Budget Resolutions and Economic Situation

Paul Blomfield Excerpts

Monday 20th March 2023 Commons Chamber

[Paul Blomfield (Sheffield Central) (Lab)]

There was an extraordinary omission in last Wednesday’s Budget: absolutely nothing to deal with the crisis in our public services, which is nowhere clearer than in health and social care. Every year, I hold an annual community consultation, giving my constituents the opportunity to say what priorities I should be taking up in this place and what the Government should be focused on. Over the 13 years that this Government have been in power, health and care has been a growing concern, and this year almost one in three said that it was by far the biggest issue for them—but clearly not for the Chancellor.

Is it any surprise? NHS staff morale is falling with the value of their pay. Ambulances are taking up to 15 hours to reach critically ill patients, with more than 500 deaths recorded last year when an ambulance did not arrive on time. Some 1.6 million people waited more than 12 hours in A&E, with waiting times linked to 23,000 excess deaths. There is a backlog of over 7 million patients for elective care, and the worst delays on record for cancer patients needing urgent treatment. So many people are struggling to get a GP appointment, and GPs themselves are struggling under pressure. There were 4.6 million—that is 9%—more appointments last December and January than in the same months in the winter before the pandemic, but the number of fully qualified GPs to deal with those appointments dropped by 2,077 since 2015, or 7%.

Then there are the difficulties that many face in getting any NHS dental treatment at all. Across England, 50% of NHS practices have reduced their NHS commitment, and 75% are planning to reduce or further cut their contracts. Patients are facing not simply the frustration of a search for a NHS dentist, but the pain of not finding one, and some are resorting to shocking, desperate DIY measures. Perhaps most shocking of all, children are unable to see a dentist. Three years ago, 58% of children saw an NHS dentist during the year. That was not good enough, but last year the figure fell to 47%. It is no surprise that in 2021 hospitals in England carried out almost 180 operations a day on children to remove rotten teeth. Last July the Government tweaked the dental contract, but according to my local dental committee, without more money we will simply see the slide towards the death of NHS dental provision continue.

Alongside the crisis in the NHS, and fuelling it in part, is the crisis in social care. How we all remember the pledge of the new Prime Minister back in July 2019 on the steps of Downing Street:

“we will fix the crisis in social care once and for all with a clear plan we have prepared to give every older person the dignity and security they deserve.”

Of course, like so many of his pledges, it was no such thing at all. Although the structure within which people make payments for the care they receive is hugely important, the crisis in social care goes deeper than that: it is about the way in which we provide services. There are so many in the care sector who work so hard, and we saw their extraordinary commitment during the pandemic, but they work with one hand tied behind their back.

There is a massive staff shortage, with 165,000 unfilled posts in adult social care in England last year, up 52% on the previous year. Pay is obviously a key factor, and it is a poor reflection of the way in which this country values those looking after our most vulnerable that care workers are struggling on a minimum wage because of the way in which local authorities have been starved of funds. Domiciliary care workers are restricted to 15-minute visits, reducing the value of that interaction with people desperately in need of care—some of our most vulnerable —to a quick, functional task. We need a fundamental paradigm shift in social care, with care workers paid, trained and supported properly—more like nursing.

The Budget also failed to recognise the support that is needed by the army of 10.6 million unpaid carers who play such a vital role. The right to carer’s leave is an important step, and I welcome the fact that it is being taken by the Government, but for many that leave needs to be paid in order to be meaningful. Carer’s allowances need urgent reform, as one in six carers are facing debt as a result of their role. Opportunities for respite care need improving, and there also needs to be proper support for young carers, some of whom came to Parliament last week and set out their objectives in a letter to the Prime Minister on Young Carers Action Day.

I recognise that addressing all of this comes at a cost, but we need an honest debate about what we need in health and care and how we fund it, stopping some of the political football around it. Rather than some of the attack lines—on one side, the “death tax”; on the other side, the “dementia tax”—we need a real debate about how we fund what the people of this country want in health and social care, and we can fund the services we need. We could start by scrapping the pension tax handout to the richest 1%, which would bring in £1 billion. We could align capital gains tax with the rates applied to income, making the system fairer and raising an extra £16 billion a year. We could scrap the gaps in inheritance tax, which benefit the wealthiest, raising an extra £4 billion a year. A wealth tax of just 1% on individual wealth above £10 million would raise £10 billion from the wealthiest 0.04% of the population. There are ways the Chancellor could have begun to address the challenge, but he did not even recognise the need to. Above everything, this Budget fails on that.