Budget Resolutions

Stuart Andrew Excerpts

Tuesday 2nd December 2025 Commons Chamber

[Stuart Andrew (Daventry) (Con)]

This Government are trying to tell the public that this Budget was all about taking tough decisions to deliver change, about raising taxes to support the NHS and about pursuing growth and backing business. Those are commendable aims, but it is simply not the reality of what was delivered in the autumn Budget. This was a Budget for benefits paid for by hard-working people.

Last year, taxes were hiked by £40 billion, borrowing went up, inflation went up, unemployment went up and living standards fell, but at least we were promised by the Chancellor that this was a one-off. She categorically said that she would not be coming back for more. But like the promises made during the general election, that was just not true. Then, as Halloween approached, we had briefing after briefing, that infamous press conference, markets affected and consumer spending depressed, particularly in the hospitality sector, all leading to one Cabinet Minister reportedly saying that

“The handling of this budget has been a disaster from start to finish.”

I wonder who that could have been.

Now we have another £26 billion in tax rises to fund more welfare, because the Prime Minister lacks the backbone to stand up to Labour MPs and make the real hard choices. At the previous Budget and spending review, big promises were made to the public about how the Labour Government would solve the challenges in the NHS through a financial settlement that they said would improve patient care, including by bringing waiting times back to the 18-week standard within five years. We warned at the time that that money would be swallowed up, in large part by decisions of the Government’s own making. The then chief financial officer of NHS England said that it would go almost entirely on pay awards, national insurance contributions and drug price increases.

What does Labour actually have to show for that? Elective care waiting lists have fallen by less than 2% since October last year. Meanwhile, waiting lists for community health services and diagnostic scans are rising. Waits to start cancer treatment are increasing. Trauma and orthopaedic waits are up; ophthalmology—up; neurosurgery—up; gynaecology—up. Winter pressures are growing, and long waits in A&E have hit record highs. The truth is that the Labour Government do not have a plan for the NHS; they have fallen into the classic Labour trap of thinking that issuing a press release about cutting waiting lists will magically make it so, just because they are in charge. I am afraid that is not how government works.

What has the Secretary of State been focused on? A top-down reorganisation of the NHS—which not only did he not tell anyone about before the election but he explicitly said he would not do. As Conservatives, we support the principle of cutting duplication, reducing bureaucracy and saving on administration costs. The House will remember that a recent Conservative Health Secretary, my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay), reduced in a single year the number of civil servants in the Department for Health and Social Care by around one in six.

Let us be clear: this is yet another announcement made by the Government without any plan for delivery. For months, not one Minister has been able to answer any of our questions about how much NHS restructuring will cost or who will be expected to cover redundancy packages. For months, integrated care boards have been warning that frontline patient services were at risk because they simply do not have the money to do what is asked of them. For months, staff were left in limbo, not knowing whether their job would still exist or for how much longer. We welcome the fact that the Budget finally provided some clarity, but shifting money between years means significant risk. The NHS is already behind on its efficiency targets. If this reorganisation falls short of its goals—no small risk given the Government’s performance—there is an even more significant shortfall to make up in future years, which will hit patient care.

There are other elements of the Budget that we welcome for the health service. Focusing on improving productivity is the right thing to do, but whether the extra investment will make any difference in the grand scheme of things remains to be seen. Neighbourhood health centres can be cautiously welcomed. They build on the great success of the Conservatives’ efforts to bring care closer to where people live through the community diagnostics centre programme. However, has Labour truly learned the lessons of all the private financial initiative deals that it botched back in the 2000s, which NHS trusts are still paying for decades later? Will the Government simply move resources around or will there be genuinely innovative new ways or working, joining up services and improving the patient care experience? I hope that it is the latter, because shuffling the deck chairs into new buildings will not deliver the benefits that patients deserve.

Despite those few bright spots, it simply is not right for the Prime Minister, the Chancellor and others to justify this latest tax grab by saying that it is to protect the NHS. As the NHS Confederation noted, this year’s Budget did not have a health focus. That means that we are left with a lot of unanswered questions. The Office for Budget Responsibility specifically raised two risks to health spending. The first was the doctors’ strikes, which the Health Secretary has failed to resolve, despite making that sound very easy to do when he was in opposition. I will give him credit, because he did briefly end them, for a few short months, but only by caving in to the demands of the British Medical Association, in return for no productivity or modernisation reforms. We warned him that giving in to the trade unions would only see them come back for more—and indeed, here we are, with patients and taxpayers paying the price, and no end in sight. The OBR confirmed that strikes have already cost £500 million, and warned about further strikes. Now it has been confirmed, just before Christmas—the worst time of year for it—that the doctors are out again.

[Noah Law (St Austell and Newquay) (Lab)]

Does the right hon. Member care to remind us how much the NHS strikes cost under his Government’s watch?

[Stuart Andrew]

Well, we did not spend tens of billions of pounds in pay rises just for the same old problem to come back. There should have been proper reform, and conditions for those pay rises, but the Government did not make that happen, and here we are again.

The NHS Confederation has also warned that local services cannot continue to absorb the costs of ongoing strikes by the BMA without consequences for patient care. I pay tribute to frontline staff, who have been trying to keep everything going. I remind the Secretary of State that we have the answer: ban doctors from striking, like the Army and the police, and introduce minimum service levels, using the legislation that our Government passed. That would protect patients and taxpayers, so why won’t he do it? Labour’s Employment Rights Bill will make things much worse, because it reduces the vote threshold for calling a strike, and there will be no minimal service levels.

