(2 days, 1 hour ago)
Commons ChamberI beg to move, That this House disagrees with Lords amendment 1.
With this it will be convenient to consider Lords amendments 2 to 19 and 21, and Government motions to disagree.
I welcome the opportunity to consider the Lords amendment to the Bill. I thank Members of both Houses for their careful scrutiny and consideration of the Bill, and I place on record particular thanks to the Financial Secretary to the Treasury, Lord Livermore, for his invaluable support and for so expertly leading the Bill through the other place.
During consideration of the Bill in the other place, 21 amendments were made, 20 of which we will address today, but before I do so directly, let me remind both Houses of the context for the Bill. When we entered government, we inherited a fiscal situation that was completely unsustainable. We have had to take difficult but necessary decisions to repair the public finances and rebuild our public services. The measures in the Bill represent some of the toughest decisions that we have had to take as a result. To restore fiscal responsibility and get public services back on their feet, we needed to raise revenue, including through the measures that the Bill will introduce. Many of the amendments from the other place put at risk the funding that the Bill seeks to raise, so let me be absolutely clear: to support the amendments is also to support higher borrowing, lower spending or other tax rises. With that in mind, I now turn to the first group of Lords amendments.
The Minister has talked about the growth mission, which is the Government’s raison d’être, but last week we found out that the economy had shrunk. Has he done any work to find out how much that 0.1% drop will cost the Government? It will have huge tax implications.
As I have set out to the hon. Gentleman in a number of debates in recent weeks, the Government have had to take difficult but necessary decisions to restore fiscal responsibility after the completely unsustainable situation that we inherited from the Conservative party. That fiscal responsibility and economic stability are essential for greater investment in the economy, which is the bedrock of the growth that we are so determined to pursue.
Will the Minister outline how many billions the Government will spend this year, what percentage £22 billion represents in that amount, and—if I may be so greedy as to ask an additional question, Mr Speaker—how much the flatlining of the economy has cost the Government compared with that £22 billion? I put it to the Minister that the impact of the national insurance contributions rise has been much greater than that of the mythical £22 billion alleged by the Government.
I am not clear from the right hon. Gentleman’s intervention whether he finally accepts that we inherited a £22 billion black hole when we entered government. I know that several of his colleagues have sought to rewrite history, but the facts are there. We inherited a completely unsustainable fiscal situation, with pressures and a £22 billion black hole, and we had to take difficult but necessary decisions to remedy that. It was important to do so, because without the basic fiscal responsibility and economic stability that a Government should deliver, investment, which is the basis for growth, will not happen.
The Minister speaks about facts. Is he aware of the fact that when the Labour party won the election, the economy was growing, and is he aware of the fact that it is now shrinking?
I am very aware of the fact that we inherited an economy and a fiscal situation in a mess. That was completely unsustainable, and it was our duty as a Government to address it. No responsible Government could have let things carry on as they were, with the fiscal situation the way it was. That is why we took the action we did.
Will the Minister give way?
I will not, as I have already given way several times and must make progress.
We had to take those decisions to put the fiscal responsibility back at the heart of government, to return economic stability to the public finances, and to have the basis for the investment on which we can grow the economy and put more money in people’s pockets.
Lords amendments 1, 4, 5, 9 and 13 relate to the NHS and social care providers. The amendments seek to maintain the employer national insurance contribution rates and thresholds at their current level for NHS-commissioned services, including GPs, dentists, social care providers and pharmacists, as well as those providing hospice care. As Members of both Houses will know, as a result of the measures in this Bill and wider Budget measures, the NHS will receive an extra £22.6 billion over two years, helping to deliver an additional 40,000 elective appointments every week.
Primary care providers—general practice, dentistry, pharmacy and eye care—are important independent contractors that provide nearly £20 billion-worth of NHS services. Every year, the Government consult the general practice and pharmacy sectors.
One question raised regularly in my constituency relates to GP surgeries. The national insurance contributions will hit them immensely hard. GPs tell me that their only choice is to reduce staff and cut back appointments. The Minister mentions £22 billion extra for the NHS, but if GP surgeries and health clinics are reducing staff and reducing their capacity to deliver services, is that not a step down in what is delivered in my constituency and beyond? Will he reconsider the measures given the impact on GP surgeries?
