Health and Social Care Levy (Repeal) Bill

Steve Brine Excerpts

Committee stage
Tuesday 11th October 2022 Commons Chamber

[James Murray]

We know that the Bill is straightforward in what it seeks to achieve: as clause 1 sets out, it simply repeals the Health and Social Care Levy Act 2021. Ministers are asking us today to overturn a piece of legislation that they and their colleagues strained to defend and voted in favour of a little over a year ago.

As I set out on Second Reading, we welcome Ministers scrapping the tax rise on working people introduced by last year’s Act, but while the levy was not due to come in until April 2023, and the Bill means that the levy will never be charged, the Act also raised national insurance contributions for the current financial year 2022-23 as a transitional measure. As clause 2 confirms, the Bill keeps national insurance contributions at that higher level for the first seven months of this year, before letting them return to their previous levels from November. The decision by Ministers to scrap the national insurance rise is, of course, better to have come late than never, but this in-year change means that yet another cost will be paid for through working people’s taxes, as public money pays to undo the mess created by the Tories having made the wrong call last year. The explanatory notes to the Bill confirm that there will be a cost of an in-year change. Under “Financial implications of the Bill”, they state:

“HMRC anticipates increased call volumes and customer contact as a result of the in-year reduction of NICs rates. There will be delivery costs in implementing this policy. IT changes will be required to be delivered at additional cost to HMRC, to support safe delivery of this policy.”

All this could have been avoided if Ministers had simply listened to people across the country, to the Opposition, to Members on their own side, to the Federation of Small Businesses, the British Chambers of Commerce, the CBI, the TUC and so many others. If Ministers had listened, they would have realised that it was wrong to go ahead with this tax rise on working people in the first place. While we know that the U-turn before us will cost more than if Ministers had made the right call last year, we do not have a figure from the explanatory notes for exactly how much this will cost. On that point, the Bill’s notes simply say that

“Costings will be set out in due course.”

In other times, I might have read that statement and concluded that Ministers genuinely do not know the costings, but if their behaviour over the OBR report is anything to go by, it could be that they are simply refusing to publish those costings for political reasons.

It is because of this Government’s lack of willingness to subject themselves to transparent scrutiny that we have tabled new clause 1. New clause 1 would require the Chancellor to publish a report on the financial implications of the Act on the day that it comes into force. That report must make an assessment of the Treasury’s plans to raise an amount of revenue equivalent to the proceeds of the levy in the context of its approach to general taxation and borrowing.

As I mentioned on Second Reading, the Economic Secretary to the Treasury confirmed in a letter sent to the shadow Chancellor and the shadow Secretary of State for Health and Social Care on 22 September that:

“The additional funding used to replace the expected revenue from the Levy will come from general taxation and may require further borrowing in the short-term.”

We already know that borrowing is set to soar thanks to the Government’s disastrous and discredited approach to the economy. We know that their approach has inflicted huge harm on our economy, damaged our international standing and pushed up mortgage payments for households across the country. We know in particular that the Government’s failure to publish the OBR report showing the detail behind their approach has aggravated the spooking effect on markets. Through our new clause, we would require the Government to explain how they will maintain the funding equivalent to the levy, given their wider reckless decisions on borrowing and the economy.

New clause 1 refers to general taxation. As Members may recall, when they announced the health and social care levy last year, the former Prime Minister and Chancellor explained that, alongside the national insurance increase, the Government would also increase taxes on income from dividends at the same time. On 7 September last year, the previous Prime Minister, the right hon. Member for Uxbridge and South Ruislip (Boris Johnson), said:

“because we are also increasing dividends tax rates, we will be asking better-off business owners and investors to make a fair contribution too.”—[Official Report, 7 September 2021; Vol. 700, c. 154.]

