(2 weeks, 2 days ago)
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The Secretary of State for Health and Social Care (Wes Streeting)
This Budget is the moment we turn the page on 14 years of Tory neglect of our NHS, when we begin to fix the foundations of our public finances and public services, when we wipe the slate clean after 14 years of stagnant growth and under-investment, and when we start to rebuild Britain. This Government were elected to deliver change: from economic chaos to stability, from crumbling schools and hospitals to first-class public services, and from short-term sticking plasters to a decade of national renewal.
On Wednesday, the Chancellor took the tough decisions to set our country on a better path to a brighter future. Labour’s manifesto promised to protect the payslips of working people while asking the wealthy to pay more, and the Chancellor delivered. We promised economic stability through new fiscal rules, and the Chancellor delivered. We promised more teachers in our state schools paid for by ending tax breaks on private schools, and the Chancellor delivered. We promised to end the non-dom tax status to fund 40,000 extra NHS appointments a week, and the Chancellor delivered.
Our country, our economy and our NHS were crying out for change, and the Chancellor delivered. She did so against the backdrop of the most appalling inheritance faced by any Government since the second world war—and not just the £22 billion black hole in the public finances. Let me set out for the House exactly what I was greeted with in my Department alone when I walked through the door on 5 July.
The Conservatives had told the country that they were on track to build 40 new hospitals by 2030. The former Health Secretary told the House that the funding had been provided. Putting aside the fact that there were never actually 40 new hospitals planned, I was informed in July not only that the programme was years behind schedule but that the funding was to run out in March. The only place those hospitals existed was in Boris Johnson’s imagination.
The Conservatives promised to cap social care costs by October 2025, just 15 months after the general election, but there was not a single penny set aside to pay for it; the cupboard was completely bare. Within weeks of the general election, councils were warning that it would be impossible to implement the cap by next October because the preparations had not been made. Those were fantasy pledges that the Conservatives never intended on keeping.
James Wild
On the new hospital programme, the Government committed in the Budget to move swiftly to rebuild reinforced autoclaved aerated concrete hospitals. The Queen Elizabeth hospital in King’s Lynn is keen to make progress with its plans. Will he meet me and the trust so that we can unlock the funding and get that hospital ready by 2030?
Wes Streeting
That is a commitment that we have made and a commitment that we will keep. I am happy to ensure that the hon. Member can meet the relevant Minister and project team as we get under way on delivering that project.
I did actually go back to check the pledges made by the Conservative party in its 2024 manifesto just to see how extensive the work of fiction was, only to find that the manifesto page on its website now reads “page not found”. The truth is, had the Conservatives won the election, it would have been deleted just as quickly.
That was not all I was told when I became Secretary of State in July. Despite 18 months of strikes in the NHS, there was no funding put aside to end the junior doctors’ dispute. What is more, the previous Health Secretary had not met the resident doctors since March—the Conservatives had given up even attempting to end the strikes. People should remember that this winter. For all the challenges that the NHS will face, this will be the first winter in three years when NHS staff will be on the frontline, not the picket line. That is the difference that a Labour Budget makes.
I was told that GPs would be qualifying this year with no jobs to go into. The Government found the funding and we are hiring an extra 1,000 GPs this year. That is the difference that a Labour Budget makes.
Dr Luke Evans (Hinckley and Bosworth) (Con)
On the Budget, GPs, hospices and care homes have been found to be either exempt or not exempt from the national insurance contributions. Will he clarify whether hospices, care homes and primary care are exempt or not? That really matters to their costs.
Wes Streeting
I am grateful for that intervention for two reasons. First, it gives me an opportunity to say to GPs, hospices and other parts of the health and care system that will be affected by employers’ national insurance contribution changes that I am well aware of the pressures, we have not made allocations for the year ahead, and I will take those representations seriously.
Secondly, it gives me a chance to ask the hon. Member and the Opposition: do they support the investment or not? Are they choosing to invest in the NHS or not? They are now confronted with the hard reality of opposition. Just as when we were in opposition we had to set out how much every single one of our policies would cost and how those would be funded, they have to do that now. If they oppose the investment, they have to tell us where they would make the cuts in the NHS. If they oppose the investment, they have to tell us where they would make the cuts in school budgets. Those are the choices that we have made, and we stand by those choices. The Opposition will have to set out their choices, too.
I was told that because the Conservatives had run up huge deficits in NHS finances, I would not be able to deliver the 40,000 extra appointments a week that we had promised. In fact, I was told that we would have to cut 20,000 appointments a week instead. The Chancellor and I were not prepared to see waiting lists rise further. She put the funding in, and an extra 40,000 patients will be treated by the NHS each week. That is the difference that a Labour Budget makes.
Jim Shannon (Strangford) (DUP)
It would be churlish of anybody in the House not to welcome the £22 billion that has been allocated to the NHS. Everyone across this great United Kingdom of Great Britain and Northern Ireland will benefit from that.
A number of my GP surgeries have contacted me about their national insurance contributions, which they see as a catalyst to perhaps not being able to deliver what they want to do for their patients. I understand that the Labour party and Government are looking at that in a consensual way. Can the Secretary of State please give me the latest position so that I can go back to my GPs and tell them, “This has been looked at and there will be something coming”?
Wes Streeting
I am grateful for that intervention. It is of course for the devolved Administrations to decide how to use the Barnett consequentials that the generous uplift in funding provided by the Chancellor will provide. We make no bones about it: we had to make some difficult choices in the Budget to plug the £22 billion black hole that we inherited, to deliver on our promises and to ensure that we are fixing the foundations of our economy and our public services. We have asked businesses and some of the wealthiest to make a contribution. I say to people right across the House that they cannot welcome the investment at the same time as opposing the means to raise it. If they do, they have to explain how they would find the money.
Mr Toby Perkins (Chesterfield) (Lab)
I congratulate my right hon. Friend on his success in getting this extra money for our national health service, which is incredibly needed. He spoke about the extra GPs that he is taking on. The doctors’ surgery in Staveley in my constituency has told me that surgeries in the most deprived communities see patients two or three times a year more than those in wealthier areas. Will he say something about how we ensure that the extra GPs we get look in particular at those more deprived communities that have greater health inequalities and need more appointments?
Wes Streeting
My hon. Friend is absolutely right about equity and fairness of access. The Government are determined to close the gap in healthy life expectancy and health inequalities that blight our nation. GPs and primary care are an important part of doing that. Unless we fix the front door to the NHS in primary care, we will not solve our NHS crisis. Unless we address the crisis in social care, we will not fix the NHS crisis. We will be able to do that only if we do so right across the country.
Jeremy Corbyn (Islington North) (Ind)
I fully understand the crisis that the Secretary of State inherited. He will be aware that most hospitals are running at a deficit, many have substantial debts and many are spending up to 15% of their income on servicing private finance initiatives. Is his Department prepared to make some kind of intervention to reduce that burden, perhaps by taking over the PFIs directly in order for our hospitals to be able to spend more on what they are there for, which is, of course, patient care?
Wes Streeting
I am grateful for that intervention. The right hon. Gentleman is absolutely right that we walked into a position of enormous deficits in the NHS, and an enormous black hole in the public finances was left by the last Government. That is why we have had to make some difficult choices. That is why we have to learn from the mistakes of the past and not repeat them in future. We are doing as much as we can as fast as we can. That is why it was important that the Chancellor made the bold choices she did in her Budget, so that, as well as plugging the black hole, we are fixing the foundations. Thanks to the fiscal rules adopted by the Chancellor, we will ensure that the Government do not repeat the waste, the profligacy and the irresponsible spending of our Conservative predecessors.
Wes Streeting
I will make some more progress.
Speaking of the Conservative party, I welcome the right hon. Member for Melton and Syston (Edward Argar) to his new position as the shadow Health and Social Care Secretary—the best job in the Opposition. In the two and a half years that I did his job, I faced five Health Secretaries. I am determined to make sure he faces only one. I had differing relationships with each of my predecessors. At best, we went hammer and tongs in this place, thrashing out our disagreements, but we would also get on the phone and work together in the national interest, particularly during covid when I had a particularly constructive working relationship with Sir Sajid Javid. I hope we can work together in that spirit. If he has any ideas to fix our broken NHS I am all ears—he just needs to go to change.nhs.uk, as hundreds of thousands of people across the country have already done. I must disappoint him, however: I will not be fired out of a cannon.
Choosing to serve is not always easy, especially in a job as thankless as being a member of His Majesty’s loyal Opposition. Let me applaud the right hon. Gentleman for stepping up to the plate. Having done his job until recently, I have some advice: first, it is easy to oppose for opposition’s sake, but the public will rightly expect him to have an alternative. The Leader of the Opposition refused to say at the weekend how Conservative Members will vote on the Budget. Apparently, whether they support or oppose £26 billion of investment in our NHS is, to quote her, “inside baseball”.
If the Conservatives finally decide to oppose the Chancellor’s measures, they will need to say what they would do instead. Would they keep our investment in the NHS? If so, how would they pay for it? Would they cancel our investment and the extra appointments, send doctors and nurses back out on strike or cause waiting lists to soar even higher? The Conservative party has to choose. At the moment, our only clue about the future of the party is the Leader of the Opposition’s comments about charging patients to use the NHS. She gave an interview to The Times just weeks ago in which, on the principle that the NHS should be free at the point of use, she said:
“we need to have a serious cross-party, national conversation.”
I am happy for the Conservative party to start that conversation any time. As far as I am concerned, it will be a short debate, and we will win: the answer is no. The Labour party will never surrender on the principle of the NHS being a public service, publicly funded and free at the point of use. It is time that the Leader of the Opposition made her position clear—although she has taken to opposition with such vigour, she tends to oppose things she said herself only days before.
I welcome the Leader of the Opposition’s call for honesty. The public have lost trust in politics, and we all have a responsibility to rebuild it. If we are not honest about the scale of the challenge and its causes, we have no hope of fixing them. Would it not be a welcome start to the role if the new shadow Secretary of State admitted what a mess his party made of our national health service and said sorry? It is not all the right hon. Gentleman’s fault; in fact, he and I have something in common. When he walked into the Department in 2019, he also inherited waiting lists already at record levels. It is true that waiting lists soared even further during the pandemic, but they were already at record levels before, and they continued to rise afterwards because of the damage that the Conservative party did to our NHS.
The Darzi investigation was clear about what is to blame: the top-down reorganisation, the chronic under-investment and the undoing of the last Labour Government’s reforms that saw NHS productivity fall off a cliff. Can the shadow Health and Social Care Secretary do what his predecessor could not, and accept the doctor’s diagnosis? Does this new Conservative leadership finally accept Lord Darzi’s findings? If the right hon. Gentleman cannot accept the work of an eminent cancer surgeon who has served both Labour and Conservative Governments, I wonder if he might agree with this damning assessment of his party’s record, made by one of his former colleagues:
“British citizens have the worst rate of life expectancy in western Europe. We have higher avoidable mortality rates than our neighbours. Survival rates for breast, cervical, rectal, lung, stomach and colon cancer are lower in the UK than in comparable jurisdictions. NHS patients who suffer heart attacks or strokes are more likely to die than in France, Spain, the Netherlands, Canada, Italy and New Zealand.
More than seven million people are on waiting lists...Every month, tens of thousands wait more than 12 hours for treatment after being admitted to accident and emergency wards. It is then no surprise that the number of (wealthier) patients opting to pay to be treated privately is at a record level...so we have a two-tier health system in this country in which the rich secure the best care, those in pain wait in agony and those with life-threatening conditions know their treatment would be better in Marseille or Madrid than in Manchester or Middlesbrough.”
The author of that quote was Michael Gove. If he can be honest about the mess the Conservatives made of the NHS, I hope the right hon. Gentleman can, too.
While the Conservatives work out what they stand for, we are getting on with cleaning up their mess, rebuilding our public services and reforming our NHS. As I said before the election, there is no point pouring more money into a broken system. Next week I will set out a package of reforms to make sure that every penny going into the NHS is well spent and benefits patients. Unless I am convinced that the money going in will deliver results, it will not get out the door.
Every bit of investment announced by the Chancellor last week will be linked to reform. The Budget will fund 40,000 extra appointments a week, and the appointments will be delivered through reformed ways of working. They are already being used in hospital across the river from here, where operating theatres are run like Formula 1 pit-stops. We will get hospitals motoring right across the country using that reformed way of working. We are investing not just in new scanners but AI-enabled scanners that diagnose faster and more accurately, increasing productivity and busting the backlog of 1.5 million patients waiting for tests and scans.
The investments in the Budget have fired the starting pistol on the three shifts that our 10-year plan will deliver. It increased the disabled facilities grant, to help people stay well, independent and out of hospital, funding an extra 8,000 adaptations to people’s homes. We are raising the carer’s allowance, worth an extra £2,300 to family carers so that they can stay in work while looking after their loved ones. That is the biggest expansion of carer’s allowance since the 1970s. We are expanding NHS talking therapies to treat an extra 380,000 mental health patients. We are investing in bricks and mortar outside of hospitals, opening new mental health crisis centres and upgrading 200 GP surgeries.
Paul Holmes (Hamble Valley) (Con)
I congratulate the Secretary of State on the extra investment that he has secured for the national health service, in spite of the Chancellor. Does he agree that primary care needs to be diversified? Could he outline whether that includes walk-in centres? If it does, could I have a meeting to discuss a new walk-in centre at Fareham community hospital in my constituency?
Wes Streeting
I am not sure whether this is within the rules of the House—you will tell me if not, Madam Deputy Speaker—but I will do the hon. Member a deal: if he votes for the investment, he can have the meeting.
Turning to the second of the big shifts that we need, from analogue to digital, the Darzi investigation found that the Conservatives left the NHS 15 years behind the private sector on technology. This Budget invests £2 billion to arm the NHS with modern technology so that staff spend less time pushing paper and more time on the frontline. In 2024, that the NHS is still using paper records to store patients’ medical history is absurd and jeopardises patient safety. The investment in this Budget will provide every trust with electronic patient records, and upgrade the NHS app so that patients can access care with a few taps on their phone. We are backing British scientists and researchers to develop the treatments of the future, with record investment in the National Institute for Health and Care Research, support for life sciences innovation and strengthening the UK clinical trial network.
We are also shifting from sickness to prevention. Today, we have announced the biggest public sector health reform in a generation. We are raising the legal age at which people can buy tobacco by one year, every year, protecting children and people from the harmful effects of second-hand smoke outdoors as well as indoors. We are cracking down on the marketing and targeting of vapes at children, so that we can create the first ever smokefree generation. Unless we act on public health reform and public service reform, the demands and costs on the NHS will spiral and the service will become unsustainable. If we want the health service to survive, and we do not want to pay ever higher taxes to fund it, we have to help people stay healthy. Prevention is better than cure—that is why we are introducing the Bill. I hope it will continue to command cross-party support.
It is not just smoking; obesity costs the NHS almost £12 billion a year. That is why we have already introduced the motion to ban the targeting of junk food ads at kids. We are strengthening councils’ powers to stop fast-food shops setting up outside schools. In the Budget the Chancellor increased the soft drinks industry levy so that manufacturers continue to reduce their sugar content while we review the exemption for milk-based drinks.
Madam Deputy Speaker, as you know, it was a Conservative Chancellor who introduced the sugar tax and a Conservative Prime Minister who introduced the first Tobacco and Vapes Bill. Because he is sensible, I know the shadow Health and Social Care Secretary will support those measures, but I cannot say the same for the Leader of the Opposition, so trapped in the prison of ideological dogma is she, so scared is she of the Reform dog that is barking over their shoulders. I hope the shadow Health Secretary will continue to hold the torch for one nation conservatism, even as its light dims in his party. If we want to know when the Conservative party has changed, maybe we will know when they have learned once again to love George Osborne.
Fixing the foundations of the NHS starts with fixing its little foundations. Lord Darzi pointed to how the Conservatives raided capital budgets time and again to plug the gaps in day-to-day spending. Indeed, that is the position we found ourselves walking into this year. Lord Darzi called it a
“combination of austerity and capital starvation”.
The Budget will begin to rebuild our NHS with the biggest capital investment since Labour was last in office, including £1 billion to tackle dangerous RAAC—reinforced autoclaved aerated concrete—and the backlog of critical maintenance and repairs across the NHS estate, keeping staff and patients safe and boosting productivity.
In conclusion, we cannot fix 14 years of mismanagement and neglect in one go, but the Budget marked an historic turning point for our country. For years the Conservatives pretended that the problems facing Britain did not exist, leaving them to grow. This week, the Chancellor ran head first into those challenges, taking the tough, difficult decisions on tax, spending and welfare because the choice was stark: we could stick to the status quo of 14 years of underinvestment that has knee-capped our economy and crippled our NHS, or we could begin to fix the foundations, kick-start the economy and rebuild our health service. The choices the Chancellor made will give the NHS the investment and reform it desperately needs to cut waiting times, rebuild crumbling buildings, arm NHS staff with modern technology, get more out of the NHS for what we put in, and fix the foundations and rebuild Britain. That is the change the country voted for; that is the change this Labour Budget delivers.
Edward Argar (Melton and Syston) (Con)
It is a pleasure and a privilege to be working once again in health and social care, although a disappointment to be doing it from the Opposition Benches. It is a privilege because, like the Secretary of State for Health and Social Care now, I had the privilege in government of working with the amazing and dedicated people who work in our NHS and in social care up and down the country. It is a pleasure to be back. It is a pleasure to be opposite the Secretary of State, as he now is. I remember our tussles back in the day, when I was sitting over there and he was sitting here.
I am sufficiently fond of the right hon. Gentleman to encourage him not to get himself fired out of a cannon, as he alluded to. Although I will say one thing for it: it would not only draw attention to his day job, but possibly even aid him in his ambitions to secure his boss’s job in due course. In respect of his comments about the Leader of the Opposition, my right hon. Friend the Member for North West Essex (Mrs Badenoch), I would only say very gently that she should probably take that as a compliment. When the right hon. Gentleman attacks someone in that way, it probably means that they are somewhat frit of her. I think he will see in the coming weeks and months why that is so.
We have already seen and heard over the previous days of debate that this is unequivocally a Budget of broken promises. Despite the pledges made over the course of the election and the commitments given to the British people, in reality those words meant nothing to the Labour party once it secured the keys to No. 10. Instead, we have seen taxes hiked on working people: the people who provide food security and food every day, our farmers, hit hard by the changes that have been made. We see living standards set to fall and mortgage rates likely to rise. We see taxes up, we see borrowing up, we see debt up, and we see that growth will be down on where it could and should be. Unfortunately, I fear, that pattern of broken promises also applies to the NHS and our social care sector.
Mr Perkins
I am grateful to the right hon. Gentleman for giving way and congratulate him on his new appointment. He is obviously very critical of the Government’s attempt to alleviate the appalling financial legacy that his party bequeathed to the nation. Does he support the extra investment for the health service, and is it just the ways of paying for it that he is against? Or is he actually opposed to it?
Edward Argar
I am very grateful to the hon. Gentleman. In his allusion to the Labour party’s inheritance, he missed the fact that the Office for Budget Responsibility singularly failed to back up the assertions made about the quantum of challenge the incoming Government faced.
Time and again, the right hon. Member for Ilford North (Wes Streeting), both in opposition and now as Secretary of State, has promised that any more money for the NHS has to be linked to reform. He has done that again today. The week before the Budget, he said that
“extra investment in the NHS must be linked to reform”.
In September, the Prime Minister himself said:
“No more money without reform”.
They are right on that. The Opposition support that condition, because it is only with reform that the NHS can sustainably continue to look after us for years to come. Yet I fear that this risks being another broken promise. I say to him now that where he is bold and provides genuine reform to benefit patients, he will have our support. Equally, if he bows to internal pressure and backs away from the radical reform that is needed, we will hold him to account.
Joe Powell (Kensington and Bayswater) (Lab)
Will the right hon. Gentleman give way?
Edward Argar
I will make a little progress before giving way to the hon. Gentleman.
I congratulate the Health Secretary on winning round 1 with the Treasury—I look across the Chamber and see the Chief Secretary to the Treasury on the Government Front Bench—in securing extra investment. He has secured more than £22 billion announced for the NHS, but without, as yet, any detailed indication of where that funding will go. I look forward to him returning to the House to set out the detail—I think he said that would be next week. What it must do is genuinely improve outcomes for patients and our NHS, rather than simply be focused on the headline figure of the inputs to it. There are, as yet, no clues as to whether it will be spent on wages, recruiting more staff, medicines or equipment; no clues as to how it will deliver the 40,000 additional appointments that have been promised; and no conditions linking the funding, as yet, to productivity improvements, modernisation or better outcomes for patients.
What we need to hear next week from the Secretary of State is an actual plan. As he mentioned, the right hon. Gentleman became shadow Health Secretary three years ago. I hope that in that time he has had an opportunity to think about what he wants to do and that he will actually set that out to the House next week.
Joe Powell
I welcome the right hon. Gentleman to his new position. On the theme of broken promises and capital investment, and in the spirit of a fresh start, I wonder whether he will extend an apology to my constituents who were promised a new hospital under the new hospital programme, which was never funded in any forward-looking Budget document?
Edward Argar
I am grateful to the hon. Gentleman. If he pauses for just a moment, I will turn to capital investment and seek to address his point.
Edward Argar
I will make a little progress, but then I will happily give way to my hon. Friend.
Apart from the press releases and the reviews, where is the action? We need to see where the £22 billion will be spent. What plans does the Secretary of State have for additional investment for the NHS this winter? He knows, as I knew when I was a Minister, that winter in the NHS is always challenging. I look forward to him setting out what additional investment he plans.
Edward Argar
I will give way to my hon. Friend the Member for Hamble Valley (Paul Holmes) in a second. Nice try, Secretary of State.
Is the right hon. Gentleman directing where that NHS funding goes himself, or will it be for his officials or NHS England to set the priorities for that, and who will be held accountable for ensuring that it is prioritised in the right places?
Paul Holmes
I thank my right hon. Friend for giving way and congratulate him on his appointment as shadow Secretary of State. Does he share my concern that, although the extra investment in the NHS is welcome, the lack of clarity from a Budget in which growth has actually been revised down means that in future years we could see additional investment in the NHS actually being cut back, because the Budget does not deliver the growth for public service investment?
Edward Argar
My hon. Friend is absolutely right. You cannot tax your way to growth and you cannot invest in public services without that growth. If the predictions we are seeing about growth are borne out, there is a real risk to our public services’ sustainability in future.
The Chancellor said that the funding would help to deliver 40,000 more NHS appointments a week, but again we see no reference to specific actions by which that will be achieved. The Government seem not to know the difference between a target and a plan, and simply restating their ambition while throwing money at the challenge will not be enough to deliver on that commitment.
As I have said, elements of the Budget relating to the Department of Health and Social Care were welcome, one of them being the Secretary of State’s one-nil win over the Chief Secretary in respect of funding. An additional £2 billion to drive productivity is important. I fear that it is a slimmed-down version of the £3.4 billion NHS productivity plans that we announced and funded, but I will study it closely, and, similarly, the Secretary of State’s plan for mental health is deserving of serious study. On both sides of this Chamber, we recognise the importance in mental health investment of not only parity of esteem but parity of services, and it is therefore right for us to scrutinise very carefully how the right hon. Gentleman intends to build further on the success that we had in driving that agenda forward.
Let me now turn to the subject of capital investment, which was touched on by the hon. Member for Kensington and Bayswater (Joe Powell). It concerns me that, as far as I am aware, the Secretary of State has still not told us exactly when his review of the new hospital programme will report and set out the future for each and every one of the hospitals that he committed himself to delivering during the election campaign—the programme to which the previous Chancellor had committed funding, building on the original £3.7 billion allocated in 2019. The question for the Government, and the question for the Chief Secretary to answer when he winds up the debate, is: “When will that review report, and when will each and every one of those colleagues and communities who are looking forward to a new hospital know whether it will be delivered in line with the Secretary of State’s pledge, or whether the programme will be cut?”
Nearly a week after the Budget, Members will be familiar with the verdict of the Office for Budget Responsibility: namely, that the £25 billion assault on businesses risks lower wages, lower living standards and lower growth. And let us not forget what this tax hike will mean for those providing essential services across primary, secondary and social care—the general practices, care homes, adult social care providers, community pharmacists on our high streets, hospices and charities such as Marie Curie and Macmillan which provide additional care for patients alongside the NHS.
I was deeply disappointed that the Secretary of State did not take the opportunity offered by my hon. Friend the Member for Hinckley and Bosworth (Dr Evans) to state clearly that all those groups would be exempt and would not be hit by this hike, and I hope that when the Chief Secretary winds up the debate he will be able to give that reassurance. The Royal College of General Practitioners has warned that the extra costs of the employer’s national insurance hike could force GP surgeries to make redundancies or close altogether, and the Independent Pharmacies Association has warned that community pharmacies will have to find an extra £12,000 a year, on average, to pay for the hike.
Pete Wishart (Perth and Kinross-shire) (SNP)
I welcome the right hon. Gentleman to his place. I was waiting for the Health Secretary to turn to devolution issues, but he never quite did. We have a particular issue in Scotland: up to £500 million of extra costs will be forced on to the NHS there because of that national insurance hike. We have heard no commitment from the Secretary of State that he will meet those costs in full, and we look forward to hearing such a commitment. I am sure the right hon. Gentleman will share my concern about what this is doing to devolved services across the United Kingdom.
Edward Argar
The hon. Gentleman is right to highlight the ill-thought-out consequences of this hike for hospices and general practices, both in Scotland and elsewhere. I would dearly love to be able to respond to his question. Sadly, however, I am on this the side of the House and not the other side, but I am sure that the Chief Secretary will attempt to do so.
The Nuffield Trust has said that without additional financial support, the tax raid is likely to force social care providers to pass higher costs on to people who pay for their own care, or potentially collapse financially. Charities are not exempt either. As a result of the increases in the national living wage and employer’s national insurance contributions, one of the UK’s largest social care charities says it is facing an unfunded increased wage bill of £12 million a year, and Marie Curie has warned that the rises in employer’s NI contributions will only serve to put the services that it delivers on behalf of the NHS under further pressure. Those charities will be looking to the Chief Secretary to say what succour he can offer them in the form of an assurance that they will not be hit.
Ms Polly Billington (East Thanet) (Lab)
I welcome the right hon. Gentleman to his place, but before throwing stones, will he just remind the House that under his Government’s plans, there would have been £15 billion less for the NHS, leaving it broken?
Edward Argar
I welcome the hon. Lady to her place as well. I think this is the first opportunity I have had to respond to a intervention or question from her.
In fact, we put record funding into the NHS—£164.9 billion per year—and on top of that we recruited more doctors and more nurses. We did not do that by piling tax hikes on hospices and general practices, among others. I am not sure how hitting primary care, social care or charities supporting NHS services will help the Secretary of State to deliver his aim of cutting waiting lists. I hope that the Chief Secretary will tell the House what steps the Treasury is taking to ensure that those organisations are not hit by these changes.
Let me take a moment to consider what was not included in the Budget.
Josh Fenton-Glynn (Calder Valley) (Lab)
Will the right hon. Gentleman give way?
Edward Argar
I will make a bit of progress, if I may.
There were no plans for social care reform after the Chancellor broke Labour’s promise to deliver the cap on social care costs. I hear what the Secretary of State says about a willingness to work on what is a challenge facing our whole country and society: with an ageing population, how do we address the challenge of social care? There were no further detailed plans for NHS dentistry, despite the election pledge to deliver more dental appointments. There was no support for pharmacies or for the day-to-day running of general practice, and there were still no additional resources for the NHS this winter—or, indeed, the details of reform to go with them.
Lizzi Collinge (Morecambe and Lunesdale) (Lab)
The right hon. Gentleman speaks about the investment that the last Conservative Government put into the NHS. Can he tell me what the outcome of that investment was? From my point of view, the outcome was longer waiting lists, poorer health and bad patient care.
Edward Argar
We increased investment significantly, not only to tackle the inevitable consequence of a global covid pandemic—which, as we all know, hit our NHS hard—but to build back better subsequently, which is the task that we began to perform. We have always said that investment in the NHS must be married to reform in order to deliver better patient outcomes and value for money, building on the reforms that we introduced in the Health and Care Act 2022 and ensuring that the NHS will be there to look after us for decades to come. The Secretary of State has worked with me before, and we will work with any party, including his.
Edward Argar
I gave way to the hon. Gentleman earlier. I am afraid I want to conclude my remarks, because I am keen for others to have a chance to speak.
That offer to the Secretary of State stands. I am always happy to work constructively with him when he is willing to work constructively with me. He knows that we have done that before, not least as we emerged from the pandemic, when I was still a Minister in the Department.
Unfortunately, despite the rhetoric, I fear that the Budget was a missed opportunity that will not achieve the ambitions the Government have set out. As I have said, we cannot tax our way to growth, and without growth we cannot sustainably fund public services. I urge the right hon. Gentleman to be brave, to stand up to those in his party who would have him back down or water down reform, and to deliver a genuinely radical plan for the future of our NHS and for social care that works for those who work in it, but also, crucially, for all the people who rely on it. Our constituents deserve nothing less from him.
Kate Osamor (Edmonton and Winchmore Hill) (Lab/Co-op)
Thank you, Madam Deputy Speaker, for calling me so early in the debate. I was not expecting that.
