Health and Social Care Levy

Ben Everitt Excerpts

1st reading
Wednesday 8th September 2021 Commons Chamber

[Ben Everitt (Milton Keynes North) (Con)]

It is a pleasure to follow my hon. Friend the Member for Bolsover (Mark Fletcher), who made a typically thoughtful and energetic contribution. There was much to agree with there.

My hon. Friend the Member for Bishop Auckland (Dehenna Davison) quoted the words, “To lead is to choose”, and here we have no easy choices. Indeed, in our job we often have tough days in the office, and nights when we lose sleep thinking about a vote, a decision, the options and the choices that we have in front of us. However, in this speech I am going to look on the bright side. I am going to try to be optimistic, and pull out the good things from the situation and the hard choices that we face. One good thing is that owing to the timing of this, I only lost one night’s sleep, but I am going to be very positive about the policy itself as well. I am going to choose three things that I want to improve, and I am glad that the Chief Secretary to the Treasury is here to listen. Those three things are how the revenue is raised, the quantum and the period over which it is spent, and how it is spent.

There are never any good options for raising taxes, but I happen to think that raising taxes on having a job should possibly be at the bottom of the list when we look at new areas of income. We have spent billions on furlough, keeping people in jobs. That has been borrowed from future generations, and will be paid back. We have kept people in jobs. We have kept the economy going. We have kept the show on the road. We have avoided the economic death spiral of mass unemployment while we have all these additional rising pressures on spending on public services, including, of course, social care—the very problem that we are here to fix. There are, I think, other less bad options. My right hon. Friend the Member for Rossendale and Darwen (Jake Berry) suggested a cocktail of taxes and levies. Normally, I instinctively avoid complexity in taxation—

[Jake Berry]

But not cocktails.

[Ben Everitt]

No—not cocktails!

We have to recognise that the simple option is not always the right one, and I look forward to the debates that will follow as this policy evolves.

As for the quantum and the period over which the revenue is spent, I must ask whether it is enough to fix the care sector. The hon. Member for Sheffield South East (Mr Betts), the Chairman of the Housing, Communities and Local Government Committee, referred to the previous report of the Health and Social Care Committee, which required an additional £3.6 billion for the sector. Are we going to get that, and is it going to go through at the right time? We need to solve the broken economics of running a care home, which mean that providers must fund the services off the back of private clients to subsidise the clients who are referred by local authorities. I think we need a big conversation about that as well.

Let us turn to how the money is spent. The additional funding must be supported by meaningful reform. We must address the issue of funding allocation, and the allocation of responsibility within the sector. Currently, the system is set up to incentivise referrals. The system is split between local authorities, care providers and the NHS.

[Dehenna Davison]

Does my hon. Friend agree that we need a wide spread of provision to ensure that we have the best possible outcomes for social care patients?

[Ben Everitt]

Absolutely. We need more providers in the market, but the market needs to be functioning for that to take place.

My hon. Friend made a very good point earlier about another aspect of how the money is spent. The £86,000 cap needs to be met and tweaked with a regional house price element to recognise the fact that houses are worth more in some areas than in others.

In conclusion, I will vote for this. Our job in this place is to make good laws, and we need to do that at every stage. This is a tricky problem. The Government are right to grasp the nettle and reform social care. The fundamental problem that we face is that the assumptions that we are basing our entire welfare system on were made in the 1940s when people went into work in their teens, retired when they were 60 and lived until they were about 65. Now, they are living much longer lives and retiring earlier. That is the funding issue that we face.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I must gently point out that colleagues may think that they are helping each other out by making interventions, but at this stage they are going to prevent other colleagues from getting in.

--- Later in debate ---

[David Simmonds (Ruislip, Northwood and Pinner) (Con)]

The key issue for me is not so much with raising the funds—there are no perfect solutions for that—but with the spending of them. I am more than happy to look my constituents in the eye and say “I voted to raise taxes” if I can demonstrate that we have something to show for it. Those of us with a local government background will know that the social care sector has been crying out for a sustainable financial settlement for at least two decades.

The fair access criteria that were implemented by a Labour Government in 2003 precipitated a financial crisis in a sector that was already under pressure by removing local authority discretion over services and failing to provide the funding for the new model, and charging policies and council tax precepts have proved unable to bridge that gap. As a chairman of a social services committee in those days, I looked my local residents in the eye while imposing Labour’s charging policy for social care on them, so I welcome the Government’s courage in bringing forward a proposal that looks both realistic and workable.

[Ben Everitt]

Does my hon. Friend, with his local government background, think that this policy will fit within a wider local government finance reform agenda?

[David Simmonds]

My hon. Friend is absolutely correct to highlight that wider reform agenda. I know we are anticipating more detailed proposals from the Government in due course, but it is clear, as he will know from his local government experience, that if we in this House are serious about fixing social care—much of which is not about the elderly, but about working with adults and children with disabilities—we must learn the lessons from the sector of several decades of change.

First, we must reflect on the lessons of the better care fund, which taught us that councils have been the efficient delivery partner. Even when the sole focus has been to relieve pressure on the NHS, councils have been much more efficient on the whole in using those funds. We must avoid, as many Members have said, that convenient political mistake of allowing all the money to disappear into an NHS black hole with nothing to show for it. However, having learned the lessons of the better care fund, we have to ensure that those additional national insurance costs do not consume the extra funding. I have heard Ministers’ assurances about this, but the care sector has heard many times of new funding that has been cancelled out by deductions from other budgets, so we need absolute clarity that this will find its way to the frontline.

The second point I would like to highlight is that this does not just affect the elderly. About two thirds of social care costs are for working age adults and children, and the NHS is barely involved in many of those cases. However, the costs can be eye-wateringly high, so we need to make sure that as we direct those funds, as my hon. Friends have highlighted, they are getting to where they are required.

The third lesson, which has been mentioned by a couple of Members, is about how the market responds. We have a thriving market for social care in this country, including charities, the private sector and local authorities. We know many of those organisations will see the £86,000 as a very tempting target: the sooner someone spends their £86,000, the sooner the state steps in. We need to ensure that we have learned the lessons of what has happened with the involvement of some businesses, particularly in the children’s social care sector, and make sure this is not seen as simply an opportunity to rip off the taxpayer.

Finally, may I urge Ministers to review the operation of the fair access criteria and the rules that underpin them? The rule of provide for one and provide for all, which was clarified by a subsequent judicial review for the London Borough of Harrow, forced the retrenchment of local authorities in adult social care towards serving only the most critical needs of people in our constituencies.