Health and Social Care Levy Bill

Jeremy Hunt Excerpts

2nd reading
Tuesday 14th September 2021 Commons Chamber

[Jeremy Hunt (South West Surrey) (Con)]

Select Committee Chairs have to hold the Government to account, but just occasionally they also have to hold the other parties to account. I am afraid that today is one of those days, because the opposition of the parties on the Benches opposite to this Bill does not bear any scrutiny at all. That is not just because Gordon Brown proposed an increase in national insurance in 2002 to fund the NHS or because senior members of those parties have supported NI as a way of funding the social care system as recently as three years ago; it is because for more than a decade the parties opposite have argued, with some justification, that more money needs to go into the health and care, and this Bill will add £12 billion every year into our health and care system. That is more than any wealth tax would generate—to my knowledge, it is more than any of them have been arguing—and it is more progressive than using plain NI, because it is progressive between the generations. That is because, for the first time, working pensioners will be paying this tax, as well as people who pay dividends.

I may not make friends on my side of the House either, because while I commend the courage of a Conservative Prime Minister and a Conservative Chancellor, supported by his team, in doing what we find extremely difficult, for the right reasons—increasing taxes—I fear that if what we have done so far is tough, what is to come will be tougher still. I say that because if you put your hands into people’s pockets and take money out of them, and they do not see visible improvements in the services they receive, they get very angry indeed.

[Steve Brine]

Will my right hon. Friend use his position on the Select Committee and his vast experience to scrutinise this plan, which I mentioned to the Minister but which I know the Secretary of State has agreed with NHS England and me, as to how exactly they are going to spend every penny of our constituents’ money on this catch-up programme? Will my right hon. Friend’s Select Committee scrutinise that for us?

[Jeremy Hunt]

As it happens, we are currently conducting an inquiry into how to deal with the covid backlog, so I commit to my hon. Friend, with whom I so enjoyed working at the Department of Health and Social Care, that we will certainly do that.

[Clive Efford]

rose—

[Jeremy Hunt]

I will give way and then make some progress.

[Clive Efford]

I have heard what the former Secretary of State has said about the record on social care, but can he explain what he did to try to prevent the Conservative Government from taking £8 billion out of social care?

[Jeremy Hunt]

First, we passed the Care Act 2014, which put in place the legislative foundations for the proposals that we are now going to fund. Secondly, I happen to agree with the hon. Gentleman: the social care system has needed more money for some time. That is why it is so extraordinary that his party is to vote against this Bill.

If we are going to take £12 billion a year out of people’s pockets, we need to avoid falling into three traps—and I say this as someone who has fallen into more traps in this policy area than anyone else in this House. The first trap that we need to be careful of is the workforce. If we put an extra £8 billion into the NHS but we do not have £8 billion-worth of additional doctors and nurses to do the extra treatments, the risk is that that money will hit the ground without touching the sides. That is why we need a workforce plan.

The Health Foundation says that the backlog will require 4,000 more doctors and 18,000 more nurses, but we have not had any workforce plan from the DHSC. I suspect that in the short term we will have to relax all the immigration requirements for doctors and nurses. That will not be great for developing countries, but it may well be our only choice. In the medium term, the best suggestion is what my Select Committee and many others have proposed: we should give Health Education England the statutory responsibility to produce independent workforce estimates and create a discipline, a bit like the OBR does for Budgets, to make sure that we are training enough doctors and nurses. That is the first trap.

[John Redwood]

rose—

[Jeremy Hunt]

I will make some progress, if I may.

The second trap is that we must not inadvertently sleepwalk into another Mid Staffs. People forget that when Mid Staffs happened, NHS budgets were actually going up. There was huge pressure to reduce waiting times and that ended up creating a targets culture in which numbers matter more than people. We have to be very careful that we do not make the same mistake again. I know that my right hon. Friend the Chief Secretary to the Treasury, who worked with me at the Department of Health and Social Care, understands that because of his commitment to patient safety.

The third trap involves social care funding. Although the settlement we are discussing is generous, if we are honest, in the next three years social care will not actually get as much money as it needs. The truth is that there is a risk that the NHS will continue to gobble up the lion’s share after that, which is why it is essential to ring-fence the amount of money that goes to social care after those three years.

[Mr Fysh]

rose—

[Jeremy Hunt]

I am going to make some progress, if I may.

Finally, let me say this. We, as Conservatives, criticised the Labour party in the 2000s for pouring money into the NHS without a proper plan. We were wrong to say that the NHS did not need more money, but we were right to say that there needed to be a proper plan. We must learn the lessons of history; that is the least we can do for frontline workers in the NHS and care system.