I very much welcome the investment in our NHS, and our renewed focus on public services. The Budget marks a break from the approach of the last Government, who presided over the decline of our health system. With this renewed investment, the biggest since 2010, there is now some hope that we can turn a dire situation around. We must improve patient outcomes, reduce waiting times and support the hard-working staff who form the backbone of our health system. However, I want to stress to the Secretary of State—my constituency neighbour —that investment must focus not only on delivering numbers, but on quality of care, with a human touch and equal access for all. That requires us to reject the creeping privatisation of our health service, which has proven costly, inefficient and bad for patients.
Before coming to this House, I worked in the NHS as a practice manager in the London borough of Enfield. I also worked in an out-of-hours GP co-operative, which covered north and east London. I know from first-hand experience that GP surgeries and core NHS services must remain publicly owned and accountable to their patients and staff, the public and stakeholders. Furthermore, I have deep reservations about the current plan to grant the NHS data platform contract to Palantir, which raises serious questions about privacy, security and the future of our NHS data infrastructure.
Christine Jardine (Edinburgh West) (LD)
I was listening very carefully to what the hon. Lady said about her experience as a practice manager. Over this past weekend and the last two days, I have been contacted by local practices in my constituency that are concerned about the impact of the national insurance changes on their ability to provide patient care and the vital first step towards getting people into the hospital and through the waiting lists. Does the hon. Lady agree that we have to address that as a fundamental problem that is potentially created by this Budget?
Kate Osamor
I thank the hon. Member for her intervention. I would add that it is important that patients, doctors and everyone else are listened to. I am assured that the Secretary of State will be listening to all voices.
NHS data is a public asset. Its management should be rooted firmly within the NHS, not placed in the hands of private interests, especially those controlled by an individual who is so hostile to the principles of public healthcare. Our NHS thrives due to the work of everyone in the system, from nurses to administrative staff and healthcare assistants, who each play a critical role in patient care. We must listen to all NHS staff, not just those in the highest-ranking medical roles, as everyone brings valuable frontline perspectives on improving efficiency, patient experience and accessibility.
I especially draw attention to the hard-working staff who provide out-of-hours services for our communities, often doing so on top of their normal hours. The Government must ensure that those professionals receive not only recognition, but the resources and support they need to continue serving our communities in this vital way. Staff in out-of-hours services often only work in such settings part time. However, they are often the last resort for people who are unable to get appointments with their GP or access the care they need.
We must also address the postcode lottery in healthcare. For various conditions, disparities persist in access to specialists, waiting times and outcomes in relation to area, ethnicity and gender.
The stark reality is that mental health services remain woefully inadequate. We face a mental health crisis, especially among young people, and this impacts on personal wellbeing and ruins life chances. We urgently need targeted investment in mental health services, and I look forward to supporting the Government in ensuring that the crisis in mental health support is treated with the seriousness it demands.
This Budget is a strong step in the right direction, but we must go further to ensure that the NHS remains public, that mental health is prioritised and that all NHS staff have a voice in shaping the future of our health system. I ask the Secretary of State to focus on all those areas, because I believe that if we have consistent investment throughout this Parliament, we can ensure that we make progress towards an NHS that works and in which everyone is able to access the quality and timely care that they justly deserve.
Helen Morgan (North Shropshire) (LD)
I declare an interest as a vice-president of the Local Government Association. I welcome the shadow Secretary of State to his place. He responded to my first Adjournment debate on a Thursday before Easter, and I was very grateful, but he will be disappointed to hear that we have not seen the improvements in ambulance response times that we would have liked to see in Shropshire.
Last week’s Budget brought £22 billion of investment for the NHS. By anybody’s standards, that is a big number, so the Liberal Democrats welcome the investment. The NHS was left in a dire state by the Conservatives, and it is clear that something radical must be done. What is the Conservatives’ legacy? Well, we all know: crumbling hospitals, 7 million people on NHS waiting lists for secondary operations, our constituents struggling to access a GP when they need one, dental deserts such as the one in North Shropshire, appalling ambulance waiting times with horrifying outcomes, and a tsunami of a mental health crisis waiting to overwhelm us. It is clear that investment is needed, which is why the Liberal Democrats put the NHS at the front of our election manifesto and our campaigning since.
It is very important that the £22 billion is spent wisely to keep people healthy and to save money in the future, so I look forward to hearing how the Budget will affect the public health grant and mental health services in particular. Those are two really important areas where we can invest to save taxpayers’ money, and to get better health outcomes for people and avoid their suffering in the future.
It is also really important that the £22 billion of investment is not undermined by a decision made by the same Government on the very same day. It is hard to believe that the decision to increase employer’s national insurance contributions and to lower the threshold—at a cost of £566 per person—was properly thought through before the Budget was delivered last Wednesday. That decision is going to hit GP practices, hospices, social care providers and the charities that provide so much additional care outside the formal NHS structure. A local GP got in touch with me over the weekend to say that the decision will
“serve to directly undermine access and patient care at a time when practices are already under strain due to years of neglect.”
Another said it will “kill the family doctor”.
Why will it kill the family doctor? Because GP practices are not eligible for employment allowance. They cannot put up their prices, and their only option is to cut staff and services, which would be a disaster. The Conservative Government proved that if we cut the number of GPs, we end up with a really big problem in the NHS—one that we are fighting now. Labour’s plan to increase the number of GPs, which is welcome, is surely in jeopardy because of the increase to employer’s NICs. The Liberal Democrats are calling on the Government to exempt GPs from the NIC hike or ensure that they are funded to cover it. Otherwise, no one is going to see their GP within seven days—a right that the Liberal Democrats think people should have.
I want to touch on social care, which feels a bit like the elephant in the room and is likely to be significantly affected by the change in thresholds and rates of employer’s national insurance contributions. We all know that the sector is in crisis, and the Budget took note of this but did not really go far enough to address it. I think we can all agree that we cannot fix the NHS without fixing social care. We know that there are thousands of patients in hospital who are medically fit to be discharged and who would recover better in their own bed at home, but who are stuck in a hospital because the social care packages are not available to allow them to return home.
That bed blocking, which is a horrible term, causes patients to be unable to flow through a hospital when they are admitted. It causes the queues of 12, 13 or 14 ambulances that we see outside hospitals in Shropshire on a regular basis, and it means that those ambulances do not arrive when somebody is in a life-threatening position in their community. Social care is so important in dealing with this urgent problem.
Stuart Anderson (South Shropshire) (Con)
As the MP for South Shropshire, I have been in the same meetings as the hon. Lady, who represents North Shropshire. In Shropshire, about 80% of council funding goes to social care. Does the hon. Member believe that we need a fairer system to support funding for social care in Shropshire?
Helen Morgan
Fair funding for rural authorities, and indeed all local authorities, is something I have talked about many times in this House, and I absolutely agree with the hon. Gentleman on that.
We saw £600 million allocated to social care in the Budget and an increase in the national living wage, both of which are obviously welcome, but the huge pressure on private providers as a result of the national insurance contributions increase will be really problematic, unless councils are funded to pay those additional costs. It is not clear that the funding announced in the Budget will even touch the sides of the crisis in local government funding or in social care. We all know that this is a thorny problem, and that funding social care is extremely expensive and difficult; that is why cross-party talks are so urgent. I urge the Secretary of State to instigate those as soon as possible, so that we can work towards a permanent fix for social care. Liberal Democrats believe that free personal care on the Scotland model would be the best way of achieving that, and the Institute for Public Policy Research says that we could save £3.3 billion by 2031 by implementing that model. That would be a good investment, because it would save taxpayer money and it would keep people in their homes—where they want to be—with dignity.
The debate today covers other public services, and I want to touch on a couple; education is an important one, and we welcome the investment in it, but I want to talk a bit about SEND budgets and local authorities. Schools are under enormous pressure to provide SEND measures for the children they look after, and local authorities are under huge pressure to provide transport and specialist places. The £1 billion for local government will be insufficient to deal with social care, the SEND crisis and SEND transport. As the hon. Member for South Shropshire (Stuart Anderson) mentioned, Shropshire council is spending about 80% of its budget on social care, so without adequate measures for social care, it seems unlikely that this Budget will address all the problems that local authorities need to deal with.
We are therefore concerned about the decision to put VAT on private school fees. Schools such as Oswestry school in my constituency take a relatively large number of pupils who have failed to thrive in a larger setting. They have special educational needs but no education, health and care plan, and they might even have refused school altogether. There is a risk that those children, whose parents are saving hard to put them into that alternative place, will end up back in the state sector, where their needs are not met. They might refuse to go to school, and the school would struggle to cope with those additional children. The capital expenditure is welcome, and I hope that the demountable buildings at the Corbet school in Baschurch will benefit from that announcement, but I urge the Government to reconsider some of those measures.
On transport, it was disappointing to see the bus fare cap increased, although in Shropshire it will not make any difference, because it is almost impossible to catch a bus anywhere. We would really like to see some of the detail behind the public transport plans announced by the Chancellor, particularly the bus service improvement plan that Shropshire council has put forward, and railway schemes such as the Oswestry to Berwyn line.
Finally—it may be stretching it to call this a point about public services—I believe that farmers provide an essential public service in feeding us, looking after the countryside and protecting the rural environment, and it is disappointing to see that there is confusion between the Department for Environment, Food and Rural Affairs and the Treasury about how many farms will be affected. My sense from talking to local farmers in Shropshire is that the DEFRA numbers are more accurate.
Peter Swallow (Bracknell) (Lab)
Does the hon. Lady not see that by opposing every measure in the Budget to raise money while supporting every measure to spend more money on our vital public services, she is creating a bigger problem than the one we inherited from the last Government?
Helen Morgan
I thank the hon. Gentleman for his intervention. The point that we are trying to make is that some of the Budget measures will cost extra money. If we look at the detail on the national insurance contributions hike, for example, we see that changes in behaviour and exemptions for the NHS will reduce the amount of money raised to about £10 billion. We have absolutely put forward alternative measures to raise £10 billion. Whether by reversing the Tories’ cuts to the banking taxes or by putting taxes on online media giants, we would find alternative ways to raise those funds. The point about private school fees is the same. If we overburden the state sector with children who have special educational needs, difficulties and disabilities, those children will not have their needs met, and that will cost us more in the future. This is all about making sensible choices to save taxpayer money in the future and, most importantly, delivering public services to the people who need them most, whether they are trying to access NHS care or whether they need help to get through their school career in order to thrive and achieve their potential.
Helen Morgan
I am just about to conclude, so I will carry on.
I was about to talk about farmers and the concerning differences between DEFRA and the Treasury on the number of farms that will be affected. My sense from talking to farmers locally is that the DEFRA numbers are more likely to be accurate, and I therefore think there may have been a serious misstep in the plan to raise what will be a relatively small amount of money.
Liberal Democrats welcome investment in the NHS. We welcome the ambition to undo the damage wrought on this vital service by the previous Government, but we are concerned that, in social care in particular, we are in danger of kicking a thorny problem down the road. We urge the Government to consider immediate cross-party talks on funding social care and providing a long-term solution. We are also really worried about the impact of increased national insurance contributions on key providers outside hospitals. We cannot have GPS going out of business because of a Government measure that was intended to improve and expand their services.
My constituents were fed up with being taken for granted by the Conservatives and they voted emphatically to change that situation, but I am sure that they are very worried that they are about to be ignored by Labour. I urge the Government to rethink their damaging policies on national insurance contributions and the care sector, to have another look at the impact of the Budget on family farms, which I think may have been underestimated, and to back the infrastructure that rural areas need.
Several hon. Members rose—
Madam Deputy Speaker (Caroline Nokes)
Members will be aware that this is a very heavily subscribed debate, so a time limit will be coming, but not until after we have heard some maiden speeches. I call Juliet Campbell.
Juliet Campbell (Broxtowe) (Lab)
It is an honour and a privilege to be making my maiden speech in this Budget debate. Our plans for the NHS and public services give me hope, and a sense of pride that they will once again be here, ready for all of us. I make my maiden speech today with a sense of gratitude and humility, and I thank my Broxtowe constituents for putting their trust in me to represent them here in this esteemed place. I pay tribute to my predecessor, Darren Henry, for all he has done for the residents in Broxtowe. Darren worked hard to establish banking hubs and continued the efforts of Anna Soubry in working with local groups to fight for our railway services. Their work in securing step-free access to Beeston station will give everyone the opportunity to visit our brilliant constituency.
I look forward to expanding upon Labour’s legacy in Broxtowe, where Labour last made its mark under the tireless efforts of Nick Palmer. Nick represented Broxtowe from 1997 to 2010, bringing about reform through many successful Bills. I would like to thank my family for their support and encouragement, particularly my son, my daughter-in-law and my brothers. I would also like to thank all the members in Broxtowe who have been a tremendous help to me. To those who have gone above and beyond: you know who you are, and I will never forget your kindness and generosity.
I began my career as a civil servant before moving into the NHS, where I worked my way up to become a senior manager, but it was education that brought me into politics. In 2011, I set up a not-for-profit organisation that focused on dyslexia, and I sincerely hope that what I advocated for—reform of the teacher training curriculum with regard to SEND provision for dyslexic students—can make it into the education reforms soon. I was elected as a councillor in 2018 and my cabinet brief was quite varied. It included public health and wellbeing, equalities, refugees, violence against women and girls, and community safety. I wanted to be part of the change that this country so desperately needed after almost a decade of austerity and decline that hit every single community in this country.
Broxtowe is a wonderful, thriving constituency of two halves. In the north, I have a particular soft spot for Eastwood, as it borders Bilborough, where I was raised. Eastwood, of course, is the birthplace of one of the most popular English novelists of the 20th century, D. H. Lawrence, who showed a much more clandestine side of British society. As well as risqué classic novels, Broxtowe has a beautiful and diverse landscape that hosts the brilliant Attenborough nature reserve. Located in the southernmost part of the constituency, it spans 540 acres of conserved land, wetland, woodland and lakes. Visitors may spot 250 species of bird, including several nationally rare species of heron and rail that have been spotted there over the years.
Broxtowe is also home to businesses, from the small and independently run to the headquarters of large international companies such as Boots, Worldline and the UK arm of Raleigh. I have had the pleasure of visiting Caunton Engineering, a steelwork company with an excellent apprenticeship scheme that offers brilliant opportunities to young professionals.
Broxtowe also hosts Forever Stars, a baby loss charity that supports families who lose their children during pregnancy or shortly after birth. Its sensitive and innovative work with hospitals is truly inspiring.
At the heart of my constituency is Chilwell, home to the impressive Chetwynd barracks, which has resisted closure three times in the past 10 years. Chetwynd is home to a reserves training and mobilisation centre that specialises in engineering. My dad is an engineer who received his training in Nottingham through the Territorial Army, and I am committed to ensuring that the voice of our armed forces is heard here in Parliament.
I stand here today as the youngest of five children, born to parents who migrated to the UK from Jamaica in the 1960s. My parents brought me up to believe that I could do anything I wanted, and that the only barriers in front of me were those that I chose to notice. I took notice of none of them. Too often, factors such as class, race, gender and disability can be perceived as hurdles in the pursuit of ambition. They should not be, and I have dedicated much of my career to challenging and advocating for the removal of barriers, so that all have the opportunity to reach their potential.
Reflecting on my journey, I must say that I have thoroughly enjoyed my varied career, but today, as I give my maiden speech in this great House as the Member of Parliament for Broxtowe, I think this is my best role yet.
Esther McVey (Tatton) (Con)
I congratulate the hon. Member for Broxtowe (Juliet Campbell) on her maiden speech and her personal story. I thank you, Madam Deputy Speaker, for calling me to speak in today’s Budget debate on fixing the NHS and reforming public services. However, the truth is that this Budget’s smash and grab on the UK’s businesses means that the money will not be there to pay for the excellent public services this country requires.
Labour has never understood the concept of private enterprise and businesses paying for public services, and that it is only with a thriving private sector that the country can have the public services it wants and needs. Make no mistake: this Budget will be catastrophic for the economic health of this country. It is the biggest tax-raising Budget in British history, and it will turn out to be the longest suicide note in Labour’s political history, too.
The Budget is socialism at its worst: high taxes, high spending and massive debt. [Interruption.] Labour Members are laughing, but this is massive debt for future generations. This Budget is anti-business, anti-farmer, anti-aspiration, anti-wealth creation and anti-worker. Yes, anti-worker. Despite all of Labour’s promises before the general election, the Government are taxing workers as they raise national insurance contributions for employers.
This begs the question: do the Chancellor and the Prime Minister not know how the economy works? They certainly do not know how business works. Not one of the current bunch of Cabinet Ministers has ever set up a business. No wonder they do not have a clue about national insurance contributions.
For clarity, both the independent Office for Budget Responsibility and the Institute for Fiscal Studies have said that 80% of the employer national insurance rises will be paid for by the workers through lower wages and reduced employment levels. No wonder Labour Members have now gone silent.
The Chancellor’s raid on the unfairest tax of all, inheritance tax, will double the number of estates that have to pay it and, disgracefully, will make it virtually impossible for family farmers to pass on their business to the next generation. Farmers are most definitely working people, just in case Labour Members do not know. This Budget will be disastrous for our rural areas and for the country’s food security, and all because of good old-fashioned socialist envy.
Esther McVey
No, I will carry on, thank you very much.
In addition to huge tax rises, this Budget will have an eye-watering impact on the country’s debt. Debt interest payments will be more than £100 billion a year, every year, and will reach an astonishing £120 billion by the end of the decade. To put that into context—
Several hon. Members rose—
Esther McVey
I will carry on for a little longer.
To put that into context, it dwarfs the UK’s annual defence spend, which stands at £55 billion. This is money being wasted instead of being spent on public services.
And if all that was not bad enough, the Office for Budget Responsibility has downgraded its growth forecast to a measly 1.5% for the years running up to the next general election. So much for Labour saying this would be a Budget for growth. This Labour Budget has taken our country back to the 1970s, with crippling taxation, unsustainable levels of borrowing and the trade unions in control. The Budget has also broken virtually every economic promise Labour made during the election. In fact, even worse than the economic misery this Budget will bring might be the further mistrust in politicians it will cause.
Labour ruled out tax hikes on working people more than 50 times, and it ruled out changing the fiscal rules to fiddle the figures. Mark my words, on top of the betrayal of pensioners with the scrapping of the winter fuel allowance, this Budget will be a nail in this Government’s coffin, only four months after they secured a huge majority.
At the weekend, the Chancellor eventually came round to admitting that Labour will be taxing workers, but I am afraid that saying it now, having denied it at the general election, does not wash. It is way too late to be admitting it. All it has done is expose the fact that this Labour Government were elected on a false premise and therefore do not have a mandate for this Budget. [Laughter.] Laughing after not telling the public what they were going to do is why I certainly will not be supporting this Budget.
Madam Deputy Speaker (Caroline Nokes)
I call Lewis Atkinson to make his maiden speech.
Lewis Atkinson (Sunderland Central) (Lab)
It is pleasure to follow my hon. Friend the Member for Broxtowe (Juliet Campbell), who spoke movingly about her experience in the NHS, as well as the barriers she has ignored and, indeed, knocked down.
I start by paying tribute to my predecessor, Julie Elliott, who not only worked with commitment for Sunderland Central, but provided political leadership and mentorship across the north-east. Julie understood that organising and advocating on a regional basis is often the best way to deliver for our communities. I hope to follow her example. It is the honour of my life to be in the House of Commons representing the city by the sea that I love.
I am pleased that my first debate contribution is about the budget and the NHS, for what is our purpose here if not to improve the economic conditions of our constituents and the care available to those we serve? Health and wealth have always been linked—twin assets—as families like mine, forged in the Durham coalfield, know well. My grandparents were only able to toil at the pit, in the munition factory or in the home for as long as they were healthy. Working-class communities have always feared illness and injury, not just in its own right but because the resulting inability to work was disastrous for family finances. The introduction of the NHS and national insurance by the Attlee Government was intended to protect against such calamities. We have important work to do to repair and renew those civilising protections today.
The link between inequalities of health, wealth and power has been impressed upon me by the privilege of working for two decades in NHS North East. Whether managing dentistry, mental health or cancer services, I saw at first hand how the poorest generally experience the poorest health outcomes. I intend to spend some of my time in this place working to right that situation.
The qualities of innovation and hard work have always been the building blocks of Sunderland’s economy. From the introduction of glassmaking in Britain at Bede’s monastery of St Peter’s, through the education of lightbulb inventor Joseph Swan, to becoming the UK’s leading digital smart city, Sunderland has always been a home of innovation. We have always made things. For 600 years, that meant ships. At our peak, the people of Sunderland were hard at work “macking” a quarter of all ships produced globally each year, and we were likely dubbed “Mackems” as a result. Wealth from shipyards and pits built Sunderland, but such work often caused a thirst, so it was handy that the most popular stout in the country was produced in the centre of town, at the Vaux brewery, until the second world war interrupted production.
In that war, as in others before and since, the patriotic people of Sunderland answered their country’s call. This weekend, I will be honoured to play a small part in what is thought to be one of the largest Remembrance services outside London, reflecting the high number of veterans in our city and the sacrifices made by so many, including my constituents who served in Iraq and Afghanistan.
While the bravery and fortitude of Sunderland’s people has never been lacking, too often they have faced the headwinds of economic change without a Government on their side. By the end of my childhood, the pits, the shipyards and even Vaux had all gone. But the people’s spirit and an understated determination remained, and it is thanks to them that our city is now on the up.
I am not just referring to top-of-the-Championship Sunderland AFC, a football club that has provided me with more agony and ecstasy than even the Labour party has managed. Our Stadium of Light stands on the site of the Monkwearmouth colliery, but now instead of coal we produce a rich seam of talented players, such as Jill Scott, Jordan Pickford, Lucy Bronze and Chris Rigg.
I also celebrate the workers at the most productive car plant in Europe, Nissan, which although not in my constituency is the modern cornerstone of our city’s economy, continuing our advanced manufacturing heritage and skills.
Elsewhere around the city, where there was previously decline we now see new beginnings. On the banks of the Wear, we no longer have shipyards, but we do have the Crown Works studio site, ready to be transformed into a landmark film studio. Where the brewery once stood, we have cranes in the sky for Riverside Sunderland, the most ambitious city centre regeneration project in the UK. We have our excellent university, with particular strengths in media and healthcare, and we have a city that loves a good time, where growing hospitality and cultural businesses provide plenty of decent days and nights. It might be a show at the Sunderland Empire, a meal at one of our many excellent British-Bangladeshi restaurants, or a gig at one of our independent venues.
Where passion and identity are strong, there is music—and Sunderland is a music city. Having produced talent from Dave Stewart to the gone-too-soon Faye Fantarrow, our city’s artists reflect who we are, honour our proud heritage and point towards our bright future as an inclusive city.
Nowadays, we celebrate that Mackems are found in mosques and churches, our community centres, our gurdwara and our social clubs, and now there are even two Mackems in the Cabinet. All my constituents, no matter what their background, deserve a strong economy and quality public services. Because Sunderland was built on hard work, its people rightly expect nothing less from their politicians. It is in that spirit that I recognise the privilege of being in the House on behalf of our entire community. I will do what I can to serve them and repay the trust they have placed in me.
Madam Deputy Speaker (Caroline Nokes)
I call Adam Dance to make his maiden speech.
Adam Dance (Yeovil) (LD)
I congratulate the hon. Members for Broxtowe (Juliet Campbell) and for Sunderland Central (Lewis Atkinson) on their fantastic maiden speeches.
On this of all days, I thank you, Madam Deputy Speaker, and your team, as well as all those who make Parliament work for the people and keep us safe. I hope our friends in the United States of America appreciate the task they have before them today, not only for America but for the rest of the world, to provide leadership in promoting opportunity and fairness for all, a theme to which I will return.
I thank my predecessor, Marcus Fysh, for his nine years of service to our community. While we certainly had our differences, I know we share a deep appreciation for the privilege of representing the place we proudly call home. When I arrived at Parliament, a member of staff greeted me with, “You’re the new Member for Yeovil, aren’t you?”. “Yes,” I nervously replied, and was promptly told, “You’ve got big boots to fill!” It was a proud moment, and one that I will strive to live up to.
My maiden speech would not be complete without acknowledging the influence of one person in particular: the right honourable Paddy Ashdown, who inspired me, and so many others across the country and the world. He, alongside David Laws, encouraged me to campaign to save South Petherton youth club when cuts threatened to close it. From there, my journey into public service began, first on the parish council, where I became chair at the age of 20, followed by the district council then Somerset county council.
I say to young people everywhere, “Don’t let the system put you down.” They should not let anyone tell them that if they have attention deficit hyperactivity disorder or dyslexia—I have both—they need to find suitable work, as they will not make anything of their lives otherwise. With good teachers—I had several excellent ones, including one who is in the Gallery—I have made it up through the political system, to the top representative role for around 100,000 people in my constituency. If I can make it, so can everyone else.
As lead member for public health, equality and diversity at Somerset council, I campaigned for our local health services, fighting to resolve the crisis caused by Conservative mismanagement. I am glad to see the new Government have used this Budget to begin reinvestment in our NHS, starting to reform our national and local health services, which is desperately needed, but that is just the tip of the iceberg.
The constituency of Yeovil is rich in history and ambition, and comprises the towns of Yeovil, Chard, Crewkerne, South Petherton, Ilminster and many surrounding parishes. Built on agriculture and the gloving industry, the area has evolved into a hub of engineering excellence, with Petters engines, which created Westland and now Leonardo, at its engineering heart. I am pleased to have received written confirmation from the Minister for Defence Procurement and Industry, the right hon. Member for Liverpool Garston (Maria Eagle), that Leonardo UK, as the sole remaining bidder, will be put forward to the next stage in the procurement process for the New Medium Helicopter. The previous Government delayed this project for decades.
Last month, I had the privilege of opening the single site logistics hub in Yeovil, a joint investment of £30 million by Kuehne + Nagel and Leonardo with much more to come. Government backing for this fantastic product could see export orders flow, which this country desperately needs. Last week, the Chancellor’s announcement of a £1 billion package for Ministry of Defence procurement—some of which is for the south-west— puts in place the necessary funding to make that a reality.
The Yeovil constituency is not just about helicopters. Chard is home to Numatic, the birthplace of Henry—everyone’s favourite vacuum cleaner—and his friends. John Stringfellow flew the first powered aircraft over Chard in 1848. In 1979, the Woodscrew Supply Company started in Yeovil, which became Screwfix in 1992, the year in which I was born. Last Friday, I visited the headquarters of Screwfix, which now has more than 900 stores nationally.
In 1986, a Lynx aircraft set a helicopter air-speed record of just over 250 mph, which remains unbeaten today. HMS Victory proudly went into battle with sails made in Crewkerne and ropes crafted in West Coker.
Finally, I wish to honour Miss Marion Wright, a less-known daughter of Yeovil, who set sail for a new life in America in 1912. Daughter of Thomas Wright, a farmer, she was carer for her three stepsisters. On 10 April 1912, she stepped aboard the Titanic as a second-class passenger. Just days earlier, the great liner had set out on her sea trials, which were designed to test the ship’s capacity in readiness for her journey ahead. Those trials confirmed her strengths, but did not prepare her for the real challenges and unseen dangers ahead. The trials could not account for the class disparity aboard, where first-class passengers were guaranteed life boats, but those in third class, below deck, fought for survival. Marion Wright was one of the lucky ones, surviving and making that new life in America. She went on to marry Arthur Woolacott, who was likely to have been a draftsman for Petter engines when he lived in the UK. The couple enjoyed a long marriage of 53 years, raising three sons and welcoming eight grandchildren.
Today, the United Kingdom faces its own sea trials. The icebergs on the horizon are clear: desperate inequality; the housing crisis; and, ironically, climate change. The class disparity, which doomed so many on that most famous ship in history, continues to manifest itself in our society today. Access to opportunity is still often determined not by talent or hard work, but by wealth and privilege. Too many are left behind, clawing for their chance to succeed.
Our nation is built on a rich history of achievement, resilience, ambition and hope, but, for too many, that is not enough. At the time, the Titanic was a marvel of engineering, the height of ambition, and, as some would say, a ticket to a new life. Today, she is a powerful reminder that, if not prepared, even the greatest and most advanced of ideas do not serve the needs of the most vulnerable. We must learn the lessons from history. We must unlock the gates of division and ensure that everyone, regardless of their background, has a fair shot at success. Failure risks allowing our nation to sail blindly towards disaster, missing the repeated warnings of inequality and division. We can instead act with the foresight that was lacking all those years ago and ensure that our great country, as well as our friends in America today, can chart a course towards opportunity and fairness for all.
Luke Myer (Middlesbrough South and East Cleveland) (Lab)
On a point of order, Madam Deputy Speaker.
Madam Deputy Speaker (Caroline Nokes)
It is not the time to make a point of order.
I call Cat Eccles to make her maiden speech.
Cat Eccles (Stourbridge) (Lab)
Thank you, Madam Deputy Speaker. May I congratulate my hon. Friends the Members for Broxtowe (Juliet Campbell), and for Sunderland Central (Lewis Atkinson), and the hon. Member for Yeovil (Adam Dance) on their excellent maiden speeches?
