David Gauke
Main Page: David Gauke (Independent - South West Hertfordshire)Department Debates - View all David Gauke's debates with the HM Treasury
(7 years, 8 months ago)
Commons ChamberAnnual funding to the Department of Health is already being increased by £17 billion by 2020-21. This reflects the priority that the Government put on investing in the NHS.
OECD statistics show that the Governments of Germany, France, Holland, Sweden and Denmark spend an average of 9% of GDP on health compared with 7.7% in the UK—a massive difference of £23 billion a year. The NHS is desperately underfunded and it is no surprise that it is suffering, so is the Chancellor really going to take this seriously in the Budget?
I think the hon. Gentleman will find that the OECD has more recently put out revised numbers to show that the UK’s expenditure on health is very close to some of those other countries. The fact is that we can only have a properly funded NHS if we have a strong economy, and only the Conservative party can deliver it—a point that the people of Copeland may have noticed.
When lives are on the line it is imperative that we as parliamentarians get it right. We need some honesty about what the current NHS crisis means: cuts to staff, longer waits, and hospitals at risk of closure. Does the Minister agree that the Government need to provide a long-term, sustainable financial package to guarantee NHS services for the future?
It was this Government who announced a long-term, financially sustainable package, which is why, in real terms, funding for the NHS will increase by £10 billion above inflation by 2020-21. Let us remember that since 2010 there are 2,300 more people attending accident and emergency departments within the four-hour A&E standard, 5,000 more operations every day, and 1,400 more people every day treated for mental health conditions, and the NHS is conducting 16,000 more diagnostic tests every day.
For the past two years the Department of Health has cut its capital budget by 20% and used that for running costs and to pay for salaries. Did the Treasury press for these cuts in capital spending—I hope not—and does the Chief Secretary agree that raiding the capital budget is no way to find efficiency savings?
The switch from capital to resource was actually made at the request of the health service and the Department of Health. In terms of finding efficiencies in the NHS, and indeed in the public sector as a whole, it is important that we deliver sustainable efficiencies, embed a culture of efficiency, and ensure that we get value for money for the taxpayer.
While I welcome this Government’s commitment to health, may I invite my right hon. Friend to take a leaf out of President Trump’s book and increase defence expenditure by 10%, funded from the bloated overseas aid budget?
It is quite a naughty idea, not because of its merits or demerits but because it has nothing to do with the Department of Health budget, as the hon. Member for Wellingborough (Mr Bone) is perfectly well aware. However, the Minister is a dextrous fellow and I am sure he can answer in an orderly way.
Although, as you say, Mr Speaker, there may perhaps have been a slightly tenuous link with the question, it was still a predictable question from my hon. Friend the Member for Aldershot (Sir Gerald Howarth). We are delivering on the 2%-plus expenditure commitment on defence, and we are increasing defence spending in real terms. Again, it is important that we have a strong economy so that we can properly fund our defence.
The shocking revelation that NHS Shared Business Services Ltd misplaced more than 500,000 pieces of sensitive medical data is a direct result of a health service that is being squeezed by the Chancellor’s purse strings. The Tory Government are clearly putting patient safety at risk through lack of resourcing and a targeted savings drive. Will the Chancellor immediately reassess the situation and the level of NHS funding?
Will the Chief Secretary confirm that record amounts of money are being spent on the NHS, that record numbers of patients are being treated and that he will give clear incentives to local authorities and health services to join up the delivery of NHS and social care?
My hon. Friend raises an important point. He is absolutely correct about the resources that we are putting in, but if we want to improve the quality of healthcare, particularly in the context of social care, it is also important that there is greater integration. That is why we announced the better care fund, which is making an important contribution to supporting social care and improving integration.
The Chair of the Treasury Select Committee is absolutely spot on. If the Chancellor does discuss with the Department of Health any increase in levels of funding, will he point the Health Secretary in the direction of the Public Accounts Committee report, which says that he should stop “plundering” NHS funds? In particular, it asks him to stop his “repeated raids” on NHS capital funds, with £950 million having been taken out of £4.5 billion.
First, may I congratulate the hon. Gentleman on his promotion to the post of shadow Chief Secretary? He is my eighth shadow as a Treasury Minister, so I look forward to sparring with him over the weeks ahead.
