NHS Funding

Martyn Day Excerpts

Monday 31st October 2016 Commons Chamber

[Mr Hunt]

I have enormous respect for my hon. Friend. I respect her passion for the NHS, her knowledge of it and her background in it, so I will always listen carefully to anything she says. I hope she will understand that just as she speaks plainly today, I need to speak plainly back and say that I do not agree with the letter she wrote today, and I am afraid I do think that her calculations are wrong.

The use of the £10 billion figure was not, as she said in her letter, incorrect. The Government have never claimed that there was an extra £10 billion increase in the Department of Health budget. Indeed, the basis of that number has not even come from the Government; it has come from NHS England and its calculations as to what it needs to implement the forward view. As I told the Select Committee, I have always accepted that painful and difficult economies in central budgets will be needed to fund that plan. What NHS England asked for was money to implement the forward view. It asked for £8 billion over five years; in fact, it got £10 billion over six years, or £9 billion over five years—whichever one we take, it is either £1 billion or £2 billion more than the minimum it said it needed.

I think my hon. Friend quoted Simon Stevens as saying that NHS England had not got what it asked for. He was talking not about the request in the forward view, but in terms of the negotiations over the profile of the funding we have with the Treasury. The reason that the funding increases are so small in the second and third year of the Parliament is precisely that we listened to him when he said that he wanted the amount to be front- loaded. That is why we put £6 billion of the £10 billion up front in the first two years of the programme.

I fully accept that what happens in the social care system and in public health have a big impact on the NHS, but on social care we have introduced a precept for local authorities combined with an increase in the better care fund—[Interruption.] This is a precept, which 144 of 152 local authorities are taking advantage of. That means that a great number of them are increasing spending on social care. It will come on top of the deeper, faster integration of the health and social care systems that we know needs to happen.

On public health, I accept that difficult economies need to be made, but it is not just about public spending. This Government have a proud record of banning the display sale of tobacco, introducing standardised packaging for tobacco, introducing a sugary drinks tax and putting more money into school sports. There are lots of things that we can do on public health that make a big difference.

On capital, I agree with my hon. Friend about the pressure on the capital budget, but hospitals have a big opportunity to make use of the land they sit on, which they often do not use to its fullest extent, as a way to bridge that difficult gap.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

With some 80% of trusts in deficit and only 4% meeting accident and emergency targets, I am grateful to the Health Committee for flagging up the dire financial state of the NHS in England, as evidenced by its letter to the Chancellor. We learn from that document that the £10 billion figure is a bit of a fallacy. In Scotland, the SNP Government are committed to investing an additional £2 billion by 2021, but any reduction in new money for the NHS from the UK Government would have an impact on Barnett consequentials. Given that the UK Government have already slashed Scotland’s budget by 10% between 2010 and 2020, they need to be honest and transparent about what that reduction will mean for Scotland’s funding. With the Department of Health having accidentally not adjusted its books for an extra £417 million from national insurance contributions, and having broken its control total by £207 million, will the devolved Governments get any share of that additional £624 million?

[Mr Hunt]

Many people in Scotland will be somewhat surprised by the hon. Gentleman’s comments, because in the last Parliament spending on the NHS in England went up by 4%, whereas in Scotland it fell by 1%. The IFS confirmed that at the time of the independence referendum, saying:

“It seems that historically, at least, Scottish Governments in Holyrood have placed less priority on funding the NHS in Scotland…than governments in Westminster have for England”.

In this Parliament, the hon. Gentleman’s party has already lost a vote on NHS cuts in the Scottish Parliament and been criticised by Audit Scotland for its performance. When the SNP has the courage to increase NHS spending in Scotland by the amount we are increasing it in England, we will listen, but until then it should concentrate on looking after Scottish NHS patients in Scotland.