Income Tax (Charge)

Edward Argar Excerpts

Tuesday 5th November 2024 Commons Chamber

[Edward Argar (Melton and Syston) (Con)]

It is a pleasure and a privilege to be working once again in health and social care, although a disappointment to be doing it from the Opposition Benches. It is a privilege because, like the Secretary of State for Health and Social Care now, I had the privilege in government of working with the amazing and dedicated people who work in our NHS and in social care up and down the country. It is a pleasure to be back. It is a pleasure to be opposite the Secretary of State, as he now is. I remember our tussles back in the day, when I was sitting over there and he was sitting here.

I am sufficiently fond of the right hon. Gentleman to encourage him not to get himself fired out of a cannon, as he alluded to. Although I will say one thing for it: it would not only draw attention to his day job, but possibly even aid him in his ambitions to secure his boss’s job in due course. In respect of his comments about the Leader of the Opposition, my right hon. Friend the Member for North West Essex (Mrs Badenoch), I would only say very gently that she should probably take that as a compliment. When the right hon. Gentleman attacks someone in that way, it probably means that they are somewhat frit of her. I think he will see in the coming weeks and months why that is so.

We have already seen and heard over the previous days of debate that this is unequivocally a Budget of broken promises. Despite the pledges made over the course of the election and the commitments given to the British people, in reality those words meant nothing to the Labour party once it secured the keys to No. 10. Instead, we have seen taxes hiked on working people: the people who provide food security and food every day, our farmers, hit hard by the changes that have been made. We see living standards set to fall and mortgage rates likely to rise. We see taxes up, we see borrowing up, we see debt up, and we see that growth will be down on where it could and should be. Unfortunately, I fear, that pattern of broken promises also applies to the NHS and our social care sector.

[Mr Perkins]

I am grateful to the right hon. Gentleman for giving way and congratulate him on his new appointment. He is obviously very critical of the Government’s attempt to alleviate the appalling financial legacy that his party bequeathed to the nation. Does he support the extra investment for the health service, and is it just the ways of paying for it that he is against? Or is he actually opposed to it?

[Edward Argar]

I am very grateful to the hon. Gentleman. In his allusion to the Labour party’s inheritance, he missed the fact that the Office for Budget Responsibility singularly failed to back up the assertions made about the quantum of challenge the incoming Government faced.

Time and again, the right hon. Member for Ilford North (Wes Streeting), both in opposition and now as Secretary of State, has promised that any more money for the NHS has to be linked to reform. He has done that again today. The week before the Budget, he said that

“extra investment in the NHS must be linked to reform”.

In September, the Prime Minister himself said:

“No more money without reform”.

They are right on that. The Opposition support that condition, because it is only with reform that the NHS can sustainably continue to look after us for years to come. Yet I fear that this risks being another broken promise. I say to him now that where he is bold and provides genuine reform to benefit patients, he will have our support. Equally, if he bows to internal pressure and backs away from the radical reform that is needed, we will hold him to account.

[Joe Powell (Kensington and Bayswater) (Lab)]

Will the right hon. Gentleman give way?

[Edward Argar]

I will make a little progress before giving way to the hon. Gentleman.

I congratulate the Health Secretary on winning round 1 with the Treasury—I look across the Chamber and see the Chief Secretary to the Treasury on the Government Front Bench—in securing extra investment. He has secured more than £22 billion announced for the NHS, but without, as yet, any detailed indication of where that funding will go. I look forward to him returning to the House to set out the detail—I think he said that would be next week. What it must do is genuinely improve outcomes for patients and our NHS, rather than simply be focused on the headline figure of the inputs to it. There are, as yet, no clues as to whether it will be spent on wages, recruiting more staff, medicines or equipment; no clues as to how it will deliver the 40,000 additional appointments that have been promised; and no conditions linking the funding, as yet, to productivity improvements, modernisation or better outcomes for patients.

What we need to hear next week from the Secretary of State is an actual plan. As he mentioned, the right hon. Gentleman became shadow Health Secretary three years ago. I hope that in that time he has had an opportunity to think about what he wants to do and that he will actually set that out to the House next week.

