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Category: Health

  • David Rutley – 2022 Speech on the Health and Social Care Levy (Repeal) Bill

    David Rutley – 2022 Speech on the Health and Social Care Levy (Repeal) Bill

    The speech made by David Rutley, the Conservative MP for Macclesfield, in the House of Commons on 11 October 2022.

    I am grateful for the chance to speak on Second Reading and to follow considered speeches by right hon. and hon. Members. I am particularly pleased to see the Economic Secretary to the Treasury, my hon. Friend the Member for North East Bedfordshire (Richard Fuller), in his place. I knew him for many years before coming to this place and he brings real expertise to the Front Bench, notwithstanding the fact that he has very big shoes to fill—that’s for sure.

    The repeal of the health and social care levy is part of the Government’s growth plan. The key elements of the plan to address cost of living challenges, caused largely by President Putin’s savage attacks on Ukraine, are most welcome. The energy price guarantee helps to limit the price of fuel bills for households across the country for two years, while the energy bill relief scheme provides similar support for businesses right across the country. Those steps are particularly welcome to the small and medium-sized businesses, both in Macclesfield and across the country, which have felt particularly exposed to the sharp increases in energy costs.

    I understand the desire for greater growth and for reducing the tax burden. I recognise that many businesses and working people will be pleased to see the health and social care levy being reversed. They will be able to keep more of what they earn and decide how best to use the saving for their own business or household. I acknowledge that many business owners will welcome another element of the growth plan: the planned rise in corporation tax will not go ahead either. That said, I believe it is important to see the removal of the health and social care levy, and other proposed tax reductions, in the context of the wider economy and our public finances.

    Financial markets have shown concerns about the cumulative effects of the policies set out in the growth plan, as was eloquently set out by my hon. Friend the Member for Salisbury (John Glen) earlier, and the lack of an associated OBR forecast to help set out an independent view has been unsettling. The forecast will help provide an independent view of the plan’s impact on our public finances and on the levels of the Government’s borrowing and debt. That is why I was pleased to learn that the Chancellor will bring forward to 31 October his statement on the medium-term fiscal strategy, and that Treasury Ministers and officials will, as is necessary, work closely with the OBR over the weeks ahead. It is vital that the Chancellor sets out his fiscal strategy soon, to help explain how the measures in the growth plan, including the impact of reversing the levy, will be funded and what they will mean for the Government’s spending plans, such as the funding for NHS backlogs and social care that the levy sought to address, as highlighted very well by my hon. Friends the Members for Winchester (Steve Brine) and for South Suffolk (James Cartlidge).

    The latest timing also means that documents will be available before the next meeting of the Bank of England’s Monetary Policy Committee on 3 November. They will help provide additional, much-needed information for the markets, to colleagues here in Parliament and, of course, to our constituents. As the Prime Minister has said, in hindsight more could have been done to roll the pitch and communicate the growth plan before the Chancellor’s statement on 23 September.

    In addition to the steps to lower taxes, such as the reversal of the levy, and to tackle energy cost challenges, the growth plan includes several innovative plans, such as the investment zones to help drive growth. In Cheshire East, our vibrant life science sector and industrial hubs would represent an exciting opportunity for such a zone to drive sustainable economic growth. That is just an idea, of course, for the Chief Secretary.

    I wish that we could spend more time talking about such opportunities, but we have to accept that we cannot wish away market concerns. We have to recognise where we are, and the Treasury needs to take the time to communicate and explain its plans in more detail and in the context of the wider economy. With that in mind, I am pleased that the Chancellor earlier agreed with the Chair of the Treasury Committee on the need to further engage with and counsel colleagues in this House over the weeks ahead.

    To conclude, this Bill will see the health and social care levy reversed. That policy and the implementation and phasing of other measures in the growth plan aim to help lift growth and will have wider economic consequences, so let us take the time to understand them more fully. Like many colleagues, I am a strong supporter of free enterprise. I recognise that lower taxes have a role to play in driving growth. As is often said, there is a time to every purpose, and at heart I am a fiscal conservative.