To be here in this place representing my home town and the community that I hold dear is an honour beyond words. Stourbridge has a history of electing female MPs and I am proud to be part of this latest cohort—we are the largest number of women in Parliament ever. I wish to pay tribute to my predecessor, Suzanne Webb, who represented the constituency from 2019. She was a vehement supporter of the Justice for Ryan campaign, as was Margot James before her. I will continue to work with the Passey family to get justice for Ryan. I hope that the stricter laws around knife crime that this Government will introduce will ensure that no family has to go through the same ordeal. Before 2010, Stourbridge was represented by Lynda Waltho and formerly Debra Shipley. They are two fantastic Labour women, who were a great support to me during my campaign.
I am Black Country through and through, growing up in Halesowen and later moving to Stourbridge. The town itself was first mentioned in 1255, named after the bridge that crosses over the River Stour. Legend has it that King Charles II hid there from the Roundheads after being defeated in Worcester in 1651.
Since the 1600s, Stourbridge has given its name to glass production; the rich local resources of coal and fire-clay made it the perfect location for the industry. This summer, Stourbridge hosted its last international glass festival, which featured contemporary work by glass makers from all over the world. Stourbridge has long produced sporting, musical and artistic talent, from England football star Jude Bellingham, to Ned’s Atomic Dustbin, Pop Will Eat Itself and Robert Plant. One of my priorities during this Parliament is to promote and protect our varied history, heritage, music and arts, and I am already working towards keeping our own glass festival at home in Stourbridge, and celebrating home-grown music with a local festival.
Across the constituency, there is a rich industrial history to discover, with the sky once black by day and red by night from the many factories. Wollaston produced the Stourbridge Lion—the first locomotive to run on a commercial line in the USA. Round Oak Steelworks in Brierley Hill provided employment for thousands of local people and was a world centre for iron making during the industrial revolution. Netherton was the home of Hingley and Sons whose most famous product was the anchor of the RMS Titanic. Lye was famous for the manufacture of nails, anvils, crucibles and fire bricks— the Stourbridge name can still be found embossed in many old bricks.
Linking all these places are the many miles of canal waterways. Once the highway for transporting goods, now it is a tranquil place to enjoy a walk in nature. The Black Country is no longer the heavy industrial power that it once was, but, with the right investment and opportunities provided by this Government, it can thrive once more with modern technology and green industries.
In last week’s Budget, Brierley Hill got a mention, as the Chancellor confirmed funding for the stalled West Midlands Metro extension. This is welcome news as we work towards a joined-up transport system along with West Midlands Mayor, Richard Parker. The constituency is also home to the Stourbridge shuttle—the shortest railway line in Europe—running between Stourbridge town and Stourbridge junction. This is where we can also find our most famous resident, George the station cat! George was the perfect mascot for the Save the Ticket Office campaign, which I ran with a local resident last year. More than 5,000 flyers were handed out at the station and Stourbridge had over 3,000 signatures for the Parliament petition—the highest constituency number in the country. I am honoured to be here to see the Passenger Railway Services (Public Ownership) Bill go through the House, which will not only improve reliability and efficiency, but protect our precious ticket offices.
Speaking of cats, it would be remiss of me not to mention Mimi, Penny and Hugo, who, along with my husband, John, help to keep me sane. I understand the value that a pet can add to our lives. I look forward to new animal welfare laws and the Renters’ Rights Bill that will allow tenants to keep a pet.
I am so proud to be making my maiden speech during this Budget debate on the NHS and public services. I welcome the £22.6 billion commitment to frontline NHS services to cut down waiting lists, invest in cancer treatments, and provide additional funding for social care. I am the very first operating department practitioner in Parliament—a milestone for our under-represented profession. We are trained specifically to work in operating theatres across the three key areas of the perioperative environment. We can be found passing instruments to the surgeon during an operation or assisting the anaesthetist with a patient’s airway. With more than 15,000 registered ODPs in the UK, it is likely that Members will have encountered one at some point.
My career in the NHS spans nearly 20 years. I have seen the best of our health service, but, sadly, I have also witnessed it crumble in front of my eyes. The impact of austerity on the NHS is what first politicised me. We saw procurement taken away from clinical staff, vacancies frozen, pay frozen, senior staff forced to reapply for their roles, older staff encouraged to take voluntary redundancy, and many more layers of middle management introduced, removing a lot of day-to-day decision making from clinicians.
During the pandemic, I worked on the frontline in emergency maternity theatres. The early days of lockdown were chaotic, with official advice changing by the day. We were given items that were not fit for purpose, face shields that fell off our faces and out-of-date masks. Sadly, we lost some colleagues along the way, including neonatologist Dr Vishna Rasiah and midwife Salaa Alam.
I hope that the contributions of ODPs during the pandemic will be recognised. So many stepped up and fulfilled roles in intensive therapy units, wards and emergency departments—a true demonstration of the flexibility and skill of our profession. I am pleased that the Government are appointing a covid corruption commissioner to investigate fully fraud, errors and underperforming contracts during the pandemic and to ensure that the country is fully prepared in the future. It is also an honour to be in this place as the covid inquiry is published, so that I can speak up for all the NHS staff whose voices were not heard.
Despite the difficulties at work, I was grateful to be able to maintain my daily routine, unlike so many who were forced to stay at home. When I was not on a shift, I was helping to run the Stourbridge covid support group, with over 100 volunteers who helped more than 200 shielding residents with shopping, prescriptions and friendly phone calls. We made over 10,000 face shields for care homes without PPE and raised over £8,000 for our local food bank. We provided Christmas food boxes for families receiving free school meals. The community really pulled together during this difficult time and many of our volunteers are still in touch with their clients.
When war broke out in Ukraine in February 2022, the community rallied again to help those less fortunate than ourselves. Large shipments of clothes, toys and sanitary products were transported to the Ukrainian border. I recently had the opportunity to visit Ukraine and see for myself what people there are dealing with. There is much to be done to ensure victory in Ukraine and I hope to play some small part in that. I welcome the Government’s commitment to providing unwavering support to Ukraine and to combat Russian aggression.
As we see global conflict heightening, I hope for peace everywhere and that the Government, along with world leaders, can influence change to keep everyone safe. I look forward to working with all colleagues in this House to bring about much needed change—not just for Stourbridge, but for our entire country and the wider world.
Several hon. Members rose—
Madam Deputy Speaker (Caroline Nokes)
Order. I propose to put a four-minute time limit on contributions after the next speaker.
Tom Tugendhat (Tonbridge) (Con)
I pay tribute to the hon. Member for Stourbridge (Cat Eccles), who gave a very full description of the constituency that she is privileged to represent. Her predecessor, Suzanne Webb, was a great friend of mine. The hon. Lady has taken over from a fine individual, who is now contributing in many other ways to our national life. I also pay tribute to the hon. Member for Yeovil (Adam Dance), who has the great good fortune of representing my godson, a farmer in his constituency, who will no doubt be contacting the hon. Gentleman shortly about some of the issues that have arisen in recent days.
I myself want to speak about those issues. Today, we are rightly speaking about public services—the NHS, on which we all rely, and those important elements in our lives that keep us together, underpin our economy and really hold us strong. But we are not just speaking about the product, the outcome—the output of those doctors, that money or those services. We are also speaking about the input, because we simply cannot have the one without the other. That is what I want to address.
What we have seen in this Budget is not just the largest tax rise in decades, the highest tax take since the war and greater indebtedness, effectively burdening our children with what we are spending today. When it comes to the fundamental challenge, the Budget is failing to understand how an economy works and why the relationship between generations matters so much. The story that the Budget tells is about a Government who do not understand what a family, generation or business is and do not understand why businesses investing today need the ability to plan long-term and not just be taxed halfway through.
The point is seen most obviously in the tax on farming and on the inheritability of farming property. The truth is that farms are unlike many businesses; they cannot simply be salami-sliced in the hope that they will survive. That just does not work. Individuals end up being forced to decide not just to pay the 20% that the Government ask for but to sell the 100% to liquidate the assets required. That is injecting a dangerous short-termism into the economy.
The truth is that the Government can really only do two things. The first, really important thing is to keep us safe. We all know that the first job of government is national defence and national security. But the second thing, often overlooked, is the ability to extend time horizons. It is very difficult for individuals to have time horizons beyond a certain point. In early human existence, the horizon was a harvest or a season; in the Anglo-Saxon period, people may have got it to a generation or possibly even a reign. But the genius of the industrial age and our democratic age has been to extend that time horizon over generations. We have done that through the rule of law and through understanding taxation and the predictability of an economy. We have done it because we have understood that if parents invest, children, grandchildren and great-grandchildren can reap the rewards.
What the Government have done, I am afraid, is to reverse that. They have shortened the time horizon and assumed that people—all our citizens—are not investors in the future, but employees of today. That fundamental misunderstanding of what it is to grow an economy is why this Budget is so bad.
Tom Tugendhat
As the hon. Gentleman is an old friend, I will—for one minute.
Paul Waugh
I thank the right hon. Gentleman on the Tory Benches, which are singularly understaffed right now. But it is the almost criminal levels of understaffing in our NHS that affects most of our constituents. He is an honourable gentleman, so does he not feel a sense of shame that, every single day in our NHS, midwives, doctors and nurses cannot fill their staff rotas? They cannot do the job that they want to do and that we need them to do.
Tom Tugendhat
It is a pleasure to hear the hon. Gentleman, who has come off the fence and now has a seat; he can express his views freely. What fills me with sorrow is when I look at the future—when I look at the businesses that have invested so hard in places such as Tonbridge and now cannot pass that on over generations and over time. The investment timeline is being reduced and so is the growth. Do not just take my word for it—the Office for Budget Responsibility, the National Farmers Union and every business in this country have been clear on the point. The Government are not just taking the eggs from the golden goose; they are slaughtering the goose by trying to get the eggs out quicker. That simply does not work.
We all know what is going to happen next: the Government are going to have to come back for more. We just need to look at the predictions by various financial bodies over the last few days, which have been talking about our running out of the money raised in the Budget in the next two or three years. We know why that is going to happen. This Budget is not investing—worse than that, it is not encouraging investing. It is trying to exploit.
Sarah Smith (Hyndburn) (Lab)
As a member of the Government at the time of the disastrous mini-Budget, does the right hon. Gentleman seriously expect us to take lessons from him on how we grow the economy, return to economic stability and get the desperately needed investment into our public services that his Government failed to deliver for the past 14 years?
Tom Tugendhat
The hon. Lady can play politics if she likes; I am trying to think about the future of the country.
Dyson, who was not in any Government, is pointing out the problems being raised. Minette Batters, who was not in any Government, is pointing out the problems being raised.
Tom Tugendhat
No, not just now.
The truth is that what we are seeing is a level of short-termism. That is completely clear in agriculture and industry, but the tragedy is that it is also clear in education. A great privilege of being the MP for Tonbridge is that I represent some of the finest schools in this country—others may claim that title, but I know that I speak the truth when I say that. Many of those schools are grant-maintained in different ways; others are private. They are, in many ways, a web of education that works extremely well together in our community. Some, such as Hillview School for Girls—a fantastic school at which I was privileged to be on the governing board—are state schools, while others, such as the Judd school, are grammar schools, and one, Tonbridge school, is private.
The truth is that the 20% plus business rates—I think the extra cost that will now fall on private schools comes to about 40%—means that every single kid in my constituency will have to pay for the VAT in some way. Either they will have to pay for it because fees go up, or they will pay for it because class sizes are larger. I am afraid that the schools will not be able to swallow the costs, so we will see pressure all the way through.
Tom Tugendhat
I will not, because I have been asked to be quick.
That is not just a burden on those kids, but a rejection of the relationship between family members in their willingness and desire to invest in the future.
I know that the Labour Government claim that the only way for investment to be done is by the state, that the only thing that really matters is when that is done by a bureaucrat and a civil servant, that the only thing that really counts is when the Government pay for it. But we know that is simply not true. We know that business and the freedom to invest, plan and forecast are what make an economy grow. Sadly, the Government have tried to nationalise the future, shorten the time horizon and make us all pay for it. That is why growth is falling, taxes are rising and the future is made worse again and again under Labour.
Kate Osborne (Jarrow and Gateshead East) (Lab)
I congratulate all hon. Members making their maiden speeches today, especially my regional colleague, my hon. Friend the Member for Sunderland Central (Lewis Atkinson).
I am proud that, while making history as the first ever woman to deliver a Budget, our Chancellor honoured a true hero of my constituency: Jarrow’s “Red Ellen” Wilkinson. Ellen was a remarkable politician and trailblazer for women everywhere. It is about time that we had some recognition of women in this place, and I am pleased that the Chancellor has made a start on the artwork, with the fabulous picture of Ellen on the wall in 11 Downing Street. We need many more pictures of women trailblazers across Parliament.
The Budget shows that we are a Government who will work for the people. There is a lot to celebrate, including the largest ever increase in carer’s allowance, closing inheritance tax loopholes, additional funding for further education, increasing the national minimum wage, investing in breakfast clubs, record investment in the NHS, ensuring that former mineworkers get the money that was kept from their pensions, which is hugely important to my constituents, and setting aside funding for the contaminated blood scandal, as well as for the victims of the Horizon scandal, for which I have long campaigned with my constituent Chris Head.
I will continue to push for people to be held to account for their role in the Horizon scandal, and for a speedy resolution so that outstanding claims are paid in full. Nothing should stand in the way of victims finally getting justice. They should not have been left waiting decades by the Conservatives. Someone might think from the contributions of Conservative Members that the last 14 years had never happened, but our public services are at the point of collapse, no youth centres are left, school buildings are crumbling, the NHS is in crisis and the economy was crashed because of the Conservatives’ gross incompetence and deliberate mismanagement, as they put their cronies over the people of this country. Finally, we can move on from 14 years of Conservative destruction of our communities. In this Budget, the poorest households gain the most and the wealthiest pay the most. That shows the difference that a Labour Government can and will make.
Of course, I wish we could have done much more. I wish the Budget had been able to lift the two-child benefit cap. I wish we had been able to right the injustice for women from the Women Against State Pension Inequality Campaign. I wish we could have increased the pension credit threshold. I wish we could have invested more in our local authorities. However, let us be very clear: the fact that we cannot do any of that is entirely down to the Conservative party.
As chair of the north-east all-party parliamentary group, I know that transport is one of our most important challenges, alongside employment opportunities and investment. Although I will celebrate the clear wins, I will continue to work with Government Front Benchers to ask for more investment to improve the lives of people in the north-east, particularly my Jarrow and Gateshead East constituents.
Gavin Robinson (Belfast East) (DUP)
It is a pleasure to follow the hon. Member for Jarrow and Gateshead East (Kate Osborne). In reflecting on the maiden speeches that we have heard this afternoon, I will just add a comment to what the hon. Member for Yeovil (Adam Dance) said in his Titanic analogy. As the Member of Parliament for Belfast East, I always remind folks that Titanic was built by Ulstermen but navigated by Englishmen. I wish him well.
I delayed my contribution to the debate until today in the hope that we might have reached the point where there would perhaps be less politics and a bit more accurate reflection on the challenges we face as a country and on how to proceed. I am pleased that the Chief Secretary to the Treasury is here, because he is a man of substance and he understands the challenges that we all face. One of the most accurate descriptions of the Budget so far has been the “sugar rush”: something that will make us feel good immediately—an initial injection of cash into public services over the coming years—but which then peters out. The benefit of that sugar rush peters out, we hit a low and crave more in years 3 and 4, but, without sufficient growth, the means will not be there to pay for it.
I say that not with any glee, but as a genuine challenge on how we invest in public services—rightly—in a way that will produce private growth, because it will be that private growth that allows investment in the years to come. From a Northern Ireland perspective, the Chief Secretary to the Treasury will know that there has been no resolution to get our finances on to a firm foundation. “Fixing the foundations” is what we hear from the Government. The negotiations that we had with the previous Government saw a considerable injection of cash.
The debate today is about health. On pay parity, NHS workers in Northern Ireland—the nurses, doctors and auxiliary staff—and the carers outside in the social care settings, are not paid like for like compared with their colleagues in England, Scotland and Wales. We obtained money to achieve pay parity just one year ago, yet it is in danger of being broken. We secured money for Northern Ireland to achieve stability under the previous Government, but are told to use it for years 2 and 3 to maintain parity for such important workers. That does not work, and I had hoped for more from the Labour Government. I hope that the Chief Secretary to the Treasury will continue to engage in those discussions.
Some political decisions feel right when they are taken but will not be easily forgotten by a jaded electorate. The removal of the winter fuel payment is one of them; the decision on inheritance tax for family farms is another. Those decisions will rest long in the minds of constituents who placed their trust in the Government. Labour Members have joyfully repeated all their party’s enthusiastic lines, but those constituents will not forget the damage and the pain caused by the decisions associated with this Budget.
Madam Deputy Speaker, I had hoped for more. I cannot be churlish and not recognise the investment in public finances that is in the Budget, but it is not going to encourage us along a positive path. There are challenges ahead, and politically and collectively—irrespective of our party outlook or differences—we are going to have to engage with those challenges more thoughtfully in the future.
Sarah Smith (Hyndburn) (Lab)
This Budget provides absolute clarity that the Government are focused on putting working people back at the heart of economic decision making. This is most evident in the Chancellor’s decision to protect and support public services, enabling the Government to kick-start a mission-led approach to reform. Let us be frank: this Government have inherited public services that are falling apart at the seams, and we know that our constituents deserve better. I commend the Chancellor and Treasury Ministers for taking the difficult decisions that will raise £9 billion per year by the end of the forecast to support public services. The tax decisions that have been taken are difficult, but I thank Ministers for being transparent, as restoring economic stability to put the country back on a trajectory of growth is essential.
It is important to highlight that investing money in our valuable public services is also about securing growth in the long term, as my right hon. Friend the Chief Secretary to the Treasury has remarked. Enabling a worker to get a quicker GP appointment so that they can return to work sooner, or supporting a parent who wants to take a job that starts an hour earlier by giving them access to a breakfast club before school, supports growth. In my constituency of Hyndburn alone, the impact of the past 14 years of economic failure is that over 7,000 children are living in families that face absolute poverty. Investment in people and public services has real economic payback, as well as being the right thing to do. Members on the notably empty Conservative Benches refuse to say what choices they would make differently. Would they choose to not invest in public services, to not lift children out of poverty, or to not get the public finances back on a firm footing?
The increase in the national minimum wage is also welcomed by many of my constituents in Hyndburn and Haslingden, who work tirelessly to support their families and the local community in skilled but often undervalued jobs, whether in retail, in hospitality or in care. Currently in my constituency, though, we are facing entrenched problems due to a lack of investment in our public services. Most obviously, we face the closure of our highly valued Accrington Victoria hospital due to the fact that the building is now entirely unsafe for both patients and staff. Neglecting public services leads to real consequences, and my constituents have been left to pay the price for the Conservatives’ dereliction of their duty to manage health services sustainably.
I therefore particularly welcome the Government’s announcement of a £1 billion investment to reduce the backlog of critical NHS maintenance. If that money had been available previously, and if maintaining NHS facilities at a local level had been a priority for the former Government, we might not have ended up in this unforgiveable situation. Is the Minister able to share any further information on that funding, and will he or a member of the Health team meet me to discuss how we can work to ensure that Accrington’s health services are both retained locally and aligned with this Government’s national strategy for community-based provision?
Jess Brown-Fuller (Chichester) (LD)
I start by recognising that this Government face an enormous challenge in clearing up the mess of a decade of Conservative mismanagement in this country, and that failure is nowhere more apparent than in our NHS and care sector. Every day, thousands of patients across the country face agonisingly long waits, often in severe pain, just to see a GP or get an appointment with a dentist.
Yesterday, I met a constituent whose 45-year-old husband—a well-loved, energetic and creative man—never regained consciousness after being left in the A&E waiting room of my local hospital for six hours after suffering a brain haemorrhage. James Palmer-Bullock leaves behind three wonderful children, a loving wife and a devastated community. His wife’s request to me was to ensure that no family ever suffers the same neglect again. I hope the Secretary of State will meet me to discuss the experience that my constituent faced and what can be done to prevent it in future.
New funding for day-to-day spend in the NHS is welcomed across this House, and it is desperately needed if we are ever to address the crisis in the NHS. However, there is no point in pouring money into a leaky bucket if that money does not get where it needs to go.
Bradley Thomas (Bromsgrove) (Con)
It is not just public services that we need to focus on: the third sector provides vital services that many of our constituents rely on, particularly children’s hospices. I would like to highlight to the House the Acorns children’s hospice in my constituency, which provides vital support to many local families in a really acute moment of need. In 2019, NHS England decided to increase the children’s hospice grant—
Madam Deputy Speaker (Caroline Nokes)
Order. That intervention was far too long.
Jess Brown-Fuller
I thank the hon. Member for his intervention. He will be pleased to know that I am going to mention hospices later in my speech.
To fix the NHS, we must fix both the front and the back door. Taking the pressure off secondary care can only be achieved by properly funding primary care. That is why the decision to increase employer’s national insurance contributions is a significant mistake, as it risks worsening the crisis in the NHS and care sector. Increasing that rate will drive up GP surgery costs, significantly raising the annual expense of GP practices. Those practices are not eligible for the employment allowance that protects our small employers, so surgeries in Chichester and across the country will bear the full weight of that rise—a burden that they and my constituents simply cannot afford. Surgeries such as Southbourne surgery, Langley House surgery and Selsey medical practice have already reached out to me with concerns about their ability to continue providing services amid those financial challenges. They all agree that this increase will directly undermine patient access and care.
Charities have long suffered the burden of failing statutory services. Chichester boasts some of the most amazing charitable organisations, and one of the great pleasures of my role is to spend time with the people at the heart of those organisations. Charities such as Stonepillow, which works to prevent homelessness in our area, face an increase in costs of £125,000. I also visited St Wilfrid’s hospice after the Budget announcement—an incredible hospice that provides palliative care for hundreds of people every year, both in the hospice and in the community. It now faces an increased bill of £175,000—money that it needs to find annually, with only 17% of its annual budget covered by the NHS. I urge the Government to consider exempting the health and social care sector from the national insurance rise, so that the Treasury is not giving with one hand and taking with the other.
Mr Toby Perkins (Chesterfield) (Lab)
I would like to start by saying how happy I am, after 14 years in this place, to finally be responding to a Budget from a Labour Chancellor. That that Labour Chancellor is also the first woman to hold the position is a source of tremendous pride to me, and to many of us on the Labour Benches.
This is a Budget that will begin the long task of national repair and renewal after 14 years of steady decline. If anyone was left in any doubt about whether the Conservative party might have some useful insights to offer, this debate should have ended that misconception once and for all. First, we had the right hon. Member for Tatton (Esther McVey), who was the Conservatives’ Minister for common sense—no wonder they lost. Then we had the right hon. Member for Tonbridge (Tom Tugendhat), who they got rid of because he was not right-wing enough. We know that the Conservative party will not be able to help us, so we must crack on alone, and the truth is that we have a huge amount of work to do.
The right hon. Member for Tonbridge did say one thing that I agreed with: that in order to get growth, we need private sector investment. Of course we do—prior to coming into this place, I ran my own business, and this whole Budget is predicated on getting growth and working with the private sector to do so. All our plans for energy development require consistency so that the private sector can invest. Nobody disputes that, but what we also need is public services that work. As someone who has employed people for most of the last 25 years or so, I know that you do not get a good workforce if your staff are living in poverty. It is not progressive politics to say that we are supporting people to be in work if they have to visit the food bank on the way home. We need an economy that works for everyone, and this Budget strikes the right tone.
We have a proud history of coalmining in Chesterfield, and its legacy can be found to this day. I am very pleased that my right hon. Friend the Chancellor has ended the historic injustice of the mineworkers’ pension scheme, with more than £1 billion being returned to 112,000 former coalminers—the right decision.
I am sad to say that I have the dubious honour of representing a constituency that, under the Conservative county council, was dubbed the pothole capital of the UK. We are very glad in Derbyshire that the Government will put in an extra £500 million to tackle the scourge of potholes, and I hope that Derbyshire county council will now start filling in Chesterfield’s countless potholes.
The increase in the national minimum wage, or living wage, is another policy that will support economic growth. If we give money to people who have nothing, they will spend it in our economy. If huge inheritances are passed on, as the Conservatives want, that money is not spent in the same way in the economy. There are issues for some family farms, and those need to be explored, but the vast majority of farmers will not be affected. Conservative Members mentioned James Dyson, who is a brilliant inventor, but why did he suddenly find such attraction in buying up huge amounts of farmland? They should pull the other one.
The Budget makes a start in getting our country back on the road to growth, repairing the appalling damage that has been done to our national health service, supporting the army of carers who also support our NHS and, finally, ensuring that at the very bottom of our economy we start to make work pay.
Alex Easton (North Down) (Ind)
Like the proverbial curate’s egg, the Budget has its good parts, but significant issues remain. While I appreciate the additional funding for policing in Northern Ireland, it must be emphasised that that does not resolve the structural underfunding of the Police Service of Northern Ireland that has persisted since 2010, nor does it alleviate the problem of recruitment, which has reached crisis point.
I warmly welcome the £1.5 billion allocated to Northern Ireland, but it is essential that that funding is utilised prudently and effectively by the Northern Ireland Executive. It is unacceptable that we face the highest waiting lists for healthcare services in the United Kingdom.
Because of time constraints, I shall concentrate on three critical areas: GP practices, inheritance tax for farmers and the winter fuel payments for pensioners. GP practices are struggling. Where will they find the funds to cover the increased national insurance contributions for employers? They are not eligible for the employment allowance, and it is unacceptable to take resources away from patient care. The Chancellor must be aware of the latest research from the Library that shows that more than 5 million people in a survey—about a quarter—cannot get through to their GPs. The additional burden will add further financial pain to a broken service.
The proposed change to inheritance tax will severely impact farmers, with estimates suggesting that more than 70% of farmers will be affected. That contradicts the Government’s projections and puts the future of farming in jeopardy. I urge the Chancellor to heed the concerns of the Ulster Farmers Union and the National Farmers Union. Our food security is dwindling, currently standing at 62%. We cannot afford industrial action from our farming community, who are already facing a financial crisis. Farming must be made viable.
While additional funding was hoped for to support pensioners’ winter fuel payments, the Chancellor has failed to deliver. We now face the grim reality of pensioners, many of whom just exceed the pension credit limit, being left in the cold, despite having worked all their lives. That is plainly wrong and it is why I will not support the Budget. In voting against it, I want to make it clear to the Chancellor that the situation for pensioners, businesses and farmers is not just bad in parts; it is downright rotten. Thank you, Madam Deputy Speaker.
Lizzi Collinge (Morecambe and Lunesdale) (Lab)
I have been sat here gobsmacked by Conservative Members’ lack of comprehension of what has happened over the last 14 years to our public services. I see that the priority of the right hon. Member for Tonbridge (Tom Tugendhat) is quoting billionaires who are worried about paying a bit more tax. Those are the Conservatives’ priorities.
Last month, I held a constituency surgery in one of my large villages, and people told me about the difficulty they had getting appointments there. When people have to travel between villages, and there is one bus an hour at most, it really makes a difference where an appointment is. The lack of home village appointments leaves my constituents at risk of their conditions worsening, and goes against everything that we know to be best for patients and the NHS—early help, at the right place and at the right time. Down in Morecambe and Heysham, even though transport is a bit better, getting an appointment can feel like a lottery, because services are having to triage patients to find which cases are the most urgent. Our residents are travelling too far, waiting too long and getting more poorly as they wait.
Last week’s Budget gave me hope, not only that the NHS will get the investment it needs, but that finally the people in charge have the integrity and the skills to dig us out of the mess; they are unafraid of listening to experts, unafraid of making long-term decisions and unafraid to stand up for patients—the people who matter.
The Budget also showed us that the Government will invest wisely in the NHS. Some people say, “You can’t just throw money at it,” and they are right—look at what happened with the investment from the last Government: nothing. That is because the people in charge were fundamentally unable to organise, at either a strategic or practical level. They were unable to join the dots. Local safety initiatives, while very welcome, were brought in to try to tackle what were fundamentally national issues. Those issues included the vacancy rates, the sickness rates, and the increasing complexity of patients’ issues, caused by our being a nation in poorer health as a direct result of austerity. So no, it is not just a case of more money, but sometimes it is about money. Money invested wisely can make a difference. If creaking digital infrastructure means that medics spend more time rebooting computers than treating patients, investment is needed, and that is what the Budget provides.
The Budget also fulfils our commitment to accessing the latest diagnostics and treatments. Through my health scrutiny role in Lancashire, I know that thrombectomy, a life and brain saving treatment suitable for about 10% of people who have strokes, is not available 24/7 in all areas. When I was scrutinising that care pathway, people needed to be lucky enough to have a stroke on a weekday morning to get a thrombectomy. In February 2022, my grandma had a devastating stroke on a Friday night, and I sat with the knowledge that she would not have access to that treatment, even if she could benefit from it. I cannot describe the pain that caused me, and it is pain that my constituents and people across the country feel every day. We have a health system that has been systematically undermined for 14 years. A recent national report showed that fewer than half of the people who could benefit from a thrombectomy get one, and that is not good enough.
