pay rise for more than 1 million workers. We took this commitment still further in the Budget, delivering on the Prime Minister’s announcement in June of the largest single public services cash commitment ever made by a peacetime Government —the biggest cash boost to the national health service in its history. Of course, it is essential that every pound of that money is spent wisely so that the national health service is put on a more sustainable footing, and we look forward to Simon Stevens’s 10-year plan setting out exactly what the British people can expect to see.
The Chancellor announced yesterday that within the NHS settlement we will provide a significant uplift in funding for mental health, to the tune of at least £2 billion a year by 2023-24. We are committed to record levels of spending on this vital area, and the NHS plan will include up to £250 million a year by 2023-24 to support people living with poor mental health. It is time to address the stigma and the suffering of those affected by mental health issues and to work towards achieving parity of esteem between mental and physical health. Mental ill health is a pressing need to be addressed, and yesterday’s Budget committed to doing precisely that.
Alongside our NHS settlement, the Budget’s commitment to social care will give a much needed boost to councils, families and patients. The Government will provide £240 million in 2018-19 and a further £650 million next year for local authorities. This money will help people leave hospital when they are able, freeing up hospital beds. All of this builds on the additional £2 billion set aside in last year’s spring Budget for councils to spend on adult care services.
Along with health and social care, a vital pillar of our public services is our world-class education system. Our children deserve the best, so we are already funding schools at record levels—schools will receive over £42 billion of core funding this year—and the results are showing: 86% of schools are now rated good or outstanding, compared with 68% in 2010.
We know that school budgets often do not stretch as far as we would like, so this year’s Budget provides even more support. That is why my right hon. Friend the Chancellor announced a one-off £400 million in-year funding bonus for schools and sixth-form colleges in England, which means that the typical primary school will receive £10,000 and the typical secondary school will receive £50,000. All of this tops up our existing commitment to invest £23 billion in improving, refurbishing and replacing school buildings between 2016 and 2021. This is a Conservative Government committed to giving every child the greatest possible start in life, and we are investing in education to make sure that happens.
This Budget is the start of a new era for our country. After eight hard years of clearing up the mess left to us by the Labour party, we are now in a position to substantially increase our support for our vital public services. We have done that by facing up to the challenges laid before us in 2010. The crippling deficit, the highest in peacetime history, was the fallout from the wanton and reckless profligacy of the Labour party. A party that is always quick to blame, to point, to impugn and, of course, to promise without the inconvenience of having to deliver. A party that now finds itself captured by those who would return us to the dark days of the crash, and far worse. A party utterly incapable of facing up to the serious responsibilities of government.
It is we, this Government, who took the tough choices and did what we always knew to be right—to be responsible even when that was the hard way, not the easy way. Those tough choices were taken not for reasons of ideology but for reasons of compassion. For we knew all along that if we stuck the course, if we kept our nerve, if we could be brave and true to our values, then we could spare the country from the cruel impossibility of the Labour party’s promises, and bring us to a place where better times were in reach.
That is where we are now. The deficit is fading, real wages are rising, better times are returning and there, right at the heart, lie those things we hold most dear: our national health service and our public services. This is a Budget for them, and I commend it to the House.
Ordered, That the debate be now adjourned.—(Michelle Donelan.)
Debate to be resumed tomorrow.