Toby Perkins debates involving the Department of Health and Social Care during the 2024 Parliament

Income Tax (Charge)

Toby Perkins Excerpts
Tuesday 5th November 2024

(2 weeks, 3 days ago)

Commons Chamber
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Wes Streeting Portrait Wes Streeting
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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.

Toby Perkins Portrait Mr Toby Perkins (Chesterfield) (Lab)
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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 Portrait Wes Streeting
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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.

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Edward Argar Portrait Edward Argar (Melton and Syston) (Con)
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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.

Toby Perkins Portrait Mr Perkins
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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 Portrait Edward Argar
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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.

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Edward Argar Portrait Edward Argar
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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.

Toby Perkins Portrait Mr Perkins
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Will the right hon. Gentleman give way?

Edward Argar Portrait Edward Argar
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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.

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Tom Tugendhat Portrait Tom Tugendhat
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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.

Toby Perkins Portrait Mr Perkins
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Will the right hon. Gentleman give way?

Tom Tugendhat Portrait Tom Tugendhat
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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.

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Toby Perkins Portrait Mr Toby Perkins (Chesterfield) (Lab)
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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.

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Darren Jones Portrait The Chief Secretary to the Treasury (Darren Jones)
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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.

Toby Perkins Portrait Mr Perkins
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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 Portrait Darren Jones
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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.