Autumn Statement

Debate between Jeremy Hunt and John Redwood

Wednesday 22nd November 2023 Commons Chamber

[Jeremy Hunt]

I have never hidden the fact that we took difficult decisions a year ago, such as freezing the thresholds, in order to get borrowing under control and in order to tackle inflation. However, because the economy since then has outperformed the expectations of nearly every independent body, we are able this time to reduce the tax burden, and I choose to reduce the things that will boost growth.

[John Redwood (Wokingham) (Con)]

Let me first declare my business interests.

I welcome the measures to promote more investment and more growth, which is vital. We have lost about 800,000 self-employed people since February 2020. The national insurance measure will help a bit, but will my right hon. Friend look again at the way in which IR35 prevents them from expanding their businesses and getting contracts? The measures to promote the growth of small businesses are also welcome, but the VAT threshold acts as a strong disincentive to expand a business when it reaches a certain point.

[Jeremy Hunt]

I thank my right hon. Friend. I had extensive discussions with him in the run-up to the statement, including many discussions about the self-employed. Indeed, it was partly his advocacy of the role of the self-employed that made me so enthusiastic about making the national insurance changes that I was able to make.

I hear what my right hon. Friend says about IR35. We took our decision partly because of concerns about avoidance, but I am happy to look at that again. As for the VAT threshold, many other colleagues have made the same point. We do have the highest threshold in any major European country, and, indeed, any G7 country, but there is always this issue of the cliff edge, and my right hon. Friend is right to draw my attention to it.

Mortgage Charter

Debate between Jeremy Hunt and John Redwood

Monday 26th June 2023 Commons Chamber

[Jeremy Hunt]

I will deal with the right hon. Lady’s specific points first. She says these measures should be mandatory, so why did Labour oppose the intervention power in the Financial Services and Markets Bill that would have made that possible? She said she wants action for savers, and I have indeed been talking to banks about action for savers and will keep the House updated. What she carefully did not mention is that we secured on Friday more than Labour committed to, because our measures provide protection for people who miss payments not for six months, but for 12 months.

The main point is that the right hon. Lady wants people to think she is fiscally responsible and will not take risks with inflation, so why on earth is she committed to borrowing £28 billion more a year when, as a former Bank of England economist, she should know that that will be inflationary and push up the cost of mortgages? Members need not listen to me; they should listen to people such as Paul Johnson of the Institute for Fiscal Studies, who said about Labour’s plans that

“additional borrowing both pumps more money into the economy, potentially”—[Interruption.]

The right hon. Lady might not want to hear this but this is what Paul Johnson says about Labour’s plans:

“additional borrowing both pumps more money into the economy, potentially increasing inflation, and also drives up interest rates.”

It is Labour’s mortgage bombshell, hidden in plain sight.

The right hon. Lady does not want people to notice the real comparison here, which is that her party faced an economic crisis in 2008, just as this Government did last year, but we are taking the difficult decisions to restore sound money and the public finances while they ducked each and every one of those decisions, ran out of money and left it to others to clear up the mess.

[John Redwood (Wokingham) (Con)]

Given that we do not want too much pressure on mortgage holders, who will be struggling, will the Government launch a series of supply-side measures to increase the supply of things that are short, to promote more home-grown food and home-produced energy, and above all to work with public sector employees and managers to have a productivity revolution in the public services where there has been a collapse in output?

[Jeremy Hunt]

As so often, my right hon. Friend is absolutely right and it is in supply-side measures that we see the long-term solution to the inflation problem that we and many other countries face. That is why the Budget was focused on labour supply measures such as a massive reduction in the cost of childcare—a reduction of up to 60% for families with young children—and it is why my right hon. Friend the Chief Secretary to the Treasury is launching the very productivity review my right hon. Friend the Member for Wokingham (John Redwood) has called for many times, to make sure we are getting better value for public money spent.

