Health and Social Care Levy (Repeal) Bill

Baroness Bennett of Manor Castle Excerpts

2nd reading & Committee negatived & 3rd reading
Monday 17th October 2022 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, at 11 am today, sitting on the number 29 bus, I flicked over to my favourite live blog to follow the speech of our newly minted Chancellor, the fourth in four months. As was noted widely over the weekend, if you are looking for some good news, it is only two more Chancellors until Christmas.

It was an historic event, but not in a good way—an emergency mini-Budget delivered not to the House of Commons but by broadcast from the Treasury. I was particularly attentive because I wanted to know whether this debate would happen today. After three years in your Lordships’ House, this was another new procedural question arising—there is always one: how late can the Government pull a Bill from the Order Paper? The Energy Bill, on which so many in your Lordships’ House and the NGO community had been labouring mightily, just disappeared from our lists over the Summer Recess. The Schools Bill, to which many stood in opposition—including, honourably, many on the Government Benches opposite, including several former Secretaries of State for Education—until the Government pulled the entire first, main section of the Bill, also appears to have gone west. Would the health and social care levy Bill go the same way? Well, we are here now and have just heard the Minister speak in favour of it, so obviously it has not—not today, anyway—which is, in its own way, very telling.

Tax cuts, to which the current Prime Minister was so attached and on which she ran her entire campaign among the 100,000 or so Conservative Party members who got to decide the direction of the Government, nearly all disappeared. In the Chancellor’s own words:

“We will reverse almost all the tax measures announced in the Growth Plan”.


That means, again in his own words,

“no longer … proceeding with the cuts to dividend tax rates, the reversal of off-payroll working reforms introduced in 2017 and 2021, the new VAT-free shopping scheme for non-UK visitors or the freeze on alcohol duty rates.”

That means that cuts announced last month—on the basis of which some people may have made important economic decisions such as applying for a mortgage; or, in the case of small businesses focused on tourism, for example, decisions about their future business plans—have gone “puff”.

As the First Minister of Scotland, Nicola Sturgeon, said today in setting out an independence plan for Scotland, the UK

“does not offer economic stability”.

The Minister might like to comment on that quote.

It is clear that these are all, broadly speaking, impacts that affect not householders but businesses. Of course, we are also seeing the scaling back of the energy bill support. It is the changes to health and social care and support for households struggling with the cost of living that have been abandoned. It is a measure of who those in charge do and do not value. I say “those in charge” because I do not really know whether I should call them a new Government. It is hard to say, although—for anyone who missed it—Downing Street has just issued a press release saying that Liz Truss is still in charge. But will she be doing Prime Minister’s Questions in the other place on Wednesday? That is not a question to the Minister, just a question out to the ether.

The Health and Social Care Levy Act received Royal Assent on 20 October 2021. This Bill, almost exactly a year later, repeals it. They say a year is a long time in politics, but these days 48 hours is an age.

The Bill maintains a legislative basis for keeping tax receipts collected under the provisions of the former Act until early November 2022. As always, the very useful House of Lords Library briefing notes that the Bill has been fast-tracked to give employers enough time to implement the changes to national insurance rates planned to be effective from 6 November this year. The Health and Social Care Levy Act 2021 was fast-tracked for similar reasons, so we have had a seesaw in respect of which businesses, particularly small and medium-sized enterprises, must be struggling to keep up.

I come to my main area of concern with this Bill. I note that the Treasury factsheet says that

“funding for health and social services will be maintained at the same level as if the Levy was in place.”

That is, I think, a promise from the previous Chancellor—it is hard to keep up—not the current Chancellor. Can the Minister confirm that the briefing also fits with this?

I shall skip over some points so as not to cross over with what others have said, but I want to highlight what the noble Lord, Lord Sikka, said in a direct question to the Minister: “That was £12 billion a year ago. Is the spending for the NHS going be maintained in real terms?” I also highlight and strongly agree with points made by the noble Baroness, Lady Brinton, and the right reverend Prelate the Bishop of London about the extreme strain under which our NHS and social care systems are suffering with the current levels of spending.

Sticking for a moment with the specific Treasury elements, I note that the Institute for Fiscal Studies, responding to today’s Statement, said that

“it remains hard to see where significant spending cuts could come from.”

As the noble Lord, Lord Sikka, said earlier, austerity has killed. Two separate studies in the British Medical Journal and from the Institute for Public Policy Research, using different methodologies, came to very similar figures when covering the period from 2012 to 2018: respectively, 120,000 and 130,000 excess deaths, in which both studies said austerity had to be considered a significant or causal factor.

I should perhaps declare my position, as did the noble Baroness, Lady Brinton, as a vice-president of the Local Government Association. We have seen local services, particularly local government services, cut to the bone. Infection has already set in, with closed libraries and community centres struggling to survive—those very same libraries and community centres that we are hoping will be warm banks to keep people alive this winter. I am aware that the Minister may not be able to comment on what cuts are coming, but it would be nice to get some reassurance on which essential services we will see maintained.

I want to pick up on a point made by the noble Lord, Lord Macpherson, who was following what might be described as Treasury orthodoxies. There are some Treasury orthodoxies that, I agree with Liz Truss, need to be busted. The noble Lord suggested that it would be nice to tax the rich and multinational companies, “But it is all too hard; they’ll just escape it.” The first thing we need to do is to get a Government who want to tax rich individuals and multinational companies and to put that money into the NHS; alternative money to that which we are taking away from government funding today. There are other alternatives: a wealth tax, a land value tax—land, of course, cannot run away—higher corporation tax. These things are indeed possible.

I want to make two brief final points. First, there has been very little discussion during our current scramble of the fact that the new Chancellor is indeed a former Secretary of State for Health. Little attention has been paid to this point. Phrases such as “a safe pair of hands” have been bandied around. We might need to look back and make a comparison with what happened from 2012 to 2018 with our National Health Service, and the discussion and the debates as we undid many of the things done in those years in the Health and Social Care Act.

Finally, I raise the point covered extensively in Oral Questions today: the fact that we have an extraordinarily parlous state of public health as huge numbers of people, particularly those over 50, are unable to take paid employment, even though they wish to, because of their health conditions. If we do not provide funding for the NHS and social care, that situation will surely only worsen. It seems unkind to ask Ministers for assurances at this moment—how can they give them?—but I will ask the noble Viscount this: does the Treasury acknowledge that the state of public health, the NHS and social care are acutely important to the state of our economy?

--- Later in debate ---

[Viscount Younger of Leckie (Con)]

I thank the noble Baroness for that. I know that I cannot give a full answer, partly because we have a new Chancellor, but I can perhaps be a little helpful in saying that we have provided councils with £1.6 billion each year in new grant funding to meet core pressures in social care and other services; that is the largest annual increase in more than a decade. I can tell that this may not satisfy the noble Baroness entirely so I will add whatever I can to my increasingly long letter.

[Baroness Bennett of Manor Castle (GP)]

I have a question that is easier, and which may not need to be added to the letter. Does the Minister acknowledge that the Treasury sees that the overall state of public health, the health of the nation—which addresses issues such as obesity, the rate of diabetes and heart disease, and issues such as poor housing contributing to asthma—is an economic issue for the UK?

[Viscount Younger of Leckie (Con)]

I most certainly acknowledge that and of course agree with the noble Baroness. The challenge for any Government is that there are a whole range of priorities, including defence and all other departments, but I cannot disagree with her; these are all very important. There are so many other priorities but, essentially, I agree with the noble Baroness.