Leaving the EU: NHS Funding

Stella Creasy Excerpts

Tuesday 15th November 2016 Commons Chamber

[Stella Creasy (Walthamstow) (Lab/Co-op)]

My hon. Friend is making a powerful case. This is such an important point for our economy, as we know in my part of London, where the Barts trust has the largest predicted overspend in NHS history. Does he agree that it is vital that those who campaigned on the pledge that this money would be provided are held to account, because communities such as mine are suffering without investment in the NHS?

[Mr Umunna]

I agree absolutely with my hon. Friend. When I had the pleasure of visiting her constituency the other week, I saw for myself the situation that she describes.

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[Mr Umunna]

The right hon. Lady pre-empts what I am about to say; I shall come on to that precise point.

To be clear, I want the Minister, on behalf of his Department, to give the same commitment that we are asking the Treasury to make, and to outline how his Department will make good on this pledge. I shall explain why this is a pledge that the Government should deliver. The Minister might give a number of reasons, perhaps echoing the right hon. Member for Broxtowe (Anna Soubry), to explain why the promise given by his ministerial colleagues during the referendum should not be treated as such. I will deal with each of the main possible reasons in turn.

First, there are those who claim that this was not a pledge at all. Nigel Farage, the interim leader of the UK Independence party, said that it was one of the mistakes that he thought the leave campaign made. The current Transport Secretary, who was also a member of the Government at the time of the referendum, has said that Vote Leave’s specific proposal was, in fact, to spend £100 million a week of the £350 million for the NHS that was originally hoped for, commenting that that would be an “aspiration” to be met. Let me tell the Transport Secretary that the poster that the Vote Leave supporters all stood next to did not say that this was an “aspiration”; it was a pledge—pure and simple. There was no qualification on the poster or on the big red bus. This statement was made, and the people who made it should be held to account for it.

Secondly, many leave campaigners deny ever using the £350 million figure. One of them said:

“I always referred to Britain’s net contribution of nearly £10 billion—some £200 million a week…rather than £350 million.”—[Official Report, 5 September 2016; Vol. 614, c. 20WH.]

It is true—my hon. Friend the Member for Ilford North (Wes Streeting) touched on this—that the Office for National Statistics said that the £350 million figure was misleading, but the head of the Vote Leave campaign said:

“the £350 million figure is correct and we stand by it.”

Vote Leave, whose banner Government Ministers campaigned under, carried on citing the figure, as my hon. Friend said, and those Ministers must now be held to account.

[Stella Creasy]

I take my lead from the right hon. Member for Uxbridge and South Ruislip (Boris Johnson), who sadly does not appear to be in this Chamber. He was one of the most prominent members of the Vote Leave campaign and said that Brexit must give the NHS a boost. In my part of town, a boost to the NHS is the vital funding that we need to get our NHS back on track. Does my hon. Friend agree that we should listen to the right hon. Member for Uxbridge and South Ruislip about that point?

[Mr Umunna]

I shall come on to him shortly.

A further thing that is said—again, I think this has been touched on—is that not all the people who made these pledges were members of the then Conservative Government. Perhaps that could be said of the right hon. Member for Uxbridge and South Ruislip (Boris Johnson). Well, of the five current members of the Cabinet whom I mentioned, three were members of the then Government and one—the right hon. Member for Uxbridge and South Ruislip—attended the political Cabinet at the time. Yes, the Secretary of State for International Trade was sitting on the Back Benches, but countless other Ministers from outside the Cabinet at the time who are now serving more than make up for that—for instance, the hon. Members for Portsmouth North (Penny Mordaunt), for Camborne and Redruth (George Eustice) and for Stockton South (James Wharton). I could go on. Those are just a few of the people who posed by those posters and next to that big red bus, and they must be held to account.

Finally, it is said—this is the crux of the argument advanced by the right hon. Member for Broxtowe—that the commitment was given by one side in a referendum campaign, not by a Government. I am sorry but that simply will not wash. Many of those people were put up to appear in the media and to campaign on Vote Leave’s behalf precisely because they carried the authority that attaches to Government Ministers. That was why they were used. That was why they were asked to stand by that red bus, and to stand by those posters.

All those key Vote Leave campaigners, whether they were Ministers or not, were Members of this House. If our democracy is to mean anything, it must mean that Members are answerable to the electorate for their policies, and held to account in the House for the things that they say. People cannot go around the country casually promising the world and betraying people by failing to deliver, but then expect to get away with it. We will not forget; we will not let up. It was in the name of parliamentary sovereignty that those Ministers campaigned, and it is time that the House, on behalf of the people whom we are elected to represent, took back control, if we want to use that phrase, and made those Ministers answer.

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[The Parliamentary Under-Secretary of State for Health (David Mowat)]

I congratulate the hon. Member for Streatham (Mr Umunna) on securing the debate, and on the points that he made. Like him, I voted and campaigned for the remain side, and, like him, I accept the result. I am now part of a Government who are responsible for delivering what was democratically decided by the British people. I should say at the outset, however, that I am speaking today for the Government and not for the leave campaign. If the hon. Gentleman feels that he is taking part in the wrong debate, I apologise for that in advance.

I will, however, address some of the points that have been made about the impact of Brexit on the NHS, because valid points were made about staff morale, the level of funding and the exchange rate. All those are variables, and I think it is good for us to spend a bit of time talking about them this evening. I will also talk about what stage I think we have reached on the pledge and the amount of money that we will no longer be giving to the European Union when we leave—although, as the hon. Gentleman knows, that depends on how we leave, and on the nature of the agreement that we eventually reach.

Let us begin by agreeing on one point. The single most important thing that the NHS needs to be properly funded is a strong economy. To the extent that Brexit may have positives and negatives, that fact is relevant, but the NHS is properly funded at the moment. We have heard some stuff about budgets and all the rest of it, but let me tell the hon. Gentleman that the OECD’s analysis of health and social care spending in every OECD country shows that we are now above average, although that has not always been the case. We are possibly 1% lower than the best of class, including France and Germany. That figure was for 2014, and the gap is likely to have been filled because this year we gave an increase to NHS spending of three times the rate of inflation and we have pledged that NHS England’s budget will increase in real terms by £10 billion between now and 2021. I do not believe Brexit will make any difference to that; indeed it is a commitment and priority of this Government that it will not.

We do know, however, that there are issues in how that money is allocated within the NHS. We are broadly at the average point of the OECD, and we do and could spend that money more efficiently and effectively. We could spend more on primary care, cancer and mental health than we do, and those are Government priorities, and we hope the sustainability and transformation plan process will help to deliver that because at the moment we spend too much on acute care.

Of course we can find efficiencies, too. Agency staffing is too high and we need to address that. There is a lot we can do on procurement—Carter and new care models and all that go with that.

[Stella Creasy]

The Minister could also work to renegotiate the private finance initiative loans that are crippling our NHS, and not use PF2 to do that. In order to do that, we need money in the NHS to be able to renegotiate. Surely the £350 million would help get us to that place; it would help us to renegotiate our debt, get our constituents back into work and get our NHS fit for purpose in the 21st century?

[David Mowat]

Nobody in this House would be more pleased than me if we did not have the PFI millstone around our neck. The hon. Lady talks of renegotiation; this is real money, and these are real contracts that were signed more or less entirely by the last Labour Government. There is no magic wand that enables us just to set those PFI contracts aside, although I wish there was; that is not how the commercial world works.