I thank the hon. Gentleman for raising the question of GPs and the funding and support that the Government are providing them. We are investing an additional £889 million in general practice, which brings the total spend on the GP contract to £13.2 billion in 2025-26. That is the biggest increase in over a decade. The changes to the contract will improve services for patients and help to make progress towards the Government’s health mission—shifting from analogue to digital, from sickness to prevention, and from hospital to community care—as set out in the Prime Minister’s plan for change. That support for GPs is an essential part of what the Budget, including the national insurance measures we are debating, delivers.
Age UK in my constituency has told me that the employer NICs rise will cost it £50,000 a year. Does the Minister agree that it is impossible to improve the public sector by taxing the public sector?
We inherited public services that were on their knees and needed urgent support. Part of the reason why we took the difficult but necessary decisions at the Budget last October was, of course, to restore fiscal responsibility, but it was also to get public services back on their feet. That is not just about the public services that people across the UK enjoy; it is also about ensuring that we have the stability for economic growth. If we do not have a health service that works well, we do not have a healthy population who can go to work. If we do not have a transport system that works well, people cannot get to work. That investment to get public services back on their feet after 14 years of Conservative control is essential for the experience of people in the UK, but it will also ensure that we have the economic growth that will enable us to put more money in people’s pockets.
I will make a little progress. I have spoken about GPs, but the Department of Health and Social Care has entered into consultation with Community Pharmacy England regarding the 2024-25 and 2025-26 community pharmacy contractual framework. The final funding settlement will be announced in the usual way, following the consultation.
I am grateful to the hon. Gentleman for giving way yet again. The National Pharmacy Association announced for the first time ever, in 104 years, that it is planning action by reducing services because of the implications of the Budget. One of its requests is the release of an independent report commissioned by NHS England on the future funding of pharmacies. Now that the Government are in charge of NHS England, will the Minister ask his colleagues in the Department of Health and Social Care to release that report before the consultations finish, so that the public and the pharmacies can see exactly what the financial situation in that independent report will be?
Reports on work that the Department of Health and Social Care is carrying out are a subject for Ministers in that Department, but on the funding that I am speaking about, the final funding settlement will be announced in the usual way, following the consultation that is under way.
The NHS in England invests around £3 billion every year on dentistry, and NHS pharmaceutical, ophthalmic and dental allocations for integrated care systems for 2025-26 have been published, alongside NHS planning and guidance. On social care, the Government have provided a cash increase in core local government spending power of 6.8% in 2025-26, including £880 million of new grant funding provided to social care—funding that can be used to address the range of pressures facing the adult social care sector.
The figures that the Minister is presenting, along with the answer that he gave to the hon. Member for Strangford (Jim Shannon), and similar to the Prime Minister, involve money going into sectors that will not mitigate the national insurance rise. Will he confirm that sectors such as hospices, social care, GPs and pharmacies will have some support, rather than tell us about money that is not going to help people with regard to the jobs tax that is coming in?
The various organisations or services that I am talking about, whether GPs, pharmacies or organisations that provide social care, receive money from Government, and the way that those discussions take place is by considering pressures on the providers of those services in the round—that is the way the negotiations take place. Direct support for employer national insurance contributions obviously applies to central Government, local government and public corporations, which is much the same way that the previous Government approached things under the health and social care levy. Pressures on social care or GPs, as I have been outlining, are considered in the round in terms of their funding settlements, and as I said, the £880 million of new grant funding can be used to address a range of pressures facing adult social care.
The hon. Gentleman makes an interesting point, but let us look at children’s hospices, which will be down £4.9 million. Most funding for children’s hospices does not come from the Government; it comes from communities and from people supporting them. Can the Minister, at the Dispatch Box, assure children’s hospices such as Acorns in the west midlands that they will not be down the money that they will be losing through extra NI contributions, and that that £4.9 million will be replaced by the Government for children’s hospices?
I thank the right hon. Gentleman for mentioning hospices, and perhaps I may set out the Government’s position on hospices and some of today’s amendments. The Government recognise the vital role that hospices play in supporting people at the end of life, and their families, and they also recognise the range of cost pressures that the hospice sector has been facing over a number of years. We are supporting the hospice sector with a £100 million increase for adult and children’s hospices, to ensure that they have the best physical environment for care, and £26 million of revenue to support hospices for children and young people. The £100 million will go towards helping hospices to improve their buildings, equipment and accommodation, to ensure that patients continue to receive the best possible care.