  • Richard Thomson – 2022 Speech on the Health and Social Care Levy (Repeal) Bill

    Richard Thomson – 2022 Speech on the Health and Social Care Levy (Repeal) Bill

    The speech made by Richard Thomson, the SNP’s economic spokesperson, in the House of Commons on 11 October 2022.

    It was a little over a year ago that the then Chief Secretary to the Treasury told the House that this health and social care levy

    “will enable the Government to tackle the backlog in the NHS. It will provide a new permanent way to pay for the Government’s reforms”.—[Official Report, 14 September 2021; Vol. 700, c. 845.]

    That was quite a spectacular U-turn on the Conservative party’s 2019 manifesto. Page 2, signed by the then Prime Minister, made a solemn pledge:

    “We will not raise the rate of income tax, VAT or National Insurance.”

    To be back here, just over a year later, seeing a reversal is really quite something. Describing it as a U-turn does not do it justice. An antisocial driver doing donuts in the car park of the local supermarket is the best analogy for how out of control this approach seems to be.

    The UK Government published a health and social care levy policy paper when the levy was introduced, and I distinctly remember this quote:

    “This levy provides a UK-wide approach which enables us to pool and share risks and resources across the UK”.

    It was therefore highly enjoyable to listen to the current Chief Secretary to the Treasury claiming that, now the levy is being repealed, the reverse also happens to be true, in terms of the UK-wide approach to pooling and sharing.

    I spoke in the debate when the levy was introduced, and I recall that there was a sparsity of Back Benchers prepared to provide political cover for their Government’s change of heart. Quite clearly, an awful lot has changed since then. We have a new Prime Minister, who makes much of the fact that she is prepared to be unpopular, which is probably just as well in the light of recent events. She also tells us, and the Chief Secretary repeated it today, that there is apparently a sinister grouping at work outside this place—the anti-growth coalition. I will not go through all the groups that supposedly comprise this coalition, but it seems to be anyone who has the temerity or the audacity to disagree with the Prime Minister, so it probably includes about half the Cabinet and most Conservative Back Benchers.

    Hywel Williams

    I am grateful to the hon. Gentleman for raising the Government’s assault with such frivolity. Does he know how one joins this anti-growth coalition? When does it meet? Does it provide lunch? Does one have to apply through the currently absent Minister? Is there a form on the internet, as there is for everything else?

    Richard Thomson

    I am sorry to disappoint the hon. Gentleman, but I do not have any answers. From a Marxist perspective—a Groucho Marxist perspective—I would not want to be part of any club that would have me as a member. I am sure the T-shirts are being printed and will be available very soon.

    The Government Benches were rather sparse in our previous debate on the levy. Judging by some of the contributions and the exceptionally well-targeted friendly fire, the Government clearly have some way to go to persuade their Members on not only the sincerity of their commitments on health and social care, but their broader approach to managing the economy.

    Scottish National party Members had concerns about the levy at the time as a means of achieving the policy objectives outlined. In our view, it was unclear what the additional resource would be used for, other than in the broadest of terms. The near £13 billion levy seemed to us to be an arbitrary amount, unconnected to any clear plan for how the funds might be used to tackle the pressures in the NHS—far less for how that resource, and how much of it, would end up being passported through to meet the challenges in the care sector. We also remarked that there was no sign of the accompanying reforms that would be necessary to get better outcomes on integrating health and social care services in England, as has been done in Scotland and as will be built on through the establishment of a national care service by the end of the current Scottish parliamentary term. The levy was also introduced, and is now being withdrawn, without our having had any indication from the OBR—although we believe the work has been done—of the impact not just of this but all the other fiscal choices that now sit around it.

    To say that the UK Government are in complete disarray in their approach not just to health and social care but to managing the economy, would be a kindness and an understatement. They are abandoning the national insurance rise in favour of increased borrowing, just as the Chancellor’s limited fiscal event has resulted in borrowing growing considerably more expensive. They are introducing tax cuts, which are intended to be funded in part by cuts to public expenditure, and those will inevitably feed through to pressures on the health and social care sectors that the levy was supposed to be bolstering. With the rampant inflation we now see in our economy, any resource that makes it through to the health and social care sectors will not travel as far as it would have done—those pounds will buy less. The huge post-pandemic health and social care problems that we face in common across these islands have also been made that much worse by the botched nature of the mini-Budget.