In addition, the Government have shown that they cannot stand up to the unions. By pushing up inflation, the Budget will make it harder to reach pay settlements across the rest of the NHS workforce. Even an additional rise in NHS pay of just 1% of what the Secretary of State included in his pay review body evidence would create another £1.5 billion hole in his budget. Is he confident that he can head off wider industrial action with a 2.5% offer, especially given that benefits are rising much faster under this Government?

The OBR has also raised the unknown risk of increasing drug prices. My understanding is that the spending review assumed that spending on branded medicines would rise by 25%—or £3.3 billion—between 2025-26 and 2028-29. In winding up, will the Minister clarify what happens when the negotiated price costs more than what was assumed in the spending review? The rest of the money is surely intended to be used to deliver more care and to cut waiting lists, so are frontline services at risk?

[Wes Streeting]

I am grateful to the shadow Health Secretary for giving way. We should be clear that the deal struck with the United States is the first and only deal with the United States that secures 0% tariffs and mitigations against most-favoured-nation pricing. It will ensure that patients get access to good drugs. For the avoidance of doubt, although some costs are unpredictable because of the complexity of medicine pricing, of course we will not cut NHS budgets to fund the pharma deal.

[Stuart Andrew]

We will see what happens. It would be interesting to know exactly where the money will come from. [Interruption.] The Secretary of State just said that if the prices go up, there will be no cuts to the NHS budget, but where will the money come from? Which other part of the national health service and social care will the money come from? We will have to wait and see.

The Budget last week made no mention of social care. After all, Labour’s only plan is to delay coming up with a plan for a few more years, despite the urgency and the scale of the challenge. Many of us entered the cross-party talks in really good faith, and they were encouraging, but we have only met once. Surely we should be getting on with it. The message was loud and clear that we want to work together, but we want to get on with it. Please can we have another meeting, so that we can get on with tackling this really important issue?

It is not quite true to say that social care is unaffected by what was announced. The increase in the national living wage will be welcomed by those on the lowest incomes, but the Nuffield Trust estimates that it will cost the social care sector £1.2 billion. The sector is already struggling with last year’s national insurance contributions hike, so who will pay for this? Will there be funding cuts to other parts of the health budget? Will self-funders have to fork out yet more again, or will it be passed on to local authorities, inevitably leading to council tax rises? What impact will this national living wage increase have on wider pay in the sector?

[Jen Craft (Thurrock) (Lab)]

The right hon. Gentleman is talking about two completely opposite ends. He says his party wants to invest in and find a way forward on social care, but he is opposing something minimal that will raise the living standards of those who work in the industry. Which one is it: does he want to invest in social care or not?

[Stuart Andrew]

I am asking the question of who is going to pay for it. There is no detail in anything this Government do. They are full of plans and no delivery. The sectors I have been meeting are asking those questions—where is the money coming from?

[Sir Alec Shelbrooke (Wetherby and Easingwold) (Con)]

My right hon. Friend worked in the hospice sector, and particularly the children’s hospice sector, long before he came to this place. Does he agree that the pressures on hospices, which are basically run by charitable contributions, have not been taken into account in all the Budget measures introduced since this Government came to power?

[Stuart Andrew]

My right hon. Friend is absolutely right. Let me tell the House, from 16 years of working in the hospice movement, primarily as the head of fundraising, that if you are suddenly asked to find nearly £100,000 overnight, it is almost impossible. It is therefore not surprising that hospices up and down this country are cutting the number of beds that are available. In some instances, up to 40% of beds are being cut, and those people will end up having to be in hospital beds, putting more pressure on our hospitals as we go into winter.

[Clive Lewis (Norwich South) (Lab)]

The right hon. Member asked who will pay for the national living wage increase in the adult social care sector, but something he omitted—and it is quite telling—is the number of private equity companies that are extracting vast profit from adult social care. He did not mention them. He did not mention them taking a hit to their profit. Perhaps they could pay for some of it as well.

[Stuart Andrew]

I understood from the Secretary of State’s 10-year plan that he wants more involvement from the private sector. Perhaps the hon. Member needs to have a conversation with the Secretary of State and see how that goes. In fact, if he wants, he can invite me along, because I would be quite happy to observe that conversation.

Finally, the Budget did not mention any of the issues that matter to many of our constituents, such as mental health, the hospice and palliative care sector—although I do welcome the announcement of the framework and look forward to seeing it—dentistry and general practice. What about the Government’s upcoming plans and strategies? The workforce plan is delayed. The cancer plan is delayed. The independent review of maternity and neonatal services is delayed. Nothing new was announced, suggesting that any resources to deliver those plans will have to come from existing budgets.

What are this Government actually doing for the NHS—not just press releases and reviews, but actual action? It is more money without a plan for reform and no strategy to end the strikes or help patients and staff this winter. They cannot deliver the reforms to social care the country needs because the Prime Minister came into office without a plan and does not have the backbone to make the tough decisions. They are still too distracted with working out how to abolish NHS England to cut waiting lists.

The Secretary of State claims Labour is investing in the NHS, but that suggests we get some kind of return on our money. It is clear that Labour does not have a plan to achieve its targets. This is a Budget where taxpayers are being asked to pay for benefits, not the NHS, and the Government need to own that. Of course, we wish them well. We want them to cut waiting lists, we want care to improve, and we want patients to get better quicker, but their actions do not match their rhetoric, and their plan is little more than an objective, with no method for getting there. For the sake of all our constituents, I hope the Health Secretary can put his leadership ambitions to one side and focus on the job he has, not the next one he wants, because if he fails to deliver, this will be his last.