The question arises of why the current Prime Minister and Chancellor have decided to cut this tax rate from April 2023. They do not need to scrap the dividends tax rise as part of the repeal of the Health and Social Care Levy Act—the dividend rate does not appear in that Act—but they have none the less committed to doing so. I would be grateful if the Minister could set out whether he agrees with the former Prime Minister’s argument that having a higher tax rate on dividends means asking better-off people to make a fair contribution. If so, can he confirm why the Government have decided that it is the right time to cut taxes for those who are better off, even if that means greater borrowing funded by all taxpayers?

As I have made clear throughout, we are glad that the Government are using the Bill to finally scrap this tax rise on working people, but it is clear that taxpayers will pay yet again to fix the mess the Tories have created, that Ministers are planning to again cut taxes for those they have described as the better-off and that this Government are desperate to avoid scrutiny of their plans. It is with that final point in mind that we ask Conservative Members who are uncomfortable with their Government’s approach to join us in supporting new clause 1.

Our new clause would simply require the Treasury to be transparent about how it will replace the money for health and social care that will no longer accrue from the health and social care levy, in the context of its wider approach to taxation, borrowing and the economy. As we have heard throughout the day in Parliament, there is widespread concern that the Government’s plans do not add up and that their lack of transparency is making matters worse. Our new clause makes clear to Ministers that this must change.

[Steve Brine]

I was not planning on speaking, but there are a couple of points that I would like to put on record, as a former Health Minister. I will not revisit the debate on the leadership campaign in the summer, or support new clause 1. I listened carefully to the hon. Member for Ealing North (James Murray) setting out his argument, and I have some sympathy with some of it, as he probably gathered from some of my interventions earlier.

I was happy to support the Second Reading of this repeal Bill—not that we had a Division on it. The Bill was well trailed throughout the ridiculously long leadership campaign in the summer; I do not think that that was the issue that spooked the markets at the time of the fiscal event a couple of weeks ago.

As my hon. Friend the Member for South Suffolk (James Cartlidge) said so eloquently on Second Reading, this is probably the most important debate that we could be having; I am miffed that the House of Commons is so quiet. It is about funding the British public’s No. 1 priority: the national health service. It was about that when we passed legislation on the levy, and it is about it now that we are repealing it. The issues have not gone away. I will listen carefully when the case for new clause 2 is outlined, but new clause 1 looks down the wrong end of the telescope. My hon. Friend cited the Office for Budget Responsibility’s projection that NHS funding will, in coming years, go from about 10.3% to 17.5% of GDP. Those are eye-watering figures. I have to say, as a former Minister for public health, primary care and prevention, that we cannot simply carry on that curve.

I want to put on record my points on three or four of the big challenges that the health service faces. If the Government let ideology get in the way of facing down those challenges, future generations—and Governments, whether Conservative or Labour—will pay the price. Take obesity. UK-wide, the NHS costs attributed to being overweight and obesity are projected to reach £9.7 billion by 2050. When I was in the Department of Health, we wrote the child obesity strategy. It is fair to say that the former Prime Minister, my right hon. Friend the Member for Uxbridge and South Ruislip (Boris Johnson), did not like a lot of it when he was running for the leadership of our party. In fact, I think he referred to the sugar tax as a sin tax, but—let the sinner repent—he came round to it. Now I hear rumours that it is for the bin.

I hear rumours that many other measures, including those around price promotion—"buy one, get one free”, as it is colloquially known—are also potentially for the bin, because we do not want to be seen as a nanny state. This from the state that recently passed a law making it illegal to leave the house without good reason. Sometimes, the state does things in the interests of the population that it serves, and there is no shame in that. If we do not tackle the obesity challenge, it will have not only a big financial impact on the NHS, which we are talking about how to fund, but a big social impact.

That takes me to my second point, which is on cancer. Around four in 10 cancers today are preventable. Smoking causes at least 15 different types of cancer. It is the biggest cause of cancer in the world today. Earlier, the hon. Member for Stockton North (Alex Cunningham) mentioned the smoking cessation plan, which I published when I was in office, and subsequently updated. We are still waiting for its revision. Press reports say that it is to be dropped as well. I gently suggest that that would be a massive own goal for our Government, and for the NHS, which we argue about how to fund.

