Income Tax (Charge)

Caroline Nokes Excerpts

Tuesday 5th November 2024 Commons Chamber

[Edward Argar]

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.

[Madam Deputy Speaker (Caroline Nokes)]

I call Kate Osamor.

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[Kate Osamor]

I thank the hon. Member for her intervention. I would add that it is important that patients, doctors and everyone else are listened to. I am assured that the Secretary of State will be listening to all voices.

NHS data is a public asset. Its management should be rooted firmly within the NHS, not placed in the hands of private interests, especially those controlled by an individual who is so hostile to the principles of public healthcare. Our NHS thrives due to the work of everyone in the system, from nurses to administrative staff and healthcare assistants, who each play a critical role in patient care. We must listen to all NHS staff, not just those in the highest-ranking medical roles, as everyone brings valuable frontline perspectives on improving efficiency, patient experience and accessibility.

I especially draw attention to the hard-working staff who provide out-of-hours services for our communities, often doing so on top of their normal hours. The Government must ensure that those professionals receive not only recognition, but the resources and support they need to continue serving our communities in this vital way. Staff in out-of-hours services often only work in such settings part time. However, they are often the last resort for people who are unable to get appointments with their GP or access the care they need.

We must also address the postcode lottery in healthcare. For various conditions, disparities persist in access to specialists, waiting times and outcomes in relation to area, ethnicity and gender.

The stark reality is that mental health services remain woefully inadequate. We face a mental health crisis, especially among young people, and this impacts on personal wellbeing and ruins life chances. We urgently need targeted investment in mental health services, and I look forward to supporting the Government in ensuring that the crisis in mental health support is treated with the seriousness it demands.

This Budget is a strong step in the right direction, but we must go further to ensure that the NHS remains public, that mental health is prioritised and that all NHS staff have a voice in shaping the future of our health system. I ask the Secretary of State to focus on all those areas, because I believe that if we have consistent investment throughout this Parliament, we can ensure that we make progress towards an NHS that works and in which everyone is able to access the quality and timely care that they justly deserve.

[Madam Deputy Speaker]

I call the Liberal Democrat spokesperson.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Caroline Nokes)]

Members will be aware that this is a very heavily subscribed debate, so a time limit will be coming, but not until after we have heard some maiden speeches. I call Juliet Campbell.

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[Esther McVey]

I will carry on for a little longer.

To put that into context, it dwarfs the UK’s annual defence spend, which stands at £55 billion. This is money being wasted instead of being spent on public services.

And if all that was not bad enough, the Office for Budget Responsibility has downgraded its growth forecast to a measly 1.5% for the years running up to the next general election. So much for Labour saying this would be a Budget for growth. This Labour Budget has taken our country back to the 1970s, with crippling taxation, unsustainable levels of borrowing and the trade unions in control. The Budget has also broken virtually every economic promise Labour made during the election. In fact, even worse than the economic misery this Budget will bring might be the further mistrust in politicians it will cause.

Labour ruled out tax hikes on working people more than 50 times, and it ruled out changing the fiscal rules to fiddle the figures. Mark my words, on top of the betrayal of pensioners with the scrapping of the winter fuel allowance, this Budget will be a nail in this Government’s coffin, only four months after they secured a huge majority.

At the weekend, the Chancellor eventually came round to admitting that Labour will be taxing workers, but I am afraid that saying it now, having denied it at the general election, does not wash. It is way too late to be admitting it. All it has done is expose the fact that this Labour Government were elected on a false premise and therefore do not have a mandate for this Budget. [Laughter.] Laughing after not telling the public what they were going to do is why I certainly will not be supporting this Budget.

[Madam Deputy Speaker (Caroline Nokes)]

I call Lewis Atkinson to make his maiden speech.

[Lewis Atkinson (Sunderland Central) (Lab)]

It is pleasure to follow my hon. Friend the Member for Broxtowe (Juliet Campbell), who spoke movingly about her experience in the NHS, as well as the barriers she has ignored and, indeed, knocked down.

I start by paying tribute to my predecessor, Julie Elliott, who not only worked with commitment for Sunderland Central, but provided political leadership and mentorship across the north-east. Julie understood that organising and advocating on a regional basis is often the best way to deliver for our communities. I hope to follow her example. It is the honour of my life to be in the House of Commons representing the city by the sea that I love.