    John Appleby, the director of research and chief economist at the health think tank the Nuffield Trust, is surely correct when he warns that the funding ball is now back in the Government’s court, saying:

    “They will have to fund the commitment through some combination of borrowing and deprioritising other public spending”.

    Let us be realistic about this: that is a far more likely set of outcomes than seeing the commitment being met through ambitions for growth, no matter how loudly and repeatedly they are stated.

    To be clear, SNP Members never believed that a levy on national insurance was the way to achieve the objectives of meeting those challenges. It is tempting to go back to what was said on 24 March, when Paul Johnson, the director of the Institute for Fiscal Studies, called the Government to account in The Times newspaper, saying:

    “Why promise to spend billions cutting the basic rate of income tax whilst going ahead with an increase in NI rates? That will make the tax system both less equitable and less efficient. It will increase the wedge between higher taxes on earnings and lower taxes on pensions and unearned incomes. And wouldn’t that money have been better spent sooner helping those most in need?”

    That was an excellent question then and it remains so today.

    Let us be clear that the funding challenge goes beyond the challenges of the economy, to meeting the parallel challenge presented by the growing and complex demands of an ageing population. In meeting that challenge, it is important that we are able to meet the demands and needs of patients, service users and staff with dignity and compassion, while making sure that the responsibility for contributing towards that financially is a burden shared fairly and equitably.

    In financial terms, that is going to be met through a combination of revenue spend and capital spend. The way in which that cost is shared will come down to political choices over how much is to be borrowed and how the tax system is to be balanced over the longer term. We certainly wait with a mixture of bated breath and nervousness as to what the Chancellor will finally bring forward later this month. I make no apology for repeating this point: it must be fairer, as a general principle, to spread the burden by increasing income taxes across the board on both earned and unearned income, as well as to look again at areas such as inheritance taxes and capital gains, so that the totality of the wealth right across the nations of these islands can be taken into consideration when sharing that burden.

    Instead, we seem to have a piecemeal and incoherent approach to reform from this Government, allied to an equally piecemeal and incoherent approach to taxation and the wider economy. It is often said of a person’s character that, when someone shows you who they are, you should believe them. My goodness, haven’t we in the past three weeks seen exactly what the essential character of this Government is when it comes to their priorities? We have seen that instinct revealed in the decision to unapologetically lift the cap on bankers’ bonuses. We see it in the attempts to cut taxes for the richest, to give least to those who need it most and to hack back on the public services that enable people to live the best lives they possibly can, irrespective of their personal circumstances. We see it in the resulting economic chaos and the fiction that out of that chaos growth will emerge, which somehow makes all of this additional borrowing affordable.

    In some kind of conclusion, it is clear that the problems that led to this levy being identified as a solution in health and social care have not disappeared, even if the levy itself is about to. The Chief Secretary repeated the Prime Minister’s lamentable jibe about the “anti-growth coalition”. As the chaos that has emerged from the mini-Budget shows, the solutions to the myriad problems we face are not going to be found among the dangerous, disruptive ideologues who cause mayhem by supergluing themselves to the policy prescriptions of the Institute of Economic Affairs. They can be found only by building long-term value in the economy and making sure that the burden for doing so is shared equitably among all people and all businesses that can make the contribution that they need to.

  • James Cartlidge – 2022 Speech on the Health and Social Care Levy (Repeal) Bill

    James Cartlidge – 2022 Speech on the Health and Social Care Levy (Repeal) Bill

    The speech made by James Cartlidge, the Conservative MP for South Suffolk, in the House of Commons on 11 October 2022.

    It is fair to say that it is a bit of a novelty for me to be called so early, and without a time limit, in a debate. I am very grateful, not least because how we pay for healthcare is one of the single most important subjects in British politics. That is essentially what we are debating today, and I feel strongly on this subject. The core principle must be one that I have always held as a Conservative, which is that we are fiscally responsible. As with the environment, we must aim to leave things in a better condition for future generations and, with the public finances, have in mind at all times the impact on those yet to be born—on our grandchildren—so that we are fiscally responsible. That is the fundamental belief of my party, in my view.