Mr Will Forster (Woking) (LD)
I am surprised to be called so quickly, so thank you, Madam Chair. I was really pleased by the statement that the Secretary of State is looking at how to compensate those in the health and social care sector for national insurance rises. I have in my constituency Central Surrey Health, a not-for-profit, employee-owned group. It serves much of Surrey, and it stands to lose £500,000 as a result of the proposed changes. It delivers community services across Woking and Surrey, including most of the services in my constituency. It would be awful if we lost services as a result of measures introduced by the Government in a Budget that is supposed to invest in the NHS. I welcome the Government’s investment in the NHS, but they must not make the mistake of increasing national insurance on social care firms, health partners and GPs.
I am concerned about the elephant in the room: social care. Local authorities and our health system are really struggling, but social care helps to fix things. It is a more efficient use of our money to invest in social care and prevention than spend on primary care in hospitals. The Government are rightly investing in the NHS, but they have failed to invest in our social care system. Surrey county council is under huge pressure, and Woking borough council has effectively gone bankrupt. It is reported that without further support, almost 50% of local authorities could go under. If the Government do not invest in social care, I fear that they will make the mistakes that the Conservatives made, which we do not want. We need to invest in social care, so I hope that the Government will agree to a cross-party social care agreement that tackles those issues.
I want to touch on the cost of living. The Government have to turn around an awful record from the previous Government. They have introduced some good measures and have suggested that they would increase the tax threshold—something for which we have long campaigned —but I am concerned about the national insurance rises, which will hit small businesses hard. I met many small businesses this morning in Woking, and they are really concerned about the impact of those rises. I like the rhetoric from the Prime Minister and the Government about this being a Government of service, and a Government who want to promote growth. They are using the correct wording, but good rhetoric needs to be followed up with good announcements. The Government say that they are going for growth, but their actions do not support that. They are ignoring Brexit, they are ignoring social care, which undermines our local authorities, and they are undermining small businesses.
The Budget is better than the Budgets of the previous Government, but that is nothing to shout about. It should be a lot better for my constituents in Woking, and for constituents of Members across the House.
Madam Deputy Speaker (Caroline Nokes)
There will be a reduction in the time limit to three minutes after the next speaker. A note: when I am in the Chair in the Chamber, I am Madam Deputy Speaker, not Madam Chair; that is for Westminster Hall, or when the Chamber is in Committee. I call Richard Burgon.
Richard Burgon (Leeds East) (Ind)
The Budget is a welcome break from more than a decade of austerity, and especially from the Tories’ slash-and-burn plans announced at their last Budget, which would have meant even more deep cuts. It is good to see public investment being emphasised, as that is key not only to rebuilding our public services but to driving growth and better living standards. Likewise, the boost in day-to-day spending for public services over the next couple of years is welcome—for example, we are funding 40,000 extra NHS appointments a week and recruiting 6,500 new teachers. Having campaigned against poverty pay for many years, I welcome the boosts in the minimum wage, although there is more to be done.
The Budget included positive measures for those like me who want the wealthiest and tax dodgers to be made to pay their fair share. That is why we have heard so much squealing from the Tories and the right-wing press in recent days. It seems that defending the super-rich is the main reason why they get out of bed in the morning. Progressive taxes, achieved by ending the non-dom scheme—why on earth would they have a problem with that?—having higher capital gains taxes, and extending the windfall tax on oil and gas profits, are what we need to fund our services. We need more of that, because public services need more funding. The increases announced in the Budget, after the initial boost over the next couple of years, will not be enough to repair the damage done by a decade of Tory cuts. The Government should grasp the nettle and introduce a series of wealth taxes, starting with a 2% tax on wealth above £10 million, which would raise billions more for our public services.
I would have liked the Budget to do more on tackling poverty. I am concerned that real-term cuts to benefits next year appear to be planned. That must not happen, and disabled people must not be subjected to more cuts and attacks. The two-child limit needs to go, fast. A Labour Government should eradicate child poverty, not allow more children to fall into poverty. The last Labour Government lifted many children out of poverty, and that is what we want to see again. The winter fuel allowance cut should be reversed. That cut makes no sense morally, politically or even economically, and it is not too late to think again and scrap it.
The Budget is a welcome break from a decade of austerity. It contains progressive tax measures, but more needs to be done now and going forward on poverty reduction. It was put together following the toxic inheritance from the Conservatives. It would be good to see more than a handful of Members on the Opposition Benches. Who knows? They might be able to learn something.
Tom Gordon (Harrogate and Knaresborough) (LD)
There are two key points that stick out in the Budget. The first has been referenced by colleagues from across the House, and it is the elephant in the room to which Liberal Democrats keep referring: social care. Members have eloquently made the point that if we do not fix social care, we will not fix the NHS. A personal experience of mine is a great example. A couple of years ago, my grandfather sadly passed away. He spent the last six months of his life bed blocking in hospital, repeatedly getting covid and pneumonia because he could not leave hospital and go home. I do not blame the NHS for his passing, but if he had been better cared for with an adult social care package at home, there might have been a different outcome.
The problem with the Budget is that while there is a token gesture for local government, what is provided is nowhere near enough to fix the gap in adult social care. The House is full of Members who have worked in local government and served as councillors, and who understand that often more than half a budget goes on adult social care. The problem will not be fixed by our tinkering around the edges; we need a lot more to support social care and the NHS.
I am worried about unintended consequences. A couple of weeks ago, I met a constituent who is working in the NHS. She is a single parent, and her daughter has SEND issues. Because local authority schools in the area could not meet her needs, she paid for her daughter to go to an independent, fee-paying school where she could get the support that she needed, but because of the introduction of VAT on school fees, my constituent will have to consider leaving the NHS and working in the private sector, so that she can afford to keep her daughter in that school and meet her needs. I am worried about the wider ramifications of some of the Government’s decisions. In this case, healthcare staff would be taken out of the NHS because of Budget measures. I hope the Government will reflect on that, and consider what more can be done to ensure that we support NHS staff in their current roles, whether that is giving them more pay rises or more support in the workplace, or by ensuring that someone does not have to leave their NHS role in order to afford to keep the provision of their daughter’s SEND needs and capabilities.
Earlier the Secretary of State made a point about prevention. Local authorities often provide that first line of public health prevention, but the money that underpins that is just not enough. We know that every pound spent saves countless more for the NHS, so I urge the Secretary of State to take a strong approach to prevention and invest in community pharmacies.
Paul Davies (Colne Valley) (Lab)
The Chancellor’s announcement of a £22.6 billion increase in the day-to-day health budget, and a £3.1 billion rise in the capital budget over this year and next, marks a pivotal moment for our national health service. That substantial investment underscores our Government’s unwavering commitment to enhancing healthcare services and ensuring the wellbeing of every citizen.
One of the most pressing issues we face is the backlog of elective surgeries and appointments, and with waiting lists currently at 7.6 million, that additional funding will enable us to deliver 40,000 extra operations and acute sector appointments each week. But this is not just about numbers; this is about reducing the anxiety and suffering of millions who have been waiting for essential medical procedures. They were badly let down by the last Government, but by addressing those delays we are taking a significant step towards restoring public confidence in our healthcare system. The Budget also allocates £1.5 billion for new surgical hubs, scanners and additional beds, which is crucial to expand treatment capacity, particularly in emergency departments.
As a survivor of cancer, I am pleased that cancer treatment—a critical area of concern—will see significant improvements. The allocation of £70 million for new radiotherapy machines will enhance our ability to treat cancer much more effectively. That funding is testament to our commitment to fighting that devastating disease, and supporting those affected by it. Mental health, which is often overlooked, receives a much-needed £26 million boost, dedicated to opening new mental health crisis centres. Those centres will provide critical support to individuals who are experiencing mental health issues, ensuring that they receive the care and attention that they need promptly.
The Budget also includes a dedicated fund to upgrade around 200 GP surgeries. By strengthening primary care we can prevent minor health issues from escalating into major problems, ultimately reducing the burden on our hospitals. Finally, the Budget represents a comprehensive, forward-thinking approach to healthcare. It addresses immediate needs, while laying the foundation for a more resilient and efficient health system. Labour Members campaigned loud and clear at the general election for change, and that is what the Budget has delivered.
Helen Maguire (Epsom and Ewell) (LD)
It is important that we recognise how the previous Conservative Government left the NHS in a weakened state, with soaring GP waiting times, crumbling hospital buildings, and promises of new hospitals that they simply could not deliver. The Liberal Democrats welcome the £22.6 billion of funding for the NHS, and the £3.1 billion of capital funding for the NHS estate. However, far too many people are struggling to get a GP appointment when they need one, which can lead to misdiagnosis or delays, with people often having to go to A&E instead. It is great that the Budget includes dedicated funding to improve GP practices, but more focus is needed on the recruitment and training of GPs, and on ensuring that we retain experienced GPs. It is therefore disappointing that GP surgeries are not exempt from the rise in employer’s national insurance, as that will ultimately reduce the number of staff they can employ, which will affect everyone. We need to prioritise general practice so that more people can be treated in the community, as that is better for individual health and will cost the NHS less. We believe that everyone should have the right to see a GP within seven days.
I was also disappointed that there was no specific mention of dentistry in the Budget. Tooth decay is one of the most common reasons for hospital admissions in children aged between six and 10, and more than 100,000 children have been admitted to hospital with rotting teeth since 2018. More funding is needed to guarantee access to an NHS dentist for everyone needing urgent and emergency care.
On the new hospital programme, hopefully one of the new hospitals will at some point be built in our constituency, but I was disappointed not to hear more about that. It is good that hospitals with reinforced autoclaved aerated concrete will be addressed urgently, but we desperately need more details on that now. Buildings such as St Helier hospital are simply deteriorating, with issues such as sinking foundations, leaking roofs, and outdated infrastructure. Epsom hospital can no longer cope with current demand, and we urgently need a new specialist emergency care hospital. My constituents simply cannot wait any longer for their promised new hospital, and the country should not be forced to fund inefficient health provision. I look forward to hearing from the Secretary of State in the new year with more information about that.
Many constituents who are just above the threshold for pension credit have contacted me about how the lack of the winter fuel payment will affect them. It will particularly affect those in ill health, because they need to turn on the heating earlier and for longer. While pensioners have been asked to apply for pension credit, Dorah-May from Age Concern in my constituency has contacted me. She said that applying for pension credit is a minefield, and that is why people from Age Concern go around all the time to help and support elderly people with that. Charities and small businesses will also be negatively affected by the Budget, and that is disappointing.
I will wrap up by urging the Government to look at raising money by reversing the Conservative tax cuts for big banks and by asking social media giants to pay their fair share.
Lauren Edwards (Rochester and Strood) (Lab)
This Budget will improve the lives of so many of my constituents in Rochester and Strood. They will see the benefit in their wage slips, see the things they care most about in their community, such as the local pub and their high street, supported, and see their public services finally invested in again.
Investment in the NHS through this Budget is key. It was the No. 1 issue raised on the doorsteps in the election and is perhaps best exemplified by the struggle to book a GP appointment. The simplest of tasks—for someone to seek help from a medical professional when they are ill—was made into what felt like an impossible task after 14 years of Conservative government. I reminded voters many times during the election that the NHS is always safer in Labour’s hands, so I am delighted to see that our first Budget sets us up to meet that promise so quickly. As others have mentioned, we have a record-breaking £22 billion increase in day-to-day spending, a £3.1 billion capital boost to pay for new technology and improve our buildings, and a landmark public consultation to set out a long-term plan for how the NHS develops over the next decade.
I am proud that we are a Government who have been transparent and honest with people about our priorities to fund that investment. The Chancellor has delivered a Budget that protects working people and instead asks big businesses and the well off to contribute. The Budget does not dodge the tough choices just to get through the next media cycle, but instead is informed by Lord Darzi’s thorough point-in-time assessment of the state of the NHS that was handed back to us by the Conservatives. It lays the foundation to take the NHS from the analogue to digital, from hospital to community-led care and from treating sickness to focusing on prevention and promoting good health.
Those approaches will take different forms across the country, but I draw the Minister’s attention to the potential for an elective care centre in the former Debenhams store on Chatham High Street in my constituency. I have written to the Secretary of State about this proposal, and I would welcome a conversation about its merits, particularly as it is a good example of the invest-to-save model that is promoted so well in the Budget. It would not only free up space at the Medway Maritime hospital and help tackle waiting lists, but would have further benefits by supporting town centre economic regeneration.
I welcome provision in the Budget for a £600 million increase in local government spending to support social care. Like many MPs, I have a background in local government and I understand all too well how much the uplift is needed.
Lauren Edwards
I have only 20 seconds left, so apologies, but I will not. We all know that the social care sector needs to be transformed, and I hope that over time we can move to a more fully integrated health and social care system in this country. Future Budgets may be able to apply the same exemptions to charitable care homes as happens for the NHS. That would be to the benefit of places such as Frindsbury House in my constituency, which is run with great care and compassion by the Mortimer Society.
Andrew George (St Ives) (LD)
I have three minutes and three quick points, on which I hope I have the attention of the Chief Secretary to the Treasury. My first point relates to the NHS. I welcome the introduction to the debate by the Secretary of State for Health and Social Care today. Certainly the Government have inherited the worst crisis in NHS history, and they have a massive challenge on their hands. I like how the 10-year plan has been framed in relation to moving from hospital to home, from sickness to prevention and so on.
The Prime Minister was right when he said that those with the broadest shoulders should bear the greatest burden, but the way this Government are raising tax through national insurance is, I am afraid, hitting some of those who will be struggling most. I hope that he will look again at that and how the Liberal Democrats have framed it. We propose to raise the money by reversing the tax cut for big banks and increasing taxes on the oil and energy giants and large social media multinationals. Surely that would be a far better way.
In responding to questions on the impact of the national insurance rise on GPs, hospices and care providers, the Secretary of State clearly recognised that a mistake was made, and I suspect that the impact was overlooked. [Interruption.] The Chief Secretary is shaking his head, but he really needs to address those issues, because a crisis will continue to occur.
Andrew George
I will, although the right hon. Gentleman has only just walked into the Chamber, so I think it is rather cheeky of him.
Graham Stuart
Cheekiness accepted. The hon. Gentleman is quite right that the £600 million extra is for both children and adult social care, whereas adult social care alone is expected to have a £2.4 billion hit, so does he agree that if the NHS, however well funded, cannot move its patients into social care, that investment and expenditure will not work?
Andrew George
I do, although that is rather rich of the right hon. Gentleman when he knows that he and his party left the country in this state.
Another issue is the housing emergency, which we have not debated much today. I welcome the additional £500 million that the Government announced, which will supplement the affordable homes programme to 2026. That is much needed. I hope that the Chief Secretary will also address the large number of shovel-ready projects that have planning permission and pre-development work in place. I must declare an interest as a former chief executive of a registered provider. I hope that the Government will look at the impact of the significant construction inflation we have seen over the last four years, which is holding up many developments that could be addressing housing need in our communities. Only 9,500 social homes were built last year. We need a great deal more if we are to address the serious housing emergency.
I have a final question for the Chief Secretary—if I may have his attention for a moment—about the announcement of two layers of business rating that will apply to the retail, hospitality and leisure sector. Many holiday home owners have managed to abuse the system by using small business rate relief. I hope that such second homeowners will not have further opportunities to take advantage of loopholes. Will he investigate that and ensure that money goes into first homes rather than second homes? I am afraid that there is a loophole in the system.
John Grady (Glasgow East) (Lab)
Glasgow has the shortest life expectancy in Scotland and in western Europe. The people of my city, who bring me so much joy, live shorter and less healthy lives than those anywhere else in the UK. Far too many die too soon. They do not get the happiness that the autumn of life brings: time with grandchildren, time with friends and time volunteering at a local church or a local mosque.
My constituency has some of the highest levels of poverty in the United Kingdom. Poverty is one the principal causes of ill health and early death. Health is the topic of today’s debate. Many of my constituents cannot afford to pay for the essentials and live in shocking housing conditions. They live every day petrified of what tomorrow will bring. This Budget confronts poverty. It increases the national living wage, giving a pay rise to the lowest paid in my constituency, and gives pensioners more than £400 this year under the triple lock and more than £1,700 over the course of the Parliament. This Budget makes a choice—it targets our scare public resources at the poorest—and I support it.
My constituents rely on the Scottish NHS, but the Scottish NHS is in crisis. Almost one in six Scots is on an NHS waiting list.
John Grady
I am discussing Scotland. This is a serious topic about my constituents’ health. The waste by the Scottish Government—hundreds of millions returned to the EU unspent and hundreds of millions wasted on ferries—could have been diverted to the hospitals in Glasgow, to put beds in the Royal Infirmary, where they are needed.
The SNP is never to blame. The 62-day cancer treatment standard has not been met for over a decade, despite cancer being one of Scotland’s biggest killers. I have met countless pensioners who have been forced to pay thousands of pounds to go private for their hip replacements and knee operations, because the Scottish NHS waiting lists are so long. This Budget means £1.5 billion this year for the Scottish Government to spend on the NHS, and an additional £3.4 billion next year.
Our Budget puts the people of Scotland first and enables the SNP to fix the mess it has made of our health service. With its record increase in Scottish funding, this Budget demonstrates our commitment to Scotland.
Ian Roome (North Devon) (LD)
Very few hospitals in Britain can claim to be as essential as North Devon district hospital, which is the remotest acute hospital in mainland England. It serves a truly massive catchment area, spanning almost 1,200 square miles and more than 165,000 people as far afield as Lynton in north Devon and Bude in north Cornwall. Thousands of my constituents would face a more than two-hour drive to reach their next nearest trauma unit. During the tourist season, our hospital’s emergency demand increases by a full 20%. Yet shockingly, North Devon hospital has just six beds in its intensive care unit, and only four elective operating theatres—far fewer than the NHS expects for any hospital of that size—and both are now approaching 50 years old. Its endoscopy and women and children’s buildings are already end of life. It has a significant backlog of £80 million of overdue maintenance costs, half of which are categorised as critical or high risk.
North Devon district hospital was included in the new hospital programme in 2019, but if it does not receive the funding now, critical and acute services will be at serious risk of service failure. There is no alternative provision for more than 40 miles. The last Conservative Government promised a major infrastructure upgrade and spades in the ground by February this year. Neither has materialised—what a surprise. Worse still, the last Government changed the terms of reference of the hospital’s submitted business case not once but twice, pushing essential work on crumbling infrastructure beyond 2030.
My local hospital has a track record of delivering projects on time and within budget, such as the new discharge lounge, electronic patient records and the jubilee ward. The path ahead could not be clearer: the business case has been submitted, the land is owned and the rebuild has the backing of the Devon integrated care board. The phase 1 enabling works, covering key worker accommodation, a new road layout and an upgraded helipad, could have been completed as soon as April 2027. Phase 2’s clinical building, replacing operating theatres and the old intensive care unit and providing a replacement women and children’s centre, should have started before the next general election. Everything is ready to go.
The can has been kicked down the road for long enough under the Conservatives. I really do sympathise with this new Government and the position they find themselves in. The only thing harder than having to deliver on their own promises is making someone else’s good.
Jas Athwal (Ilford South) (Lab)
Our NHS is literally a lifeline for so many of us across the country. Last year, I witnessed that at first hand. From riding 85 miles on a Sunday, I went for precautionary tests on the Monday. To my horror, the arteries around my heart were completely blocked. It was an incredibly difficult time for me and my family, but the NHS was there for me: the doctor, the cardiologist who told me the news in such a nice way it felt as if nothing was wrong, the surgeon who operated on me very urgently because that needed to be done quickly due to the potential impact it could have had on me, and the nurses who nursed me back when I needed the care the most. Like so many in this Chamber and across the country, the healthcare professionals—the doctors, nurses and administrative staff—are the reason I am able to stand here today in good health to address the Chamber. Among them are the very neighbours who took care of me during my time in hospital.
As Members are all too well aware, however, the NHS is far from perfect. Tory austerity decimated the NHS and the covid mismanagement added fuel to the burning fire engulfing the NHS. Our waiting lists are at record levels: 7 million people waiting for elective treatments; 10% of patients now waiting 12 hours or more in A&E; and 350,000 people a year waiting for mental health support. This is the worst crisis for our NHS since its formation 76 years ago.
Protecting our NHS is crucial, so that people can get the treatment they need, when they need it. Whether it is a heart bypass like mine, a transplant or cancer treatment, this Labour Budget delivers a decisive shift from the disastrous—
Several hon. Members rose—
Madam Deputy Speaker
Order. Before I call the next speaker, I gently remind Members that we are on a three-minute time limit. Also, when I am standing, Members should please sit down.
Mr Tom Morrison (Cheadle) (LD)
The Liberal Democrats have long been pushing for the Budget to be a Budget for the NHS, so it was pleasing to see so much investment in our national health service. The boost in capital expenditure is particularly welcome, because Cheadle’s local hospital, Stepping Hill, is in dire need of support and investment. Only a few weeks ago, Stockport NHS foundation trust released figures showing that the maintenance bill required to bring the hospital up to scratch was over £130 million, up from £80 million just five years ago. The cost of the previous Government is there for all to see.
Last year, the hospital’s out-patients building was condemned and demolished. In March, the intensive care unit was temporarily closed because the ceiling was coming in. Since January, almost 10,000 people have had to wait for longer than 12 hours in A&E. Some 70% of Stepping Hill’s estate is now classed in the highest risk category. In fact, when I was there just a few months ago, the incredible nurses talked me through how on rainy days they had to place buckets down to ensure that water coming through the roof was caught. That is utterly shameful and my constituents are suffering.
One constituent contacted my office shortly after I was elected to tell me about their experience. After waiting months for a simple surgical procedure, the partial collapse of the ICU led to their surgery being delayed. It was then confirmed again as delayed. Then, after it was rearranged, there was a further delay because there were not enough beds for aftercare. Each time, the delay seemed to be imposed last minute and out of the blue, which of course drives uncertainty and worry not just for my constituent but for their friends and family.
I want to put on record that this is not the fault of the doctors and nurses. The doctors, nurses and other NHS staff do an incredible job in the worst circumstances, and they are suffering also. They are being forced to work in these conditions. They are the ones who have to break the bad news to patients when their surgeries and appointments are cancelled, although it is rarely their fault. Every day those staff show up and deliver the best service that they can for their patients. The fault lies with the Conservatives. For 14 years they sat back and watched as Stepping Hill, like many other hospitals, crumbled.
Mr Morrison
I will carry on; I am nearly done.
For 14 years, the Conservatives ignored health professionals and patients who were crying out for their hospitals to be fixed. As those cries were ignored, the problems became worse and worse. We are now facing a repair bill of £130 million, and without urgent action that will only become more expensive, so the new Government must act now. I am delighted that there is a commitment to our hospital, but they must act now and give the patients, the staff and my constituents the hospital that they need. If they delay further, costs will only rise and even more parts of the building will crumble.
Ms Marie Rimmer (St Helens South and Whiston) (Lab)
This Budget will deliver to communities such as mine. May I begin by welcoming the mineworkers’ pension scheme resolution? It means that £1.5 billion of miners’ pension payments to their fund will be distributed among 112,000 former miners and their families. It is absolutely right that an injustice has been corrected, for those people have waited far too long. It is also shameful that the last Government failed to budget for the resolution of the Post Office Horizon and infected blood scandals, and I applaud our Chancellor for correcting that now. I urge the pensioners who will not receive the winter fuel allowance—those who are just missing out—to apply for universal credit; in St Helens, £6.5 million remains unclaimed. I regret that we have been unable to remove the two-child cap, or deal justice to the WASPI women.
Let me now turn to the issue of local authority funding for adult and children’s social care. Local councils bore the brunt of austerity; successive Government cuts since 2010 have left them in dire straits, which disproportionately affects the people who are most likely to access social care. There have been increasing pressures to find savings, which has not only cut services and jobs but seriously limited the ability to invest in cost-effective preventive services. Some 73% of the budget of St Helens borough council is spent on adult and children’s social care. I welcome the Chancellor’s 3.2% real-terms increase in local government funding, including the £600 million to support social care—
Ms Rimmer
No.
It is good that, in the short term, a Labour Government will target additional grant funding at the councils that are most in need, but that needs to be the start of a process that will reverse years of financial decline. For too long, local council funding formulas have worked against underprivileged communities, and the areas that need funds the most often do not receive their fair share. Sadly, that creates a downward spiral, with an ever-increasing percentage of local government funding being spent on social care. This is not sustainable.
As I have said, 73% of our council’s budget is spent on social care. Moreover, the 48 members of the Special Interest Group of Municipal Authorities are unable to invest in their local areas in the same way as their counterparts because of the funding formulas. One in four households in England live in a SIGOMA council area. At present, social care services are a postcode lottery, and that needs to be addressed. We need a methodology that takes actual needs into consideration, and ensures that the funding follows. However, I applaud the Chancellor for providing £250 million for children’s social care and £600 million for adults.
Pete Wishart (Perth and Kinross-shire) (SNP)
It is a long time since I have had the pleasure of speaking in a Budget debate. Usually there is a bit more competition for the opportunity to speak, but given the much-diminished numbers present, I got this chance today.
Having been more of an observer in the past few years, I have noticed one aspect of the Budget: the form, the tempo and the rhythm that seem to be part of every single Budget debate. It always starts with a high, fevered crescendo of excitement. The Government reel off all the staccato of freebies and giveaways. Cheers come from the Back Benches, Order Papers are waved, and the nation feels bamboozled by this apparent avalanche of largesse. Then, of course, the first cracks appear—a negative forecast from the OBR here, bad news on the gilt markets there. Beyond that, it all starts to fall apart. Once the public realise what the Budget means to them and get over the intoxication, the hangover starts and the first opinion polls start to come out. There was one in Scotland at the weekend, and it showed a calamitous decline in Labour’s fortunes, just as the party was measuring up the curtains for Bute House. It is not so straightforward for Labour any more.
I want to do something different and actually praise the Labour Government. I want to thank them and say, “Well done for getting that funding for infected blood. That’s great!” I also thank them for the extra funding that Scotland will get—it would be churlish not to do so. It is what we asked for, and I am really glad that they have started to listen to us. I just wish they would do a little bit more of that.
However, there are issues with all of this. One of the main issues is the change in employer’s national insurance contributions, which has caused a real problem for some of our colleagues in Scotland, because we do not know what we will get as a block grant. Will we be fully funded for the national insurance contributions in our health and policing budgets? We need to have clarity, and the money has to be in addition to the block grant funding, not in place of it. I would like clarity from the Minister on that issue.
There is one local issue that I want to raise: the levelling-up funding for Perth. Levelling-up funding was pork barrel politics at its most gratuitous, and we were the only city local authority that did not get one penny from the Conservative Government. We finally got a paltry £5 million, and we were so excited about that. We had three shiny projects in Perth city centre that we were going to develop. Then, of course, the Budget came along. After we secured practically nothing from the Conservatives, a Labour Government are taking the money away from us. I want to hear the Government say that they will give Perth what it is due.
Budgets are like fireworks on bonfire night: they go up like a rocket, with lots of noise and colour, then they come down like a damp squib. Today, the Government’s Budget feels very much like that damp squib.
Becky Gittins (Clwyd East) (Lab)
I begin by welcoming the Tobacco and Vapes Bill, particularly the part about smoke-free spaces. For those of us with anaphylactic allergies, vapes represent a higher risk, because clouds of vape smoke contain allergens. We have seen the first report of anaphylactic reactions to second-hand vape smoke, so I very much welcome the prevention included in the Bill.
I will move on to the Budget. There is a reason why people across Wales overwhelmingly rejected the Conservatism that crashed our economy, failed to fund our public services and oversaw economic decline. Furthermore, the Conservative Government were not honest about the challenges that we faced. They were not honest with farmers in Clwyd East, small business owners, public servants or potential investors. They spent money that was not budgeted for—the height of irresponsibility. To say that they overpromised and underdelivered would be a colossal understatement.
Last week, however, this Labour Government delivered an honest Budget that gave hope to the people of Wales, with the largest funding boost that Wales has received since devolution: £21 billion, with a £1.7 billion Barnett formula uplift for the Welsh Government to support the vital public services on which my constituents rely. That includes £250 million for capital investment. It is the biggest Budget settlement for Wales since devolution.
We are working with the Welsh Government to invest in our NHS and increasing the national minimum wage, benefiting more than 70,000 workers across Wales. Some £2.3 billion has been provided for prison expansion, to sort out the mess that the previous Government made of our criminal justice system. We have provided £5 billion for the farming budget, to accompany a new veterinary agreement that this Government are seeking in order to cut the red tape and get Welsh food exports moving. We have provided £100 million to support steel communities, and £25 million to make coal tips safe.
Importantly, we are ending the injustice of the mineworkers’ pension scheme. As someone who grew up in a coalfield community and whose family worked at the Point of Ayr colliery, I was proud to stand on a manifesto pledge to return the investment reserve—over £1 billion—to those who need and deserve it: the former miners themselves. That means a huge amount to the nearly 300 former mineworkers in Clwyd East. We owe them this, and we delivered it. While the Budget makes difficult choices, it sets us on a path to growth and provides vital investment for Wales. It has my full support.
Claire Young (Thornbury and Yate) (LD)
While this Budget has some welcome measures, including adopting Liberal Democrat proposals on increasing the earnings limit for carer’s allowance, others raise serious concerns. The previous Conservative Government left our NHS on its knees. People in Thornbury and Yate are fed up with struggling to get a GP appointment or register with an NHS dentist, so I will be holding the Government to account to ensure that the extra funding actually delivers for patients.
