National Insurance Contributions (Secondary Class 1 Contributions) Bill

Debate between Roz Savage and Polly Billington

2nd reading
Tuesday 3rd December 2024 Commons Chamber

[Ms Polly Billington (East Thanet) (Lab)]

The decision we are taking today to raise employer’s national insurance contributions is a difficult one, but ultimately, it is the right choice. The situation we inherited from the last Government was so dire that it means tough choices need to be made. Asking larger businesses to pay a little more so that we can fix our broken services is a fairer option than asking working people—who already face the highest tax burden since the second world war—to pay more.

My case today is not only a moral case, but an economic one. People who think public services are a drain on the economy fail to understand how those public services make our economy function. I am reminded of a 70-year-old woman I met on the doorstep in East Thanet who was told she would have to wait 16 weeks for an initial scan to find out whether she had cancer, or the mother who had to drive around east Kent in the dark before Christmas to get medical treatment for her child who was suspected of having meningitis, because she could not register her child at a GP practice. Healthcare in east Kent is on its knees. This year, East Kent hospitals trust, which runs the Queen Elizabeth The Queen Mother hospital in Margate, recorded the highest number of 12-hour waiting times in England. When polled, only 45% of its staff said that they would be happy for a loved one to be treated at that trust—what an indictment.

I am prepared to accept that problems like this have existed for longer than 14 years in coastal constituencies such as mine. The NHS crisis is particularly acute in coastal communities such as East Thanet, as highlighted by a 2021 report by Chris Whitty entitled “Health in Coastal Communities”. We have some of the worst healthcare outcomes in England, with a higher rate of major diseases and a lower life expectancy, so this funding is essential for healthcare outcomes in East Thanet and in coastal communities across the country. There is a real need for a coastal communities healthcare strategy, but I challenge the Opposition to say how they would fund our NHS and improve health outcomes in coastal communities. They want all the benefits of the Budget, but they will not back the measures to deliver those benefits. They need to take some responsibility for the situation we find ourselves in.

There are structural problems that we can put down to the last 14 years of Tory Government. Chronic mismanagement of the NHS and years of underfunding have left the health service crying out for help. Shifting public health responsibilities to local authorities makes sense and moving healthcare to where people live is an essential reform, but doing that while cutting real-terms funding for local authorities has been a disaster.

This is not just about making a moral argument for free healthcare at the point of use. I hope that argument has been won across most of society and in this place. This is an argument about people being able to contribute to the economy. We cannot have growth with a sick workforce and a failing healthcare system. This is about the people who are using savings to go private, or having to take time off work because they cannot afford to pay and are too sick to work. There are shift workers trying to earn money and waiting weeks for a doctor’s appointment, and small business owners working through healthcare issues when they should be getting treatment, because they cannot afford to take time off. Nobody says that this does not have an economic impact.

[Dr Roz Savage (South Cotswolds) (LD)]

I know that difficult decisions have had to be made, but I have been talking to small business owners. I am particularly thinking of the owner of a chain of convenience stores in Lechlade, and the difficult decision he is having to make of which of his part-time workers he is going to lay off in the run-up to Christmas. Should not the difficult decisions be those of the big tech companies about whether they actually pay their fair share of corporation tax? Should they not be the really tough—