Income Tax (Charge)

Jeremy Corbyn Excerpts

Tuesday 5th November 2024 Commons Chamber

[Wes Streeting]

My hon. Friend is absolutely right about equity and fairness of access. The Government are determined to close the gap in healthy life expectancy and health inequalities that blight our nation. GPs and primary care are an important part of doing that. Unless we fix the front door to the NHS in primary care, we will not solve our NHS crisis. Unless we address the crisis in social care, we will not fix the NHS crisis. We will be able to do that only if we do so right across the country.

[Jeremy Corbyn (Islington North) (Ind)]

I fully understand the crisis that the Secretary of State inherited. He will be aware that most hospitals are running at a deficit, many have substantial debts and many are spending up to 15% of their income on servicing private finance initiatives. Is his Department prepared to make some kind of intervention to reduce that burden, perhaps by taking over the PFIs directly in order for our hospitals to be able to spend more on what they are there for, which is, of course, patient care?

[Wes Streeting]

I am grateful for that intervention. The right hon. Gentleman is absolutely right that we walked into a position of enormous deficits in the NHS, and an enormous black hole in the public finances was left by the last Government. That is why we have had to make some difficult choices. That is why we have to learn from the mistakes of the past and not repeat them in future. We are doing as much as we can as fast as we can. That is why it was important that the Chancellor made the bold choices she did in her Budget, so that, as well as plugging the black hole, we are fixing the foundations. Thanks to the fiscal rules adopted by the Chancellor, we will ensure that the Government do not repeat the waste, the profligacy and the irresponsible spending of our Conservative predecessors.

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[Jeremy Corbyn (Islington North) (Ind)]

I welcome this debate, which centres on health and inequality within our society. The hospitals are in a crisis situation, with huge demands on them, insufficient resources and underfunding, and of course huge debts from the past that are not being addressed. In an intervention on the Secretary of State earlier, I asked a question about the future of private finance initiative projects, which take up over 15% of most hospitals’ budgets. I think PFIs need to be taken over by the Treasury—as was envisaged in previous manifestos—as a way of releasing that cash directly into the national health service, which would help with waiting lists for operations and all the demands that are not being met.

My second point is that healthcare is not just about hospitals: it is also about social care and mental health. In the case of my own borough, Islington—a very typical inner-city borough in many ways—our social care costs are up by £20 million and going up all the time, because there are more and more people with demands. Families are moving away, more and more people are isolated, and demands are getting greater and greater. There has to be a change in the whole social care policy, and I hope the Government will bring forward serious proposals for a universal, wraparound national care service to take away the pain and stress that so many families face as a result of social care costs.

Likewise, the mental health crisis is real, it is serious and it is here, particularly among young people—sadly, often particularly among young males. I realise that it is early days for this Government, but I hope they will appreciate that not only do we need a much more effective and efficient mental health service, but we need to recognise that mental health stress comes from other stresses in society such as housing, jobs, families, environment and many other issues.

We cannot separate the question of healthcare and health needs from poverty in our society. Ending the two-child benefit cap would release some people, including children, from the desperate poverty they are in. Not taking away the winter fuel allowance from very poor pensioners would help a great deal. Likewise, the issues of housing stress, huge rent levels in the private rented sector and desperate levels of overcrowding for many people in communities such as mine have to be addressed. Under the proposals of the 1945 Labour Government, health and housing were linked together, and we need to look seriously at that.

My local authority, Islington, has lost £105 million in payments since 2010. That is typical for local government. We need the money put back in to deliver the services our people need.

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[Darren Jones]

The hon. Gentleman perhaps forgets that the vote is tomorrow. No doubt he will come to the House to vote to support the allocation of £22 billion of extra funding so that the national health service can cover the cost of the doctors and nurses who, under his Administration, were striking on the picket line while Ministers refused to talk to them. Under this Government, they are back on the wards and in the theatres delivering for the people of this country.