On that note, I am deeply concerned about the knock-on impacts of raising employer’s national insurance contributions on those parts of the system that are not in the public sector. GPs and pharmacists play a vital role in preventive health and in detecting serious problems early, yet because many are privately run businesses, they will be left footing a huge new tax bill. I have been contacted by several concerned local GP surgeries. One told me that as it had a large number of part-time workers who were previously exempt but will now be eligible, the national insurance increase alone will wipe 2.5% off its top-line budget. Another told me:
“This change will have a significant financial impact on general practices, including my own, and can only serve to directly undermine access and patient care”.
Mr Adnan Hussain (Blackburn) (Ind)
Blackburn has the third highest number of patients per GP. Does the Member agree that, despite the ringfencing of the funding that GP surgeries get, the increase in national insurance will essentially reduce the number of available appointments at GP surgeries?
Claire Young
That is exactly the point that my local GP was trying to make, and I am not clear from the Secretary of State’s earlier remarks whether this will be addressed.
Similarly, the majority of social care providers are privately run companies. They play a huge part in reducing pressure on hospitals, and raising employer’s national insurance will deal a hammer blow to struggling providers. That is why I urge the Government to think again and provide them with the same support they have provided for publicly owned NHS services. They should instead look to raise the money needed by reversing Conservative tax cuts for the big banks, or by asking the social media giants to pay their fair share. I was disappointed that the Budget made little or no reference to social care, and I urge Ministers to start cross-party talks on social care now.
The other area that I want to touch on is flooding. I draw the House’s attention to the letter I sent ahead of the Budget about the need to support local authorities to prevent and respond to flooding. My Thornbury and Yate constituency recently endured 50% of its annual rainfall in just one month. The council has had to respond to that within its already overstretched budget. While I welcome the funding for flood resilience projects, it needs to be recognised that years of underfunding under the last Government have left councils struggling to maintain their infrastructure to prevent surface water flooding.
Given more time, I would like to cover other topics, including the concern that the additional SEND funding will barely touch the sides, the impacts on farmers, bus users and small businesses, and the ongoing financial crisis in local government. Instead, I will conclude by noting that the unintended consequences lurking in this Budget put at risk much-needed improvements to our public services. I hope the Government will think again and make the right decisions now for the long term, including fixing social care and delivering long-term infrastructure improvements.
Kevin Bonavia (Stevenage) (Lab)
I want to start by saying that we cannot and should not ever underestimate the power and strength of the message that having our Budget delivered by the first female Chancellor in history sends to young women and girls across the country. There should be no limit to their ambition.
In Stevenage and across the country, 14 years of Conservative rule have left a crippling cost of living crisis, record NHS waiting lists, rapidly reducing school funding and worsening public transport. I could go on, but I represent a town of aspiration. The people of my town have had their ambitions and hopes dampened by decline and held back by a broken Britain. However, this Budget sends a clear signal that Labour has started the work of getting politics to work for working people again.
One of the Labour manifesto’s most fundamental promises was to fix the foundations of our broken public services. I recently attended a local older persons day hosted by Stevenage borough council, where we talked about pensioners’ priorities. The Budget maintains the triple lock, which will be worth an extra £470 for pensioners next year, on top of the more than £900 they are receiving this year from the same commitment.
I spend a lot of time speaking to carers in my area who are looking after loved ones in testing circumstances. This Budget delivers the largest increase in the carer’s allowance since its introduction, starting the work of recognising the huge sacrifice they make. However, I know that this work will be complete only when we fundamentally reform our broken social care system, and I very much look forward to that.
Kevin Bonavia
I am afraid not.
I represent a constituency with multiple borough and district councils that have borne the brunt of 14 years of Government cuts. This Budget delivers £1.3 billion extra for local councils to provide essential services that are vital to our communities.
Fifty per cent of patients in my local NHS trust wait longer than the target treatment times, and 31% wait over four hours to be seen in A&E. Despite the heroism and hard work of NHS staff, something simply has to change. The Secretary of State for Health and Social Care has made the brave decision to stand up and fight for our NHS, boldly supported by our Chancellor. I greatly welcome the shift in focus from sickness to prevention, from analogue to digital, and from hospital to community. This crisis cannot be fixed in one Budget, and it may even take a few Budgets, but at least now there is hope where there was none before.
Sarah Gibson (Chippenham) (LD)
Since the Budget, many healthcare providers in my constituency have told me how worried they are about last week’s announcement. These healthcare providers, which include GP surgeries, dental practices, healthcare operators and pharmacies, are small businesses operating in the heart of our communities. They did so much with so little over the last 14 years under the Conservatives.
Although I welcome the increased investment, this Labour Budget was supposed to be a breath of fresh air for primary care and for our health service. Instead, our GPs, pharmacists and dentists feel taken for granted. They feel let down, and they are scared.
The rise in employer’s national insurance contributions and the lowering of the earnings threshold is life-threatening for GP practices such as Rowden surgery in Chippenham. They do not have the profit margins to absorb these costs, and they cannot pass them on to their clients. Because they are designated as public authorities, they are not even eligible for the employment allowance, meaning that they will bear the full weight of this rise in employment costs, which they simply cannot afford.
A GP practice partner in my constituency told me over the weekend, “I love my job. I have never regretted becoming a GP until this week. Now I am seriously contemplating my future in this role.” This GP is one of eight partners in their practice, which delivers care to 19,000 patients in my constituency, but the financial pressure on them is bleak. If our GPs cannot afford to run their practice because of this Budget, they will have to reduce services, lose staff or, worse, cease to exist. My constituency cannot bear the loss of a single GP, let alone a whole practice. Will the Minister consider meeting me to look at options for mitigating the increased costs faced by GPs in my constituency due to the rise in national insurance contributions and the lowering of the earnings threshold for surgeries like Rowden?
Peter Lamb (Crawley) (Lab)
I am grateful for being called to speak in the Budget debate, particularly during this discussion of the UK’s most beloved national institution. The NHS may be well loved, but unfortunately it has not been well cared for over the past 14 years—and don’t we all know it: our inboxes are filled with messages from people crying out for our support in getting the treatment that they desperately need. All the data shows the problems. In my area, we are more than four times over the NHS national target rate for people waiting in A&E for over four hours. Elective operations are being cancelled at the last minute. In the first quarter of 2010, when the last Labour Government were in power, just 75 such operations were cancelled in my area, but 520 operations were cancelled in the first quarter of this year. That shows the scale of the problem that we face.
We know from personal experience—from whenever we come into contact with the health service—that NHS workers bend over backwards to try to make things work for us, often when they are in overtime, but mistakes and delays are inevitable in an organisation that has been systematically under-resourced. NHS workers need a Government who are on their side. In this Budget, we are providing exactly that by delivering a £22.6 billion increase in NHS funding, with 40,000 new elective appointments per week, and new surgical hubs and scanners. That will get on with the job of clearing the Conservatives’ backlog.
I found some of the comments made by Conservative Members deeply surprising. They are best summed up by what the right hon. Member for Tonbridge (Tom Tugendhat) said. He wrings his hands for millionaire families, but was perfectly happy to see child poverty grow to include over a third of children in the UK. Conservative Members talk of the Budget plunging people into debt, when they racked up £2.6 trillion of debt—three times the amount they inherited from the Labour Government. They talk about the amount of tax on businesses while ignoring the fact that working people in the UK have never been more highly taxed than under the last Government. They talk about being on the side of businesses, but ignore the fact that a Prime Minister who they put into office used a very rude four-letter word to say what he thought about businesses in this country. When it comes to NHS investment, there is one thing that we can all rally around: it is desperately needed for research on the collective amnesia of Conservative Members.
While the Chief Secretary to the Treasury is in the Chamber, it would be remiss not to mention that Crawley could do with a brand new acute hospital, if they are being dished out. However, as this Government do not tend to promise hospitals and then not put any funding aside for delivering them, I will leave that debate for the future. The services that we have need to deliver for patients once more. The Darzi report has shown us the way forward, and this Budget puts us back on course to deliver the world-class, cradle-to-grave health service that Labour Members gave to the country in the 1940s, that Labour Members rescued in the 1990s, and that Members here will save again in the 2020s. If Conservative Members wish to save that service, they are perfectly welcome to join us in the Division Lobby later in the week.
Joe Robertson (Isle of Wight East) (Con)
This is not a Budget for growth. On the Treasury’s own figures, growth will decline from 2% next year for the rest of the decade. On the OBR’s analysis, this Budget is inflationary. It is not on small businesses that the responsibility should land. Small businesses employ people. Small and medium-sized businesses drive the UK economy. If we tax them, we tax growth. If we tax their greatest assets—the people who work for them—then we take away employment opportunities for hard-working people.
I will talk more substantively about the dire impact of the Budget on health and social care, including health and social care providers that are not part of the NHS. The increase in employer’s national insurance contributions will cause great difficulty and hardship for GP practices; charities, including hospices; dentists; pharmacies, which are crucial providers of health services; and social care providers. Those organisations, charities and businesses thought that they might have a friend in a Labour Government, but I assure Government Members that they do not feel as though the Labour Government are a friend right now. I have been speaking to those in GP practices in my constituency on the Isle of Wight. One said:
“Our increase in tax from this Budget is the equivalent of the salary of a practice nurse. There will be no new practice nurse for us.”
Graham Stuart
Does my hon. Friend agree that no one would think less of the Government if they listened to these arguments, heard the message and changed? For instance, there is the message about social care being hit by £2.5 billion of extra costs. The £600 million that has been given to local authorities will not cover those costs. If the Government simply listened and changed, people would think much better of them, and we would have a social care system that supported the NHS, rather than one that stops the NHS being able to do what it needs to do.
Joe Robertson
I agree with my right hon. Friend. In fact, there has been one common theme running through this debate: GP practices, charities such as hospices, dentists, pharmacists and social care providers are all being taxed by this Government. At a time when they need Government most, these providers find increased pressure on their ability to employ and provide services to the British people. There would be no shame if the Labour Government were to do something about this gross problem with their own Budget.
Moving on to social care, the Secretary of State for Health and Social Care said that there would be no more money for the NHS without reform, yet the Chancellor provides £22 billion for day-to-day spending unattached to reform. She and the Secretary of State are giving the equivalent of just 2.5%—£600 million—of that £22 billion for social care. That is a tiny fraction, yet the biggest reform that our NHS needs is fairer funding for social care. Money would be better spent on relieving the pressure on hospitals, and getting people out of hospital beds who do not need or want to be there, but who have nowhere safe to go to. Through this Budget, social care providers not only face the full burden of increased national insurance contributions, as employers, but receive a small fraction of the funding that the NHS receives. I urge the Government to go back to the drawing board and provide for our GPs, dentistry, pharmacies, hospices and social care.
Tim Roca (Macclesfield) (Lab)
The first Labour Budget in 14 years needs us to take a clear-eyed view of what has been inherited. Looking at the Conservative legacy for our country, we see: terrible, almost non-existent, average earnings growth; lower productivity per worker hour than in every G7 country besides Italy; GDP per capita growth stalling for the longest time since the end of the war; record debt; high taxes; and poor public services. The lack of growth in real wages is unprecedented in the last 200 years of British economic history. That is the Conservatives’ record, and that is what they have to face up to.
Particularly savage, as hon. Members have pointed out, were the cuts to public investment. The Conservative Government inherited a debt-to-GDP ratio in 2010 of 65%. Ten years later, pre-covid, it was 83%. The Conservative Government promised to eliminate the deficit in 2010; then they promised to eliminate it in the 2015 and 2017 elections; and then they gave up the ghost entirely in the 2019 election. After that dazzling record, we were treated to the Liz Truss magic—Liz, a prophet currently not recognised in her own land. She presented a mini-Budget with £45 billion of unfunded tax cuts. There were no forecasts—the Conservatives like the Office for Budget Responsibility today, but they did not like OBR then—and we know what happened. We saw Tory chaos, and we can never go back to that.
When my right hon. Friend came to office as Chancellor of the Exchequer and looked under the hood, what did she find? More chaos: unfunded policy decisions; undisclosed pressures; and overspends. The OBR listed them. The previous Government promised but did not allocate a penny for the £10 billion infected blood compensation scheme. They promised but did not budget for the £2 billion Horizon Post Office scandal. I am glad to see stability and common sense finally return. There are fiscal rules that make sense and will be adhered to; we are bringing the current budget into balance, so that we do not borrow to fund day-to-day spending; and we are moving to a proper recognition of net financial debt that takes into account investment that delivers. Those sound, sensible decisions put us on a sustainable path. Compare that to a Conservative party that would rather we continued
“to founder under old habits, rotting institutions,”
and that is content for Britain’s hull to be “encrusted with nostalgia”, and for us to drift off into the 21st century.
Jack Rankin (Windsor) (Con)
The theme of this debate is public services, but there has been a distinct lack of discussion from Government Members about what delivers the finances necessary to fund those services; this is the Budget, after all. The answer is simply the productive economy, and small businesses in particular.
The Government talk a good game about wanting better funded public services, and each and every one of us in this House would be hard pressed to find a constituent who disagreed, but the Government’s measures—particularly the jobs tax in the Budget, but also their wider agenda in the Employment Rights Bill, through which we are moving to French-style labour laws—are an attack on where that money comes from.
We must always remember that every single penny spent by the British state has to be earned in the private sector. Chucking money at an unreformed public sector while ballooning public sector pay, and doing that on the back of the productive economy and small business, shows a distinct lack of real world, private sector experience among Government Members. My first memories are of my parents going to night school on alternate evenings to get the qualifications they needed to set up their small business. Their aim was simple: to give my brother and me opportunities that they could never have dreamed of. In doing that, they paid hundreds of thousands of pounds—I ended up with quite a prosperous upbringing, I admit—into the Government exchequer. They created apprenticeships and skilled jobs in a tough part of urban Greater Manchester. They not only transformed our lives but improved the lives of children around them, and created opportunities for local people while paying for public services through their taxes.
Graham Stuart
Does my hon. Friend agree that the absence on the Government Front Bench of anyone with any experience of running a business, when businesses create the wealth that pays for public services, may explain why the Budget is so financially illiterate?
Jack Rankin
I thank my right hon. Friend. That absolutely shows, as we see from the Office for Budget Responsibility forecasts mentioned by my hon. Friend the Member for Isle of Wight East (Joe Robertson). Putting up taxes unsustainably may mean adrenaline into the public sector from an injection of cash, but the medium and longer-term result will be lower growth, which will mean that public services are just getting a larger slice of a smaller pie.
It is clear to me that the tax burden is higher than is necessarily sustainable. Tax rises now will not necessarily flow into greater revenue, particularly in the medium term. I ask the Government to check their approach, support small businesses first and foremost, and focus their public service efforts in the first instance on productivity reforms.
Katrina Murray (Cumbernauld and Kirkintilloch) (Lab)
Lord Darzi’s independent report pronounced that the NHS in England was in a critical condition. By commissioning the report and through the announcements in last week’s Budget, the Government have declared their intention to fix our NHS and set a firm foundation for the future.
I particularly commend the decision in the Budget to invest in mental health crisis centres, in order to move those experiencing a mental health crisis away from the accident and emergency unit. Although we will always need crisis support, mental health provision—like physical health provision—should focus on intervention at the earliest possible juncture, rather than relying on emergency care.
So often, those in need of mental health care face barriers to accessing help. They face difficulty in getting GP appointments and being referred to the appropriate waiting lists, and they then spend years on those waiting lists. Young people with neurodevelopmental conditions might spend years not being seen by local child and adolescent mental health services, until their case is referred to the private sector because they are about to turn 18 or they are transferred to the bottom of the adult waiting list. The Budget is clear that there is a need for investment.
My Scottish constituents have been failed by two Governments. The previous Conservative Government have rightly been the focus of much of today’s debate, but the current Scottish Government have been asleep on the job, quite frankly. All the signs that made Lord Darzi say that the NHS was in crisis in England apply just as much to Scotland. One in six Scots are on a waiting list for treatment, tests or appointments. Hospitals post on social media telling patients not to go to accident and emergency unless their condition is life-threatening—my local hospitals did so on 27 October. GPs are at breaking point, with a prescription system that still requires paper and fax machines, and there is no NHS app or e-prescribing for Scottish patients. I commend the largest budget settlement for the Scottish Government in the history of devolution. Now, the Scottish Government must use it to fix the system that they broke.
Devolution is massively important to me—I knocked on doors to campaign for the creation of the Scottish Parliament—and I will defend it with my life, but we want to ensure that it works for everyone, so that there is no chance of “big boy done it and ran away.”
Liz Jarvis (Eastleigh) (LD)
Over the past few days, I have been contacted by GPs from St Andrew’s surgery in my constituency, whose busy practice looks after 13,200 patients. They include Dr Katie Popplewell, who told me that the proposed increase to employer national insurance contributions is likely to cost the practice a whopping £27,000—the equivalent of two GP sessions a week—before other staffing costs are factored in. As she puts it:
“At a time when the Government has promised to repair and invest in the NHS, this decision to place a further burden on practices must change, or we will see an adverse impact on patient care on offer in Eastleigh and more practices closing their doors for good.”
Every Liberal Democrat Member recognises the challenges facing the country after years of Conservative mismanagement, but I hope that the Chancellor will consider exempting GPs, small businesses, pharmacies, dentists, care homes and charities from the proposed increase to employer national insurance contributions.
Although I was pleased to see a commitment to more funding for breakfast clubs, there was no mention of the two-child benefit cap in the Chancellor’s statement, and frankly I am at a loss in understanding why. The Conservative Government trapped hundreds of thousands of children in poverty with their cruel and counterproductive two-child limit. As numerous charities and the Liberal Democrats have pointed out, scrapping the two-child benefit cap would be the quickest and most effective way of lifting children out of poverty in my Eastleigh constituency and across the UK, with huge long-term benefits for our society and our economy.
In Eastleigh, we are also facing a local transport crisis. Hampshire county council has withdrawn funding from multiple routes over the past year, which has had a huge impact on my constituents, particularly in Chandler’s Ford and Valley Park. The bus fare hike will impact those in my community who can least afford it, and could result in yet more routes being cut with no alternative public transport provision.
Thousands of women in my constituency who were born in the 1950s have been impacted by the DWP’s failure to communicate changes to their state pension age. It was incredibly disappointing that the WASPI women did not get a single mention in the Chancellor’s speech. It has been eight months since the ombudsman found that the DWP had failed to adequately communicate the changes. I implore the Chancellor to make the resolution of that issue a priority. Do not leave it until the next Budget; those women have already waited long enough.
Kevin McKenna (Sittingbourne and Sheppey) (Lab)
Thank you, Madam Deputy Speaker, for calling me to speak in this debate about the Budget—a Budget I am very proud to support as the first Labour Budget in 15 years.
I also thank the various Members who have made their maiden speeches in this debate, particularly because like myself, so many of them have worked in the NHS. Many of us have felt the urge to get selected for, and elected to, this House because of our experiences over the past 14 years. I understand that among Opposition Members, there is a feeling that Labour Members do not understand business, but I can tell them that we understand the public sector, public services and our communities—and actually, that is a disservice to all the Members on the Labour Benches who have run businesses. It is particularly important to me that a couple of Labour Members have previous experience as NHS managers. In his report, Lord Darzi made it very clear that one of the problems the NHS has faced is an undervaluing of the management side, as opposed to the clinical side, so those Members’ voices will be really important in this debate.
This Budget gives us solid foundations for investment and rebuilding this country—of that, I have no doubt. This Budget is also what people in my constituency have been crying out for, because they know that our public services are frayed to a point that is almost beyond repair. Honestly, that is what people in my constituency keep telling me. Unlike some Members, who have apparently had some very negative responses to the Budget, I can tell those Members from canvassing at the weekend and from what is in my inbox that I have seen a really positive response to this Budget. People are really glad to see that the investment has started, and frankly, there is a sense of reality—a recognition that this is not going to be a quick fix.
On the health service and social care in particular, I applaud the fact that the Secretary of State has not just commissioned the diagnostic investigation from Lord Darzi, but has now commissioned a 10-year plan for the NHS.
Kevin McKenna
I do not think so.
That plan will be needed to get the NHS back on its feet, and as a counter to some of the comments about national insurance and burdens on businesses, the Secretary of State was very clear that he is going to look at the NHS allocations to GPs and other people supplying the NHS—that comes with the plan. Beyond that, it is really important to recognise the damage that has been done to businesses over the past 14 years by all the other costs that have been accrued. The mental health crisis damages recruitment and retention, and businesses have had to cope with all those extra costs across the board.
Jeremy Corbyn (Islington North) (Ind)
I welcome this debate, which centres on health and inequality within our society. The hospitals are in a crisis situation, with huge demands on them, insufficient resources and underfunding, and of course huge debts from the past that are not being addressed. In an intervention on the Secretary of State earlier, I asked a question about the future of private finance initiative projects, which take up over 15% of most hospitals’ budgets. I think PFIs need to be taken over by the Treasury—as was envisaged in previous manifestos—as a way of releasing that cash directly into the national health service, which would help with waiting lists for operations and all the demands that are not being met.
My second point is that healthcare is not just about hospitals: it is also about social care and mental health. In the case of my own borough, Islington—a very typical inner-city borough in many ways—our social care costs are up by £20 million and going up all the time, because there are more and more people with demands. Families are moving away, more and more people are isolated, and demands are getting greater and greater. There has to be a change in the whole social care policy, and I hope the Government will bring forward serious proposals for a universal, wraparound national care service to take away the pain and stress that so many families face as a result of social care costs.
Likewise, the mental health crisis is real, it is serious and it is here, particularly among young people—sadly, often particularly among young males. I realise that it is early days for this Government, but I hope they will appreciate that not only do we need a much more effective and efficient mental health service, but we need to recognise that mental health stress comes from other stresses in society such as housing, jobs, families, environment and many other issues.
We cannot separate the question of healthcare and health needs from poverty in our society. Ending the two-child benefit cap would release some people, including children, from the desperate poverty they are in. Not taking away the winter fuel allowance from very poor pensioners would help a great deal. Likewise, the issues of housing stress, huge rent levels in the private rented sector and desperate levels of overcrowding for many people in communities such as mine have to be addressed. Under the proposals of the 1945 Labour Government, health and housing were linked together, and we need to look seriously at that.
My local authority, Islington, has lost £105 million in payments since 2010. That is typical for local government. We need the money put back in to deliver the services our people need.
Leigh Ingham (Stafford) (Lab)
I join my colleagues in welcoming the Budget and all it represents in making a real difference to the healthcare outcomes of my constituents in Stafford, Eccleshall and the villages. In a way, campaigning on rebuilding the NHS during the election was easy. I did not have to explain to my constituents that our health service is broken. The NHS is not something that happens off in the distance: it is a GP on the end of a phone, or the ambulance service that comes running the second 999 is called, or the kind nurse who sits with a grandparent in their hospital bed. It is the real beating heart of this country. My constituents feel the impact of the NHS every day of their lives, except now for many the phone call to the GP at 8 am takes 40 minutes, the ambulance arrives after several hours, with luck, and there are no beds available in hospitals. We see the impact of the last 14 years on our health service and the shameful legacy left by the Conservatives.
The Budget is the first step in delivering the change my constituents voted for. It represents a new chapter, a commitment to put health and community first and the beginning of rebuilding what has been lost. I know that the Minister for Care has recently stated that the Government are determined to shift more healthcare out of hospitals and into our communities. I wholeheartedly support that goal, especially when it comes to palliative and end of life care, which local hospices in Stafford faithfully provide. I recently met staff at Katharine House hospice in my constituency to discuss the importance of palliative care. I was very moved to see the care and empathy with which they provide services in our community.
The Budget is a reset for the NHS, allowing us to focus on preventing ill health in the first place and moving healthcare from hospital to community as we build an NHS fit for the future. I welcome it, as do my constituents.
Mr Angus MacDonald (Inverness, Skye and West Ross-shire) (LD)
It is appropriate that I am following the words of the hon. Member for Stafford (Leigh Ingham) about the palliative care sector. I am grateful for the substantial settlement for the NHS, especially as Scotland will get £3.4 billion, which will make an enormous difference. The Belford hospital in Fort William has been condemned, effectively, for 25 years. Unfortunately, I have very little confidence in the Scottish Government to spend that £3.4 billion well.
I recently spoke with Kenny Steel, the chief executive officer of Highland hospice in Inverness, who told me that the changes to employer national insurance are expected to add an unaffordable £177,000 to its annual salary bill. That comes on top of the need to remain competitive with the 5.5% salary increase awarded to NHS staff. Marie Curie anticipates that the NI increase will cost it £3 million a year—money it does not currently have.
The Government’s planned increase in employer NI contributions to 15% from April 2025 is an impossible amount for the palliative care sector. If those essential care providers cannot absorb the additional cost, their survival is at risk. If hospices fail, the patients they support will inevitably turn to the NHS, placing greater pressure on an already overstretched system. If the Minister could listen to me and put his phone down for a moment, I would be grateful—can you listen to me, just for a second?
Madam Deputy Speaker (Judith Cummins)
I remind the hon. Member not to address other people in the Chamber as “you”, as he is actually addressing me. Please continue.
Mr Angus MacDonald
Palliative care charities are essential partners that deliver compassionate, dignified end-of-life care on behalf of, and much cheaper than, the NHS. Organisations that provide healthcare for the NHS should be treated like NHS bodies in these decisions. Increasing NI contributions for hospices but not the NHS places those providers in a critical financial position, and firmly indicates that the Government regard organisations such as Highland hospice as second-class.
Pam Cox (Colchester) (Lab)
I am proud to speak in this debate on a Budget that marks a turning point for our country and my constituency of Colchester. It is a Budget that fixes the country’s foundations and a Budget that works to repair and reform our NHS.
Our health service means a huge amount to those we represent and their families. Our health and social care staff do an amazing job, day in, day out. They and those for whom they care have long deserved better. Members of my own family have spent decades working in the NHS: my mother as a midwife, health visitor and then public health champion; and my sisters as nurses, one now a diabetes specialist, one supporting a parish nursing community programme. I have heard from them at first hand about the challenges they face. Those challenges are immense and will take a long time to address.
The Budget recognises that. It walks towards those difficulties, rather than kicking the can yet further down the road. The Chancellor faced a stark choice and she rightly chose the hard road. As a Government, we could have continued with the failed policies of the past 14 years, with the low growth and austerity that have left our public services on their knees. Instead, we opted for change and to invest in those services, in the workforce who make them possible, and in the technologies that must transform them.
I particularly welcome the extra £25 billion for the NHS across resource and capital budgets to cut waiting lists and invest in new equipment. That, combined with increases in the minimum wage, will help the frontline workers who struggle to make ends meet. That includes workers at Colchester hospital in my constituency who are fighting plans to outsource their jobs to the lowest bidder. On that matter, I am backing those staff who, like our wider workforce, deserve fair pay and conditions.
As the Secretary of State for Health and Social Care said in his opening speech, new investment for the NHS must be combined with innovation and take full advantage of the potential of life sciences and new technology. Colchester is home to the Institute of Public Health and Wellbeing at the University of Essex, which is leading the charge. Together with local and global partners, it is developing new digital health, health informatics and health analytics that will help us to meet the challenges of the future. It is also working with our integrated care board to improve existing community and preventive services—something which my mother would have cheered to the rafters. She was rather old-school on that. She believed that we needed the high-tech stuff, but we also needed the low-tech stuff—basic things—to support people to live healthier lives through access to good food, green spaces, good housing and early years support. A Labour Government will bring all those things, and I am proud to support that and this Budget.
Graham Leadbitter (Moray West, Nairn and Strathspey) (SNP)
The theme of today’s debate is fixing the NHS and reforming public services. To do that, the Government require a strong will to drive reform and financial support for public services that were hammered for far too long by 14 years of Tory austerity.
As a former council leader who dealt with tightening public sector budgets against a backdrop of changing demographics, which increased pressure on the NHS, care services and early services, I am well aware of the impact of austerity on our communities in Scotland and, indeed, throughout the UK. I welcome the substantial increase in investment in public services in the Budget, but the Government could generate more to support the NHS and public service reform. I am referring to the flawed increase in spirits duty, which follows the brutal increase in spirits duty introduced by the Tories last year.
I am proud to represent Moray West, Nairn and Strathspey, which is home to 48 distilleries, including some of the best known brands in the world—brands that can be found in pretty much every major airport and high-end department store. The industry has a GVA—gross value added—of more than £7 billion, and exports more than 40 bottles of whisky every second. The whisky sector has been investing heavily in sustainable operations and decarbonising its production, which has led to incredible innovations in hydrogen for energy, waste treatment and waste heat transfer, shortening the supply chain and much more. Those innovations are then used in other sectors, including the public sector, to drive sustainable reform in how services are delivered.
Despite independent studies showing that the Treasury lost £300 million because the Tory duty increase went too far, the incoming Labour Government have pushed that even further—a move likely to cost the Treasury even more in lost revenue, when a duty cut would have driven sales of a high-quality product and generated increased revenue, supporting jobs and investment.
In the election campaign the Prime Minster stated that he would
“back Scotch producers to the hilt”
The Scotch Whisky Association described that commitment as “broken”, with its chief executive, Mark Kent, stating:
“This is more than a broken promise, to many it will smack of a betrayal. Scotland’s national drink, and the associated investment and jobs, has been actively undermined and discriminated against.”