I am pleased that my first debate contribution is about the budget and the NHS, for what is our purpose here if not to improve the economic conditions of our constituents and the care available to those we serve? Health and wealth have always been linked—twin assets—as families like mine, forged in the Durham coalfield, know well. My grandparents were only able to toil at the pit, in the munition factory or in the home for as long as they were healthy. Working-class communities have always feared illness and injury, not just in its own right but because the resulting inability to work was disastrous for family finances. The introduction of the NHS and national insurance by the Attlee Government was intended to protect against such calamities. We have important work to do to repair and renew those civilising protections today.

The link between inequalities of health, wealth and power has been impressed upon me by the privilege of working for two decades in NHS North East. Whether managing dentistry, mental health or cancer services, I saw at first hand how the poorest generally experience the poorest health outcomes. I intend to spend some of my time in this place working to right that situation.

The qualities of innovation and hard work have always been the building blocks of Sunderland’s economy. From the introduction of glassmaking in Britain at Bede’s monastery of St Peter’s, through the education of lightbulb inventor Joseph Swan, to becoming the UK’s leading digital smart city, Sunderland has always been a home of innovation. We have always made things. For 600 years, that meant ships. At our peak, the people of Sunderland were hard at work “macking” a quarter of all ships produced globally each year, and we were likely dubbed “Mackems” as a result. Wealth from shipyards and pits built Sunderland, but such work often caused a thirst, so it was handy that the most popular stout in the country was produced in the centre of town, at the Vaux brewery, until the second world war interrupted production.

In that war, as in others before and since, the patriotic people of Sunderland answered their country’s call. This weekend, I will be honoured to play a small part in what is thought to be one of the largest Remembrance services outside London, reflecting the high number of veterans in our city and the sacrifices made by so many, including my constituents who served in Iraq and Afghanistan.

While the bravery and fortitude of Sunderland’s people has never been lacking, too often they have faced the headwinds of economic change without a Government on their side. By the end of my childhood, the pits, the shipyards and even Vaux had all gone. But the people’s spirit and an understated determination remained, and it is thanks to them that our city is now on the up.

I am not just referring to top-of-the-Championship Sunderland AFC, a football club that has provided me with more agony and ecstasy than even the Labour party has managed. Our Stadium of Light stands on the site of the Monkwearmouth colliery, but now instead of coal we produce a rich seam of talented players, such as Jill Scott, Jordan Pickford, Lucy Bronze and Chris Rigg.

I also celebrate the workers at the most productive car plant in Europe, Nissan, which although not in my constituency is the modern cornerstone of our city’s economy, continuing our advanced manufacturing heritage and skills.

Elsewhere around the city, where there was previously decline we now see new beginnings. On the banks of the Wear, we no longer have shipyards, but we do have the Crown Works studio site, ready to be transformed into a landmark film studio. Where the brewery once stood, we have cranes in the sky for Riverside Sunderland, the most ambitious city centre regeneration project in the UK. We have our excellent university, with particular strengths in media and healthcare, and we have a city that loves a good time, where growing hospitality and cultural businesses provide plenty of decent days and nights. It might be a show at the Sunderland Empire, a meal at one of our many excellent British-Bangladeshi restaurants, or a gig at one of our independent venues.

Where passion and identity are strong, there is music—and Sunderland is a music city. Having produced talent from Dave Stewart to the gone-too-soon Faye Fantarrow, our city’s artists reflect who we are, honour our proud heritage and point towards our bright future as an inclusive city.

Nowadays, we celebrate that Mackems are found in mosques and churches, our community centres, our gurdwara and our social clubs, and now there are even two Mackems in the Cabinet. All my constituents, no matter what their background, deserve a strong economy and quality public services. Because Sunderland was built on hard work, its people rightly expect nothing less from their politicians. It is in that spirit that I recognise the privilege of being in the House on behalf of our entire community. I will do what I can to serve them and repay the trust they have placed in me.

[Madam Deputy Speaker (Caroline Nokes)]

I call Adam Dance to make his maiden speech.

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[Luke Myer (Middlesbrough South and East Cleveland) (Lab)]

On a point of order, Madam Deputy Speaker.

[Madam Deputy Speaker (Caroline Nokes)]

It is not the time to make a point of order.

I call Cat Eccles to make her maiden speech.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Caroline Nokes)]

Order. I propose to put a four-minute time limit on contributions after the next speaker.

