Health and Social Care Levy

Karin Smyth Excerpts

1st reading
Wednesday 8th September 2021 Commons Chamber

[Karin Smyth (Bristol South) (Lab)]

For too long, successive Governments of all stripes have failed to grasp the nettle on social care reform. In fact, we have mostly failed to acknowledge that there was a nettle at all. That is largely because this burden overwhelmingly falls on women, and our voices have been silent. I will not rehearse all the debates that we have had, but this is this time to start something better.

When he came into office, the Prime Minister promised that he had “a plan” to fix social care in England. It is now clear that he did not. But—I say this with all sincerity—he has since started one, and he has brought it to this place at some political risk. This is worthy of a sliver of credit in itself. But having brought these plans forward, we now need an honest and thorough debate here and across the country about their merits and deficiencies. Yesterday I said that the Prime Minister may have broken the dam, and he looked slightly confused. That is because he thinks he has now fixed the problem. The trio of the Prime Minister, the Chancellor and the Health Secretary looked very comfortable with themselves yesterday. They are very wealthy men. They seem to have heard something, but this has not fixed it. They need to understand that behind the dam there is a torrent of questions, costings and aspirations, none of which the Government seem prepared to acknowledge.

This motion does not represent a sustainable plan. Instead, what we have is a shoddy push to nod through these changes without even paying lip service to the scrutiny that they need. Millions of families are hoping for something else, and we must not give them false hope. That would be cruel and unnecessary. There is only one longer-term solution that we will need to inch our way towards in the coming months and years, and that is a universal system based on the same NHS principles of fair taxation based on the ability to pay and according to need. Crucially, like the last Labour Government, we need to start moving people with us on the journey to that solution. Pitting people and generations against each other and talking solely about tax rises is a narrative that is now infecting our debate. It needs to stop.

Today is my birthday—[Hon. Members: “Hear, hear!”] Very kind. I was once in my 20s, and my message to young people is that they will get older. A young woman talked movingly on the BBC yesterday about her struggles with social care, and she said that everyone is one accident away from social care. We have to remake the social contract for a new generation.

Reform is too late for my mother, who is in her 80s, and it is too late for me in my mid-ish 50s. It cannot be too late for my children, which is what I need to explain to them, rather than talking of generational warfare.

On the smoke and mirrors around the NHS settlement, I spent most of my career in NHS management and I was part of the great improvement in health services under the last Labour Government. If we are really going to start delivering on this, it will require a massive clinical and managerial effort to transform the legacy of the pandemic and austerity in the health service, and to change those waiting lists.

Politicians like to talk nicely to managers in private conferences and then take pot shots at them the rest of the time, but clearing the waiting lists is a massive managerial and clinical challenge. The clerical and clinical validation of that list to help people move through the care system will be a massive task, and they need support.

The Prime Minister has a majority of 80 MPs. It is in his gift to deliver a policy that could truly stand the test of time. Having bitten the bullet and picked the fight, he seems determined to squander the opportunity with the solution before us today. I urge him and the Government to think again. He should seek to build the consensus that could exist in this House on doing something truly lasting after the terrible pandemic we have all been through.