Those are strong words, and the Government should take heed of them. Instead of penalising this incredibly successful and innovative jewel in the crown of our food and drink sector, the Government must cut the duty on spirits to generate more sales and more tax revenue to support public services—revenue that could be used to protect GP practices, like the rest of our NHS, from changes to employer’s national insurance. It could also go some way to avoiding the outrageous cut to winter fuel payments—a cut that has a particularly difficult impact in my constituency, which has some of the highest altitude and coldest communities in the UK. I hope that the Government will listen and act on those concerns.
Dan Aldridge (Weston-super-Mare) (Lab)
It is privilege to serve in this Parliament, and I am immensely proud to speak in support of the Budget, the Chancellor, and her remarkable team. As someone raised by strong, brave, and kind women, I cannot in good faith ignore the significance of having a woman lead the charge to rectify the economic instability left by the men before her. This Budget lays the foundation for a fairer, more productive economy, and aims to fix the very bedrock of our society. It is genuinely inspiring to see how the Chancellor’s team has embraced the challenge of balancing both the big picture of reform and national renewal, and the critical details that support those most vulnerable to economic shifts.
The investment outlined in the Budget cannot come soon enough, especially in constituencies such as mine, where average earnings are nearly £7,500 below the UK average. My sister is a nurse at Weston general hospital at the heart of my constituency, and as a family we know the true weight of the crisis in healthcare. Indeed, last week my mother, who has Parkinson’s, fell over. We waited for nine or 10 hours, and eventually ended up dragging her into the car. There was no dignity in that, and that is the state we have been left with.
For us, if Labour had not won the election, healthcare free at the point of use would have been at risk of disappearing forever. Thankfully, under the Labour Government the NHS has been given a vital eleventh-hour reprieve. The £22.6 billion investment promised in the Budget will not only prevent further decline, but actively rebuild our health services. For Weston general and our GP surgeries, that means more appointments, long-overdue maintenance and improvements, and a sense of hope for our community. The Budget is not just about holding back the tide of decline; it is about building a dam to protect the future. It is progressive, targeted investment where it is needed most.
In Weston-super-Mare, increasing the minimum wage will see nearly 4,000 workers in North Somerset up to £1,400 better off each year, and with £1.6 billion allocated for road maintenance, we can start to tackle the huge backlog of potholes that plague Weston, Worle, and everywhere between. The £6.7 billion investment in education will mean better funding for Weston’s schools and colleges, and the £1 billion uplift for special educational needs, disabilities and alternative provision, is a particularly welcome change for many families in my constituency, and will begin a much-needed reform of SEND provision. Although we know it will take time properly to address the crisis in local government funding that we inherited, £1.3 billion of new grant funding will increase resources for North Somerset council, supporting essential services for our communities.
The Budget delivers on why we were elected: to tackle the cost of living crisis, get our NHS back on its feet, and lay the foundation for an economy that not only grows, but does so in a way that builds stronger, healthier and more resilient communities. When people see the changes in our hospitals, surgeries, schools and roads, they will once again believe that government can be a force for good. This is just the beginning of our journey towards a fairer, more hopeful future.
Luke Taylor (Sutton and Cheam) (LD)
Members of this House will have seen that the celebrated Scottish comedian Janey Godley passed away on Saturday, after her long struggle with cancer came to an end in the Prince and Princess of Wales hospice in Glasgow. In her final days, Janey used social media to highlight the wonderful hospice care she received, and when her daughter announced her death, she took time to mention that her mother’s passing was
“peaceful and a nice transition.”
That is the profound value of hospice care to our society and the nation’s families.
Janey Godley’s choice to highlight the care she was receiving in her final days should remind us all why hospices matter, yet across the country it is not an exaggeration to say that hospices are at breaking point, as we have heard from Members across the House this afternoon. Many hospices are grappling with severe staff shortages and tight budget constraints. Redundancies and supply shortages have become alarmingly common, highlighting systemic issues in the hospice sector. This most vital of services is reliant on an unsustainable model which, on average, requires two thirds of hospice funding to come from some sort of charitable donation. That leaves hospices vulnerable, reliant on charity shops and large contributions with no guarantee of financial stability, and it also adds to the postcode lottery for patients. Even the NHS funding that hospices receive fails to keep pace with inflation.
Nowhere is that crisis more evident than at St Raphael’s hospice in my constituency of Sutton and Cheam. St Raph’s is more than just a healthcare facility; it is a sanctuary for those seeking to die with dignity. The compassionate care provided there not only supports the dying, but brings comfort to their families in one of the most challenging times in their lives. However, it receives only 25% of its funding from the NHS, which is substantially below the national average. In recent months, the hospice has been forced to reduce its clinical community nurse team by 20% and has completely discontinued its hospice at home programme, which once made sure that patients who wanted to spend their final days in the comfort of their own home could do so with dignity and support.
Over the past four years, running costs for St Raph’s have risen by more than a million pounds, but NHS funding to the hospice has increased by only £140,000. In last week’s Budget, the Chancellor pledged £22.6 billion to the NHS, which is long overdue after years of Conservative neglect. However, hospices were notably absent from Labour’s 10-year plan for the NHS, and the rise in employer NI contributions threatens to push hospices already struggling with fragile finances over the cliff edge.
If this Government are serious about delivering change, they will exempt hospices from the rise in NI contributions and listen to calls from the sector and inside this very House to sort out a proper funding deal to rescue our hospices.
Terry Jermy (South West Norfolk) (Lab)
Prior to the election, I spent the past 10 years running my own business. Since July, one of the aspects of this role that I have enjoyed the most is going out and talking to local businesses about how we can work together and how I can support them. I hear time and again from local businesses that they need a healthy workforce to survive. Businesses do not want their staff sat on NHS waiting lists, unable to come to work or with health conditions impacting their productivity. We all rely on strong public services and we have all felt their decline over the past 14 years of Conservative Government.
Businesses also need customers, and in South West Norfolk we will benefit from the national living wage increase. We are sadly a low-wage area. In my experience, when people on lower incomes get a pay boost, they spend it. They replace something that is broken, such as a toaster or a microwave, or they get the children some new clothes, or they complete home repairs. That is money going back into the local economy, supporting, I hope, local businesses as much as possible. Despite covering some 500 square miles and containing 100,000 people, nowhere within the boundaries of South West Norfolk do we have a hospital or even a minor injuries unit. Towards the south of my constituency, our nearest hospital is West Suffolk in Bury St Edmunds, which is a 15-mile drive from the constituency border, and it is roughly the same journey in the north of the constituency to the Queen Elizabeth hospital in King’s Lynn.
When people eventually get to one of those hospitals, there is a similar greeting. Both hospitals that serve my constituents are massively oversubscribed, and both are riddled with RAAC—the Queen Elizabeth is literally held up by more than 5,000 metal and wooden props. I saw for myself over the summer how that was inevitably making it difficult to provide excellent patient care. I was delighted that the Chancellor made reference to West Suffolk hospital in her Budget statement. We are desperate to see that hospital replaced; it is the same with the Queen Elizabeth. I am pleased that this Labour Government are so focused on the RAAC challenge. We simply cannot expect NHS staff to deliver first-class hospital care when the buildings are falling down around them. It is not just the focus on hospital buildings that will be welcomed; the more than £20 billion of extra funding for NHS services will go a long way towards addressing the huge backlogs.
Access to health and social care services came up time and again during the election campaign in South West Norfolk. People face difficulties accessing a GP appointment and seeing a dentist is near impossible. The focus on health and social care and the support for those on low incomes are just what is needed in my constituency. I look forward to supporting this Budget boost for west Norfolk.
Iqbal Mohamed (Dewsbury and Batley) (Ind)
I congratulate hon. Members who have made their maiden speeches in the House today. The first Budget of a Labour Government in nearly 15 years is definitely an improvement on the 14 years of Tory austerity and waste, but it is a missed opportunity to bring about the transformative change that the country needs. I welcome the increases in the national minimum wage and carer’s allowance, but it is disappointing that those changes have been accompanied by cuts to social security and disability benefits.
I am grateful for the long-overdue investment in hospitals and the NHS. However, the Government must guarantee that those resources will go into our NHS and not into the pockets of private shareholders.
Some 4.2 million children are growing up in poverty and a quarter of a million people are homeless; meanwhile, we are on the brink of an irreversible climate disaster. Those crises demand bold solutions. The Government could have implemented wealth taxes and closed corporate tax avoidance loopholes to bring about a more equal and sustainable society. Instead, they have chosen to bake in decades of inequality by feigning regret over tough choices they do not have to make. Those include keeping the two-child benefit cap, cutting the winter fuel allowance and increasing the bus fare cap by 50%. At the same time, the Government have committed to an additional £3 billion of military spending.
I echo the comments of my right hon. Friend the Member for Islington North (Jeremy Corbyn) on the link between housing and health. While I welcome the measures in the Budget to increase funding for housing, I am concerned that they do not go nearly far enough. Real security is when everybody has a decent home, and we will solve the housing crisis only with rent controls and a huge council house building programme.
The Government will be aware that plans to freeze the local housing allowance will have a detrimental impact on hundreds of thousands of families struggling in temporary housing or facing eviction. According to the Joseph Rowntree Foundation, if the LHA remains frozen over this Parliament, private renters on housing benefit will on average be about £700 worse off.
If the Government are serious about tackling child poverty and homelessness, they need to start by ending the LHA freeze and linking housing costs to housing support. While I welcome the commitment from the Deputy Prime Minister to deliver 5,000 new social and affordable homes, that is only scratching the surface.
Mr Adnan Hussain
On the winter fuel allowance, does the hon. Member agree that freezing pensioners will only increase the need for NHS resources when hospitals are already struggling?
Iqbal Mohamed
I thank my hon. Friend for his intervention. I completely agree that there is a direct link between pensioner poverty and demands on the NHS.
The Government’s proposals in the Budget do not go nearly far enough. The situation is simply not sustainable. The ability to provide the bulk of its citizens with a roof over their head is a litmus test for the success of any state. Unfortunately, that test has been failed by successive Governments. Without more radical measures to increase the stock of affordable housing, I fear it is a test that this Government will also fail.
Douglas McAllister (West Dunbartonshire) (Lab)
This Budget delivers the largest Scottish block grant in the history of devolution, delivering a total of £47.7 billion for Scotland’s budget in 2025-26, including the £3.4 billion boost to spending through the Barnett formula next year, which comes on top of the £1.5 billion this year. Our Chancellor has provided £2.8 billion extra for day-to-day spending and £610 million for capital investment, including £20 million for my home town through the Clydebank town fund and tens of millions for Dumbarton’s regeneration. This Budget marks the end of the era of austerity, raising much-needed funds for our public services in Scotland. It keeps our promises to Scotland and to my constituents in West Dunbartonshire, and demonstrates the value of Scotland’s having voted Labour in July.
The historic funding must be used by the Scottish Government to fix the NHS and support our public services. The SNP Government are now out of excuses. They must show the same level of ambition for our NHS in Scotland as this Government. They must not squander this opportunity with their usual financial mismanagement. No more excuses; no more blame game. The SNP Government are facing a make-or-break chance to revive Scotland’s failing NHS, where one in six Scots is stuck on a hospital waiting list.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
The hon. Gentleman is making a very good speech outlining the Scottish context. Should the SNP Government not repair the damage done to maternity services in the north of Scotland, where mothers have to make a more than 200-mile round trip to give birth? They should put things right in the north and all parts of Scotland.
Douglas McAllister
Yes, I agree. The SNP is not here this afternoon, but this Budget means that the Scottish Government are receiving more per person than equivalent spending in the rest of the UK. The SNP just needs to get better at spending it. Scots can see that the SNP has lost its way and is out of ideas, and that its Ministers are incompetent and as bad with their money as they are for taxing us more and giving us less.
Figures released today for the past month reveal the scale of the crisis: the Scottish NHS is flagging on multiple fronts. The number of operations cancelled due to hospital capacity rose to the highest level since August 2022. Delays to patient discharge rose to an average of 29 days, while thousands of Scots attending A&E waited more than eight hours to be seen. There were 50,000 fewer planned operations in the past 12 months than at the same point before the pandemic.
The new money that the Government announced in the Budget should not be diverted by the Scottish Government. They must spend every penny of the extra NHS cash on Scotland’s ailing health service, and use the boost of billions of pounds to cut waiting lists. The message should be clear: they have the power and they now have the money, so no more excuses and no more hiding places. They must get the money to the frontline and get the one in six Scots off the hospital waiting lists.
This is a very good Budget for Scotland, but only if, finally, the Scottish Government are able to display a semblance of economic competence. But not for too long—just until 2026, when the people of Scotland get to complete the job of getting rid of both the failing Tories and the SNP.
Victoria Collins (Harpenden and Berkhamsted) (LD)
After more than a decade of Conservative chaos, there is no doubt that the Government inherited a challenging task. We all recognise the enormous responsibility faced by the Chancellor this autumn. Her announcement of an increase in NHS investment is welcome, but my concern is that the Budget ignores the back door of the NHS. The crisis in our NHS cannot and will not be fixed until the Government fix social care too.
My inbox, like those of many Members across the House, has been filled by GP practices concerned about the increase in employer’s national insurance contributions. With no shareholders and no ability to increase prices, some of my local GPs have said that they fear layoffs will be the only option. Without an exemption from the tax rise, the vast majority of health and care providers that are private companies, including hospices and pharmacies, will not benefit, further threatening the integrity of the Government’s commitment to the NHS.
It is more important than ever that we protect our beloved local businesses, which are the backbone of our local economy. They cover everything from hospitality to accounting, to local shops run by working people, such as Threads and Oui in Harpenden, Fancy That of Tring, Graze Life and the Oakman Group, which is very worried about the pre-profit money it will have to raise and what that means for the business. Along with fellow Liberal Democrats, I am therefore calling for better business support, including fairer reform of business rates.
Our local communities rely on our councils, which deliver social care and local services. They need the funds to deliver those services. Our local communities are also fed by our farms. Already working on tighter and tighter margins, they now face selling off land and breaking up their farmland. Jamie from Sandridgebury farm is already contemplating how he will have to break up his family farm and what that means for his two daughters, as well as for the food he grows for our communities.
The Conservatives left our economy in a mess, but we have an opportunity to turn things around. I call for better support for all our healthcare providers, but also for our small and medium-sized enterprises. The Budget must support our communities. That includes our local businesses, our local government, our local farmers and, of course, at the heart of it, our health and social care deliverers.
David Burton-Sampson (Southend West and Leigh) (Lab)
This Budget starts to deliver the change our country voted for, the change our country needs. It is a tough Budget that makes the right choices to start repairing the foundations of our economy, while investing in our public services where investment is most needed. After 14 years of the last Government, it is now clear that the adults are back in charge. Looking at the attendance, or lack thereof, on the Opposition Benches, it is very clear that the Tory party called a general election, handed back the keys and ran away from any responsibility. However, this Government will fix our NHS and invest in our hospitals—something that is badly needed in my constituency of Southend West and Leigh.
Things are so bad in my local hospital that just recently, hospital staff have been banned from ordering new uniform as part of new cost-cutting measures. Excluding cancer pathways, Southend University hospital has average waiting times of 29 weeks for out-patient appointments and 26 weeks for general surgery. They are sometimes much longer. That is simply unacceptable, as people wait suffering in pain. This Budget will start to fix that.
There are huge gaps in local mental health provision. I am sure Members agree that we need parity of care, with as much emphasis on mental health as physical health. For young people in need of mental health services in my constituency, the aim is for assessments within 12 weeks and treatment within 18 weeks, but the reality is that waiting lists can be as long as 18 to 24 months. Practitioners, such as The Lighthouse in my constituency, are working very hard to bring those numbers down, so it is really pleasing to see included in the Budget, on top of the money committed, the £26 million for new mental health crisis centres.
Families waiting for assessments for special educational needs are being let down, so I am delighted to see the £1 billion uplift in SEN provision. New funding for the NHS, mental health services and SEN provision will provide much needed help to my constituents. Without our health, our nation will struggle to rebuild our economy, so the long-term plan for the NHS will develop as a result of the current consultation and through our 10-year plan for national renewal.
The days of sticking heads in the sand are over—hope is not a plan. I thank the Chancellor and her team for putting in place a credible plan to fix our NHS.
Steve Witherden (Montgomeryshire and Glyndŵr) (Lab)
It is a pleasure to follow my hon. Friend the Member for Southend West and Leigh (David Burton-Sampson).
I welcome this Budget, which marks a significant milestone for Wales: the largest funding boost since devolution. I am especially proud of the £25 million allocated for the continued safe maintenance of coal tips, which is vital for places such as the Bersham Colliery spoil tip in Rhostyllen, in my constituency, made famous by the Hollywood-style “Wrexham” sign. The Budget is testament to the positive impact of two Labour Governments working together. We should never forget the 14 years of brutal austerity under the Tories, whose legacy has left vital services in disarray, record low living standards, and more than 4 million children living in poverty. After such devastation, investment is not just welcome but essential.
Food security is one of the most pressing issues that the UK faces. The Tories failed our farmers, as is clear from dodgy trade deals with New Zealand and Australia, delays in post-Brexit payment schemes and the closure of 12,000 farms, leaving many struggling financially. Investing properly in farming and addressing farmers’ concerns is essential for the industry’s future, so I welcome the £60 million allocated to the farming recovery fund in order to support farmers affected by last winter’s extreme wet weather. I also welcome the £208 million to protect against threats such as peste des petits ruminants, bluetongue and other diseases that blight the lives of our farmers, and the £5 billion for the farming budget over the next two years.
Inequality in our society is stark. Raising the national living wage by 6.7% to £12.21 per hour is a key step forward, benefiting about 70,000 minimum wage workers in Wales. Keeping petrol duty frozen is crucial for those of us in rural areas, where affordable fuel is essential to daily life, work and accessing essential services. I know that that was a major concern for many of my constituents before the Budget. Our Labour Government will invest in public services, particularly the NHS and schools, which are devolved but vital. I wholeheartedly welcome the £2.3 billion increase in the core school budget, which will enable the recruitment of 6,500 new teachers and enhance school maintenance. As a dyslexic and dyscalculic child who was illiterate until the age of 11, I know that the Government’s commitment of £1 billion to special educational needs and disabilities will make a real difference.
Amanda Martin (Portsmouth North) (Lab)
I wonder whether the Chief Secretary to the Treasury agrees that those on the depleted Government Benches continue to paint a picture showing that the last 14 years of Tory neglect were not a choice. That is made even more delulu by attacks on the changes that this Government have made to fix the foundations and improve the lives of people in constituencies up and down the country. This shameful attempt to rewrite history would be laughable if it were not so tragic for the people who live in my city.
The Budget is the first step in a different and positive direction. I am proud to say that the Government have seized the opportunity to create real change for my constituents. There are 9,600 minimum wage workers in my constituency, a number proportionally higher than the national average, and many work in our public sector. Increasing the national living wage to £12.21 per hour is a huge win for those low-paid workers, and the increase to £10 for those aged between 18 and 20 gives young people a decent chance to start their independent lives.
More than 12,300 unpaid carers are fighting to provide vital care in my city. Unpaid carers deserve our unwavering support, and I am proud that we are raising the threshold for carer’s allowance, which will provide a vital boost for many families. The review of the carer’s allowance overpayment scandal that we saw under the last Conservative Government is very much overdue, and I am pleased that we are launching it.
Some 63,000 people are waiting to start treatment at Portsmouth’s NHS trust, with almost half waiting more than 18 weeks. The injection of spending into the NHS represents a real-terms growth rate of 4%. The additional funding will support the delivery of extra appointments, reduce waiting times and deliver an 18-week target, which is vital for my constituents. I am looking forward to hosting the first joint NHS public consultation in December with my hon. Friend the Member for Portsmouth South (Stephen Morgan), and to feeding our city’s views into the 10-year plan for the NHS. In Portsmouth North, 6,730 people are on universal credit. Our reforms to universal credit will mean the introduction of a fairer debt repayment rate. We are bringing the rate down from 25% to 15%, which will help so many people.
As a teacher, it would be remiss of me not to mention the 43,000 children in my city who are in education. We are bringing in breakfast clubs to ensure that children are set up every day, and removing the VAT exemption and business rates relief for private schools, so that 94% of the kids in our country get money into their schools. We are recruiting teachers and, crucially, supporting 14,000 children with SEND in my city.
David Baines (St Helens North) (Lab)
I welcome this Budget, not because it solves all the problems in the country—we have heard a lot about them this afternoon, and they would be impossible to solve quickly—but because it begins to do so. In many ways, this Budget is a reset moment for our politics and our economics. It is a deliberate choice to invest in growth and essential public services, not least the NHS, in St Helens North and across the country—just as the austerity that we suffered under previous Governments was a deliberate choice.
As Liz Truss’s Chancellor was reported as saying last week, Labour is dealing with the Conservatives’ mess. We have that responsibility because people voted for change in July. They want a change in direction, because the consequences of the choices made by previous Governments are clear for us all to see: the funding black hole in social care, the crisis in the SEND system, our crumbling state schools, roads falling apart, councils going bankrupt, and the crisis in our prisons and the justice system.
In St Helens North, the number of children living in poverty rose by more than 50% between 2015 and 2023. Was that good for business? This is the mess that we are cleaning up. Of course, we cannot talk about the mess that we are cleaning up without talking about public health and the crisis in the NHS. The recently published report by Lord Darzi spells it out: life expectancy increased under the last Labour Government, but plateaued during the 2010s under the Tories. That is not a coincidence. The absolute and relative proportion of our lives spent in ill health has increased. That is not a coincidence. To quote the Darzi report summary,
“Many of the social determinants of health—such as poor quality housing, low income, insecure employment—have moved in the wrong direction over the past 15 years with the result that the NHS has faced rising demand for healthcare from a society in distress.”
Is that good for business?
This Budget provides the largest cash injection into the NHS outside covid since 2010, but the Government also recognise the need for reform. I encourage everyone in St Helens North and across the country to take part in the largest NHS consultation in its history, which is happening right now. Last month I met north-west ambulance workers, and there was frustration, anger, heartbreak and exhaustion because of the circumstances in which they are being forced to work. That is just one of the messes that we have to clear up. It will not all be fixed overnight, but with this Budget and other measures, including the Employment Rights Bill and the introduction of GB Energy, GB Railways, renters’ rights and more, we are taking big steps towards clearing up the mess that the Conservatives left behind.
Dr Beccy Cooper (Worthing West) (Lab)
A healthy economy means healthy people, but let us not forget that, conversely, healthy people are the backbone of a healthy economy. This Budget is working its way through some very difficult circumstances and dealing with problems that have been ignored for far too long. Problems in our economy have had an adverse effect on the health of the people we are here to serve, so I am heartened to see that this Budget is aware of the need not only to get the financial engine room running again, but to rebuild the foundations of good health for this country.
This Budget rightly prioritises the NHS, with vital capital investment and increased spending. I know that many of my constituents and those across the country will welcome the announcement of funding for mental health crisis centres, providing services that are so desperately needed. That will go some way towards taking the pressure off our A&E departments.
I would like to highlight a couple of the investments made beyond our NHS that are so vital for our health. I am delighted to see investment in giving all children the best start in life, with spending on early years and family services rising to £8 billion. The £30 million expansion of breakfast clubs will ensure that children start their days with a meal and positive social time. I have seen how much value is added when the catering is integrated into a school’s wider vision for health, wellbeing and pastoral care.
I am also encouraged to see that the debilitating cuts to local government funding in recent years have finally stopped, and that a plan has been put in place to support essential providers of frontline services in continuing their vital work. As well as the 3.2% real-terms increase in local authority core spending power, the additional £500 million going into the affordable homes programme will kick-start an increase in decent, affordable social housing and finally begin to address some of the unacceptable emergency accommodation that our constituents find themselves in while waiting far too long on our housing waiting lists.
As we move forward and build on the healthy economic foundations outlined in this Budget, I look forward to considering the reforms that will be needed for social care. The £600 million grant funding for it is a good starting point for the necessary work to come. Similarly, the public health grants in local government must be protected and funded properly in order for us to move sustainably from treatment to prevention. We know that our public services and NHS cannot be fixed overnight, but I congratulate the Chancellor on delivering a Budget that has given us a firm marker of intention and direction. The measure of our collective health and wellbeing is not GDP per capita alone. We can rebuild the services that we need to lead healthy and productive lives, and with this Labour Government, we will all thrive.
Danny Beales (Uxbridge and South Ruislip) (Lab)
The last few years have been incredibly difficult for our constituents and our national health service. Public services are on their knees, a £22 billion black hole has been left in our public finances and there have been real-terms falls in incomes and living standards. The Conservatives, as we have heard today, are still labouring under the fantasy that no problem exists, and that they are sitting in opposition—well, a few of them are sitting over there—through no fault of their own, but through some sort of electoral dysfunction. They are entirely unwilling to say what they would do to fix the broken services and our NHS, and what they would do to close the financial gaps that they have left.
I am pleased that we have taken the tough and necessary decisions on spending and taxation to put our NHS back on a firm footing—tough decisions that any Chancellor and any Government would have to make. The Conservatives have continually shirked those tough decisions. This Budget ensures that no one will see higher taxes on their payslip; there are no increases to employee national insurance, income tax or VAT. Those are promises that I made to my constituents when going door to door, and promises that we are keeping today. The necessary tax rises in this Budget rightly fall on those with the broadest shoulders; we are asking the wealthiest and largest businesses to pay their fair share to help rebuild our NHS and public realm.
This Budget is fundamentally pro-growth, and is focused on investment in our country’s future. We have heard Conservative Members today continually make the tired argument that it is the private sector alone that drives growth. As Members have rightly said, economic growth relies on a strong public and private sector. Without a functioning public sector, businesses cannot thrive. If trains are late, people cannot get to work. If staff are off sick, they cannot pay tax and cannot contribute. If workers do not have the necessary skills, productivity and growth stall. This Budget addresses those issues and those determinants of growth, and that is why I am proud to support it today.
Over 14 years, the Conservatives have starved our NHS of vital funding, but today we are talking about a vital £25 billion investment in our NHS—the biggest investment in it since the last Labour Government, excluding the covid years. This investment is transformative. I hope that some of this spending will be made available to primary care and to community pharmacy—the desperately underfunded front door of our NHS. I am really pleased that in recent days we have heard a commitment from the Front Bench health team of a further £2.5 million to support the development of proposals for Hillingdon hospital. I am sure that I will return to that issue and discuss it with the team in the days ahead. In summary, this Budget delivers on our promises on tax, on growth and on the NHS, and I am delighted to support it.
Rachel Hopkins (Luton South and South Bedfordshire) (Lab)
As we all know too well, politics is about choices. The choice in this Budget is clear: five more years of the same failed Conservative policies and more austerity, or change with a Labour Government who will invest in Britain’s future so that we can fix the NHS and rebuild our country.
The Chancellor’s tough but fair choices will benefit so many people across the country, including in my constituency, by delivering on tax commitments to help fund our vital public services. This includes ending both the non-dom tax loophole and VAT tax breaks for private schools so that everyone pays their fair share.
I am pleased to see the £11.2 billion investment in our education system to give every child the best start in life by increasing per-pupil funding in real terms, providing £1 billion in additional support for the SEND system and enabling the roll-out of free breakfast clubs in thousands of primary schools.
For far too long, working people have paid the price for the previous Government’s failures. Whereas the previous Conservative Government focused on funnelling pounds into the pockets of their friends through dodgy covid contracts, this Labour Government have chosen to put pounds in the pockets of working people. The increase in the national living wage to £12.21 is therefore very welcome in my constituency, where over 3,000 people in Luton alone will be better off as a result.
As well as the boost to people’s wages, I am delighted that we will deliver the biggest boost to affordable housing over this Parliament, with a £500 million boost to the affordable homes programme to build up to 5,000 additional affordable homes. Reducing the discounts on the right-to-buy scheme and enabling councils in England to keep all the receipts generated by sales will also deliver on our commitment to protect existing council house stock.
Of course, the NHS is the cornerstone of our public services. Investment in education, jobs and homes will be fruitless if we do not have a healthy population. Our healthcare system was pushed to the brink under the previous Government, with waiting lists for vital scans and operations stretching to months or even years, 24 hour-plus waits in A&E, and the worst staffing crisis in history.
The creation of the NHS was the pride and joy of a post-war Labour Government, and it is a Labour Government who will rebuild it once again by investing an extra £25.6 billion over the next two years. The 40,000 extra elective appointments per week will mean reduced waiting times.
Where previous Budgets felt like reading lines from the same tired script, I can say with pride that this Labour Government’s first Budget really is the start of a new chapter in making Britain better off. It supports better wages, ensures that the NHS is there for people when they need it, and invests in building homes, infrastructure, roads and railways to create wealth and opportunity for all. That is the power of a Labour Government.
Jen Craft (Thurrock) (Lab)
This Budget will make a real difference to the lives of my constituents. It is designed to fix the foundations of our economy, to turn the page on the failed policies of the previous Government, and to deliver the change that people across the country and in my constituency voted for.
As hon. Members on both sides of the House have made clear, we have all seen, experienced and heard about the decline of the last 14 years. The economic failures of the previous Government left our constituents worse off than they were in 2010. Every day, families in Thurrock tell me about the challenges they face. Public service performance is at a historic low, and behind every statistic is the real-world experience of one of my constituents, whether it is the tragic loss of life while waiting to see a doctor following heart surgery, the learning-disabled man I met who had resorted to pulling out his own teeth because he could not see an NHS dentist, or the parents desperate to receive a diagnosis for their child’s special educational needs so that they can start receiving the support they need.