Economic Update

Debate between Jeremy Hunt and John Redwood

Monday 17th October 2022 Commons Chamber

[Jeremy Hunt]

It is a pleasure to exchange comments with the hon. Lady and I look forward to working with her closely in the months ahead. I remind her that this Conservative Government are spending £37 billion this year to support people across the United Kingdom with cost of living concerns. That is possible because of difficult economic decisions that the SNP has opposed at nearly every stage, and that includes large support for businesses up and down the country. The main thing I would say to her very gently is that she cannot claim to be concerned about the economic turmoil of the last few weeks when the central policy of the SNP—independence—would leave turmoil for Scotland not for a few weeks but for many, many years to come: a new currency; somehow finding a way to trade with the UK internal market but also the European single market; border checks between England and Scotland, as announced today by the First Minister; and a massive gap in public finances that would have to be breached. That is a recipe for precisely the austerity she says she is worried about. Let me say this: if we want economic stability and if Scotland wants economic stability, to coin a phrase we are stronger together.

[John Redwood (Wokingham) (Con)]

What will the impact of these measures be on the growth rate, and will we still avoid recession?

[Jeremy Hunt]

I will publish the economic forecasts from the OBR when I make my statement in a fortnight’s time. I think it is better for me to wait until I hear that. The proper answer to my right hon. Friend’s question is that what we are seeking is a long-term sustainable increase in the economic growth rate. That is a central policy of the Prime Minister, which has my wholehearted support.

Health and Care Bill

Debate between Jeremy Hunt and John Redwood

Report stage
Monday 22nd November 2021 Commons Chamber

[Jeremy Hunt]

I see the Minister wants me to give way. May I make my argument for one moment, and then give way?

There is a plethora of internal NHS targets, there are operational targets and there are financial targets. They often have an excellent purpose, but, as in the case of Mid Staffs and other cases where things went badly wrong, being under a lot of pressure to meet those targets means corners can be cut, and the quality of care experienced by patients can be really damaged. The amendment would make sure that there was discipline in the system, so that whatever pressure NHS managers were under, they were always focused on safety and quality of care.

[John Redwood]

I pay tribute to my right hon. Friend for what he did as Secretary of State to stress the importance of this crucial work, and he is not on his own: I support him.

Health and Social Care Levy Bill

Debate between Jeremy Hunt and John Redwood

2nd reading
Tuesday 14th September 2021 Commons Chamber

[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.

NHS Long-Term Plan

Debate between Jeremy Hunt and John Redwood

Monday 18th June 2018 Commons Chamber

[Mr Hunt]

First, may I thank the hon. Lady for doing something that the shadow Health Secretary did not do, which is to welcome this £20 billion annual rise in the NHS budget? I completely agree with her about the importance of prevention, the importance of social care and the importance of making sure that we sustainably invest in transformation funding. The think tanks do disagree on what level of rise is necessary. Lord Darzi and the Institute for Public Policy Research said 3.5%; we are on 3.4%, which is not far off that. The IPPR went a little higher, but, like the hon. Lady, Paul Johnson said that this will stop the NHS going backwards.

With respect to overall funding levels for the NHS, the United Kingdom currently funds the NHS at the western European average as a percentage of GDP. That is not as high as France or Germany and it is true that, by the end of this five-year period, our funding will end up at broadly similar levels to those of France today, although of course it may change them over the five-year period.

I gently say to the hon. Lady that if that is a worry for her, she needs to explain to NHS users in Scotland why, when NHS spending has increased by 20% in England over the past five years, it has increased by only 14% in Scotland because of choices made by the Scottish National party. For every additional pound per head invested in the NHS in England only 85p has been invested in the NHS in Scotland. I hope that she makes a pledge, as I hope Labour does with its responsibility for Wales, that every extra penny that she gets through the Barnett formula will go to the NHS, because that is what the voters in Scotland want.