The point that Opposition Members are trying to emphasise is that the Government appear to be giving with one hand, but taking away with the other. The hospice sector is just one example of many sectors that have been adversely affected by the Government’s cruel tax.
As I said a few moments ago, the way that the Government support central Government, local government and public corporations—that is Departments and other public sector employers—is the same way that the previous Government responded to the health and social care levy. That is a standard way in which the Government offer support for employer national insurance costs.
Will the Minister give way on that point?
No, I will make some progress. The Government want to shift healthcare out of hospitals and into the community, to ensure that patients and their families receive personalised care in the most appropriate setting.
I thank the hon. Gentleman for giving way. Southern Area hospice, which is located just outside my constituency, has to raise £3.6 million per year, or £300,000 per month. It is not Government funded, as has been mentioned, so what reassurance can the Minister give to those currently using Southern Area hospice for end of life care that the Government will do the right thing and support our hospices by not including them in the increase to national insurance contributions?
I have explained how the Government are approaching employer national insurance contributions and the support that they offer for central Government, local government and public corporations. That is an established way of responding to changes to employer national insurance contributions, which the previous Government did—
The right hon. Gentleman is being so persistent. He must have an amazing point to make, so I will give way to him. I wait with bated breath.
It is an amazing point, and I hope that the hon. Gentleman will get it, because it was clear that the Prime Minister did not get it at Prime Minister’s questions. Let’s tell the real truth: the money that is being given by the Government—taxpayers’ money—to children’s hospices such as Shooting Star and Demelza hospices, is for buildings. The national insurance increase is directly hitting the people who do the work on which very sick children depend. Why is that imposition being made?
The £100 million that the right hon. Gentleman alluded to is important funding to help hospices improve their buildings, equipment and accommodation, to ensure that patients receive the best care possible. As I said a few moments ago, there will be £26 million of revenue to support children and young people’s hospices. More widely, the Government provide for charities, including hospices, through the wider tax regime, which is among the most generous in the world. That included tax reliefs for charities and their donors worth just over £6 billion for the tax year to April 2024. Finally, as the right hon. Gentleman will know, all charities, including hospices that are set up as charities, can benefit from the employment allowance that the Bill more than doubles, from £5,000 to £10,500. That will benefit charities of all sizes, particularly the smallest.
The Minister knows that that is funding for one year, and mainly for buildings, as he has admitted. This will be a cost on hospices every single year going forward. It will be cumulative and mean that hospices have to ask their communities for more and more, just to give that basic help. Will he commit to funding children’s hospices by the £4.9 million that the Government are taking off them every year, or not—yes or no?
The points I was making before I gave way to the right hon. Gentleman are recurrent features of the tax system. The support through the tax regime for charities and their donors, which was worth more than £6 billion in April 2024, is a feature of the system that happens every year. The increase in the employment allowance from £5,000 to £10,500, which will benefit hospices that are set up as charities, is a permanent change that we are making through the Bill.
As is evident to many hon. Members, the Minister has, for the first time, found himself unable to answer some very straightforward questions from Opposition Members about the difference between the allocation of funding for capital expenditure and for current expenditure, and the impact that that difference will have on our hospices, children’s hospices, GPs and others affected by Labour’s jobs tax.
I am sure Members of the House of Lords who brought these amendments back will also have noticed that the Minister has been unable to answer those questions. Prior to the Bill going back to the House of Lords, will the Minister agree to speak to the Chancellor or the Chief Secretary to the Treasury to get a clear answer to the questions that have been raised today about which money will be available for capital and which money will be available to offset the national insurance charge increase?
I am sorry that the hon. Gentleman felt that I was being unclear—I think I was being perfectly clear on the Government’s position. He may not agree with that position—he is entitled not to—but on the employer national insurance contribution changes I have been very clear that the Government will provide support directly to central Government, local government and public corporations, such as Departments and other public sector employers, as was the case under his Government with the health and social care levy. That does not apply to GPs, dentists, hospices and the other organisations that we have been discussing today.