Nowhere are the Conservatives’ austerity and broken promises more obvious than in our NHS. My constituents face some of the most acute GP shortages in the country, with each of our local surgeries caring for an average of nearly 3,500 patients. People continue to struggle with NHS dentistry, with only 31% of adults in Thurrock having seen an NHS dentist in the last two years. Nearly a third of patients at the local trust have waited more than six weeks for a diagnostic test. I welcome the commitment to provide an extra £22.6 billion of funding for day-to-day spending for the health service, to cut waiting times and deliver 40,000 extra appointments every week. The commitment to more capital funding cannot come soon enough. I look forward to working with Ministers to ensure that benefits are felt in Thurrock, particularly in areas such as Tilbury, where health inequalities are felt more keenly.
On a personal note, I welcome the commitment in the Budget to deliver for unpaid carers. From my own experience as an unpaid carer, I know that the increase in the amount that carers can earn without losing their carer’s allowance, as well as the commitment to review the current cliff edge of carer’s allowance, will be welcomed by those who do the vital work of caring for their loved ones.
For so many people, this Budget will tackle the challenges our country faces. Our party founded the national health service and brought it back from the brink after years of Tory neglect. On the campaign trail, I told my constituents that we did it before and we will do it again. This Budget delivers on that promise, and I am proud to support it.
Alex Baker (Aldershot) (Lab)
The Budget delivered a game-changing announcement for my community: the news that Frimley Park hospital will be rebuilt, as it is one of the seven hospitals severely affected by RAAC. That is such welcome news and will make a real difference in Aldershot and Farnborough in the years ahead. Frimley is my local hospital. I have spent my fair share of nights there and have seen at first hand the incredible work NHS staff do in a hospital that, in parts, is literally crumbling around them. I thank the Chancellor, the Secretary of State for Health and Social Care, and the wider health team for listening to the arguments my hon. Friend the Member for Bracknell (Peter Swallow) and I put forward to prioritise Frimley as part of the new hospital programme. This vital project was in jeopardy because of the truly dreadful deficit inherited from the previous Government. My community needs a new hospital in the right location—one that works for residents from Aldershot to Blackwater and Yateley. I will continue to campaign for that hospital until the day it is built.
This Budget, with its investment in our NHS, will bring down waiting lists, lay the foundations for our 10-year health plan and make a welcome investment in our economic future, because a healthier nation is a wealthier nation. If we can help the 2.8 million people currently unable to work because they are on long-term sick leave, many of them stuck on waiting lists, that will not only help us grow economically, but allow more of our neighbours to live their lives to the fullest.
Let me share the example of Gloria Cornwall, who came to my surgery shortly after I was elected. She lived in agony, in desperate need of a hip replacement, struggling to get an NHS appointment for five long years. In early October, she emailed me, delighted to have finally been given a date in November for the operation, but sadly it was too late. She passed away from natural causes just 12 days ago.
From the brief time I spent with Gloria, I could tell she was a very special lady. She was the linchpin of her family and was so proud of her grandchildren. Gloria’s story is a powerful reminder of the lives that, at best, are not being fully fulfilled and, at worst, are being lost because people cannot get the healthcare they need. I know how much hope that appointment letter gave Gloria just before she died, so when I hear that my right hon. Friend the Health Secretary is bringing forward 40,000 more elective NHS appointments each week, it is cases like Gloria’s that I will remember.
Warinder Juss (Wolverhampton West) (Lab)
The Chancellor’s Budget last week finally ended the Conservative party’s austerity. It is a Budget that fixes the foundations to deliver real change, by fixing the NHS, cutting hospital waiting lists, reforming public services and rebuilding our country.
As the Chancellor said, this Budget is about “investment, investment, investment”. This Labour Government are investing over £25.5 billion over two years in the NHS. That will cut waiting times, so that patients do not have to wait longer than 18 weeks from referral to consultant-led treatment; provide 40,000 extra appointments; put in place new surgical hubs and diagnostic scanners, building capacity for more than 30,000 additional procedures and over 1.25 million diagnostic tests; and provide new radiotherapy machines to improve cancer treatment.
We are investing in NHS technology and digital, to run essential services and to drive NHS productivity improvements, freeing up staff time. We are providing a dedicated capital fund to deliver upgrades to GP surgeries, boosting productivity and enabling the delivery of more appointments.
We are investing £26 million to open new mental health crisis centres. At last, we have a Government who are committed to tackling the root causes of mental health problems and to supporting people to remain in work and to return to work.
We are supporting social care through at least £600 million of new grant funding to be able to increase local Government spending, alongside an £86 million increase to the disabled facilities grant to support more adaptations to homes for those with social care needs, thereby reducing hospitalisations and prolonging independence.
This Government are cutting down barriers to opportunity for all by increasing the core schools budget by £2.3 billion, supporting the recruitment of 6,500 teachers in key subjects and tackling retention issues, to prepare our children for life, work and the future.
We are providing a £1 billion increase to improve SEND provision and to improve outcomes and an additional £300 million for further education to ensure that young people are learning and developing the skills they need to succeed in the modern labour market, which will help the City of Wolverhampton college in my constituency. We are increasing investment in children’s social care reform, and it is great to see a real-terms funding increase for local government spending.
We are taking all of these decisions, while also taking tough decisions on spending and welfare, eliminating fraud and error in the welfare system—
Baggy Shanker (Derby South) (Lab/Co-op)
It is a privilege to contribute to today’s debate on the first Labour Budget delivered in more than 15 years. Let me start by welcoming the unwavering focus of the Chancellor and her team on improving the lives of working people by investing in our public services. This Government have not ducked the difficult decisions, as the previous Government did, but confronted them. We have committed to rebuilding our country and its public services, prioritising the lives and livelihoods of working people in doing so. That is why I take immense pride in rising to speak today to discuss this Labour Budget.
Having served since 2008 as a Derby City councillor, and with my wife working in the NHS, we have seen at first hand the impact of Tory austerity, which, as Lord Darzi has highlighted, caused our NHS to face its most austere decade and has pushed many local authorities to the brink. In my constituency, the Florence Nightingale community hospital delivers critical health and care services to Derby residents, ranging from in-patient rehabilitation to palliative care. Services such as those provided by the Florence Nightingale Community Hospital must be protected. That is why I was delighted to hear the Chancellor announce the largest real-terms growth in day-to-day NHS spending outside of covid since 2010.
With the record funding announced for our NHS and the investment across our public services, there is much to welcome in the Budget. Although it marks the start of a welcome new chapter, delivering long-term stability and much-needed change, it is important that working people feel the positive impact of this Labour Government.
Continuing the focus on public service, I turn to the matter of the settlements for local authorities in the Budget. As in every constituency, our council plays an important role in providing for families and individuals who are facing specific challenges, whether that be in social care, housing or the availability of SEND provision. Given that crucial role, and the cost and demand pressures that are not unique to Derby but face councils across the UK, I welcome the Chancellor’s announcement of an additional £1.3 billion of funding.
I close by again welcoming the Chancellor’s Budget, which last week took responsible if difficult decisions to redress the Tory budget deficit and begin rebuilding Britain.
Sarah Coombes (West Bromwich) (Lab)
For too long, our economy has not worked for West Bromwich—low wages, low growth, broken public services, families unable to make ends meet and our huge potential going unfulfilled. That was the legacy of the Conservative Government, and that is why the country voted for change. Last week, finally, we saw a Budget that turns the page.
I would like to thank the Chancellor for this historic Budget and talk about three things: how it looks after the finances of families in West Brom, how it gets our public services back on their feet, and how it will turbocharge growth in the west midlands. Last week, Labour’s Budget looked after ordinary families in West Brom. During the election, we promised that we would not put up taxes on working people—a promise that we have kept. Carers were being trapped in poverty by the weekly earnings limit, so we have raised it. Young people were doing the same work for less pay, so we are changing that. Perhaps most significantly of all, 12,000 workers on the minimum wage in Sandwell will receive a £1,400 pay rise next year. That is the difference that the Labour Budget makes.
The Budget was also for public services and, critically, our NHS. In West Brom, our GP satisfaction rate is 15% below the national average. We have 80,000 people waiting for a hospital appointment and, absolutely scandalously, life expectancy in my area has been falling over the last 10 years. The Conservatives spent a decade destroying the NHS and now it falls to us to rebuild it.
Last week, our Labour Chancellor gave the NHS a cash injection that will deliver 40,000 extra appointments a week, state-of-the-art new equipment, and support for our NHS staff, who have been pushed to breaking point. All that is futile without reform, and earlier the Secretary of State set out how we will achieve that. But the people of West Bromwich know that if we want a well functioning and modern NHS, we have to pay for it. We have made difficult decisions to do that.
I finish by highlighting that the Budget was fantastic for the west midlands. It will support manufacturing jobs in the automotive industry, which is so important to the region. It secured the future of HS2 to Euston because people do not want to get on at Birmingham and off at Old Oak Common. It funded the extension of the metro to Brierley Hill and gives our Mayor, Richard Parker, a funding settlement for good bus services and local projects that will make a difference. Under a Labour Government, West Bromwich is going to see the change that my constituents voted for. I am proud that my party has delivered a Budget that fixes the foundations, protects ordinary people and rebuilds our NHS.
Clive Jones (Wokingham) (LD)
My constituency has suffered from the previous Government’s failure to fix our NHS. My constituents were promised a rebuild of the Royal Berkshire hospital. That amounted to nothing. The Conservatives failed to fund the programme; they did not allocate the proper amount of money and they dithered and delayed.
I therefore welcome this Government’s extra funding in the Budget for the NHS and its infrastructure. However, they need to make clear how they will manage a backlog of maintenance repairs amounting to £102 million for the Royal Berkshire hospital, on top of upwards of £1.3 billion required to build a new hospital. The trust could start construction as early as 2028, but that requires urgent confirmation that the funding will go ahead. Does the Minister agree that a hospital sooner rather than later will deliver better outcomes for patients?
I do not blame the Government for the financial mess that they have inherited from the Conservatives, but when it comes to primary care, the Budget has taken one step forward but two steps back. I simply do not understand why, at a time when Wokingham has an increasing GP-to-patient ratio and a growing population, the Chancellor has decided to levy a tax on jobs through the national insurance employer contribution. That will impact GP care provision and leave our overstretched services struggling even more.
I am campaigning for the community of Arborfield to have their own dedicated GP practice. My constituents are crying out for change so that they can get the services that they deserve. Does the Minister agree that GPs in Wokingham and across England should be protected from the national insurance hike? If that does not happen, we risk losing their services. Will he engage with my local integrated care board to impress upon it the need to fund a GP surgery in the community of Arborfield?
Joe Powell (Kensington and Bayswater) (Lab)
In July, I was proud to be elected the new Member of Parliament for Kensington and Bayswater—a fantastic community but one that has, like so much of the country, suffered 14 years of low growth, stagnant wages and crumbling public services. We have some of the highest health inequalities in the country. The major local hospitals have the largest high-risk repair backlog of any NHS trust in England. Much of my casework involves people in substandard temporary accommodation battling damp and mould and slow repairs, and victims of no-fault evictions and overcrowding.
What compounds that dreadful inheritance is false hope. The fantasy new hospital programme told people in my community that they would have a brand new St Mary’s hospital, as well as overhauls of Hammersmith and Charing Cross hospitals, but it was never budgeted for. Instead of taking responsibility, the Conservatives overspent, avoided the tough choices and signed off cheques that they knew would never have to be cashed. I welcome the Budget, and especially the investment to meet our election commitment to reducing waiting list and expanding surgical capacity and diagnostic hubs. I also look forward to the 10-year plan for the NHS, and I hope that the Chief Secretary to the Treasury will set out in the spending review plans to build a new St Mary’s and invest for the long-term to get people healthier, improve productivity and deliver an NHS that we can all be proud of.
Of course, our housing crisis is directly linked to challenges in our NHS, so I welcome the investment in the affordable homes plan and the warm homes plan, and the reduction in right-to-buy discounts with councils keeping receipts. The damning National Audit Office this week laid bare the cost of inaction on building safety, so I welcome the Chancellor’s support for speeding up the remedial work. The NAO said that, on current trends, the last building will not be fixed until 2037—20 years after Grenfell. That is unacceptable, and I look forward to the Government’s plan to speed up the remedial work.
Trust in politics has collapsed to an all-time low after the covid VIP lanes, the lobbying scandals, and the Liz Truss mini-Budget, for which my constituents have still not received an apology.
Ben Coleman (Chelsea and Fulham) (Lab)
I am sorry for interrupting my hon. Friend at the very last minute, but he raised the important issue of the rebuilding of St Mary’s. May I suggest to him that that should come alongside the full refurbishment of Charing Cross hospital and Hammersmith hospital, as they all form part of the Imperial College healthcare NHS trust?
Joe Powell
I thank my constituency neighbour for that point. The Imperial College trust has the highest major repair backlog of any NHS estate in the country, so we hope that it will, on merit, be a strong candidate in the Secretary of State’s review of the new hospital programme.
As the shadow Minister, the hon. Member for Brentwood and Ongar (Alex Burghart) would know from our work together on open government and international transparency, I welcome the Chancellor’s focus on tackling corruption, fraud, tax avoidance and waste; the ending of the non-dom tax regime; the additional guardrails to ensure that public investment is well spent; and the appointment of a covid corruption commissioner to uncover which companies used a national emergency to line their own pockets. Taxpayers want that money back.
Four months ago, this Government were elected with a mandate for change. The Budget marks the end of the short-term cycles of chaos and mismanagement, and the start of a serious plan to build a fairer and more prosperous Britain.
Anna Dixon (Shipley) (Lab)
I refer the House to my entry in the Register of Members’ Financial Interests.
This Budget rejects 14 years of Tory austerity for public services and instead begins a process of investment and reform to NHS and social care. The 4% increase to day-to-day spending, and a cash injection of over £25 billion into the NHS over two years, will make an immediate impact to improve patient experience. This Budget begins to make good on Labour’s election promise to get the NHS back on its feet and to address the issues laid bare in Lord Darzi’s damning report, which set out so clearly the mess left by the Conservative party: the highest waiting times on record and the lowest public satisfaction. I also welcome the much-needed capital investment to ensure that RAAC-infested Airedale hospital, which serves my constituents, gets funding for a new hospital. With Labour, promises made are promises kept.
But the money is not enough: we need to change the NHS so that it is more focused on improving health, with more care delivered in the community and close to home. Those changes will be set out in the 10-year plan for the NHS in the spring, and I welcome the fact that everyone will have the opportunity to contribute their ideas. Change means spreading best practice; examples include Grange Park GP surgery in my constituency. I was pleased to show the Secretary of State for Health and Social Care this great community-centred general practice, which delivers continuity for patients, group therapy sessions such as singing for lung health and on-site counselling.
Investing in primary care and community health services is vital to a strong NHS, but as the Secretary of State recognises, we also need to deliver with social care. Local authorities have sought to provide social care in the context of severe budget cuts imposed over 14 years by the Conservative party. The Chancellor’s Budget provides a £1.3 billion uplift to local authority budgets, including £600 million of new grant funding for social care. That money is hugely welcomed and much needed, as are the increases in the national living wage, which will lift thousands of care workers out of poverty. However, many non-profit care providers are already on the brink after 14 years of cuts to social care, and may be forced to hand back contracts if their higher costs are not reflected in the fees paid by local authorities. I urge Ministers to explore those challenges with care providers and local authority commissioners to ensure we have a strong foundation for our national care service.
It is right that we ask those with the broadest shoulders to pay their fair share in order to address the crisis in public services. I am confident that this Labour Government can and will restore the NHS, making it a service we can once again be proud of. That is why I support this Budget.
Mr Bayo Alaba (Southend East and Rochford) (Lab)
This Budget represents a huge step towards restoring the vibrancy and potential of my constituency. The commitments in this Budget will support our hospital and health services, revitalise trade and hospitality, and knit the community closer together.
Over the past 14 years, our public services have been neglected and the hospitality and retail industries have been unsupported. That is why I am so proud that the Labour Government are working to fix the foundations and reform our public services at their very roots. This Budget invests £25.6 billion in the NHS over two years, which will cut waiting times by creating an extra 40,000 elective appointments a week so that the NHS will be there when we need it. I know how important this is in Southend East and Rochford, where hospital and health workers are working hard to serve their community.
The businesses, restaurants and bars that are integral to Southend East and Rochford’s local offer will be pleased by the measures announced in this Budget—as someone who has run businesses in that sector for over 24 years, I know how important it is. The Government are choosing to protect small businesses by increasing the employment allowance to £10,500 and expanding that allowance to all eligible employers. This Labour Government are making business rates fairer to protect our high streets and are permanently introducing lower rates for retail, hospitality and leisure—as many as 6,380 microbusinesses in the Southend city council area stand to benefit from those changes. These are steps that will deliver the change that our communities deserve and regenerate our local economies.
Finally, this Labour Government are increasing the national minimum wage to £12.21 per hour——an increase of 6.7%—which will serve to revitalise the hospitality and retail sectors. The Low Pay Commission estimates that 54% of all jobs paying at or below the minimum wage are in retail, hospitality, cleaning and maintenance occupations. The workers in those industries have been overlooked for too long. Labour’s Budget puts those workers back on the agenda, with more money in their pockets at the end of the month. I welcome the actions of this Labour Government to support essential services and equip our leisure and retail industries with the tools for the future.
The Budget turns a page on the last 14 years and begins to create the conditions for an area such as Southend East and Rochford to thrive.
Laurence Turner (Birmingham Northfield) (Lab)
I draw the House’s attentions to my declarations in the Register of Members’ Financial Interests. As we approach Remembrance weekend, I would like to draw attention in this health debate to the excellent work that the Royal Centre for Defence Medicine does in Birmingham.
In July, the people of Birmingham Northfield voted for change. It was a vote for economic stability and investment in public services after 14 years of chaos, 14 years of austerity, and 14 years of running down our schools and hospitals. This Budget is delivering that change.
I welcome the biggest increase in NHS funding in 20 years, linked to service improvements. We are a young city, but one in 10 people in Birmingham are on an NHS waiting list. Some of my constituents have been waiting for years for lifesaving treatments; some of them waited for too long. This is the sort of investment that will make a difference that people can feel, and that is a credit to the Ministers on the Front Bench today.
The investment in school buildings and equipment is welcome. It is especially important for the projects to rebuild Green Meadow primary school and King Edward VI Balaam Wood academy, which were committed to under the school rebuilding programme, but which face rising construction costs. I also welcome the wider investment in education, particularly in SEND and further education.
Other hon. Members have mentioned the important commitments that have been made to the West Midlands combined authority. That is excellent news for the region as a whole and money that can be invested in better housing and better transport services, alongside the additional money for social care and road maintenance in local government. I look forward to seeing Birmingham’s allocation, ahead of a tough local government budget-setting process next year.
As a trade union official, I was proud to represent care and NHS workers, but I was ashamed of the conditions in which they had to work for too long. I feel that same sense of shame at the state to which the Conservative party reduced our public services. This is a Budget for investment in health and social care. It turns the page on years of failure and it sets the long-term certainty that businesses need. I hope that it will be carried overwhelmingly tomorrow.
Peter Swallow (Bracknell) (Lab)
I start by declaring that my brother and his wife are both NHS doctors, and I am incredibly proud of them.
The Budget begins the work to undo a decade of recklessness and neglect by the Conservatives, who left our NHS uncared for, our schools crumbling and carers unsupported. It will fix the foundations of our economy, build the growth we need to invest in public services and end 14 years of Tory austerity. With this Budget, my right hon. Friend the Chancellor has put forward a bold, tough vision to deliver on our manifesto promise of change—£25.7 billion over two years for the NHS to slash waiting times, with an extra 40,000 elective appointments a week, and £2 billion committed to technology to begin a serious transformation towards digital healthcare.
Labour Members understand the need to fund our NHS properly, but we also understand that after 14 years of neglect, the NHS is badly in need of reform. We cannot cure 14 years of sickness in one Budget, but with this investment, we are finally taking the medicine we need.
I warmly welcome the £1 billion investment the Chancellor is making to address the crisis in special educational needs—a first step in fixing a broken system. During the Conservative leadership contest, the new Leader of the Opposition endorsed the view that getting an autism diagnosis brings
“economic advantages and protections”
and
“better treatment or equipment”.
That is a far cry from the experience of parents and children with SEND in my constituency. The Leader of the Opposition would do well to listen to the former Conservative Education Secretary, who described the SEND system under her party as “lose, lose, lose”. The Government’s commitment to increase SEND funding by £1 billion is a step towards addressing the crisis. It must be only the beginning of tackling this huge long-term problem. Ultimately, the system needs root and branch reform, but the money will start to make real, concrete differences and to break down the barriers to opportunity for many young people in Bracknell and across the country.
I will briefly mention the fantastic commitment to set up a £44 million investment to trial a new kinship carer’s allowance—again, that is a real contribution to solving a problem that has long been neglected.
This is a Budget that invests in our NHS, in education, and in families and working people. If the Opposition choose to oppose it, they need to be honest with their constituents and the British people about what that means. Opposing the Budget means less money for our NHS, less money for our struggling SEND system, and no additional support for the kinship carers who have felt invisible for too long. The Government have chosen to fix the foundations—
Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)
Thank you, Madam Deputy Speaker.
I welcome the measures that the Chancellor has announced to support our NHS as we begin the enormous ask of repairing the damage caused by 14 years of neglect. I absolutely commend this imaginative and transformative Budget to the House. As the first ever Labour MP for Bury St Edmunds and a consultant ear, nose and throat surgeon, I welcome the specific commitment to replace the RAAC-infested West Suffolk hospital. My ears certainly pricked up when I heard that.
We will see great investment too in medical research, and I welcome that. This country continues to be very proud of our amazing and historic contribution to discoveries and innovation, which are certainly the best way to ensure that we find cures for many mysterious afflictions. The Government have rightly emphasized the need for investment in the NHS to be accompanied by reform. With reform must come value for money.
I would like to bring a serious matter to attention of the House: an example of a reform which, while at first sight appears to be of benefit, is neither value for money nor the right thing to have done. I am sorry that so few of the previous team are here to listen. NHS eye surgery services are in difficulty, and I am informed that we are in danger of creating ophthalmic deserts, just like the dental deserts familiar to us in the east of England.
The last Government took their eye off the ball as cataract services were outsourced to private providers, taking with them the very same NHS surgeons and staff who were providing the service in the hospitals. The generous tariffs for the provision of cataract surgery means that private cataract clinics, often owned and run by the same surgeons, are springing up everywhere. The number of cataract operations has shot up, and a relatively minor cataract, which is a cause of correctable visual difficulties, can be operated on within a few weeks by a choice of private clinics, generating annual profits of well over £100 million. Meanwhile, NHS eye surgery departments which are treating serious causes of irreversible blindness such as glaucoma and macular degeneration are in trouble, with long waiting lists. They cannot recruit surgeons and are struggling to survive.
This is the next dentistry crisis. Just as in dentistry, a reform of the contracting system is now urgent, and I urge the Government to do that. It will save millions of pounds and preserve NHS eye surgery services. As my ophthalmic colleague informed me, we can treat dental problems with false teeth, but false eyes do not work very well.
John Slinger (Rugby) (Lab)
My right hon. Friend the Chancellor inspired many people last week, including girls and women. The unfortunate comments from the new Leader of the Opposition about the first Budget by a woman Chancellor are not shared by the young women I have spoken to. My right hon. Friend inspired us MPs too, not merely with big-ticket items such as the core schools budget going up by £2.3 billion, but with a more subtle form of inspiration about the long term. It would be more popular in the short term simply to spend money on public services, but our Government have made difficult choices, such as £5.5 billion-worth of savings and ensuring that public money is spent wisely through the new office for value for money. My right hon. Friend has made tough decisions on tax, spending and welfare to restore our economic stability, which helps my constituents.
Freezing the small business multiplier for one year will protect more than 1,000 small businesses in Rugby constituency from inflationary bill increases. Thousands of my constituents will benefit from the increases in the national minimum wage and national living wage, boosting incomes by up to £1,400, and 1,100 carers in Rugby who are in receipt of carer’s allowance will benefit from the working limit being lifted, allowing them to earn more and still claim. Rugby’s 19,000 pensioners will see the state pension increase by 4.1% with my right hon. Friend the Chancellor maintaining the triple lock—that is more than twice the uplift given to people receiving benefits.
Some in my constituency have expressed concern about local hospital health provision. Labour founded the NHS—we will fix it and we will fund it. It is because of my right hon. Friend’s decisions that this Government can provide an extra £25.7 billion in two years to help cut waiting times, and £1.5 billion capital funding nationally for new surgical hubs and diagnostic scanners. That much-needed investment could not have happened had my right hon. Friend chosen immediate popularity by making unfunded promises that raised perfectly legitimate hopes among the public, just as the last Government did when they promised 40 new hospitals without having funding streams in place. The toxic legacy of that false hope is felt by the public, and expressed to every one of us in our inboxes. This Chancellor, this Labour party, this Government will restore faith in the very concept that government can improve lives.
It would perhaps have been more popular to pretend that there were no difficult decisions, only sunlit uplands, or that green shoots do not require watering and that public services can improve without proper investment. But we do not seek short-term popularity. This Budget lays the foundations for long-term economic stability, growth, investment and fairness, and enables us to begin delivering much-needed change to improve our constituents’ lives. As we do that, we will have the opportunity to earn the trust of the public we serve.
Zarah Sultana (Coventry South) (Ind)
The Government have a profound duty to tackle poverty with urgency and ambition. After 14 years of Tory austerity hollowing out our public services and leaving our communities struggling, eradicating poverty must be at the heart of the Government’s agenda. Yet the Budget falls short, and without bold action the most vulnerable in our constituencies will continue to suffer.
Ending austerity is not just about stopping cuts; it is about real action to lift people out of poverty. The critical first step must be to scrap the two-child benefit cap, which unfairly punishes families for having more than two children. If it remains, according to the Resolution Foundation an additional 63,000 children will be in poverty by 2025. We must scrap it immediately. We must also reverse the means-testing of winter fuel payments. No pensioner should have to choose between heating and eating in a cost of living crisis. Providing warmth to those at risk should be non-negotiable for a Labour Government. The 50% rise in bus fare cap is equally unacceptable. Affordable public transport is vital for low-income families, students and those without cars. Increasing fares deepens and entrenches inequality, and hinders our climate goals.
The Labour Government must ditch Tory welfare reforms that will slash billions from disability benefits, pushing people into more severe hardship. Those reforms must be rejected root and branch, not piecemeal. The more than 330,000 excess deaths in the past decade remind us that austerity costs lives and that politics is a matter of life and death. In one of the world’s wealthiest nations, no family should be in poverty, no child should be left hungry and no pensioner should be unable to heat their home.
Our response must be transformative in rebalancing the economy for the many, not the few. We need a fair tax system that places the burden on those who can pay the most. A 2% tax on assets over £10 million could raise £24 billion annually, and equalising capital gains with income rate thresholds would bring in an additional £17 billion. Those funds could truly transform our NHS, schools and communities.
Finally, we need a bold economic plan to secure our future, with a worker-led just transition to renewable energy, creating thousands of unionised jobs and ensuring that no one is left behind. My constituents in Coventry South and communities across the UK deserve a Budget that marks the end of austerity with action not just words, and with a true commitment to ending poverty.
Clive Jones
On a point of order, Madam Deputy Speaker. I must apologise to the House for not making a declaration at the beginning of my speech. I am a governor of the Royal Berkshire hospital, and I have a family member who has shares in a health company. I apologise for not mentioning it at the beginning of my speech.
Madam Deputy Speaker (Ms Nusrat Ghani)
I thank the hon. Member for advance notice of his point of order. It is most definitely relevant to the debate, and his transparency is noted.
Neil Duncan-Jordan (Poole) (Lab)
I should place on record that my wife is a hard-working NHS employee, and she will thank me for saying that. I have today met representatives of the Royal College of Paediatrics and Child Health, which has raised serious concerns about the waiting times that children with conditions such as motor neurone disease face in accessing community services and hospital treatment. I am hopeful that children’s health will be targeted for additional resources in the Budget, because if we can tackle children’s health early, we can help to reduce poor health in later years.
I welcome the key point in the Budget, which is the recognition that increasing public spending—on health, for example—benefits those on lower incomes the most. Likewise, the Budget concentrates increases in tax on the households with the highest incomes, as it should. I have received representations from hospices in my constituency about the increase in national insurance contributions for employers, and I urge the Chancellor to consider granting hospices an exemption, in recognition of the difficult and much-needed work they do.
The announcement of £1 billion of additional funding for SEND is to be warmly welcomed, and I am keen to see how that funding will be distributed to benefit the children and families who have been struggling for so long. The announcement of compensation for victims of the Post Office Horizon scandal and the infected blood scandal is a welcome step in recognising those injustices, but I urge the Chancellor to see what similar support can be given to women born in the 1950s who were never properly informed about the changes to their state pension age. I also recognise the £600 million grant funding for social care for local authorities, but the entire sector urgently needs reform, especially if we are to realise the Government’s stated aim of moving healthcare from hospital to community.