[John Redwood (Wokingham) (Con)]

As soon as we are fully out of the EU, there will indeed be a very big Brexit dividend, which a lot of us want to get on and enjoy here at home. Will the Secretary of State confirm that some of that money will be spent on training and educating and recruiting people already settled here into full-time NHS jobs to cut down on very expensive agency staff and to stop denuding the health services often of poorer countries around the world?

[Mr Hunt]

My right hon. Friend is absolutely right. One thing that we have historically got wrong in the NHS is not having a long-term workforce plan. Whatever Members’ views on the Brexit debate, it was always a false economy to say that we could get away with not training enough people because we could import them from other EU countries. The truth is that we are not the only country with an ageing population: France, Spain and Portugal need their doctors and nurses as well, as indeed, as he rightly says, do poorer countries.

NHS Winter Crisis

Debate between Jeremy Hunt and John Redwood

Wednesday 10th January 2018 Commons Chamber

[Mr Hunt]

That is completely unacceptable, but it is disappointing that the hon. Lady stands up and runs down the NHS when her own trust, which received £3.4 million before Christmas to help with winter, has managed to improve its performance: last November’s figure was 91.8% compared with 77.7% a year earlier. That is a huge achievement for Mid Yorkshire Hospitals NHS Trust. Why will she not praise what is happening, rather than running the NHS down?

[John Redwood (Wokingham) (Con)]

I support the leadership that the Secretary of State has offered during this winter crisis and the tone he has adopted in this debate. As a result, there is not the kind of crisis we have had in past years. Now that he has widened responsibilities for social care, will he help West Berkshire and Wokingham, which have had problems with past formulas and do not have enough money to take pressure off the hospital in the way he would like?

[Mr Hunt]

I will certainly revisit the issues in my right hon. Friend’s local authorities because I have looked at them before and know that there are particular pressures there. He alights on something else that the Opposition have not wanted to talk about, but which is very significant: the Prime Minister’s commitment to the integration of health and social care, which eluded the previous Labour Government over 13 years, despite their talking about it a lot. We are starting to see that happen in this country. Monday’s decision means that policy leadership will come back to the Department of Health, which will help us to make even faster progress.

NHS Shared Business Services

Debate between Jeremy Hunt and John Redwood

Tuesday 27th June 2017 Commons Chamber

[Mr Hunt]

I gently say to the hon. Gentleman that it is totally inappropriate to try to make political capital from this incident. The facts of the case are that the NAO today published a report saying that patient safety was the primary concern of both the Department of Health and NHS England throughout. There were some problems with the assurance of that contract, but the contract and the relationship with SBS in particular dates back to 2008. Both sides of the House need to learn the lessons of properly assuring NHS contracts, and I dare say the same is true in Scotland.

[John Redwood (Wokingham) (Con)]

I fully support the Secretary of State’s actions, which were quite right in the difficult circumstances in which he found himself, but what action will be taken against the executives who presided over this shambles? Is there any enforcement mechanism under the contract against the other owner of the company?

[Mr Hunt]

The company has been stripped of that contract; it was relieved of the contract back in 2015. We are very clear that it will have to fulfil all its contractual requirements, including paying its fair share of the costs that have been incurred as a result of this wholly regrettable incident.

Defending Public Services

Debate between Jeremy Hunt and John Redwood

Monday 23rd May 2016 Commons Chamber

[Mr Hunt]

The hon. Lady shakes her head, but let us consider what the King’s Fund said in the run-up to the election:

“Labour’s funding commitment falls short of the £8 billion a year called for in the NHS five year forward view.”

It was there in black and white: Labour was committing to a £2.5 billion increase in the NHS budget, not the £8 billion that this Government committed to. The hon. Lady cannot have it both ways. If this figure was £5.5 billion, the efficiency savings needed would be not £22 billion, but £27.5 billion, which is a 25% increase. That would be the equivalent of laying off 56,000 doctors, losing 129,000 nurses or closing down about 15 entire hospitals.

