Budget Resolutions
Debate between Edward Leigh and Yuan Yang
Sir Edward Leigh
Well, let us see. Of course we can pump more and more money into this broken system and solve some of the short-term problems, but soon we will be not just a country with an NHS, but an NHS with a country attached to it. Is it 44% of total spending that goes on the NHS? It is growing all the time, which means that, as a country, we are gradually becoming poorer and poorer. The long-term result will be that we will have a worse health service. I say to the hon. Lady that, of course, it is totally unacceptable that people wait hours to be treated in A&E, and wait months and years for an operation. In Lincolnshire, 58% of people in A&E now have to wait more than four hours—four hours! I can tell the House horror stories of my constituents waiting up to 24 hours. That is not happening in any other developed country. It is totally unacceptable. Surely everyone in this House can unite around the a principle that those who have paid into the system for years should be treated with dignity and expeditiously.
Sir Edward Leigh
I must not give way too much, because I will prevent other people from getting in.
A study of 18 developed countries shows that the UK is in the bottom three when it comes to survival rates for common cancers, strokes and heart attacks. Lord Darzi’s review found that 14,000 avoidable deaths per year were due to long waits in A&E. This drags our life expectancy statistics down and down. Meanwhile, even before the Budget, the NHS was eating up 44% of day-to-day public spending. We are paying more and more and the results are getting worse and worse. I predict that for the rest of this Parliament, the Government will keep on pumping more of our national wealth into this failed system and we will still fail to catch up with other countries.
Sir Edward Leigh
No; I have to keep going.
I accept that some issues, such as hospital capacity, can only be dealt with by spending, but we do not need to reinvent the wheel; we need to learn from other countries. The Health Secretary, who I admire for his apparent radical zeal—although we have not seen much evidence of it—studied Australia, for instance. Let me break the national taboo on “our NHS”, our religion. There are other countries that are like ourselves but which deliver much better—incomparably superior—health outcomes. It is my personal belief, and I think I am about the only person who has said this year after year, that we should adopt Australia’s social insurance model. There is nothing wrong with encouraging private provision in health. Is that some great heresy? Is it some sort of right-wing philosophy? Well, it is followed by France, Germany, Australia and the Netherlands, and all those other countries produce much better health outcomes.
Australia slowly developed a hybrid system of state and private health insurance. Everyone has universal public health insurance, but workers are encouraged to purchase private health insurance on top of that. My point is that, with a ballooning, ageing population, yes, we have to spend more on health, but we have to get people to put more of their own money into health; and they must be assured that, having put their money in, they will not just end up at the back of a queue, because they have personal rights and are committed to this health service.
For instance, the average cost of a treatment-only plan for a 20-year-old in Australia is just £23.14 a month, and comprehensive cover starts at £31 a month. That cost rises to £109 per month for a 70-year-old. People earning less than £119,000 can claim rebates to reduce the cost of health insurance, and higher earners without insurance pay a surcharge of between 1% and 1.5%. Research commissioned by Australia’s Department of Health shows that the cost to the taxpayer would be greater without the rebates, because there would be increased stress on the public system.
The health outcomes are noticeable. Australia has one of the lowest rates of avoidable mortality among the developed nations. Its cancer survival rates are several percentage points higher than the UK’s, and stroke and heart attack mortality rates are several points lower. It is not perfect, of course, and not everything can be imported from other countries, but Australia’s system shows that there are other models.
We must have a national debate about how, with an ageing population, we can produce the kind of health outcomes that people desire. There is a cumulative effect: in 2022, the Australian Government debt was 70% of GDP. In other words, it is running a tight, well-run ship. That is a country much like us—but the UK has already, even before this Budget, reached a staggering 104% debt in the same year. We are going broke because we do not have the courage, on either side of the aisle, to think from first principles. I am making this argument as much to those on my own Benches as I am to the Government. This situation simply cannot go on and on, otherwise people will start talking about charging or giving tax relief for private health insurance.
We have to have a fundamental debate about the whole structure of health, and the Health Secretary has the good will of people across the House and across the country to start thinking big and thinking of new ideas. If he can find a way forward and improve health outcomes, he will go down in history as one of the greatest Health Secretaries we have ever had.
The second fundamental problem we have is the ballooning benefits system, particularly when it comes to incapacity. It is trapping more and more people in dependence. We need a culture of the necessity of work. We have 4 million people on incapacity benefit, and two thirds of them—recent joiners—are claiming mental illness. The situation is out of control. Work should always pay more than benefits. I would have liked to have heard more from the Chancellor about how she is going to attack the benefits system and incapacity, which is gradually reducing the Government into penury.
