Autumn Budget 2025

Baroness Rafferty Excerpts

Thursday 4th December 2025 Lords Chamber

[Baroness Rafferty (Lab)]

My Lords, it is a pleasure to add my congratulations to the right reverend Prelate the Bishop of Portsmouth on his excellent maiden speech. I look forward to working with him in the future. I speak as a nurse, past president of the Royal College of Nursing and fellow of the Queen’s Institute of Community Nursing.

I counter the challenge from the noble Baroness, Lady Jones, about the lack of vision in the Budget. When I look at the health elements of this Budget, I see that it speaks very much to the wider social determinants of health and the impact they have on health outcomes, as well as specific health-related investments. Several non-health parts of the Budget, such as housing, education and the environment, can boost future health.

As we have heard, according to government and independent estimates, changes to welfare, including removing the two-child limit and boosting support for low-income families, will lift 450,000 children out of poverty, rising to around 550,000 with the expansion of free school meals. That is no mean achievement. As a result of this, together with the cutting of energy bills, the raising of the national living wage and the protection of pensions, households are more likely to be able to afford food, heating and other essentials that underpin good physical and mental health, both for parents and for children, by reducing chronic financial stress.

I turn to health per se. The £300 million capital investment in tech infrastructure seeks to ensure co-ordination between primary and secondary care through the NHS app. This is to be welcomed as the tech “front door” to connecting care through a single user interface. In many ways, this is the digital dream come true and, if I understand it correctly, it promises to bring together patient records from different parts of the system that cannot now talk to each other. It will help patients not only to navigate and co-ordinate their own care but to deal with some of the barriers to care co-ordination that are growing in complexity with an ageing population contending with multiple comorbidities.

The Government’s establishment of 250 new neighbourhood health centres across England will help with another of the Government’s shifts: bringing care closer to home. These one-stop shops bring together a range of services to support more preventive and sustainable health care. The programmes will be provided through a combination of public investment and public/private partnerships, and I hope they will be informed by lessons from the previous PFI initiatives.

The Queen’s Nursing Institute and the Royal College of Nursing have welcomed the investment in neighbourhood health centres, but we must ensure that the Labour Government’s NHS workforce plan supports these hubs via adequate staffing. The Nuffield Trust notes a staggering 43% decline in district nurse numbers since 2009. Secure staffing is essential if the policy goal of moving care closer to home is to be achieved. Although the new centres are to be welcomed, they will require such investment to reverse the cuts to public health services such as health visiting and school nursing. Can my noble friend the Minister assure me that the investments to achieve this will be made available? I am sure he joins me in supporting the Budget’s welcome ambition of more nurses. I would welcome his reflections on how these numbers will be translated into the reality of the NHS workforce plan and its implementation.