Let me repeat what I said earlier: the agreement on the budget settlement for the NHS and the balance between resource spending and capital spending was reached with the Department of Health. Indeed, that switch towards more on resource was very much pushed by the Department of Health.
So I am the eighth shadow Minister,
“How very promiscuous of you”,
as I said in my tweet to the Chief Secretary.
Some 4,000 urgent operations have been cancelled, 18,000 people a week waited on trolleys in January, 3,000 community pharmacies are going to be lost and £4.6 billion has been cut from social care. When those funding levels are discussed with the Department of Health, will he tell his colleague that he should be caring for the NHS, not giving it a lethal injection?
If the Labour party’s policy could move beyond the level of placard design, that might help. Let me be clear: we are putting more money into the NHS and it is providing more support and help to people than ever before. I have listed some of the achievements since 2010. This Government remain committed to the NHS, which is why it has been a priority in our public spending plans for the past seven years.
We do need to speed up in terms both of questions and of answers.
The Treasury regularly discusses social care funding with the Department of Health and the Department for Communities and Local Government. We have introduced a new social care precept and additional grant funding for social care. Taken together, those provide an additional £7.6 billion of dedicated funding for social care over the four years of the current settlement. That means that councils can afford to increase spending on social care every year.
The lack of funding for social care is having a devastating impact on people requiring care, carers and workers themselves. The 3% levy raises only £2.8 million for Rochdale. That does not even cover the cost of increasing the minimum wage for care workers. Does the Minister accept that?
As I say, it is not just about the council tax precept. We also have the better care fund coming in. We should also accept that this is not just about money. There is very variable performance around the country. It is worth pointing out that 50% of the delayed discharges attributed to social care take place in only 24 local authority areas.
Some areas, including the island, have taken the difficult decision to increase council tax by 3% to protect social care. Would the Chief Secretary to the Treasury consider finding ways of ensuring that councils have done all that they can to help themselves as well as ensuring that any Government support is made available now?
The Government have focused on taking forward city deals with Edinburgh, Stirling and Tay cities and we are looking to agree city deals with all of Scotland’s great cities. The Government have also published their Green Paper on the industrial strategy and are engaging closely with the Scottish Government and local partners on how the strategy can work for all parts of the United Kingdom.
We heard earlier about investment in Yorkshire. Would the Chief Secretary to the Treasury acknowledge that the Ayrshire growth deal would provide a much-needed economic boost to the area and reflect the Government’s promise to drive growth throughout the whole country, as outlined in their recently published industrial strategy?
The Government are taking forward plans for the lower Thames crossing and major road upgrades, such as at junction 5 on the M2. We are also establishing a Thames estuary 2050 growth commission, which will set out a vision for development in the area.
Last week, the Government snuck out a statement on regulations denying 150,000 disabled people access to personal independence payments awarded by the upper tribunal. That was brutal. Last year, the previous Chancellor absorbed the costs when the Government were forced to halt cuts to personal independence payments to disabled people. In this case, are those disabled people being denied benefits because the Chancellor has refused to absorb the costs resulting from the upper tribunal decision?
My hon. Friend makes an important point, and road safety is a key priority for the £15.2 billion road investment strategy. In November 2016 we announced an additional £175 million to improve the 50 most dangerous roads in the country. As she will be aware, Cornwall has received £78 million from the local growth fund, including for investment in local roads.
Our biggest businesses are already benefiting significantly from the cut to corporation tax, yet today we find that profit-making Caffè Nero has paid zero in corporation tax. Given that the Chancellor is trying to balance the Budget on the backs of the disabled and the ill, what more will he do to stop profit-making companies avoiding tax on his watch?
I very much welcome this Government’s healthy commitment to scientific spending over several years, but it seems that our business investment in research is below the OECD average. May I urge the Chancellor to examine measures that will increase private company business expenditure on research?
As the Chancellor announced at the autumn statement, the Government are significantly increasing investment in research and development, rising to an extra £2 billion a year by 2020-21. We have also made the R and D tax credit regime much more generous. We want to ensure that the UK remains an attractive place for business to invest in innovative research.
Given the shameful neglect of social care spending in the autumn statement and straws in the wind about how that is going to be put right in the Budget, will the Chancellor take account of the fact that authorities such as ours in Wirral are having to deal with £45 million-worth of pressure due to the number of our older people who are needing help, and that a 3% increase in council tax will deliver us only £22 million?