Income Tax (Charge) Debate
Full Debate: Read Full DebateNusrat Ghani
Main Page: Nusrat Ghani (Conservative - Sussex Weald)Department Debates - View all Nusrat Ghani's debates with the Department of Health and Social Care
(2 days, 3 hours ago)
Commons ChamberThe Chancellor’s Budget last week finally ended the Conservative party’s austerity. It is a Budget that fixes the foundations to deliver real change, by fixing the NHS, cutting hospital waiting lists, reforming public services and rebuilding our country.
As the Chancellor said, this Budget is about “investment, investment, investment”. This Labour Government are investing over £25.5 billion over two years in the NHS. That will cut waiting times, so that patients do not have to wait longer than 18 weeks from referral to consultant-led treatment; provide 40,000 extra appointments; put in place new surgical hubs and diagnostic scanners, building capacity for more than 30,000 additional procedures and over 1.25 million diagnostic tests; and provide new radiotherapy machines to improve cancer treatment.
We are investing in NHS technology and digital, to run essential services and to drive NHS productivity improvements, freeing up staff time. We are providing a dedicated capital fund to deliver upgrades to GP surgeries, boosting productivity and enabling the delivery of more appointments.
We are investing £26 million to open new mental health crisis centres. At last, we have a Government who are committed to tackling the root causes of mental health problems and to supporting people to remain in work and to return to work.
We are supporting social care through at least £600 million of new grant funding to be able to increase local Government spending, alongside an £86 million increase to the disabled facilities grant to support more adaptations to homes for those with social care needs, thereby reducing hospitalisations and prolonging independence.
This Government are cutting down barriers to opportunity for all by increasing the core schools budget by £2.3 billion, supporting the recruitment of 6,500 teachers in key subjects and tackling retention issues, to prepare our children for life, work and the future.
We are providing a £1 billion increase to improve SEND provision and to improve outcomes and an additional £300 million for further education to ensure that young people are learning and developing the skills they need to succeed in the modern labour market, which will help the City of Wolverhampton college in my constituency. We are increasing investment in children’s social care reform, and it is great to see a real-terms funding increase for local government spending.
We are taking all of these decisions, while also taking tough decisions on spending and welfare, eliminating fraud and error in the welfare system—
I start by declaring that my brother and his wife are both NHS doctors, and I am incredibly proud of them.
The Budget begins the work to undo a decade of recklessness and neglect by the Conservatives, who left our NHS uncared for, our schools crumbling and carers unsupported. It will fix the foundations of our economy, build the growth we need to invest in public services and end 14 years of Tory austerity. With this Budget, my right hon. Friend the Chancellor has put forward a bold, tough vision to deliver on our manifesto promise of change—£25.7 billion over two years for the NHS to slash waiting times, with an extra 40,000 elective appointments a week, and £2 billion committed to technology to begin a serious transformation towards digital healthcare.
Labour Members understand the need to fund our NHS properly, but we also understand that after 14 years of neglect, the NHS is badly in need of reform. We cannot cure 14 years of sickness in one Budget, but with this investment, we are finally taking the medicine we need.
I warmly welcome the £1 billion investment the Chancellor is making to address the crisis in special educational needs—a first step in fixing a broken system. During the Conservative leadership contest, the new Leader of the Opposition endorsed the view that getting an autism diagnosis brings
“economic advantages and protections”
and
“better treatment or equipment”.
That is a far cry from the experience of parents and children with SEND in my constituency. The Leader of the Opposition would do well to listen to the former Conservative Education Secretary, who described the SEND system under her party as “lose, lose, lose”. The Government’s commitment to increase SEND funding by £1 billion is a step towards addressing the crisis. It must be only the beginning of tackling this huge long-term problem. Ultimately, the system needs root and branch reform, but the money will start to make real, concrete differences and to break down the barriers to opportunity for many young people in Bracknell and across the country.
I will briefly mention the fantastic commitment to set up a £44 million investment to trial a new kinship carer’s allowance—again, that is a real contribution to solving a problem that has long been neglected.
This is a Budget that invests in our NHS, in education, and in families and working people. If the Opposition choose to oppose it, they need to be honest with their constituents and the British people about what that means. Opposing the Budget means less money for our NHS, less money for our struggling SEND system, and no additional support for the kinship carers who have felt invisible for too long. The Government have chosen to fix the foundations—
On a point of order, Madam Deputy Speaker. I must apologise to the House for not making a declaration at the beginning of my speech. I am a governor of the Royal Berkshire hospital, and I have a family member who has shares in a health company. I apologise for not mentioning it at the beginning of my speech.
I thank the hon. Member for advance notice of his point of order. It is most definitely relevant to the debate, and his transparency is noted.
Even those of us who are new to this place know to expect more communication from our constituents about what is wrong than what is right, so it is notable that I received emails of thanks and congratulations from constituents last week, after the Chancellor delivered her historic Budget. Stability is highly prized by people after so much chaos, and investment, especially in our NHS, is something that people have been crying out for.
