Health and Social Care

Keir Starmer Excerpts

Tuesday 7th September 2021 Commons Chamber

[Keir Starmer (Holborn and St Pancras) (Lab)]

I thank the Prime Minister for advance sight of his statement—I think I had almost as much notice as the Cabinet. May I also thank everybody who works in the NHS and social care? During the darkest days of the pandemic they kept our health service from collapsing, they looked after the elderly when others could not and they rolled out the vaccine, which has finally provided the light at the end of the tunnel. Despite their efforts, we are facing the toughest winter in the history of our health service. Not only do we have the threat of another covid surge, but waiting lists for diagnosis and treatment have reached record levels, we risk cancer survival rates going backwards for the first time ever, and social care remains neglected and strained. It is a crisis, but how did we get here?

The pandemic has undoubtedly placed the NHS under huge strain, but that is only part of the story. A decade of Conservative neglect weakened the NHS. Waiting lists had spiralled—up 2 million before the pandemic. Targets were missed, on cancer, on accident and emergency, and on mental health, before the pandemic. The same is true on social care, with £8 billion cut, despite growing demand, before the pandemic. Carers were on poverty wages, without secure contracts, before the pandemic. There were 100,000 vacancies before the pandemic. And the Prime Minister has just referenced the 30,000 hospital beds occupied by those who should go into the community—this is before the pandemic—and he called that an “indictment of failure”. Who had been in government for 10 years at that stage? Just remind me. Prime Minister, an “indictment of failure” is an accurate description of the situation in our health service and social care before the pandemic, so the pretence that he is “only here” because of the pandemic is not going to wash. He is putting a sticking plaster over gaping wounds that his party inflicted. He made that commitment on social care before the pandemic, and he said he would pay for it without raising taxes before the pandemic.

Yes, the NHS urgently needs more investment, but the backlog will not be cleared unless the Government hit the 18-week target set out in the NHS constitution—the Prime Minister did not mention that. It was set and it was met by the last Labour Government. Let me ask a direct question: if there is to be improvement, Prime Minister, can you commit today to hitting the target and clearing the backlog by the end of this Parliament—yes or no? I know he likes to avoid these questions, but if he cannot answer that basic question, it is clear he has not got a plan.

Let me turn to social care. Under these proposals, people will still face substantial costs. I heard what the Prime Minister said, so I have another direct question for him: can the Prime Minister guarantee that under his plan no one will have to sell their home to fund their own care—yes or no? [Hon. Members: “He just told you.”] Well, let us hear him make the commitment, at the Dispatch Box, that under his plan no one will have to sell their own home to fund their own care, and then we will come back to it.

Social care is about so much more than this. The blunt and uncomfortable truth is that under the Prime Minister’s plans the quality of care received will not improve—there is no plan for that. People will still go without the care that they need—there is no plan for that. Unpaid family carers will still be pushed to breaking point—there is no plan for that. Working-age adults with disabilities will have no more control over their lives—there is no plan for that. Pay and conditions will not improve for care workers—there is no plan for that. Let me spell it out: a poorly paid care worker will pay more tax for the care that they are providing without a penny more in their pay packet and without a secure contract.

[The Prime Minister]

indicated dissent.

[Keir Starmer]

The Prime Minister shakes his head; my sister is a poorly paid care worker, Prime Minister, so I know this at first hand.

This is a tax rise that breaks a promise that the Prime Minister made at the last election, a promise that all Conservative Members made—every single one of them. It is a tax rise on young people, supermarket workers and nurses; a tax rise that means that a landlord renting out dozens of properties will not pay a penny more, but the tenants working in full-time jobs will; and a tax rise that places another burden on businesses just as they are trying to get back on their feet. Read my lips: the Tories can never again claim to be the party of low tax.

The alternative is obvious: a timetable and plan to clear waiting lists, just as we did under the last Labour Government, and a comprehensive reform plan for social care that deals with the inadequacies that I just pointed out and drives up the quality of provision—not just tinkering with the funding model. We do need to ask those with the broadest shoulders to pay more, and that includes asking much more of wealthier people, including in respect of income from stocks, shares, dividends and property. [Interruption.] Chancellor, I was listening. The Chancellor knows the numbers just as well as I do—he will have done the sums and we have done them. Tinkering and fiddling with dividends will not do it. The Government are placing the primary burden on working people and businesses struggling to get by.

As I have said to the Prime Minister, if the Government come forward with a plan to genuinely fix the crisis in social care and they have a fair funding model, yes, we will work together. Thousands of families who are struggling with the current system and only want the best for their loved ones deserve nothing less.

[The Prime Minister]

Now we know why over decades the Labour Government totally refused to deal with this problem, and now we know why both Blair and Brown failed to do it: the right hon. and learned Gentleman has absolutely no plan. I was waiting, and I am amazed that he sat down. What is his answer to the backlogs in the NHS? What is his answer to the problems in social care? The Opposition have absolutely no plan. They have no idea how they would raise the money.

Let me answer some of the right hon. and learned Gentleman’s questions. We will of course be investing in social care. I thank his sister for what she is doing in social care, but we have lifted people’s wages across the country with record increases in the living wage; we are investing in 700,000 training places for people in social care; and we are making sure that we invest £500 million—that is in the plan I announced today—in the social care workforce.

What this plan will also do is enable us to get our wonderful NHS back on its feet and enable it to deal with the backlogs. The right hon. and learned Gentleman totally failed to explain how a Labour Government would do that. One year of capital gains tax would not even begin to deal with this problem. He has not got a solution and it is deeply irresponsible of him to come to this place without having any kind of alternative.

Let us be in no doubt: if we did what we have heard from the Labour party over the past few weeks, we would still be in lockdown, because the right hon. and learned Gentleman opposed coming out of stage 4; we would have absolutely nothing by way of dealing with the NHS backlogs; and after decades of inertia from the Labour party we would have absolutely no way of dealing with the anxiety of millions of families across this country who face the prospect of catastrophic social care costs.

This Government are dealing with those things—we are dealing with all of them. We are getting on with it. We are taking the decisive action. We are doing it all together. This is the Government who get on and deal with the people’s priorities; this is the Government who tackle social care; and, indeed, this is the party of the NHS.