[Joe Powell]

I welcome the right hon. Gentleman to his new position. On the theme of broken promises and capital investment, and in the spirit of a fresh start, I wonder whether he will extend an apology to my constituents who were promised a new hospital under the new hospital programme, which was never funded in any forward-looking Budget document?

[Edward Argar]

I am grateful to the hon. Gentleman. If he pauses for just a moment, I will turn to capital investment and seek to address his point.

[Paul Holmes]

Will the shadow Secretary of State give way on that point?

[Edward Argar]

I will make a little progress, but then I will happily give way to my hon. Friend.

Apart from the press releases and the reviews, where is the action? We need to see where the £22 billion will be spent. What plans does the Secretary of State have for additional investment for the NHS this winter? He knows, as I knew when I was a Minister, that winter in the NHS is always challenging. I look forward to him setting out what additional investment he plans.

[Wes Streeting]

On that point.

[Edward Argar]

I will give way to my hon. Friend the Member for Hamble Valley (Paul Holmes) in a second. Nice try, Secretary of State.

Is the right hon. Gentleman directing where that NHS funding goes himself, or will it be for his officials or NHS England to set the priorities for that, and who will be held accountable for ensuring that it is prioritised in the right places?

[Paul Holmes]

I thank my right hon. Friend for giving way and congratulate him on his appointment as shadow Secretary of State. Does he share my concern that, although the extra investment in the NHS is welcome, the lack of clarity from a Budget in which growth has actually been revised down means that in future years we could see additional investment in the NHS actually being cut back, because the Budget does not deliver the growth for public service investment?

[Edward Argar]

My hon. Friend is absolutely right. You cannot tax your way to growth and you cannot invest in public services without that growth. If the predictions we are seeing about growth are borne out, there is a real risk to our public services’ sustainability in future.

The Chancellor said that the funding would help to deliver 40,000 more NHS appointments a week, but again we see no reference to specific actions by which that will be achieved. The Government seem not to know the difference between a target and a plan, and simply restating their ambition while throwing money at the challenge will not be enough to deliver on that commitment.

As I have said, elements of the Budget relating to the Department of Health and Social Care were welcome, one of them being the Secretary of State’s one-nil win over the Chief Secretary in respect of funding. An additional £2 billion to drive productivity is important. I fear that it is a slimmed-down version of the £3.4 billion NHS productivity plans that we announced and funded, but I will study it closely, and, similarly, the Secretary of State’s plan for mental health is deserving of serious study. On both sides of this Chamber, we recognise the importance in mental health investment of not only parity of esteem but parity of services, and it is therefore right for us to scrutinise very carefully how the right hon. Gentleman intends to build further on the success that we had in driving that agenda forward.

Let me now turn to the subject of capital investment, which was touched on by the hon. Member for Kensington and Bayswater (Joe Powell). It concerns me that, as far as I am aware, the Secretary of State has still not told us exactly when his review of the new hospital programme will report and set out the future for each and every one of the hospitals that he committed himself to delivering during the election campaign—the programme to which the previous Chancellor had committed funding, building on the original £3.7 billion allocated in 2019. The question for the Government, and the question for the Chief Secretary to answer when he winds up the debate, is: “When will that review report, and when will each and every one of those colleagues and communities who are looking forward to a new hospital know whether it will be delivered in line with the Secretary of State’s pledge, or whether the programme will be cut?”

Nearly a week after the Budget, Members will be familiar with the verdict of the Office for Budget Responsibility: namely, that the £25 billion assault on businesses risks lower wages, lower living standards and lower growth. And let us not forget what this tax hike will mean for those providing essential services across primary, secondary and social care—the general practices, care homes, adult social care providers, community pharmacists on our high streets, hospices and charities such as Marie Curie and Macmillan which provide additional care for patients alongside the NHS.