The important point that I was making, which I hope was clear to him and his colleagues on the Conservative Benches, was about the wider support that the Government are providing to hospices, the funding that we are providing to GPs and the discussions we are having with other primary care providers. That is the context in which the Bill has to be seen. We are able to take decisions around funding for public services because of the difficult decisions that we took at the Budget last year, and this Bill implements one of those decisions.
At Prime Minister’s questions earlier today, it was noticeable that when the Prime Minister asked the Leader of the Opposition whether she would reverse the national insurance contribution rise that we are bringing in through the Bill, she refused to commit to that. I am unclear exactly what the Conservative position is—[Interruption.]
I think one of the Conservative Members said that he will update me in his speech later. I may have misheard him, but I think I heard him say that he will confirm later whether the Opposition will reverse the national insurance changes we are making, so I look forward to that update.
Will the Minister explain to the House how it is right for the Government to cover the extra national insurance contributions of those working in the public sector, for example in hospital provision, but it is not right to do that for those working in hospices, in end of life care? How can that circle be squared? Why will they cover the national insurance contributions for those working in hospitals that are treating people, but not for those working in hospices that deliver end of life care?
The fundamental principle is about which organisations the Government will support in response to the changes to national insurance contributions. The approach the Government are taking, which is in line with the approach taken by the previous Government in the health and social care levy, is for the Government to provide support for Departments and other public sector employers for additional employer national insurance contributions. As I said to the hon. Member for North Bedfordshire (Richard Fuller), that means central Government, public corporations and local government. Primary care providers are independent contractors and will therefore not be exempt from the changes.
The Minister makes the point that this is secondary for primary care providers. However, he does not acknowledge that primary care providers still do not know how they will be compensated by the Government, as I hear from dentists, community pharmacies and social care providers in my constituency. We are very close to the start of the tax year and those small businesses are providing critical primary care services in our communities. How can they operate when the Minister obfuscates and says other people might talk to them at a later stage about the money that they might receive? Would it not be easier for the Minister to accept the Liberal Democrat amendment from the House of Lords and clear up this matter today?
For clarity, primary care providers who are independent contractors will not receive the direct support that the Government provide to Departments and other public sector employers. The pressures that those providers face are considered in the round before funding is provided to them, so the solution is arrived at in a different way from the way suggested by the hon. Gentleman.
As I set out earlier, the revenue raised by the decisions set out in the Bill will help fund public services, including those provided by the NHS and other social care providers. The amendments would put much of that funding at risk, so to support these amendments is to support higher borrowing, lower spending or other tax rises.
What advice can the Minister give Thames hospice and Alexander Devine children’s hospice service in Maidenhead, which are looking at a £300,000 and £50,000 increase in bills respectively? Is he saying that they should cut services, or is he expecting residents in our constituencies to raise more money for them, for it to be given directly back to the Chancellor?
I do not know the situation of those hospices, so I will not give them direct advice on managing their operations. More generally, I have set out the Government’s approach to providing direct support for Departments and other public sector employers. It depends how hospice care is provided. In many cases, integrated care boards are responsible for commissioning palliative and end of life care services to meet the needs of local populations. Where hospices are commissioned by the NHS, contractual arrangements should be discussed with the integrated care board at local level.
The Minister has a capital budget and revenue budgets. We are talking about a small amount of money—£4 million or £5 million—so will he consider switching £4 million or £5 million from the capital budget to the revenue budget? Opening up that opportunity would have merit, and would help these very vulnerable organisations.
I have set out the Government’s approach to supporting Departments and other public sector employees when it comes to the changes to employer national insurance contributions. As I said to the shadow Chief Secretary to the Treasury, the hon. Member for North Bedfordshire, we are taking the same approach that his Government took to the health and social care levy. We are talking about the wider pressures faced by organisations, be they GPs or hospices, and what we can do to support them and their processes. We are considering the pressures on them in the round. I have made a considerable number of points about Lords amendments 1, 4, 5, 9 and 13. In the light of those points, I urge the House to disagree with those amendments.