[John Redwood (Wokingham) (Con)]

I welcome the Secretary of State’s policy that foreign visitors should be asked to pay for non-urgent treatment that they get when they are here and that European visitors should have to recoup this through their national systems. Why do we need extra legislation, and how much money does he think we can get from that?

[Mr Hunt]

We need extra legislation to expedite the process. I point out to my right hon. Friend that that is another policy which has been opposed by the Labour party. All the time it says we should be doing more to get a grip on NHS finances and yet it opposes every policy we put forward in order to do precisely that. The answer to his question is that the issue with the NHS is primarily that we are not very good at collecting the money to which we are entitled from other European countries, because we are not very good at measuring when European citizens are using the NHS. This legislation will help us to put those measurement systems in place so that we can get back what we hope will be about half a billion pounds a year by the end of this Parliament.

We will no doubt hear later this afternoon the charge that the Government have lost control of NHS finances, but we strongly reject that charge. The House may want to ask about the credibility of that accusation from a party that is at the same time proposing a funding cut for the NHS and criticising the difficult decisions we need to take to sort out NHS finances.

Junior Doctors Contracts

Debate between Jeremy Hunt and John Redwood

Monday 25th April 2016 Commons Chamber

[Mr Hunt]

I agree with the hon. Lady on one point: it is a total tragedy when the Health Secretary ends up with no other choice but to impose. Had we had sensible negotiations, that would have not have been necessary. She talked about the royal colleges. They say that the withdrawal of emergency care should not happen. Clare Marx, the president of the Royal College of Surgeons, has said that she personally would not and could not strike. I have tried to be very clear this afternoon about exactly what we are trying to do, and we have been clear on many occasions that this does not apply to elective care.

If the hon. Lady is concerned about the statistics, I would encourage her to read some of the 15 international studies covering stroke, cancer, emergency surgery and paediatric care, including the very thorough Fremantle study published last September. She is right to suggest that many of them talk about senior decision-makers being present. That could be a consultant, but it could also be an experienced junior doctor. As she knows, the term “junior doctor” is something of a misnomer because someone could have been a doctor for seven years and still be a junior doctor.

The hon. Lady also asked about the link with the junior doctor contract. The single outstanding issue is Saturday pay rates, as the BMA has confirmed in private emails that it has sent out. We need to make it possible for doctors to roster more people at weekends, and Saturday pay rates are obviously connected to that. What I have tried to do today is to show that the supply of trained doctors into the NHS will be going up during this Parliament, so we will not be depending on the current workforce to supply the additional Saturday cover in its entirety. There will be more doctors going into the NHS, which will spread the burden, and that is the way that we will get the safe NHS that we want.

[John Redwood (Wokingham) (Con)]

I support the vision of a seven-day NHS and a safer NHS that my right hon. Friend is so energetic about. However, for the benefit of all those uncommitted people listening to our debate who just want the NHS to work, will he tell us how big the gap is over that remaining issue, and how he sees it being resolved as quickly as possible?

[Mr Hunt]

My right hon. Friend is right to draw attention to the difficult paradox that we face. Earlier this year, we came close to an agreement and, had there been a willingness to negotiate rather than what I fear was the BMA’s desire to settle for nothing less than a full Government climb-down, we could have had a deal. The outstanding issues were about pay for antisocial hours and particularly about Saturday hours pay. That is where the main difference lay. We proposed a sensible compromise on that but, as Sir David Dalton, the chief executive at Salford Royal, said, we had to decide quickly what we were going to do because the contracts are coming in this August and there is a process we have to go through. So that will be in the new contracts from this August, but we are very willing to talk to all parties, including the BMA, about the implementation of these contracts, about the contents of future contracts and about anything to ensure that this contract works, because we would much rather have a negotiated agreed solution and it is a great tragedy that we were not able to do that this time.