However, we must be honest with ourselves about the state of our NHS in east Kent and in coastal communities like mine. East Thanet has been overlooked for far too long. The service has had to endure the chaos and incompetence of the past 14 years, and has not been as resilient as other places to the onslaught. The director of public health in north-east Lincolnshire, Stephen Pintus, has described people living in coastal communities as “old before their time”. We need to reform the way we deliver NHS services in coastal communities. Investment on its own will not be enough. We need to redesign our health service to answer the questions: what care do people need, where do they need it and how do they need it delivered?
My constituents have been suffering with poor NHS services for far too long. East Kent hospitals university NHS foundation trust, which runs the Queen Elizabeth the Queen Mother hospital in Margate, is ranked the third worst in England for its 12-hour waits for emergency services. Its maternity services have been deemed inadequate. When staff were asked, “If a friend or relative needed treatment, would I be happy with their care?”, only 45% of staff said yes. I have people emailing me about their urgent care and essential appointments being delayed by waiting lists. People in dire need of mental healthcare are being told to wait for months to get the help they desperately need. There is denial of continuous care due to costs and a lack of staffing—and, shockingly, poor communication and record keeping resulted in a cancer patient being misdiagnosed.
In a 2021 report by Chris Whitty entitled “Health in Coastal Communities”, he highlighted the problems faced by constituencies such as mine, and found that they had some of the worst health outcomes in England, with low life expectancy and high rates of major diseases. One of the major reasons for that is simply lack of access to healthcare services—both a lack of NHS services in coastal communities and a lack of transport options.
Whatever the reasons for the challenges in coastal communities, we need to see reform. The extra funding the Chancellor announced last week is crucial to bringing down waiting lists and stopping the chaos of 14 years of Tory mismanagement. The British people delivered us a mandate to fix the NHS. If done well, this reform will be transformative for the country, especially in coastal communities like East Thanet.
I am about to call the final Back-Bench Member. No doubt a lot of colleagues who have contributed will be making their way back to the Chamber for the Front-Bench speeches. I call Matt Turmaine.
Thank you very much, Madam Deputy Speaker.
Prior to being elected to this place I worked in health and social care, so it has been interesting to hear some of the pronouncements from the mouths of Opposition Members, which in many instances are, frankly, farcical.
In my constituency, the legacy of 14 years of failed Conservative government is plain to see: people unable to get GP appointments; a lack of NHS dentists for residents to sign up with; poor mental health support for young people and adults; and, of course, the undelivered promise of a new hospital in Watford, cancelled under the coalition and not delivered by the Conservatives over subsequent years. The previous Government’s track record is one of decline. In 2010, average waiting times were 18 weeks and satisfaction levels in the NHS were at their absolute highest. What a contrast to 2024, with the NHS on its knees.
The Chancellor of the Exchequer announced in the Budget an additional £22.6 billion to support the NHS. That will help to deliver more appointments for my constituents in Watford, and it will bring progress towards once again having to wait no more than 18 weeks from referral to treatment. As has been said, we have done it before and we will do it again.
I also welcome the Chancellor’s £1.4 billion to help rebuild schools. She mentioned Watford in her Budget speech, noting that schools in my constituency will benefit from RAAC being dealt with. Mentioning RAAC also brings us to the new hospital programme. I know my right hon. Friend the Chief Secretary to the Treasury will be listening when I say loud and clear that Watford is desperate for a new hospital. That has been the case for many years. The trust’s plan is ready to go, go, go, but I recognise that the Chancellor has achieved the seemingly impossible by managing to start the new hospital programme and moving forward with addressing the hospitals affected by RAAC. We hope the rest will follow soon.
I campaigned in good faith in the general election for a new hospital and to honour the commitment made by the previous Government, but as we heard from the Chancellor in the summer, there was no money there. The Chancellor has worked wonders with this Budget. She has dealt with the financial black hole, she has got the country back on its feet and she has put it on the road to recovery. It is an excellent Budget for the people of Watford; it is an excellent Budget for the country. I wholeheartedly support it.
We have been able to get in over 80 contributions, so thank you very much to everybody for abiding by the time limit. I now call the shadow Minister.
Thank you very much, Madam Deputy Speaker. It is a great pleasure to play a part in bringing today’s interesting debate to a close.
I take this opportunity to welcome the Chief Secretary to the Treasury to his post—I know he has been in post for a few months, but we have not had the chance to get to know each other. I must say I have been very impressed him. He is a fluent speaker. He is good on detail. That is not sarcasm—I was once warned by Hansard that sarcasm did not come across well in the written record—but I know what it is to be sent out to defend the indefensible. I can see that he is developing a fine skill and that he is some way on his way to mastering it. I just gently say to your man starting out in his Front Bench career in government not to get too good at it, because you will find your party will give you ample opportunities to defend the indefensible in the years ahead.
Order. Shadow Minister, I do not think you are speaking to me when you say “you”. You are obviously speaking to the Minister.
It has been a long day, Madam Deputy Speaker. I hope you will forgive me.
