Health and Social Care Levy

Meg Hillier Excerpts

1st reading
Wednesday 8th September 2021 Commons Chamber

[Jesse Norman]

I am grateful to the hon. Gentleman, and I am also very grateful to him for actually reading the document, which many of his colleagues may not have done, and he is absolutely right to draw attention to that section. What the levy does, of course, is to provide a very substantial form of funding for social care. The question of the capacity of local authorities, which is of course a matter of great interest to Government and an area that we have supported significantly in the last year or two, will be considered in the Budget in the normal course of things.

If I may, I will now set out why a levy based on national insurance is the best way to raise the funds needed for the Government’s plan for health and social care. The first reason is that there is already a clear precedent. Indeed, in 2003 the then Labour Government increased these same NICs rates by 1% specifically to put more funding into the NHS. Within the NICs system there is, as Members across the House will know, already a long-standing ring-fenced proportion of receipts directed to the NHS.

The second reason is that this is a fair method. Businesses will play their part. In fact, the largest 1% of businesses will contribute 70% of the revenue. However, existing NICs reliefs and allowances will also apply to the levy. That will mean, as I have said, that 40% of all businesses will not be affected due to the employment allowance. When it comes to individuals, those earning more will pay more. Conversely, at least 6.2 million people earning less than the NICs primary threshold will not pay the levy at all.

The third reason why a levy based on NICs is the right approach is that it has worked elsewhere. France, Germany and Japan have all increased social security contributions to fund social care provision. Finally, the question of how to fund health and social care is one that applies to a whole nation. NICs are set on a UK-wide basis, and the levy therefore provides a clear UK-wide solution.

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

Would the right hon. Gentleman put on the record for the House the consequentials for public bodies that are employers? They would normally be expected to pay this, but I understand there are some mitigations. Perhaps he could explain that, because in the time we have had we have not been able to get to the bottom of it.

[Jesse Norman]

The overall fiscal approach is set out in detail in the document that has already been referenced by the hon. Member for Sheffield South East (Mr Betts). We will be presenting a Bill in due course, which will have further explanatory notes and a tax information and impact note associated with it, and of course we have a Budget in which the wider fiscal position will become clear, so the House is not going to be short of information about how this will land.

Finally, if I may, I will just remind the House why this levy is so important. As the Prime Minister and the Chancellor set out yesterday, the levy will enable the Government to tackle the backlog in the NHS. It will provide a new, permanent way to pay for the Government’s reforms to social care, and it will allow the Government to fund our vision for the future of health and social care in this country over the longer term.

--- Later in debate ---

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

It is a pleasure to follow the right hon. Member for Gainsborough (Sir Edward Leigh), who made a thoughtful speech, but I have to take issue with him about the Labour Government pumping money into the NHS and it going nowhere. Which party set targets for things such as A&E waiting times and the reduction of waiting lists and achieved them while in government? The Labour party. Where the right hon. Gentleman and I agree—he is a former Chair of the Public Accounts Committee, and I have the honour of being the current Chair—is that it is vital that we measure the effectiveness of every pound of taxpayers’ money spent against delivery for citizens and taxpayers. This proposal fails woefully on that.

This is another headline from the Government with no detail attached. Parliament has been bounced, but even the Prime Minister’s party and Cabinet were not involved in the decisions about how the money is to be raised and what it will be spent on. It is clearly an announcement without a plan. There is no plan, other than to put money into the NHS for three years. We all recognise the need there, but the message is being deliberately muddled. Where is the plan for care workers? Nothing. Where is the plan for skills for care workers? Nothing.

Where is the plan for a stable market? There are 25,000 or so care providers or residential care properties in the UK, mostly small, private providers. Their market had been shaken to the core before covid, but covid has really wracked them hard, and there is no support, plan or promise—anything—for them. What about the money for local authorities? I completely associate myself with the remarks of my hon. Friend the Member for Sheffield South East (Mr Betts) earlier and a number of Conservatives yesterday, including my constituency neighbour, the hon. Member for Cities of London and Westminster (Nickie Aiken). There is also no plan on domiciliary care; more of us will receive care in the home than in institutions.

This proposal is about protecting the capital assets of the wealthiest. I am a London MP, and this proposal will protect a lot of people in London who are like me: a homeowner in London with a wealthy asset for whom £86,000 is a small percentage of the home I own. The right hon. Member for Rossendale and Darwen (Jake Berry) made an excellent speech highlighting the real challenge in this respect. I worry that the Government are using this proposal as another opportunity to try to buy votes in London for the next London mayoral election. Nothing seems to stop them in their ability to attack our London Mayor and try to buy people in. We have to make sure we have a policy for the whole country.

There are not even any targets for the NHS funding that is going in. The Minister came to the House and rattled through his speech at pace without answering any of these important questions. It is important that we tackle the NHS backlog, but with £12 billion a year on a base NHS budget of around £150 billion—of course, during the pandemic it has gone up by around £60 billion—that is still going to be a challenge. We need to make sure we are getting outcomes and we need to measure them. The Secretary of State for Health and Social Care himself admits that he does not know whether tackling the backlog will be possible in three years; I think it will be a huge challenge.

Let us look at the challenge on finances. By 2038, compared with 2018, there is a projected 90% increase in costs for adult social care for those aged 18 to 64 and a 106% increase in costs for adults over 65, so of course something needs to be done. The Public Accounts Committee has looked repeatedly at the social care market, of which the Department of Health and Social Care has responsibility for oversight. That includes looking at skills and the supply of places, but it has woefully failed—it has failed on drug prices and on making sure that the market and the workers in it are skilled up properly. Of course, there was also the woeful failure on personal protective equipment, where the Public Accounts Committee concluded, in—of course—a cross-party report, that care homes had been “thrown to the wolves” because of what happened.

The inequality really bites. As others have highlighted, wealthy pensioners on good private pensions will not pay an extra penny. That includes those who have retired early because of the Osborne pension reforms. Senior civil servants and so on who are able to retire at 55 on a full pension can then work again, and they may pay money on their new earnings but not on their pension. They are earning way more in their pension than the minimum wage and will not pay an extra penny from that.

In my constituency, we have more private renters than homeowners and more people who rent socially than either of those two options. They do not have assets that need to be protected; they need the insurance to get good social care. They do not have income from assets that they will ever benefit from. Of course, many of the people who do own their own homes have interest-only mortgages. A whole generation is coming through—generation rent—without an asset, worrying about whether they can afford to pay into a pension and unable to afford today’s rent. This proposal just hammers that generation to the benefit of people like me—as I move through my 50s towards retirement—who have an asset. This proposal does not work. There is no plan.