Health and Social Care Levy

Mark Fletcher Excerpts

1st reading
Wednesday 8th September 2021 Commons Chamber

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

I want to begin by congratulating the Government Whips on bulldozing this proposal through with such great haste. They have done their job today. They have prevented a Back-Bench rebellion. They have used their own Back Benchers as cannon fodder. It will not be the charlatan in No. 10 who pays the price for broken promises and tax rises that hit the young and the low-paid; it will be those Tory MPs hung out to dry: some of them unexpected victors in 2019, and some of them quite good MPs, but with small majorities. When the emails and the messages of complaint start flooding into their offices, and when the refusals ever to vote Tory again start to hit home, it will not be the occupant of No. 10 who has to suffer—he will have flitted on to his next fantasy—but those who are betraying the very people who voted for them. They will be left to pay the price.

[Mark Fletcher (Bolsover) (Con)]

I am very grateful for the hon. Gentleman’s concern about our future job prospects, but I would much rather be standing for a party that is willing to invest in the NHS, to be the party of the NHS, and to try to fix the problems in social care. I would much rather have those job prospects than be a Back-Bench Labour MP who stands for nothing, has no plan and has weak leadership.

[Steve McCabe]

Well, that was a wonderful intervention. The hon. Gentleman has not only been hung out to dry; he has been brainwashed in the process.

This is a measure built on deception. There was a promise of no tax rise or national insurance rises, yet this is a tax rise to hit young workers; to hit people who will never get the opportunity to buy a house; to hit the self-employed struggling to get back on their feet, many of them ignored by this Government during the pandemic; to hit employers struggling to get their businesses back on track who now face a tax on jobs; and to hit the low-paid battling to keep life and limb together who will end up subsidising others whose assets they can never hope to match.

Only last year, the Government were boasting about raising the national insurance threshold and now they are squeezing the very same people. What happened to the promise to raise the threshold to £12,500 by the end of this Parliament? This is money to pay for two things: first, to subsidise those who hope to inherit large properties from elderly relatives; and secondly, to cover for the disastrous cuts in the NHS over the period the Tories have been in office. Even on their own reckoning, only about £5.3 billion of this tax grab will ever make it to social care. We were promised that a plan was ready, that it was a priority, that the PM would get cracking within his first 100 days, and that it would fix the crisis in social care once and for all—none of it true.

Age UK estimates that there are about 1.5 million people in need of help with daily living who do not get it. This tax rise will not address those issues. It will not help people needing help with washing, dressing, eating and taking their medicines. This is a broken tax promise: a penalty for those who took a chance on voting Tory at the last election. On social care, it is a fiction and a deception from people whose promises will never again be given any credence.

--- Later in debate ---

[Mark Fletcher (Bolsover) (Con)]

It is a pleasure to follow the hon. Member for Ilford South (Sam Tarry), if only because he asked what we would say to the people in his constituency who have been struggling. It seems a strange time to ask that question when the Government have just spent £400 billion helping individuals and businesses through a tremendous crisis, keeping the show on the road and making sure that our economy can recover, that jobs grow and that we have a way of life we can continue with. I feel that the timing of his points was somewhat ill-judged.

It has been interesting to be in the Chamber today, because we seem to have covered all the reasons that we should not do something. It seems that all the ways in which we are doing something are imperfect. I feel we have captured the political paralysis that has surrounded social care over the past couple of decades. It is incredibly difficult to do anything in this area, because it requires tough choices and a punt into the dark that may or may not work—we can never be sure.

We often speak in this Chamber as if we are certain, as if we are positive and as if we know where things will go, but sometimes we have to say, “We think this is the best way forward and we hope it works.” To acknowledge that the Prime Minister and the Government are doing something today on the NHS backlog and on social care is to admire their bravery. To govern is to choose, and that is what the Prime Minister is doing.

We have heard some tremendous speeches about the alternatives to taxation or to systems, but we have been having this debate for so long. When I look my suffering constituents in the eye or when they come to our surgeries and say that the system does not work, we cannot sit there and say, “Okay, but I’m going to engage in an academic exercise for another decade until we find perfection.” Sometimes we have to acknowledge that the best way forward is to take a chance.

Today is a massive step in the right direction. We are investing £12 billion per year over the next three years to try to ensure that any damage done by the global pandemic to our NHS is no longer a problem and that we can reach 110% capacity. We are also grasping the nettle of social care reform. However, there is an intriguing paragraph in the health and social care plan: paragraph 9, which states that

“the Government will ensure this money is well spent and goes to frontline care in England, increasing efficiencies and using reforms to drive up productivity.”

I think that there is an acknowledgment, particularly among Conservative Members, that NHS funding cannot go on becoming a black hole. There is a need to ensure that outcomes and productivity are improved. Look at the lessons of the pandemic, particularly from the Nightingale hospitals, which went up in 10 days through the combination of logistical support from the Ministry of Defence and the NHS—it was unprecedented.

We saw in the vaccine roll-out that when we bring additional expertise into the NHS, we can achieve amazing things.

My “nudge” today is that I do not think we can continue to assume that more and more money will solve the problems that we have. Equally, however, I will not look my constituents in the eye and say, “I did not try.” However tough some of the decisions are that we have to take, I will back our Prime Minister and I will back our Government, because our constituents need to see our country get better, and that is what we are trying to achieve.

--- Later in debate ---

[David Simmonds]

My hon. Friend is absolutely correct to highlight that wider reform agenda. I know we are anticipating more detailed proposals from the Government in due course, but it is clear, as he will know from his local government experience, that if we in this House are serious about fixing social care—much of which is not about the elderly, but about working with adults and children with disabilities—we must learn the lessons from the sector of several decades of change.

First, we must reflect on the lessons of the better care fund, which taught us that councils have been the efficient delivery partner. Even when the sole focus has been to relieve pressure on the NHS, councils have been much more efficient on the whole in using those funds. We must avoid, as many Members have said, that convenient political mistake of allowing all the money to disappear into an NHS black hole with nothing to show for it. However, having learned the lessons of the better care fund, we have to ensure that those additional national insurance costs do not consume the extra funding. I have heard Ministers’ assurances about this, but the care sector has heard many times of new funding that has been cancelled out by deductions from other budgets, so we need absolute clarity that this will find its way to the frontline.

The second point I would like to highlight is that this does not just affect the elderly. About two thirds of social care costs are for working age adults and children, and the NHS is barely involved in many of those cases. However, the costs can be eye-wateringly high, so we need to make sure that as we direct those funds, as my hon. Friends have highlighted, they are getting to where they are required.

The third lesson, which has been mentioned by a couple of Members, is about how the market responds. We have a thriving market for social care in this country, including charities, the private sector and local authorities. We know many of those organisations will see the £86,000 as a very tempting target: the sooner someone spends their £86,000, the sooner the state steps in. We need to ensure that we have learned the lessons of what has happened with the involvement of some businesses, particularly in the children’s social care sector, and make sure this is not seen as simply an opportunity to rip off the taxpayer.

Finally, may I urge Ministers to review the operation of the fair access criteria and the rules that underpin them? The rule of provide for one and provide for all, which was clarified by a subsequent judicial review for the London Borough of Harrow, forced the retrenchment of local authorities in adult social care towards serving only the most critical needs of people in our constituencies.

[Mark Fletcher]

My hon. Friend is giving an excellent speech. One thing he has touched on, but perhaps not expanded on, is the efficiencies that local government has found. Are there any particular lessons that he thinks are relevant to the NHS as we move forward?

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. We really are pushed for time, and this is not fair on those who are winding up.