(7 years, 9 months ago)
Commons ChamberNobody in this House would be more pleased than me if we did not have the PFI millstone around our neck. The hon. Lady talks of renegotiation; this is real money, and these are real contracts that were signed more or less entirely by the last Labour Government. There is no magic wand that enables us just to set those PFI contracts aside, although I wish there was; that is not how the commercial world works.
I am sure the Minister will be aware that the £10 billion figure for increased funding he has just cited is rejected by the cross-party Select Committee on Health. It is also very well him referring to what he alleges are increases in NHS funding, but the other cuts his Government have made over the last five to six years, in particular to local authority budgets, have put huge pressure on social care, which has led to a knock-on impact on the NHS and its funding.
The hon. Gentleman mentions social care, and that is fair. It is funded separately to the NHS, and the budgets are separate. During the course of this Parliament the social care budget will increase in real terms. I do accept that the social care system is under pressure, but there is a massive disparity in performance in social care between councils. The top 10% of councils are about 20 to 25 times better in terms of outcomes for delayed transfers of care and so forth than the bottom 10%. There are many facets to this, therefore, but I accept the basic point. I think that, all other things being equal, Members on both sides of the House would like the NHS to have more money; let us agree on that and see how we make progress on it.
Brexit introduced a number of variables that may not have been there before. What will be the impact of Brexit on our economy? Our GDP in three or four years could be higher, but also could be lower, because of Brexit. The truth is that neither the hon. Gentleman nor I knows the answer to that. There are different views on that in this House, too, although some with other views may not be here today. This is important and relevant because if the economy were to have a significant difficulty, that could impact on spending commitments.
The second variable is a very substantive one and was mentioned earlier: the exchange rate. Our exchange rate went down about 15%, principally, it would seem reasonable to say, as a consequence of Brexit. That is a good and a bad thing for the economy. Many countries in the world are trying to get their exchange rate down. I represent a constituency in the north of our country where we have a more manufacturing-based economy. Frankly, a lower exchange rate will help the economy there. That may not be the case in other parts of the country and in the City.
The exchange rate has an impact on the NHS. In fact, it has two impacts. As the hon. Member for Nottingham South (Lilian Greenwood) mentioned, it will be more expensive to import products such as scanners and, potentially, to import drugs. She asked what the figure was, but I cannot give her an exact figure. My understanding is that it is considerably less than 5% of the total NHS expenditure of about £100 billion. Nevertheless, this is a relevant factor and it makes a difference.
The other impact of the exchange rate, which the hon. Lady did not mention, is that it will affect the attractiveness to overseas workers of the UK economy in general and the NHS in particular. If someone comes in from the EU to work in our economy and the value of the pound is 15% lower than it was a year ago, they will be earning 15% less in their home currency. That will have an impact on the margin in relation to staffing, and that is an issue that we need to manage.
The third variable is the one that we have spent so much time talking about—namely, the payment that we make to the EU. I am not going to get bogged down in the numbers, but I believe that we pay the EU about £20 billion a year, of which we get roughly £10 billion back. Leaving the EU would therefore create a bonus. The hon. Member for Streatham mentioned a letter. Even if that bonus were to materialise, as I expect it to, it will not happen until after we have left the EU, so his writing a letter to the Chancellor now strikes me as somewhat symbolic.
To be absolutely clear to the Minister, the ask was that the Chancellor should set out the path for achieving this payment after we have left. I want to ask the Minister two questions. First, given his view that the pledge to make a payment to the NHS was made not by the Government but by the campaign, would he say that it was wrong for people to go around giving the impression that the Government would dish out that money? Secondly, for the record, is he saying that this Government will not meet that pledge?
Just for the record, I am not saying that this Government will not meet it. All I can say is that this Government have yet to decide how they will spend any bonus that comes from any rebate we get. This will all depend on the precise negotiations that take place and the precise type of exit that we make from the EU. Nobody in this Chamber knows the answers to those questions. For example, we could get a Norwegian-type deal that could entail paying money to the EU. I am not a member of the Department for Exiting the European Union and I do not know where the current thinking is on that, but this is of course a variable.
Had I been writing something on the side of the bus, and had I been campaigning on that cause in the referendum, I might have been more circumspect. I might have said that £350 million could become available and could be spent on whatever the Government’s priorities were, one of which was very likely to be the NHS. I hope that that satisfies the hon. Gentleman.
I regret that I seem to have stumbled into a sort of elongated primal scream therapy session involving refighting last June’s referendum. The hon. Member for Streatham (Mr Umunna) would have a more persuasive and cogent argument if he saw the other side of the equation. Yes, EU workers have a massive impact on and are committed to the NHS, but unrestricted EU migration over a number of years has put massive strains on the delivery of our health services. He has never conceded that point.
I want to make some progress in the debate, although I understand that I have until 7.30.
We have mentioned the payments to the EU, and there is also the point about staff. Another point that has not been mentioned—I shall mention it for completeness—is that there will be an impact on EU institutions. For example, the European Medicines Agency is located in London, which is of benefit to our pharmaceuticals industry. Where it ends up should be an issue for the people negotiating this deal, because of the potential impact involved. From my point of view, we talk too often about the conditions in relation to the EU for the City of London and passporting and all that goes with it, but not enough about other world-class industries, one of which is pharmaceuticals. I hope that those responsible will listen to that.