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[Bradley Thomas (Bromsgrove) (Con)]

It is not just public services that we need to focus on: the third sector provides vital services that many of our constituents rely on, particularly children’s hospices. I would like to highlight to the House the Acorns children’s hospice in my constituency, which provides vital support to many local families in a really acute moment of need. In 2019, NHS England decided to increase the children’s hospice grant—

[Madam Deputy Speaker (Caroline Nokes)]

Order. That intervention was far too long.

[Jess Brown-Fuller]

I thank the hon. Member for his intervention. He will be pleased to know that I am going to mention hospices later in my speech.

To fix the NHS, we must fix both the front and the back door. Taking the pressure off secondary care can only be achieved by properly funding primary care. That is why the decision to increase employer’s national insurance contributions is a significant mistake, as it risks worsening the crisis in the NHS and care sector. Increasing that rate will drive up GP surgery costs, significantly raising the annual expense of GP practices. Those practices are not eligible for the employment allowance that protects our small employers, so surgeries in Chichester and across the country will bear the full weight of that rise—a burden that they and my constituents simply cannot afford. Surgeries such as Southbourne surgery, Langley House surgery and Selsey medical practice have already reached out to me with concerns about their ability to continue providing services amid those financial challenges. They all agree that this increase will directly undermine patient access and care.

Charities have long suffered the burden of failing statutory services. Chichester boasts some of the most amazing charitable organisations, and one of the great pleasures of my role is to spend time with the people at the heart of those organisations. Charities such as Stonepillow, which works to prevent homelessness in our area, face an increase in costs of £125,000. I also visited St Wilfrid’s hospice after the Budget announcement—an incredible hospice that provides palliative care for hundreds of people every year, both in the hospice and in the community. It now faces an increased bill of £175,000—money that it needs to find annually, with only 17% of its annual budget covered by the NHS. I urge the Government to consider exempting the health and social care sector from the national insurance rise, so that the Treasury is not giving with one hand and taking with the other.

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[Mr Will Forster (Woking) (LD)]

I am surprised to be called so quickly, so thank you, Madam Chair. I was really pleased by the statement that the Secretary of State is looking at how to compensate those in the health and social care sector for national insurance rises. I have in my constituency Central Surrey Health, a not-for-profit, employee-owned group. It serves much of Surrey, and it stands to lose £500,000 as a result of the proposed changes. It delivers community services across Woking and Surrey, including most of the services in my constituency. It would be awful if we lost services as a result of measures introduced by the Government in a Budget that is supposed to invest in the NHS. I welcome the Government’s investment in the NHS, but they must not make the mistake of increasing national insurance on social care firms, health partners and GPs.

I am concerned about the elephant in the room: social care. Local authorities and our health system are really struggling, but social care helps to fix things. It is a more efficient use of our money to invest in social care and prevention than spend on primary care in hospitals. The Government are rightly investing in the NHS, but they have failed to invest in our social care system. Surrey county council is under huge pressure, and Woking borough council has effectively gone bankrupt. It is reported that without further support, almost 50% of local authorities could go under. If the Government do not invest in social care, I fear that they will make the mistakes that the Conservatives made, which we do not want. We need to invest in social care, so I hope that the Government will agree to a cross-party social care agreement that tackles those issues.

I want to touch on the cost of living. The Government have to turn around an awful record from the previous Government. They have introduced some good measures and have suggested that they would increase the tax threshold—something for which we have long campaigned —but I am concerned about the national insurance rises, which will hit small businesses hard. I met many small businesses this morning in Woking, and they are really concerned about the impact of those rises. I like the rhetoric from the Prime Minister and the Government about this being a Government of service, and a Government who want to promote growth. They are using the correct wording, but good rhetoric needs to be followed up with good announcements. The Government say that they are going for growth, but their actions do not support that. They are ignoring Brexit, they are ignoring social care, which undermines our local authorities, and they are undermining small businesses.

The Budget is better than the Budgets of the previous Government, but that is nothing to shout about. It should be a lot better for my constituents in Woking, and for constituents of Members across the House.

[Madam Deputy Speaker (Caroline Nokes)]

There will be a reduction in the time limit to three minutes after the next speaker. A note: when I am in the Chair in the Chamber, I am Madam Deputy Speaker, not Madam Chair; that is for Westminster Hall, or when the Chamber is in Committee. I call Richard Burgon.