--- Later in debate ---

[Steve Brine]

Without question. We had some success with our tobacco control plan, but progress has stalled. We cannot ignore the pandemic, as the Opposition Front Benchers sometimes try to, and I understand that it disrupted the smoke-free England plans, but we need to get back to it, for social reasons, and for economic reasons relating to the health service that we seek to fund.

I am sure that right hon. and hon. Members from across the House have heard of the “Be Clear on Cancer” campaign, and of the “Touch, Look, Check” message encouraging women to check their breasts. I lost my mother to breast cancer; it destroyed much of my family. I brought a ten-minute rule Bill on the subject to the House earlier this year. Breast Cancer Now tells me that it thinks that there are 12,000 undiagnosed breast cancers in this country today. One does not need to be a genius, a former Health Minister or a breast surgeon to understand what that could mean: undiagnosed breast cancers move beyond stage 1, into 2 and 3, when they are untreatable. That is what happened to my mother, and I do not want it to happen to others. If the nanny state means implementing “Be Clear on Cancer” campaigns to help people avoid cancer, I am a nanny state-ist.

[David Rutley]

My hon. Friend makes an important point about raising awareness, particularly on public health, and I support the points that he makes, but does he agree that, at this time of real challenge, it is also important to drive public awareness of how to use energy more efficiently, in order to help people with their fuel bills?

[Steve Brine]

I know why Dame Rosie is smiling: she thinks that I have possibly attempted to fit my Second Reading speech into this response to new clause 1. If I go down the road of energy policy, I may test her patience. All I would say to my hon. Friend is that, if the energy price guarantee was a price cap, and people could not pay more than the amount at which the cap was set, there would be some argument for not having a public campaign advising people on their energy use. It is not a cap; it is an energy price guarantee. If people use more energy, they will pay for more energy. It therefore seems logical to me, on lots of levels, to help people save energy—but what do I know?

I was just coming to diabetes. The NHS spends about £10 billion a year—that was about 10% of its budget, when I was in the Department—on diabetes care. That is a phenomenal amount of money, yet type 2 diabetes is preventable and, as we have heard from Members, people can turn it around. Why would we not want to encourage people to manage their weight better, when weight is one of the big drivers of diabetes?

Finally, stoke is a big killer in this country. It costs the NHS billions. During conference recess, I visited a group in my constituency called Say Aphasia—I figured it was a better use of my time. I met a group of 15 men who had had strokes. One was two years younger than me. They had severe communication difficulties. I see my hon. Friend the Member for Bury St Edmunds (Jo Churchill), a former public health Minister, by the Front Bench. She knows what I am going to say. Why would we not want to help the NHS prevent stroke through a proper salt reduction strategy? Given my surname, when I tried to suggest one to the Department, it caused some amusement among officials, but I think it is the right thing to do. If we cannot prevent stroke, I will meet a lot more people like those I met in the Say Aphasia group last week. Their ongoing cost to the NHS is significant.

In conclusion, the point I am trying to make, and maybe I am not making it very well, is that, if we do not believe in prevention—and in my heart I believe that those on the Front Bench do believe in prevention—the costs of the NHS predicted in the OBR book are going to look quite conservative. I think I am right in saying that those projections include this levy being in place, not repealed—

[James Cartlidge]

And corporation tax.

[Steve Brine]

And corporation tax, as my hon. Friend says from a sedentary position. If we believe in prevention—and, as I say, I believe that those on the Front Bench do—we need to have the courage to act on that. That will mean doing unpopular things, but sometimes we have to do unpopular things to do the right things, and that means preventing some of the major killers and some of the major causes of ill health that I have mentioned. If we do not do that, the NHS will continue to cost unsustainable amounts of money and it will become unsustainable. There endeth the lesson of Dr Brine.