I turn to the Lords amendments relating to charities, local government and special educational needs transport. Lords amendments 2, 7, 12 and 16 seek to exempt charities from the changes to employer national insurance contribution rates and thresholds. The Government recognise the crucial role that charities play in our society. We recognise the need to protect the smallest charities; that is why we have more than doubled the employment allowance to £10,500 pounds, meaning that more than half of businesses, including charities with national insurance liabilities, either gain or will see no change next year.
As I have noted, it is important to recognise that all charities can benefit from the employment allowance. The Government provide wider support for charities via the tax regime; tax reliefs for charities and their donors were worth just over £6 billion in the tax year to April 2024. Again, the amendments would put much of the funding that the Bill seeks to raise for public services at risk, so supporting these amendments is support for higher borrowing, lower spending or other tax rises.
After yesterday’s announcement about benefit changes and benefit cuts, the Government have said that they want more people to go into work. A lot of help to get people into work is delivered by charities, so we are expecting a greater need for such charities. How will they cope if they are being taxed through further NICs? They will have to reduce their services and their ability to provide support, so there will be a gap in the market. Will the Minister explain how the Government intend to bridge that gap?
I thank the hon. Gentleman for drawing attention to the very important reforms that my right hon. Friend the Secretary of State for Work and Pensions set out in this House yesterday, which are a crucial part of getting people back into work. Further details on interventions to help people back into work will be set out. We recognise that charities may, in some cases, provide that support, which is why many of the elements of support for charities in the tax regime remain so generous. There was £6 billion for tax relief for charities and their donors in the tax year to April 2024 through features that will continue in the tax year that we are entering. The employment allowance is more than doubling from £5,000 to £10,500, which will benefit all charities in this country. Charities, particularly small charities, will benefit directly from changes that we have made to the employment allowance. [Interruption.] Sorry, Madam Deputy Speaker—I thought you were going to intervene on me.
The Minister is making a lengthy contribution; I am just waiting for a conclusion.
In that case, I will not take any more interventions, and I will make speedier progress. I will address Lords amendments 3, 6, 11 and 15, which relate to employers who provide transport for children with special educational needs. In the Budget and the recent provisional local government finance settlement, the Government announced £2 billion of grant funding for local government in ’25-26, which includes £515 million to support councils with the increase in employer national insurance contributions. That funding is not ringfenced, and it is for local authorities to determine how to use it across relevant services and responsibilities.
Lords amendments 8, 10, 14 and 17 to 19 together seek to maintain the current threshold for businesses employing fewer than 25 members of staff. When it comes to protecting the smallest businesses, the Government are taking action through this Bill by increasing the employment allowance from £5,000 to £10,500, as I have said. That means that next year, 865,000 employers will pay no national insurance at all, and more than half will see no change, or will gain overall as a result of this package.
Finally, Lords amendment 21 would require the Government to conduct assessments on the economic and sectoral impacts of the Bill. As we have discussed previously in this place, the Government have already published an assessment of this policy in a tax information and impact note published by His Majesty’s Revenue and Customs. That note states that as a result of the Bill, around 250,000 employers will see their secondary class 1 national insurance contributions liability decrease, and around 940,000 employers will see it increase. Around 820,000 employers will see no change. The Office for Budget Responsibility’s economic and fiscal outlook also sets out the expected macroeconomic impact of the changes to employer national insurance contributions.
I hope that hon. and right hon. Members will understand why we are not supporting these amendments from the other place. Through this Bill, the Government are making difficult but necessary decisions in order to fix the public finances and get public services back on their feet. The amendments from the other place require information that has already been provided, do not recognise other policies that the Government have in place and, most seriously, undermine the funding that this Bill seeks to secure. I therefore respectfully propose that this House disagrees with the amendments, and urge all hon. and right hon. Members to support the Government on that disagreement.
I rise to speak to Lords amendments 1, 4, 5, 9 and 13. These amendments tabled by the Liberal Democrats in the other place would ensure that care providers, NHS GP practices, NHS-commissioned dentists, NHS-commissioned pharmacies, charitable providers of health and social care, and hospice care continue to pay secondary class 1 contributions at the rate of 13.8%.