I was deeply disappointed that the Secretary of State did not take the opportunity offered by my hon. Friend the Member for Hinckley and Bosworth (Dr Evans) to state clearly that all those groups would be exempt and would not be hit by this hike, and I hope that when the Chief Secretary winds up the debate he will be able to give that reassurance. The Royal College of General Practitioners has warned that the extra costs of the employer’s national insurance hike could force GP surgeries to make redundancies or close altogether, and the Independent Pharmacies Association has warned that community pharmacies will have to find an extra £12,000 a year, on average, to pay for the hike.

[Pete Wishart (Perth and Kinross-shire) (SNP)]

I welcome the right hon. Gentleman to his place. I was waiting for the Health Secretary to turn to devolution issues, but he never quite did. We have a particular issue in Scotland: up to £500 million of extra costs will be forced on to the NHS there because of that national insurance hike. We have heard no commitment from the Secretary of State that he will meet those costs in full, and we look forward to hearing such a commitment. I am sure the right hon. Gentleman will share my concern about what this is doing to devolved services across the United Kingdom.

[Edward Argar]

The hon. Gentleman is right to highlight the ill-thought-out consequences of this hike for hospices and general practices, both in Scotland and elsewhere. I would dearly love to be able to respond to his question. Sadly, however, I am on this the side of the House and not the other side, but I am sure that the Chief Secretary will attempt to do so.

The Nuffield Trust has said that without additional financial support, the tax raid is likely to force social care providers to pass higher costs on to people who pay for their own care, or potentially collapse financially. Charities are not exempt either. As a result of the increases in the national living wage and employer’s national insurance contributions, one of the UK’s largest social care charities says it is facing an unfunded increased wage bill of £12 million a year, and Marie Curie has warned that the rises in employer’s NI contributions will only serve to put the services that it delivers on behalf of the NHS under further pressure. Those charities will be looking to the Chief Secretary to say what succour he can offer them in the form of an assurance that they will not be hit.

[Ms Polly Billington (East Thanet) (Lab)]

I welcome the right hon. Gentleman to his place, but before throwing stones, will he just remind the House that under his Government’s plans, there would have been £15 billion less for the NHS, leaving it broken?

[Edward Argar]

I welcome the hon. Lady to her place as well. I think this is the first opportunity I have had to respond to a intervention or question from her.

In fact, we put record funding into the NHS—£164.9 billion per year—and on top of that we recruited more doctors and more nurses. We did not do that by piling tax hikes on hospices and general practices, among others. I am not sure how hitting primary care, social care or charities supporting NHS services will help the Secretary of State to deliver his aim of cutting waiting lists. I hope that the Chief Secretary will tell the House what steps the Treasury is taking to ensure that those organisations are not hit by these changes.

Let me take a moment to consider what was not included in the Budget.

[Josh Fenton-Glynn (Calder Valley) (Lab)]

Will the right hon. Gentleman give way?

[Edward Argar]

I will make a bit of progress, if I may.

There were no plans for social care reform after the Chancellor broke Labour’s promise to deliver the cap on social care costs. I hear what the Secretary of State says about a willingness to work on what is a challenge facing our whole country and society: with an ageing population, how do we address the challenge of social care? There were no further detailed plans for NHS dentistry, despite the election pledge to deliver more dental appointments. There was no support for pharmacies or for the day-to-day running of general practice, and there were still no additional resources for the NHS this winter—or, indeed, the details of reform to go with them.

[Lizzi Collinge (Morecambe and Lunesdale) (Lab)]

The right hon. Gentleman speaks about the investment that the last Conservative Government put into the NHS. Can he tell me what the outcome of that investment was? From my point of view, the outcome was longer waiting lists, poorer health and bad patient care.

[Edward Argar]

We increased investment significantly, not only to tackle the inevitable consequence of a global covid pandemic—which, as we all know, hit our NHS hard—but to build back better subsequently, which is the task that we began to perform. We have always said that investment in the NHS must be married to reform in order to deliver better patient outcomes and value for money, building on the reforms that we introduced in the Health and Care Act 2022 and ensuring that the NHS will be there to look after us for decades to come. The Secretary of State has worked with me before, and we will work with any party, including his.

[Mr Perkins]

Will the right hon. Gentleman give way?

[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.