[Richard Burgon (Leeds East) (Lab)]

I want to focus my remarks on my new clause 2. I thank the 25 right hon. and hon. Members who added their signature to mine on the amendment paper, and I am pleased that it has support from Plaid Cymru, Alba, Labour, Green, and Social Democratic and Labour party MPs.

The Conservative party was wrong to introduce the health and social care levy, so it is right that it is being scrapped, but it is wrong that the Government are imposing a package of unfunded tax cuts, which have created financial panic and led to interest rates shooting up and millions of people fearing how they will keep their home. The package has created a Tory crisis made in Downing Street, but being paid for by working people.

As I say, I welcome the scrapping of the levy, but of course health and social care still need the extra funding that it would have raised. We only have to look at today’s news about how the number of social care workers has fallen for the first time in a decade to see just how broken our care system is, and rising waiting lists and soaring ambulance waiting times show that the NHS is in dire need of a funding boost. So my new clause 2 would require the Chancellor, in addition to scrapping the levy, to look at different taxes to raise the income that would have been raised by the levy. Specifically, it calls on the Chancellor to look into the iniquity of tax rates on wealth being lower than the taxes paid on income from work.

We are, I am afraid, one of the most unequal countries in Europe when it comes to income distribution, but it is even worse when we look at wealth. The richest 1% hold almost a quarter of UK wealth, so we need a full and wide debate in our country about wealth taxes. I have been calling for a wealth tax—for example, a one-off wealth tax of 10% on wealth over £5 million, which could raise £100 billion and provide an emergency wealth fund to help get us through this crisis—but today, with new clause 2, I want to concentrate not on the taxing of wealth itself, but on taxes on income deriving from wealth.

We have a scandalous situation in our society in which income derived from wealth is taxed below income derived from work. If someone is lucky enough to be able to live off share dividend payouts, they will pay less in tax than someone who earns exactly the same amount by getting up each and every day and going out to work. Likewise, capital gains tax, which is paid on profits when selling assets such as a second home, is paid at rates below income tax rates. How on earth can that ever be justified, and how can it be justified when the Government are plotting—without any democratic mandate, I would add—to cut benefits and public services across society?

In fact, there is huge potential for increasing tax revenues by simply ending the significant tax discounts that go to income from wealth over income from work. How much would be raised by doing this? Ending the lower rates paid on capital gains and share dividends, and removing the related exemptions on those taxes, would raise around £24 billion per year. That is a lot more—nearly double—than the amount from the national insurance tax hike on working people, which would have raised around £12 billion to £13 billion. The funds that my proposal would raise could be a big down payment on the investment that we need to ensure our social care system delivers for everyone, and it could make a big difference in addressing the crisis in our health service.

For those on the Conservative Benches who may be appalled by this idea or this moderate proposal, I want to point out that the former Chancellor—not the last one, but the one before, the right hon. Member for Richmond (Yorks) (Rishi Sunak)—commissioned a review of capital gains tax, and that review recommended slashing the annual allowance and aligning capital gains tax rates more closely with income tax, in a move that could raise billions of pounds for the Exchequer. On this, Margaret Thatcher, even, had an interesting view. Under Thatcher’s premiership, the same basic unfairness of lower taxes on capital gains was ended. It was back in 1988 that the then Chancellor, Nigel Lawson, said that

“there is little…difference between income and capital gains, and many people effectively have the option of choosing…which to receive. And…it is by no means clear why one should be taxed more heavily than the other.”—[Official Report, 15 March 1988; Vol. 129, c. 1005.]

Since then, wealthy people living a low-tax lifestyle have been benefiting from even lower capital gains rates than over 30 years ago, so something has gone wrong and it is now time to put that right. We need solutions to deal with this economic crisis in a socially just way, not through austerity, not through benefits cuts and not through public service cuts. Social justice means putting tax justice at the heart of our economy. We should start by ensuring that those who live off their wealth pay at least the same level of tax as those who live off their own work.