National Health Service

Debate between Jeremy Hunt and John Redwood

Wednesday 21st January 2015 Commons Chamber

[Mr Hunt]

I am going to make progress, but I will give way later.

I want to look at the pressures that the NHS is facing, because the right hon. Member for Leigh asked about the direct causes. There are more than 1 million more over-65s than there were four years ago. Many older people become particularly vulnerable when it is cold, which is why winters are always difficult for the NHS. The truth is that over successive decades, we have made older people more dependent on emergency care by under-investing in primary and community care, reducing the responsibility of GPs for out-of-hours care, removing the personal responsibility for patients from GPs, and failing to integrate health and social care.

The right hon. Gentleman spoke as if that was nothing to do with Labour. However, he knows what damage was caused by the GP contract changes in 2004, he knows that his Government failed to integrate health and social care for 13 years, and he knows that where Labour runs the NHS today—in Wales—the performance is even worse. Instead of debating constructively, he chose to start this year by putting up a scaremongering poster that implied that the NHS would cease to exist if this Government were re-elected. That is not good enough. The whole country can see that, for him, it is not about the ward, but the weapon; it is not about the patients, but the politics. For this Government, it is about the patients.

[Mr Redwood]

Does my right hon. Friend understand Labour’s attack on privatisation? Under Labour, the NHS always had private-sector contractors as GPs— and nothing has changed; and it always bought all its pharmaceuticals from competitive, profit-making pharmaceutical companies—and nothing has changed. What is the shadow Secretary of State’s grievance?

[Mr Hunt]

Privatisation is one of the most pernicious fears that Labour is seeking to stoke up—not least because, as Secretary of State, the right hon. Member for Leigh allowed the decision to go through that Hinchingbrooke hospital should be run by the private sector. He has been running away from that decision faster than anything that anyone has seen before, because he is still trying to curry favour with the unions.

The companies on the shortlist for Hinchingbrooke hospital were Circle, Serco and Ramsay Health Care. He could have stopped that as Secretary of State, but he did not. He knows—[Interruption.] Those were the three bidders—the private sector-led bids. He could have stopped that process when he was Secretary of State, but he chose not to. That makes my point very well.

Francis Report

Debate between Jeremy Hunt and John Redwood

Wednesday 5th March 2014 Commons Chamber

[The Secretary of State for Health (Mr Jeremy Hunt)]

I beg to move,

That this House has considered the matter of the Francis Report: One year on.

A year on from the Francis report, let us remember that we stand here today thanks to the courage of a few lonely voices who fought against the odds to be heard as they campaigned against appalling neglect and abuse at the heart of our national health service. They had a truth to be told, they refused to be ignored, they stood up to a mighty system, and when they were turned away by regulators, NHS leaders and Ministers, they just came back speaking even louder—people such as Julie Bailey and Helene Donnelly, both of whom received honours this year, and thousands more who wrote and campaigned for loved ones, not because they wanted a penny of compensation but because they wanted to prevent this tragedy from ever happening again.

The last Government repeatedly refused to set up a public inquiry into what happened at Mid Staffordshire NHS Foundation Trust, but to his enormous credit, my predecessor overturned that decision, with the honourable support of a number of Staffordshire Members. As a result, the voices of their constituents were finally heard, and hard truths were told.

Today, the whole House will want to thank Robert Francis QC and his inquiry team for the thorough and thoughtful job that they carried out. Their remarkable report demanded a monumental response, and I sincerely hope that that is what the coalition Government have delivered. The Care Quality Commission, once ridiculed, is now trusted, with a record number of calls to its whistleblowing helpline. Failing hospitals are being turned around, with stronger leadership and improved staffing levels: there are 3,500 more nurses on our hospital wards since the Francis report, more than 80% of hospitals have taken new action in response to the report, and confidence among NHS staff that their organisation has the right priorities has risen. Of course, there are many more things to do, but it is clear that something profound has changed in the culture of the NHS.

