Health and Social Care Levy Bill

Debate between Stephen Flynn and Nigel Mills

Committee stage & 3rd reading
Tuesday 14th September 2021 Commons Chamber

[Stephen Flynn]

I thank the hon. Gentleman for his intervention and for the tone in which it was made, and I shall reflect on two points in relation to what he said. He said that perhaps the biggest change to health and social care was the action of Tony Blair, but I happily disagree with that. In fact, it was in 2016 in Scotland, when we did something that I heard Members discussing earlier at length: we integrated health and social care in Scotland. That was on top of the fact that we provide free personal care for our elderly and so on, and that is in contrast to the situation in England, which has led to the crisis we see before us.

On the hon. Gentleman’s point about finance, which is the crux of this argument, do the ends justify the means? That is the purpose of this discussion. I believe in the ends. I believe our NHS and social care services deserve more money, but I do not believe that this is the right way to do it. That obviously leads to the next question, which is about how we should fund this. I heard Conservative Members—rightly—shouting at the Labour Benches, “What is your plan?”, but what is the cost of Trident? What is the cost of nuclear weapons? Over their lifespan I believe it is between £164 billion and £200 billion. Conservative Members will not say that those weapons should be scrapped, but I will. They should absolutely be scrapped, and we can use that money to fund our vital NHS services. The answer is staring them in the face, but they choose not to look at it because this is about priorities, and their politics and priorities differ massively from mine, and ultimately from those of the people of Scotland.

Finally, amendment 4 goes to the nub of where much of our frustration lies with the Bill, because if we shake it about a bit, this is ultimately another UK Government power grab. They are seeking to tell the Scottish Parliament how it should spend money in devolved areas. Whether they agree or disagree with the national insurance hike, all members of the Committee, certainly Unionist Members, should be concerned about the consequences of the UK Government seeking to impose themselves once again on devolution. I say that not as someone who seeks to defend the Union—by all means continue to do it—but because all the UK Government are doing is driving home the message in the minds of the people of Scotland that they do not respect the devolution settlement and they do not respect the Scottish Parliament.

[Nigel Mills]

I come at this debate from a slightly different angle. When we first heard rumours of a tax rise to fund health and social care I felt that, given that we had just spent £400 billion to get us through a pandemic, and that we wanted to get health care services to 110% of previous capacity to clear the backlog, we could accept that a tax rise had to be found to do that. I thought there was no other way, given that the economy and tax revenues are still smaller than they were, and that that was the responsible and prudent thing to do. I may not have chosen national insurance, but I accept that it is probably one of three taxes that the Government could have chosen.

My interest is in why, in the long term, we have chosen not to raise national insurance but to have a new tax. I remember that when I was first elected we were keen on simplifying the tax regime. We even had a review into whether we could merge income tax and national insurance, so that we could have one tax fewer, and make it cheaper and simpler to collect. For some reason that I will try to work out, we have now moved on to adding a kind of son or daughter of national insurance to the tax code. I think the only slight difference is that the new tax will apply to the earned income of people over retirement age, where national insurance does not. I do not know how much that will collect—the Minister would not give us an estimate—but I think it is a pretty tiny amount, and I am not sure there is huge advantage in that.

Being a bit of a cynical sort of person I thought that perhaps because our manifesto promise ruled out tax rises we could have a levy, and that people would fall for that, but I am glad we did not take that line. Indeed, the Government were clear that we are breaching our manifesto promise, for justifiable reasons in the circumstances.

Perhaps we are trying to create some clarity, thinking that if people can see a hypothecated tax, they can see how much they are paying for health and social care and they will understand and value what is happening, except of course we are raising by this levy £12 billion a year or so—a tiny fraction of what we spend on the NHS, let alone social care—and people will see a social care levy on their council tax bill. In fact, this money is not even the biggest part of national insurance that will go to the NHS; as I said earlier, £26 billion a year—roughly 2% of the national insurance contributions in each class—already goes directly to the NHS and does not go down the usual route of national insurance funding. I am not sure that we are going to get the benefit of clarity for people about what they are paying.