The Government recognise the need to reform the social care system, and we thank those who work in the system for the work they do to help those in need. That is why we agreed a £600 million funding increase for 2025-26, and we will return to this issue in the second phase of the spending review.

I politely say to Members that I understand the temptation to ask for more spending, as I often did in opposition, but Ministers have to explain how they will pay for it. If Opposition Members want more spending or, indeed, fewer tax rises, they will have the opportunity tomorrow to set out to the House what they would do differently. Would they increase income tax and national insurance on workers once again? Would they increase VAT on people who go to the shops? Would they increase corporation tax for businesses, which we have pledged not to do? Would they reject the investment in schools, hospitals, the police service and the future of our country? Given their behaviour under the last Administration, do they wish just to borrow money every single month to pay the bills, month after month, increasing the national debt and increasing the cost of the national debt, but not investing in the fabric of this country, as this Government will do?

[Jeremy Corbyn]

May I take the Minister back to the question of social care? I understand what he is saying and that proposals will be brought forward, but there are two things: immediately, there is a crisis in local government about simply paying for existing social care, and, for families all over the country, there is a crisis about how they will support people who are in care at the present time. Is there an aspiration to bring forward a much more comprehensive model that will provide hope for people who are often going deeply into debt, selling property and all kinds of things, just to support a loved one who is in desperate need of profound social care?

[Darren Jones]

I thank the right hon. Member for his question. This Government have aspirations to improve the social care system, and we will set out further detail on those plans in due course.

Lastly, although not related directly to the NHS or public services, I welcome the supportive comments from Members across the House about the mineworkers’ pension scheme and the Post Office Horizon compensation scheme. As you know, Madam Deputy Speaker, I worked on those issues for many years when in opposition. We failed to persuade the former Government to do the right thing, but the great thing about being in government is that we can just say it is so, and it has been so. That is the difference that a Labour Government can make.

The Labour party has a proud heritage of delivering public services to meet the needs of the nation: the national health service, social security, comprehensive schools, the Open University, academy schools. This new Labour Government will seize the generational need to reimagine public services once again. We have an ageing society, fewer working people paying tax, increasing demand, failing standards and increasing costs. After 14 years of a Conservative Government, that is the legacy they have left this country. We will not walk by on the other side and ignore those challenges. We will set out how we will reform our public services, building on this Budget of investment, choosing it over decline, focusing on outcomes, prevention, devolution and innovation in order to modernise our public services.

As I have set out today, the big opportunity—the opportunity to build the new foundations of the new public sector—is technology. The productivity of our public service is held back by IT systems often dating back to the 1950s and the 1970s: fax machines in the NHS, an inability to share information between public services, tens of thousands of public servants doing their best to administer casework using paper. That situation has not been affected in any positive way over the past 14 years.

This is not about machine-learning algorithms, but about old computers in cupboards with information that is in desperate need of being transferred to the cloud. It is about the un-newsworthy but vital work of integrated software across Departments, an area of spending I protected and encouraged in phase 1 of the spending review. It is about what might seem obvious to people at home who are now used to doing their banking on an app or their shopping online, who cannot get through to a GP surgery, a decision on their universal credit or an answer to their tax question without a lengthy and often unsuccessful attempt to speak to someone on the telephone.

Our new digital centre of Government will drive digital transformation across Government, because modernising public services is not just a great opportunity; it is a non-negotiable requirement for any modern party in a modern Government today. If we had followed the Conservatives’ path of further decline, we would have broken public services that cost more, while failing the public who rely on them and the public servants who work in them. By choosing to invest, this party—this Government—will deliver a modern state that meets the needs of the nation and delivers a bright future for us all. Reform and growth, investment over decline—those are the choices reflected in this Budget and that is the change this Labour Government will deliver.

Ordered, That the debate be now adjourned.—(Gerald Jones.)

Debate to be resumed tomorrow.