With healthcare in such a dire state in Glastonbury and Somerton, it is essential that providers are not put into further financial difficulties due to increases in employer national insurance contributions. Like so many Members, my inbox has been brimming with correspondence on this matter from organisations across my constituency. The measure will disproportionately impact businesses run by women. For example, early years provider Acorn Day Nursery in Somerton has told me that it believes that the employer national insurance contribution increases, in combination with other recent funding announcements, could be the final nail in the coffin for its business, leaving families without crucial early years care provision. I have heard from hospice care providers such as Dorothy House, which provides crucial end of life care for my constituents. It will be hard hit by the rise in employer national insurance contributions, which will impact care provision for people who live in rural areas.
Vine GP surgery in Street shared with me its concerns about the impact of the changes to employer national insurance contributions, stating that it will undermine access to patient care following years of neglect from the previous Conservative Government. A constituent from Langport recently wrote to me to raise their concerns about the negative impact of the rise in national insurance on care homes. Already stretched care homes could see an increase of around £650 per employee for anyone working more than eight hours a week. That will have a knock-on impact on the cost of care provision.
Community pharmacies play an essential role in providing care in the community, in line with the Government’s strategic agenda. However, if the rise in national insurance contributions goes ahead, pharmacies such as Bruton, Castle Cary, Stoke-sub-Hamdon and Martock could all be put at risk. If they go, vital frontline services for rural communities will be lost. The National Pharmacy Association has predicted that around 1,000 will close by 2027. The combined effect of changes to the national insurance contributions and the national living wage could add an extra £25,000 to each pharmacy in rural Somerset, affecting their viability. Given the rate of pharmacy closures in Glastonbury and Somerton is nearly double the national average, my constituents will be hard hit by this tax hike.
In rural areas we simply cannot afford to lose any more pharmacies or our critical frontline services. I fear that these measures will only increase the pressure on GPs and other services that will be badly impacted by this decision. I urge colleagues to back the Liberal Democrats’ amendments so that we can protect frontline health providers, who, shockingly, are not included in the Government’s exemption. Without it, health and early years provision across the country will be drastically reduced.
I will respond briefly to some of the points raised in the debate. I thank all hon. Members for their contributions. The shadow Minister, the hon. Member for Grantham and Bourne (Gareth Davies), repeated many points that I addressed in my opening remarks. He asked a fundamental question: why must the Bill be implemented? My response is because of the mess that his party left when we won the election last July. I noted that he refused to say whether he would reverse the national insurance changes that we are making, despite being asked by Government Members. He refused to make clear his party’s position, as the leader of his party did earlier.
The hon. Member for Gosport (Dame Caroline Dinenage) spoke of choices in politics. She is right that politics is about choices. But she was also incapable of explaining what different choices she and her colleagues would make, since they oppose our changes to national insurance contributions. Would they go for higher borrowing, lower spending or other tax rises?
My hon. Friend the Member for Poole (Neil Duncan-Jordan) Poole and the hon. Member for Chester South and Eddisbury (Aphra Brandreth) spoke about special educational needs transport facilities. I mentioned in my earlier remarks that the Budget and the provisional local government finance settlement set out £2 billion of new grant funding for local government in 2025-26. That includes £515 million to support councils with employer national insurance contributions. However, it is not ringfenced, which means that it is for local authorities to determine how to use this funding across relevant services and responsibilities.
There was a comment from the right hon. Member for Stone, Great Wyrley and Penkridge (Sir Gavin Williamson), although he is not in his place and I do not know where he is—perhaps he is off feeding his spider. He made a rather colourful comparison between some of my points and those made by a former colleague of his. I do not know whether he realised that in doing so he implied that the position that the former Secretary of State for Health was defending was indefensible. I would be interested to see which of the previous Government’s policies he thought were indefensible. When he returns from his spider-care duties I will ask him, but in his absence, let me say what is indefensible: for Conservative Members to have voted for the Liz Truss mini-Budget. What is indefensible is what they did to public services over 14 years. What would have been indefensible would have been our letting the situation carry on as it was when we won the general election.
The Bill makes some of the difficult but necessary decisions that we as a Government have had to take to fix the public finances and get public services back on their feet. The amendments from the other place require information that has already been provided. They do not recognise other policies that the Government have in place, and most seriously they seek to undermine the funding that the Bill will secure. I therefore respectfully propose that this House disagrees with the Lords amendments.
Question put, That this House disagrees with Lords amendment 1.