We have talked about the economy, which is a big variable. To be frank, neither I nor the hon. Member for Streatham knows whether the economy will be better or worse as consequence of leaving the EU, but it is true that the 15% fall in the value of the pound is helping manufacturing firms in the north and will have an effect on GDP, but it will also have some effect on imports of, for example, scanners, accelerators and drugs.
The NHS is hugely reliant on staff from the EU. Some 58,000 people from EU countries work in the NHS, and another 90,000 work in social care. I want to take this opportunity to reiterate the Government’s position that we understand that massive contribution and know that it is important to our NHS that it continues. The Secretary of State said exactly that to the Health Committee and the Prime Minister has said that she hopes and expects citizens from the EU to stay in our vital services. I would like—perhaps the hon. Gentleman and the group he is speaking for today can help with this—some of our EU colleagues and friends to make a similar commitment about people from this country who are working in EU countries, because that has not yet happened.
I speak for my constituents above all others whenever I speak on such issues in this House. On that specific point, will the Minister explain why the Government do not simply guarantee the right to stay of EU citizens working in our health service? I understand the demand for the reciprocal right to be given to UK citizens living in other EU countries, but they should not be used as a bargaining chip. When the Immigration Minister appeared before the Home Affairs Committee, he admitted that we do not know where most of the EU citizens are in this country or who they are, so if we were not to deliver on the promise to guarantee them the right to stay we would have no way of removing them.
It is not for me to make that specific guarantee. The Prime Minister clearly said that she hopes and expects them to remain. It is disappointing that a similarly strong statement has not been made by any Head of State in any other European country.
It is also right that we do more to train more of our own nurses and doctors—not because we need to replace people from the EU, but because it is the right thing to do. We should try to become self-sufficient in these matters, and that will happen.
We have knocked around this point quite a lot during the debate and have talked about variables such as the exchange rate, GDP and the EU bonus or payment that we will get, but there is one thing that is not a variable and it is probably the single most important constant: the extent to which this Government give priority to the health service in their spending commitments. That constant is absolutely clear. The previous Prime Minister treated the NHS as his No. 1 commitment, as does the current Prime Minister. Many of the points we have discussed this evening are things that should properly form part of the negotiation that we are going to have after we trigger article 50, as we hope to do by the end of March, and I am certain that that will be the case. What is not negotiable is that our commitments to NHS funding and social care funding are unmoved by any of these things; this is the No. 1 priority for this Government.
I will make a bit of progress, because I want to ensure that there is time for others to get in.
Part 1 will set up the green investment bank. I have stated on many occasions, as has the Leader of the Opposition, that it is crucial to long-term economic growth to have an active Government working in partnership with the private sector. In our view, the Government should work with business to identify the sectors from which future demand will come and to ensure that companies are set up to meet that demand. There is and will continue to be a growing demand for green technologies, so we need an active industrial strategy to support the low-carbon economy, as I and my right hon. Friend the Member for Don Valley (Caroline Flint) have argued.
A critical component of that is the green investment bank. That is why we set up the green investment bank commission in 2009 with a view to establishing such a bank, and why we committed ourselves to establishing such a bank in our 2010 manifesto. We will therefore not oppose the bank—our amendment makes it clear that we support it in principle. Also, I do not want to add further long-term policy uncertainty in this area, after the huge uncertainty that the Government have heaped on the low-carbon sector since coming to office. I note that the deputy leader of the Liberal Democrats, who has left his place, conveniently ignored the decision on feed-in tariffs, which is perhaps the most glaring example of the uncertainty that has been created.
As the Secretary of State said, Lord Smith of Kelvin and Sir Adrian Montague were appointed as the chair and deputy chair of UK Green Investment Bank plc during the Whitsun recess. We welcome their appointment. Having heard what the Secretary of State has said, I suggest that until this entity is given the power to borrow and to lend, allowing it to leverage its initial equity to make more capital available, it will not be a body that most people would recognise as a bank. It is a fund, whereas it is an operational bank that the country needs. The Secretary of State made has made it clear that it will not be allowed to borrow—he repeated this today—unless public sector net debt is falling as a percentage of GDP in 2015. The earliest it is likely to be able to borrow is therefore 2016. That is a delay of four years from now. Ed Matthew, the director of Transform UK, the business alliance campaigning for the bank to be set up, put it well:
“Allowing the bank to borrow is the key to generating growth and rebooting the UK economy. Delaying this power until the economy has recovered is like a doctor waiting for a seriously ill patient to recover before giving him life-saving medicine”.
I am listening carefully to the shadow Secretary of State’s comments on the green investment bank. He has talked about the importance of low-carbon industries. Does he agree that the scope of the green investment bank should include the nuclear supply chain, which is far and away the biggest low-carbon industry in our country? That would enable us to lend to Sheffield Forgemasters, a company that I have heard him talk about many times.
We will wait to see the detail that the Government come forward with in Committee. We are clear that the bank needs to step in to fill the funding gap if we are to green our economy. It is with that in mind that we will decide our position, as and when the Secretary of State comes forward with the detail.
(12 years, 6 months ago)
Commons ChamberI want to make a little more progress.
We need a more diverse and competitive banking system that is rooted in our communities and that better serves the financing needs of our businesses, as the Federation of Small Businesses and other organisations have argued. We need better developed equity finance, too, which is why we are exploring the possibility of creating in the UK something akin to the US Government’s small business investment company programme. That programme financed the likes of Apple and Intel in their early stages. We are also considering plans to set up a British investment bank that could step in if the market failed to provide for our entrepreneurs.