[Mr John Redwood (Wokingham) (Con)]

I admire what my right hon. Friend is doing to get a new culture of honesty in the NHS. Does he think that all the major hospitals in the country now automatically report problems and mistakes, so that they can be investigated and remedied?

[Mr Hunt]

The truth is that the process takes time, and there are still examples of where candour is lacking. Allegations have recently surfaced in the press, the substance of which makes it appear that that reporting has not happened. There is much work to do, but the signal has gone out loud and clear that if people are open, transparent and honest from the start when something goes wrong, that should not be punished but should be recognised as a way of improving how we look after patients, in the same way as profound changes in the airline industry have made our aeroplanes much safer. We need that change in the NHS.

We also now recognise that however important ministerial objectives and national targets may be, NHS organisations should never prioritise them at the expense of dignity and respect for patients. We now know that the best way to deal with poor care is for people to speak out about it, whether they are a health care assistant, doctor, nurse or even Secretary of State, and that that should never be confused with “running down the NHS”. We also know that failing to speak out about poor care, or to support those who do, is a betrayal not just of patients but of the kindness and humanity of more than 1 million dedicated NHS staff, thousands of whom pledged themselves to compassionate care just two days ago on NHS change day.

What has happened in the past year? Robert Francis asked why the system effectively failed to detect or deal with the problems at Mid Staffs for a shocking total of four years. We have re-established the CQC as a rigorous and independent inspectorate, with three powerful new chief inspectors appointed to speak truth to power. The Keogh review inspected 14 hospitals last summer, and the new chief inspector of hospitals, Professor Sir Mike Richards, has already completed inspections of a further 18 trusts, with 19 more inspections taking place now. As a direct result, 14 trusts are now in special measures—a record in NHS history—and, thankfully, long-standing problems are finally being tackled.

On staffing, the inquiry found

“an unacceptable delay in addressing the issue of shortage of skilled nursing staff.”

The latest figures show that not only are there 3,500 more nurses on our hospital wards since the Francis report, in just a year, but we now have more nurses, midwives and health visitors in the NHS than ever in its history. From this summer, all hospitals will publish their staffing levels monthly, on a ward by ward basis, so that shortfalls are speedily identified.

Robert Francis identified a closed, defensive and secretive culture at Mid Staffs. In response, we have ended gagging clauses and we are making it a criminal offence for trusts to publish or provide specified information that is false or misleading. We are also placing a statutory duty of candour on organisations so that they are required to be honest with patients about poor care, and professional regulators are consulting on a new professional duty of candour that provides protection for staff against being struck off if they are open about the problems they see. I believe that will create one of the most transparent and open health care systems in the world.

Social Care Funding

Debate between Jeremy Hunt and John Redwood

Monday 11th February 2013 Commons Chamber

[Mr John Redwood (Wokingham) (Con)]

Does the Secretary of State see any difficulty in this coalition Government pre-empting a future Chancellor of the Exchequer over tax policy, when I thought everybody in the House wanted a different kind of Government after 2015, who might have their own ideas?

[Mr Hunt]

We have funded these proposals until 2020 on plans that have been agreed by the Liberal Democrats and the Conservatives. We hope very much that we will have the support of the Opposition for these plans as well. Then we can have a national consensus around them, which is what we need because in the end, if we are to create that certainty in the markets, people need to know that whichever Government are elected, they support the basic approach that we are endorsing.

Oral Answers to Questions

Debate between Jeremy Hunt and John Redwood

Tuesday 23rd October 2012 Commons Chamber

[Mr John Redwood (Wokingham) (Con)]

T3. What is the administration overhead cost to the NHS and the Department this year and how does it compare with 2009-10?

[Mr Jeremy Hunt]

I will get back to my right hon. Friend with the exact details, but the impact of the reforms that the Government have introduced will cut administration costs by a third across the whole NHS, leading to net savings of £4 billion during this Parliament.