Sir Edward Leigh
The hon. Lady has made her point, although I was talking about incapacity benefit, so I am not sure how her point has addressed mine.
The culture of people living off the state for years, when they are capable of doing some work, needs to be stamped out. We have to work together in the House to get people off benefits and help them. It is about not just reducing benefits, but having innovative schemes, like those that the former Secretary of State for Work and Pensions, my right hon. Friend the Member for Central Devon (Mel Stride), was trying to bring about to encourage people back into work, making their whole lives better and more productive.
Thirdly, tackling benefits is a vital ingredient of curbing immigration. What is the spur for mass immigration? It is that health and social care simply cannot get enough workers for the salaries they are paying. There are too many people on benefits, and we are dragging more and more people from all over the world into our system. We need to insist that anyone entering the country earns at least average UK earnings. We cannot go on undercutting our native workers with cheap foreign labour. We have to pay decent wages in our care service, and reform the whole benefits structure so that people actually want to work. We cannot solve our problems with mass immigration, and mass illegal immigration is part of the problem. It is gradually destroying the social contract and people’s belief in the system, and the Government must have a plan to deal with it, which basically means arresting people when they land illegally on these shores, and offshoring them.
The other great problem in our national psyche that we have not really addressed is the whole pension system. I have to declare an interest: I am of pensionable age. [Hon. Members: “Never!”] Some Members will be very happy when I retire from this House, but I do try to tell the truth according to my own lights and to state difficult truths. The fact is that we have more and more elderly people, more and more sick people, and more and more people with multiple health problems. We are all committed to keeping the triple lock, and I would get into awful deep water if I said that doing so is becoming increasingly unaffordable, but of course if the portion of the state spending devoted to pensions increases every year in real terms, we will gradually ensure that the country cannot pay its way.
This is a difficult truth that nobody yet has had the courage to address: we have to do more to encourage private pensions, and not—I say this to the Chancellor—seeing private pension pots as a convenient thing to raise taxes on. Many years ago, I served on the Social Security Committee under the late, great Frank Field, a man immensely respected on both sides of the aisle. We studied countries like Chile that were making explicit the creation of contributory pension systems. People were encouraged to put more into their pensions and plan for their old age. That is the only way, with an ageing population, that we can solve our problems.
In addition to all this, I am afraid that wokery and human rights legislation are gradually eating away into our—[Laughter.] Government Members may all laugh, but it is true. Many people feel that they are not part of the way in which this country is run. These are just lessons that the Government have to learn.
Sir Edward Leigh
The hon. Lady has tried to intervene again and again, so I will give way.
Yuan Yang
The right hon. Member mentions that many people do not feel part of how the country has been run, and for the last 14 years we have seen regressive Budgets that have hit the poorest hardest. Does he welcome, with me, that our Budget is progressive and in fact distributes the burden where it is most well shouldered?
Sir Edward Leigh
Well, if the hon. Lady thinks that, I wish her luck, but I fear that we are just going to gradually paper over the cracks—and I will criticise my own side in this regard. For 14 years, Ministers went along with the liberal consensus, talking about “our NHS”, papering over the cracks with more and more money, employing more and more nurses and doctors, and getting worse and worse outcomes. Meanwhile, productivity nosedived and mass immigration reached unimaginable heights to keep public services going.
We have to be honest, as we are now in opposition. I welcome the fact that one of our leadership candidates is saying that we have to start from first principles. That is what I am trying to do: start from first principles on how to recreate the British state. That is what Mrs Thatcher did; I worked for her when she was Leader of the Opposition in the 1970s. We need a whole new intellectual drive. In opposition, Keith Joseph and the Institute of Economic Affairs created a new vibrant Conservative philosophy for how we could solve the deep-seated problems in this country. The Budget could have been such an opportunity, but I am afraid it reflects the old tax and spend instincts of the Labour party. I agree with the Labour party that housing is a great failure of our state. Of course we need a massive house building drive, or more appropriately a flat building campaign. The easy way out is to take good agricultural land and greenbelt land, particularly around London. Instead, we need to incentivise building in cities and on brownfield sites.
I fear I have wearied the House, so I will stop now. [Hon. Members: “More!”] No doubt these difficult words about the national health service or the triple lock will be used by Labour party spokesmen for years to come, if anybody is interested. However, I hope that we have the intellectual courage to try to solve the real problems in our society. How are we going to get a decent health service that is on a par with what we find in France, Australia and the Netherlands? How are we going to get a decent housing programme? How are we going to get people to contribute more towards their old age? Unless we address the fundamental deep-seated problems in the British state we will just gradually become a poorer and poorer nation.