But enough of such pleasantries. This is a bad Budget. It is as bad as bad can be. At its heart is a decision to tax businesses hard—very hard—and through them to tax workers until the pips scream. It is a Budget that sees the total effective tax rate on low-earning roles increase to its highest level since 2010, hitting working people hard, as the Chief Secretary to the Treasury admitted on Sky television on Friday. We know that taxing business is a bad idea. As my right hon. Friend the Member for Tatton (Esther McVey) said earlier, businesses and working people are the dynamo of the economy. If we denude and degrade them, there is nothing for public services to feed on.
But we discover, as this Budget unravels, that it is not just businesses that are being taxed. It is GPs, it is care homes, it is hospices—as the hon. Member for Poole (Neil Duncan-Jordan) pointed out—and it is dentists, charities, childcare, higher education and school support staff. I understand that Labour Members will want to support big tax rises in the Budget, but before they vote on them, I ask them to consider whether they want to vote for tax rises on those services. In response to an intervention from my hon. Friend the Member for Hinckley and Bosworth (Dr Evans), who is sitting behind me, the Health Secretary said that he would listen to GPs, but either the money from the national insurance contributions is in the Budget, or it is not. Either it is in the envelope, or it is not. Has the thinking been done on this? At present, it would seem that all those services are in limbo. Yesterday, during Education questions, the Education Secretary was asked by both the shadow Secretary of State, my right hon. Friend the Member for Sevenoaks (Laura Trott), and the shadow Minister, my hon. Friend the Member for Harborough, Oadby and Wigston (Neil O’Brien), whether school support staff would be affected. She could not answer.
These are serious questions, and the Government must know the answers. His Majesty’s Treasury must have the data, and it must publish that data. So let me first ask the Chief Secretary if he will publish figures showing who will be hit by his national insurance contribution tax rises, what the costs will be to the services concerned, and whether they will receive compensation. As I said, the Treasury must have the data, and if the Chief Secretary does not have it at his fingertips, I ask him to put it in the Library of the House of Commons as soon as possible. We all want better public services; the question is, do we think we can get them if the services that I have mentioned are being taxed? As the Chief Secretary said on television the other day, without reform more generally, money will just follow money out of the door.
We are told that Labour has a plan for improving the NHS. We know that, because the Prime Minister told us in a speech on 11 September that in the spring he would have a plan. That plan, he said, would contain a transition to a digital NHS, moving more care from hospitals to communities, and focusing efforts on prevention over sickness. Who could argue with those sensible measures? It was good to read in the Red Book at a time of the Budget that His Majesty’s Government intend to:
“Invest more than £2 billion in NHS technology and digital to run essential services and drive NHS productivity improvements”,
which
“will deliver 2% productivity next year.”
That is very sensible, but it gives rise to a strange sense of déjà vu—and then one remembers that in the spring Budget this year the then Chancellor, my right hon. Friend the Member for Godalming and Ash (Jeremy Hunt), announced £3.4 billion in additional funding for the NHS to deliver 2% annual increases in productivity through new technology and digital across the health service in England.
So part 1 of Labour’s three-point plan is not new at all. It is a Conservative initiative, already accounted for by a Conservative Chancellor. Let us proceed to part 2, moving more care to communities. On that, the Red Book says absolutely nothing. As for part 3, prevention, there is a small increase in tobacco duty and a vaping products duty. Not content with taxing us into growth, the Chancellor intends to tax us into health—but it is all right, because apparently the Prime Minister has a plan to have a plan in the spring.
I will tell you a funny story about the spring, Madam Deputy Speaker. When I was first working as a parliamentary researcher, there was some long-forgotten report that the Department for Children, Schools and Families was producing. We asked when it would be published, and we were told, “In the spring.” We asked, “When does spring end?” The Department told us, “When summer begins.” In that tale is an insight into the way in which Labour Governments think. It is tomorrow and tomorrow and tomorrow, and never does reform come.
That is the plan for the NHS. It is relatively well developed, next to the non-existent plan for welfare reform. My right hon. Friend the Member for Central Devon (Mel Stride), who is now the shadow Chancellor, started that work, but silence has now descended. More workers are needed to grow the economy—the OBR was quite clear on that. The Chancellor has chosen tax over employment, which will not deliver growth.
The Government’s plan has been to tax, to spend, to think a bit, to set up a website, to get told to serve waffles for every meal, and to think a bit more. Then they will see whether any money is left, they will discover that there is not, and they will need to increase taxes again. What is becoming painfully apparent is that Labour wasted its time in opposition. It had 14 years to come up with a plan for the NHS, but it did not, and now it is scrabbling to find one. By the time we see the Prime Minister’s fabled plan, more than 10% of this Parliament will have passed, and very little will have been done that was not already being done before.
The Prime Minister said there would be no extra money without reform, but that is precisely what he has given the country. That is the price of political complacency. It is the price of thinking that governing is easy. It is the price of believing your own hype, and of failing to be honest with yourselves.
Some people said that the Labour party was trying to pull the wool over people’s eyes, and I was one of them. I thought that behind the great ambiguities of the Labour manifesto there would be a game plan, but game plan has come there none. We have £140 billion of extra borrowing, and £10 billion more in higher debt repayments. Mortgage payments are up, and there is austerity for employers and workers. A loveless landslide has become a loveless tax rise for the British people, and they will not wear it.