Finally, I again express my concerns about the decision to means-test the winter fuel allowance. I am looking forward to meeting the Minister with responsibility for pensions, my hon. Friend the Member for Wycombe (Emma Reynolds), tomorrow to discuss that further. I hope we can explore what further support we can give to those who are just above the pension credit threshold. There is much to welcome in this Budget, but those with the broadest shoulders need to carry the heaviest burden.
Sojan Joseph (Ashford) (Lab)
I welcome the opportunity to speak in this debate on the first Labour Budget for nearly 15 years. I must disclose that I worked in the NHS for the past 22 years as a mental health nurse. As a result of the Budget, the NHS will receive the largest rise in day-to-day spending outside the pandemic since the last Labour Government. The additional £22.6 billion over two years will play a major role in cutting waiting times from their current unacceptably high levels. We all know that money on its own will not be enough to create an NHS fit for the future, so I agree with my right hon. Friend the Secretary of State for Health and Social Care that it is important that the increased investment outlined in the Budget comes with the necessary reform of the NHS.
On that point, I was pleased to see that there will be more than £2 billion spent on healthcare technology and digital investment to run essential services and drive improvements in NHS productivity. I believe that will have widespread support from my former colleagues working in the NHS. If we ensure that all trusts have access to electronic patient records, that will not only be much better for the patient, but will increase staff productivity, freeing up more time to treat patients. When I paid a visit to the William Harvey hospital in the Ashford constituency in August, 19 patients were being treated in corridors. That is deeply concerning, as during the summer there is supposedly less demand on the A&E department. This money will be well received in hospitals such as the William Harvey.
I was pleased by the recent confirmation from the Health and Social Care Secretary that there will be more details on the new hospital programme in the new year. I would like to make a strong case for the William Harvey and the other hospitals in the East Kent hospitals university NHS foundation trust. In 2019, when Boris Johnson was Prime Minister, he promised that east Kent would get a new hospital. Proposals were drawn up for either a new hospital in Canterbury or upgraded facilities at the William Harvey hospital and the Queen Elizabeth the Queen Mother hospital in Margate. Despite what Boris Johnson said, last year the Conservative Government broke that promise. At the time, it was reported that at least £210 million would have to be spent over the next five years on essential improvements to hospitals in east Kent just to maintain safe services. As we look to deliver an NHS fit for the future, I say to my right hon. Friend the Minister that money spent patching up ageing buildings would be better invested in improving standards for patients in east Kent. I therefore hope that the proposals and promises from the previous Government can be reconsidered.
The choice made by the Chancellor to invest in the country’s future and fix the broken public services left by the Tories is a clear rejection of that party’s failed policies, so I welcome the Budget.
Elaine Stewart (Ayr, Carrick and Cumnock) (Lab)
The Budget was a huge victory for mineworkers. I was born in a mining community, in a pit village called Bellsbank. Today, sadly, coalfield communities like the one I was raised in are still behind the national average on growth and prosperity. Unemployment, poor health and lack of opportunity have created a legacy of deprivation in those once lively communities. With that in mind, I was immensely proud to stand for election on a manifesto that promised to end the injustice of the mineworkers’ pension scheme, so that the people who powered our country would receive a fairer pension. I am delighted that we have a Chancellor who listens to colleagues and a Government committed to ending injustices. Now, almost 700 pensioners in my constituency of Ayr, Carrick and Cumnock will receive £29 a week more in their pension. That was the pension uplift for 112,000 former mineworkers across the country.
The Budget protects working people in Scotland, and injects more money than ever before into our public services. The Scottish Government will need to ensure that that additional funding for public services reaches the frontlines, bringing down waiting lists in the NHS and raising attainment in our schools.
People in Scotland rightly expect results. The SNP is pretending that its hands are tied, and that somehow its decisions do not matter, but this is not just about having more money; it is about spending money better. The NHS in Scotland is in perpetual crisis because of the SNP Government’s chaos, mismanagement and incompetence. After 17 years of the SNP in power in Scotland, we are left with the reality of a two-tier health system. Patients in pain are forced to scrape money together to go private. Over 860,000 patients—equivalent to one in six Scots—are on an NHS waiting list for tests or treatment. My sister has awaited a hip replacement for over 14 months. Decisions in the Budget mean that the Scottish Government will receive more per person than the rest of the UK.
The Labour Government are committed to growing day-to-day spending on essential services, delivering 40,000 extra appointments a week and reducing NHS waiting lists. When will we see the same ambition from the Scottish Government and the SNP?
Mike Reader (Northampton South) (Lab)
I welcome the Government’s commitment to fixing our national health service and delivering the real change that my constituents in Northampton South voted for in July. Northampton South is home to four hospitals: our general hospital; St Andrew’s and Berrywood hospitals, which both provide fantastic mental health care provision; and the Three Shires hospital, which is part of the Circle Health network. Despite all that choice, time and again, constituents tell me that they struggle to get appointments. Each week at my constituency surgeries, and in my inbox, I learn of residents across Northampton South who are desperate to see a doctor or secure an appointment for much-needed surgery. As their representative in this House, I have a duty to speak up for them, and to welcome the changes that this Budget will bring to their life. I am particularly proud that it delivers funding for 40,000 additional appointments every single week. That commitment means that more residents in Northampton will get the care they need, when they need it. That means fewer days off work, less time in pain, and, more importantly, better health outcomes.
Having joined this House from the construction sector—I should declare that my team was working in the new hospital programme supply chain—I think we must be honest about the state of our NHS buildings. The previous Government’s empty promise of 40 new hospitals became a national embarrassment—a classic example of a headline-grabbing announcement that delivered little for our communities. Instead, this Budget delivers real, tangible investment: £3.1 billion in capital funding, including £1 billion to tackle the critical maintenance backlog. In Northampton, we know all too well the impact of ageing NHS infrastructure. Northampton general hospital and our sister hospital Kettering general have served our community well, but are showing signs of age. Unlike many Members here, I will not ask the Treasury for more money for my hospital; I support my local integrated care board’s calls for major investment in Kettering, just down the road. I hope that the review of the new hospital programme, once complete, will see a positive outcome for our county.
I finish by acknowledging the dedication of our NHS staff in Northampton South. The doctors, nurses, specialists, healthcare assistants, porters, cleaners, managers and administrators who keep our NHS running deserve our thanks and support. This Budget gives them the resources they need to do their jobs effectively in buildings that are fit for purpose, with technology that works for them, rather than against them. This Budget delivers our first steps in building an NHS fit for the future.
Ms Polly Billington (East Thanet) (Lab)
Even those of us who are new to this place know to expect more communication from our constituents about what is wrong than what is right, so it is notable that I received emails of thanks and congratulations from constituents last week, after the Chancellor delivered her historic Budget. Stability is highly prized by people after so much chaos, and investment, especially in our NHS, is something that people have been crying out for.
However, we must be honest with ourselves about the state of our NHS in east Kent and in coastal communities like mine. East Thanet has been overlooked for far too long. The service has had to endure the chaos and incompetence of the past 14 years, and has not been as resilient as other places to the onslaught. The director of public health in north-east Lincolnshire, Stephen Pintus, has described people living in coastal communities as “old before their time”. We need to reform the way we deliver NHS services in coastal communities. Investment on its own will not be enough. We need to redesign our health service to answer the questions: what care do people need, where do they need it and how do they need it delivered?
My constituents have been suffering with poor NHS services for far too long. East Kent hospitals university NHS foundation trust, which runs the Queen Elizabeth the Queen Mother hospital in Margate, is ranked the third worst in England for its 12-hour waits for emergency services. Its maternity services have been deemed inadequate. When staff were asked, “If a friend or relative needed treatment, would I be happy with their care?”, only 45% of staff said yes. I have people emailing me about their urgent care and essential appointments being delayed by waiting lists. People in dire need of mental healthcare are being told to wait for months to get the help they desperately need. There is denial of continuous care due to costs and a lack of staffing—and, shockingly, poor communication and record keeping resulted in a cancer patient being misdiagnosed.
In a 2021 report by Chris Whitty entitled “Health in Coastal Communities”, he highlighted the problems faced by constituencies such as mine, and found that they had some of the worst health outcomes in England, with low life expectancy and high rates of major diseases. One of the major reasons for that is simply lack of access to healthcare services—both a lack of NHS services in coastal communities and a lack of transport options.
Whatever the reasons for the challenges in coastal communities, we need to see reform. The extra funding the Chancellor announced last week is crucial to bringing down waiting lists and stopping the chaos of 14 years of Tory mismanagement. The British people delivered us a mandate to fix the NHS. If done well, this reform will be transformative for the country, especially in coastal communities like East Thanet.
Madam Deputy Speaker (Ms Nusrat Ghani)
I am about to call the final Back-Bench Member. No doubt a lot of colleagues who have contributed will be making their way back to the Chamber for the Front-Bench speeches. I call Matt Turmaine.
Matt Turmaine (Watford) (Lab)
Thank you very much, Madam Deputy Speaker.
Prior to being elected to this place I worked in health and social care, so it has been interesting to hear some of the pronouncements from the mouths of Opposition Members, which in many instances are, frankly, farcical.
In my constituency, the legacy of 14 years of failed Conservative government is plain to see: people unable to get GP appointments; a lack of NHS dentists for residents to sign up with; poor mental health support for young people and adults; and, of course, the undelivered promise of a new hospital in Watford, cancelled under the coalition and not delivered by the Conservatives over subsequent years. The previous Government’s track record is one of decline. In 2010, average waiting times were 18 weeks and satisfaction levels in the NHS were at their absolute highest. What a contrast to 2024, with the NHS on its knees.
The Chancellor of the Exchequer announced in the Budget an additional £22.6 billion to support the NHS. That will help to deliver more appointments for my constituents in Watford, and it will bring progress towards once again having to wait no more than 18 weeks from referral to treatment. As has been said, we have done it before and we will do it again.
I also welcome the Chancellor’s £1.4 billion to help rebuild schools. She mentioned Watford in her Budget speech, noting that schools in my constituency will benefit from RAAC being dealt with. Mentioning RAAC also brings us to the new hospital programme. I know my right hon. Friend the Chief Secretary to the Treasury will be listening when I say loud and clear that Watford is desperate for a new hospital. That has been the case for many years. The trust’s plan is ready to go, go, go, but I recognise that the Chancellor has achieved the seemingly impossible by managing to start the new hospital programme and moving forward with addressing the hospitals affected by RAAC. We hope the rest will follow soon.
I campaigned in good faith in the general election for a new hospital and to honour the commitment made by the previous Government, but as we heard from the Chancellor in the summer, there was no money there. The Chancellor has worked wonders with this Budget. She has dealt with the financial black hole, she has got the country back on its feet and she has put it on the road to recovery. It is an excellent Budget for the people of Watford; it is an excellent Budget for the country. I wholeheartedly support it.
Madam Deputy Speaker (Ms Nusrat Ghani)
We have been able to get in over 80 contributions, so thank you very much to everybody for abiding by the time limit. I now call the shadow Minister.
Alex Burghart (Brentwood and Ongar) (Con)
Thank you very much, Madam Deputy Speaker. It is a great pleasure to play a part in bringing today’s interesting debate to a close.
I take this opportunity to welcome the Chief Secretary to the Treasury to his post—I know he has been in post for a few months, but we have not had the chance to get to know each other. I must say I have been very impressed him. He is a fluent speaker. He is good on detail. That is not sarcasm—I was once warned by Hansard that sarcasm did not come across well in the written record—but I know what it is to be sent out to defend the indefensible. I can see that he is developing a fine skill and that he is some way on his way to mastering it. I just gently say to your man starting out in his Front Bench career in government not to get too good at it, because you will find your party will give you ample opportunities to defend the indefensible in the years ahead.
Madam Deputy Speaker
Order. Shadow Minister, I do not think you are speaking to me when you say “you”. You are obviously speaking to the Minister.
Alex Burghart
It has been a long day, Madam Deputy Speaker. I hope you will forgive me.
But enough of such pleasantries. This is a bad Budget. It is as bad as bad can be. At its heart is a decision to tax businesses hard—very hard—and through them to tax workers until the pips scream. It is a Budget that sees the total effective tax rate on low-earning roles increase to its highest level since 2010, hitting working people hard, as the Chief Secretary to the Treasury admitted on Sky television on Friday. We know that taxing business is a bad idea. As my right hon. Friend the Member for Tatton (Esther McVey) said earlier, businesses and working people are the dynamo of the economy. If we denude and degrade them, there is nothing for public services to feed on.
But we discover, as this Budget unravels, that it is not just businesses that are being taxed. It is GPs, it is care homes, it is hospices—as the hon. Member for Poole (Neil Duncan-Jordan) pointed out—and it is dentists, charities, childcare, higher education and school support staff. I understand that Labour Members will want to support big tax rises in the Budget, but before they vote on them, I ask them to consider whether they want to vote for tax rises on those services. In response to an intervention from my hon. Friend the Member for Hinckley and Bosworth (Dr Evans), who is sitting behind me, the Health Secretary said that he would listen to GPs, but either the money from the national insurance contributions is in the Budget, or it is not. Either it is in the envelope, or it is not. Has the thinking been done on this? At present, it would seem that all those services are in limbo. Yesterday, during Education questions, the Education Secretary was asked by both the shadow Secretary of State, my right hon. Friend the Member for Sevenoaks (Laura Trott), and the shadow Minister, my hon. Friend the Member for Harborough, Oadby and Wigston (Neil O’Brien), whether school support staff would be affected. She could not answer.
These are serious questions, and the Government must know the answers. His Majesty’s Treasury must have the data, and it must publish that data. So let me first ask the Chief Secretary if he will publish figures showing who will be hit by his national insurance contribution tax rises, what the costs will be to the services concerned, and whether they will receive compensation. As I said, the Treasury must have the data, and if the Chief Secretary does not have it at his fingertips, I ask him to put it in the Library of the House of Commons as soon as possible. We all want better public services; the question is, do we think we can get them if the services that I have mentioned are being taxed? As the Chief Secretary said on television the other day, without reform more generally, money will just follow money out of the door.
We are told that Labour has a plan for improving the NHS. We know that, because the Prime Minister told us in a speech on 11 September that in the spring he would have a plan. That plan, he said, would contain a transition to a digital NHS, moving more care from hospitals to communities, and focusing efforts on prevention over sickness. Who could argue with those sensible measures? It was good to read in the Red Book at a time of the Budget that His Majesty’s Government intend to:
“Invest more than £2 billion in NHS technology and digital to run essential services and drive NHS productivity improvements”,
which
“will deliver 2% productivity next year.”
That is very sensible, but it gives rise to a strange sense of déjà vu—and then one remembers that in the spring Budget this year the then Chancellor, my right hon. Friend the Member for Godalming and Ash (Jeremy Hunt), announced £3.4 billion in additional funding for the NHS to deliver 2% annual increases in productivity through new technology and digital across the health service in England.
So part 1 of Labour’s three-point plan is not new at all. It is a Conservative initiative, already accounted for by a Conservative Chancellor. Let us proceed to part 2, moving more care to communities. On that, the Red Book says absolutely nothing. As for part 3, prevention, there is a small increase in tobacco duty and a vaping products duty. Not content with taxing us into growth, the Chancellor intends to tax us into health—but it is all right, because apparently the Prime Minister has a plan to have a plan in the spring.
I will tell you a funny story about the spring, Madam Deputy Speaker. When I was first working as a parliamentary researcher, there was some long-forgotten report that the Department for Children, Schools and Families was producing. We asked when it would be published, and we were told, “In the spring.” We asked, “When does spring end?” The Department told us, “When summer begins.” In that tale is an insight into the way in which Labour Governments think. It is tomorrow and tomorrow and tomorrow, and never does reform come.
That is the plan for the NHS. It is relatively well developed, next to the non-existent plan for welfare reform. My right hon. Friend the Member for Central Devon (Mel Stride), who is now the shadow Chancellor, started that work, but silence has now descended. More workers are needed to grow the economy—the OBR was quite clear on that. The Chancellor has chosen tax over employment, which will not deliver growth.
The Government’s plan has been to tax, to spend, to think a bit, to set up a website, to get told to serve waffles for every meal, and to think a bit more. Then they will see whether any money is left, they will discover that there is not, and they will need to increase taxes again. What is becoming painfully apparent is that Labour wasted its time in opposition. It had 14 years to come up with a plan for the NHS, but it did not, and now it is scrabbling to find one. By the time we see the Prime Minister’s fabled plan, more than 10% of this Parliament will have passed, and very little will have been done that was not already being done before.
The Prime Minister said there would be no extra money without reform, but that is precisely what he has given the country. That is the price of political complacency. It is the price of thinking that governing is easy. It is the price of believing your own hype, and of failing to be honest with yourselves.
Some people said that the Labour party was trying to pull the wool over people’s eyes, and I was one of them. I thought that behind the great ambiguities of the Labour manifesto there would be a game plan, but game plan has come there none. We have £140 billion of extra borrowing, and £10 billion more in higher debt repayments. Mortgage payments are up, and there is austerity for employers and workers. A loveless landslide has become a loveless tax rise for the British people, and they will not wear it.
The Chief Secretary to the Treasury (Darren Jones)
I rather enjoyed that! I hope the hon. Gentleman can take a breather now. May I welcome the new shadow Chancellor of the Duchy of Lancaster to his place? From what he has said today—I should confess that I am not a clinician—I think he may have some amnesia about the performance of his party in government, but maybe the right hon. Member for Tatton (Esther McVey), the former Minister for common sense, can help him find some before he next appears before the House.
May I also welcome the new shadow Chief Secretary to the Treasury, the hon. Member for North Bedfordshire (Richard Fuller), to his place? Madam Deputy Speaker, some Members of this House will know that you, the shadow Chief Secretary and I worked very well together for many years on the Business and Trade Committee. Clearly, some things have changed and some have not. You, Madam Deputy Speaker, are now very much in control in the Chair; I am on the other side of the Table and answering the questions; and the shadow Chief Secretary will still shout at Ministers, irrespective of whether they are Conservative or Labour, for being too socialist.
Every Government come into office seeking to improve the country, but it is now clear that the last Conservative Government did not come into office to improve public services. In a recent report from the Institute for Government, two key conclusions were drawn: first, that most public services are performing substantially worse in 2024 than they were in 2010, and secondly, that public service performance has been damaged by a lack of capital investment.
After 14 years of failure from the Conservative party, this Government will begin the work of implementing a bold programme of public service reform. This Budget starts that work by choosing a different path—by choosing investment over decline. In doing so, we will make sure that every pound is spent well and that reform is baked into our approach to governing, but we have also signed up to the much greater challenge of fundamentally reforming our public services. I see no greater opportunity than modernising the very nature of the state—not to get stuck on the old debate about the size of the state, but to fundamentally rewire and improve the state of the state.
This is a generational Budget. It is a Budget that meets the scale of the challenges we face as a country. To illustrate that more clearly, it is worth the House reflecting on the story so far and on where the country found itself before this new Labour Government came into office. Our national debt was almost the same size as our GDP, our investment share was the lowest of any in the G7 and, perhaps most significantly, our growth lagged behind that of other OECD countries over the course of the last Parliament, resulting in lost opportunities and lost growth totalling £171 billion.
The impact of this is painfully clear in our fiscal picture, because the public finances we were told we had inherited from the last Government have been proven to be a fiscal fiction. Ahead of the election, we all knew that the public finances were bad. That was no secret, but nobody expected to discover the negligent, shameful hidden secret of the £22 billion black hole of in-year spending. That was hidden from this House, from the media, from the Office for Budget Responsibility and from the public—[Interruption.] I encourage Conservative Members to look at the evidence from the OBR to the Treasury Committee today, which makes just this point. These issues were a direct result of 14 years of papering over the cracks in our country’s foundations instead of fixing them.
Mr Perkins
My right hon. Friend is repeating a statistic that we will all be familiar with—that of the £22 billion black hole—but it is important to make the point that that £22 billion is not the extra money the Conservatives were spending compared with what they were bringing in. The deficit last year was £120 billion. This £22 billion was extra money—worse than the £120 billion deficit we already knew we were inheriting.
Darren Jones
My hon. Friend is absolutely right. These were promises made by the last Government that they knew they did not have the money to pay for. This was spending from the general reserve—the money put aside for genuine emergencies each year—that they blew three times over within the first three months of the financial year. Anyone who runs a business, anyone who runs family finances and anyone who is in charge of the country’s finances should know that that is shameful, and the Conservatives should apologise to the country for it. Nowhere is that more true than in our public services, which have suffered as a consequence of the Conservatives’ mismanagement. For example, Lord Darzi’s independent report into the state of our NHS found that the past 14 years had left the NHS in a critical condition.
Jim Shannon
We very much welcome what the Government are doing in relation to the contaminated blood and Post Office Horizon scandals, but let ask the Minister a very gentle question—a question that needs to be answered—in relation to the WASPI women? When the right hon. Gentleman was in opposition, we all supported the WASPI women, and now he is in government. I understand that the Government are looking at this issue. What will happen to the WASPI women? Can we expect to have that addressed during this term?
Darren Jones
As the hon. Gentleman knows, the ombudsman reported to this House before the election, making a number of recommendations, but did not conclude the basis on which a compensation scheme might apply. Further work is therefore required, which the Secretary of State for Work and Pensions is looking at, but I would point him to the fact that this is a Government who honour their promises. If we look at the infected blood scandal or the Post Office Horizon scandal—an issue that I worked on for many years—we were told by the Conservatives that they were doing the right thing by compensating the victims, but they did not put £1 aside to pay for it.
From education to our justice system, we have inherited public services that are on life support, but I do not need to tell working people that. Sadly, they know it all too well, because the last Government lost control of both our public finances and our public services. This Budget and this Government will get both back under control. I will now outline how we should do that, by focusing on one simple word: reform. Reform is urgent, because we cannot simply spend our way to better public services.
This is a Government for working people, and we are determined that they will get the best possible public services for the best possible price, but public service reform is not just about policy or IT systems or procurement, as important as they are; it is about people. It is about the people at the end of each of our decisions: the patient in the hands of the NHS with worry and hope in their heart; the pupil in a school, college or university with aspirations that should be met; and the pensioner who wants to feel safe walking to the shops on their high street. Behind each of those people is a doctor, a nurse, a teacher, a police officer or a civil servant.
These are public servants who have chosen to work in public service to serve the public, as this Government do. They are public servants and people who today feel frustrated by not being able to access public services and not being able to deliver them. These are public services that, when performing well, deliver a well-functioning state and help keep workers educated, well and able to help grow our economy and protect our country. It is for these people that my right hon. Friend the Chancellor confirmed we will deliver a new approach to public services that is responsible, that looks to the future and that balances investment to secure public services for the long term with reforms to drive up the quality of those services today, and with reform as a condition for investment. From the Attlee Government founding the NHS to the Blair Government reforming poorly performing state schools, reform is in Labour’s DNA.
I now turn to some of the points made by right hon. and hon. Members today, and I begin by congratulating my hon. Friends the Members for Broxtowe (Juliet Campbell), for Sunderland Central (Lewis Atkinson) and for Stourbridge (Cat Eccles), and the hon. Member for Yeovil (Adam Dance), on delivering their maiden speeches.
There were many speeches today, so colleagues will have to accept my apologies for not being able to address all 80 contributions individually. However, I join my Labour colleagues in celebrating this Budget, because building an NHS that is fit for the future is one of this Government’s five missions. That is why we have invested over £22 billion, the highest real-terms rate of growth since 2010 outside of the covid response.
I have also heard the voices of hon. Members from Northern Ireland and Scotland, including the hon. Member for Inverness, Skye and West Ross-shire (Mr MacDonald), who encouraged me so dearly to listen to his speech but has not returned to the House for my summing up. Under this Labour Government, the largest real-terms funding increase since devolution began has been delivered for Scotland, Wales and Northern Ireland. This Labour Government are delivering from Westminster for the people of Scotland, Wales and Northern Ireland, and we will work in partnership with the devolved Governments to deliver the change for which people voted, and which we have now given the devolved Governments the money to deliver.
Pete Wishart
We thank the Minister for that, but will he reassure the Scottish Government right now that their £500 million of national insurance contributions for public sector employees will be given back in full compensation to the Scottish Government, rather than being put into the block grant?
Darren Jones
It is the greatest real-terms increase in funding since devolution began. If the devolved Government wish to take responsibility for devolved matters, they should do so. If they do not wish to do so, Labour will happily take over at the next election to deliver better services for the people of Scotland.
Many Members have asked me to comment on the new hospitals programme. As the Secretary of State for Health and Social Care has confirmed, this Government are committed to delivering a realistic and deliverable plan, and we will deliver the outcomes of the review to the House in due course.
Many Members have also asked me about the difficult decision to increase employer national insurance contributions, in the context of Labour honouring its promise to working people not to increase employee national insurance contributions or income tax in their payslips. It is right that the Government are not legislating to exempt non-public sector organisations from these changes but, as the Secretary of State said, we pay for these services and it will be reflected in their settlements. To answer the shadow Chancellor of the Duchy of Lancaster, whether now or in the spring at the conclusion of the spending review, those departmental settlements will be published in the normal way.
Alex Burghart
Does the Minister not think that it is important that hon. Members see those figures, to see how much the services I mentioned will be taxed, before they vote on this Budget? Would that not be transparent?
Darren Jones
The hon. Gentleman perhaps forgets that the vote is tomorrow. No doubt he will come to the House to vote to support the allocation of £22 billion of extra funding so that the national health service can cover the cost of the doctors and nurses who, under his Administration, were striking on the picket line while Ministers refused to talk to them. Under this Government, they are back on the wards and in the theatres delivering for the people of this country.
The Government recognise the need to reform the social care system, and we thank those who work in the system for the work they do to help those in need. That is why we agreed a £600 million funding increase for 2025-26, and we will return to this issue in the second phase of the spending review.
I politely say to Members that I understand the temptation to ask for more spending, as I often did in opposition, but Ministers have to explain how they will pay for it. If Opposition Members want more spending or, indeed, fewer tax rises, they will have the opportunity tomorrow to set out to the House what they would do differently. Would they increase income tax and national insurance on workers once again? Would they increase VAT on people who go to the shops? Would they increase corporation tax for businesses, which we have pledged not to do? Would they reject the investment in schools, hospitals, the police service and the future of our country? Given their behaviour under the last Administration, do they wish just to borrow money every single month to pay the bills, month after month, increasing the national debt and increasing the cost of the national debt, but not investing in the fabric of this country, as this Government will do?
Jeremy Corbyn
May I take the Minister back to the question of social care? I understand what he is saying and that proposals will be brought forward, but there are two things: immediately, there is a crisis in local government about simply paying for existing social care, and, for families all over the country, there is a crisis about how they will support people who are in care at the present time. Is there an aspiration to bring forward a much more comprehensive model that will provide hope for people who are often going deeply into debt, selling property and all kinds of things, just to support a loved one who is in desperate need of profound social care?
Darren Jones
I thank the right hon. Member for his question. This Government have aspirations to improve the social care system, and we will set out further detail on those plans in due course.
Lastly, although not related directly to the NHS or public services, I welcome the supportive comments from Members across the House about the mineworkers’ pension scheme and the Post Office Horizon compensation scheme. As you know, Madam Deputy Speaker, I worked on those issues for many years when in opposition. We failed to persuade the former Government to do the right thing, but the great thing about being in government is that we can just say it is so, and it has been so. That is the difference that a Labour Government can make.
The Labour party has a proud heritage of delivering public services to meet the needs of the nation: the national health service, social security, comprehensive schools, the Open University, academy schools. This new Labour Government will seize the generational need to reimagine public services once again. We have an ageing society, fewer working people paying tax, increasing demand, failing standards and increasing costs. After 14 years of a Conservative Government, that is the legacy they have left this country. We will not walk by on the other side and ignore those challenges. We will set out how we will reform our public services, building on this Budget of investment, choosing it over decline, focusing on outcomes, prevention, devolution and innovation in order to modernise our public services.
As I have set out today, the big opportunity—the opportunity to build the new foundations of the new public sector—is technology. The productivity of our public service is held back by IT systems often dating back to the 1950s and the 1970s: fax machines in the NHS, an inability to share information between public services, tens of thousands of public servants doing their best to administer casework using paper. That situation has not been affected in any positive way over the past 14 years.
This is not about machine-learning algorithms, but about old computers in cupboards with information that is in desperate need of being transferred to the cloud. It is about the un-newsworthy but vital work of integrated software across Departments, an area of spending I protected and encouraged in phase 1 of the spending review. It is about what might seem obvious to people at home who are now used to doing their banking on an app or their shopping online, who cannot get through to a GP surgery, a decision on their universal credit or an answer to their tax question without a lengthy and often unsuccessful attempt to speak to someone on the telephone.
Our new digital centre of Government will drive digital transformation across Government, because modernising public services is not just a great opportunity; it is a non-negotiable requirement for any modern party in a modern Government today. If we had followed the Conservatives’ path of further decline, we would have broken public services that cost more, while failing the public who rely on them and the public servants who work in them. By choosing to invest, this party—this Government—will deliver a modern state that meets the needs of the nation and delivers a bright future for us all. Reform and growth, investment over decline—those are the choices reflected in this Budget and that is the change this Labour Government will deliver.
Ordered, That the debate be now adjourned.—(Gerald Jones.)
Debate to be resumed tomorrow.