    With that in mind, there is a lot of excitement about what the OBR will say on Hallowe’en, but it has already pronounced on the matter of health expenditure. In July it published “Fiscal risks and sustainability”, a fascinating bedtime read. The crucial thing is what it says about the OBR’s estimate for the future cost of healthcare in this country. It predicts that the current spend on health and adult social care will go from around 10.3% of GDP to 17.5% of GDP in 50 years’ time. That is an extraordinary increase—almost double—and it would take up so much more of our wealth and public expenditure. The OBR’s track record is very accurate on estimating health spend. It is based on a lot of cautious variables that are obviously difficult to predict, but essentially this is, if you like, cutting the mustard in telling us the future cost we have to face up to.

    To put this in context, the OBR estimates that the headline estimate for public debt that we will be passing to our grandchildren will be 100% of GDP in 30 years’ time and that in 50 years’ time it will be 267% of GDP. That is what it says in this document. If we carry on as we are, we will have a national debt of 267% of GDP because of the rising cost of what is called demographics. That is mainly healthcare but also the state pension and other aspects of the pensions system. Overwhelmingly, however, it is healthcare. Adult social care will double as a percentage of GDP as well.

    I should declare an interest in the sense that I had an indirect role in the creation of the health and social care levy, and it is fair to say that I have many reservations about what we are doing today. As colleagues know, the former Prime Minister—who deserves great credit for this—was determined that we would not just have another Green Paper or White Paper on social care. He wanted to actually deliver something for the country and he introduced the cap that had been promised by successive Governments, so that although people who have saved hard and have assets have to contribute to their care, they know that there is a limit. It is incredibly important that we brought that forward, and I sincerely hope that in removing the funding mechanism for the cap, the Treasury will resist the temptation to water it down. Local authorities are not yet aware of exactly what the cap will cover, and with the funding stream gone, the Treasury must resist the temptation to water the cap down. That is absolutely paramount.

    When the Prime Minister came forward with wanting to pursue the cap, it was the view of the then Chancellor —my right hon. Friend the Member for Richmond (Yorks) (Rishi Sunak), who I had the privilege of being Parliamentary Private Secretary to throughout the pandemic—that it must be funded, and that it could not just go on the national credit card. The social care cap on its own is massive rising liability. I have just set out what is going to happen to health costs more generally. So, how to fund social care? The most common suggestion was an increase in national insurance, for the simple reason that it applies to businesses and individuals and so raises the sorts of revenue we can get. It is not easily avoided, and it can give us the money in the bank to pay for these expensive costs that we face.

    However, I submitted a paper to the Chancellor at the time and suggested that, rather than having just a narrow national insurance levy—a social care levy, as it were—we should have a full health and social care levy that should be hypothecated and appear as an explicit line on people’s payslips. It will be there on our payslips until November. I accept that we have not made the most of it, and there has been almost no enthusiasm from any quarter—possibly only from the social care sector—but with a transparent, hypothecated statement on payslips, if the NHS came back to us two years into a five-year funding settlement saying, “We need this additional big item,” we could say, “Fine, but it will come out of the levy.” That would be transparent, and it would have provided the discipline that we have terribly lacked in health spending for many years, under successive Governments. I thought it had great potential, but it is being vapourised today. The Prime Minister has a mandate for it and the whole House seems to support that view, as does the Labour party even though it does not have the foggiest idea how it would fill the gap.

    Peter Grant

    The former Prime Minister had a mandate to do what he did last year. The hon. Member for South Suffolk (James Cartlidge) says the new Prime Minister has a mandate to do this. Where did that mandate come from? I do not remember Parliament being dissolved for a general election in the last couple of months.

    James Cartlidge

    The new Prime Minister would rightly say that our manifesto said we would not increase national insurance, so she can draw on the mandate of the general election. We also seem to have vapourised our memory of the pandemic, but I would argue that it changed everything. The enormous borrowing accrued to this Government during the pandemic, which everyone supported—everyone wanted even more spending and even more support for businesses and individuals, as I remember because I was the then Chancellor’s PPS—made it exceptional, and we had to balance the books. I make it clear that this was not my preference, as I would not have wanted a levy to fund the NHS and social care. Given the politics of the time, it was the best way forward.

    This is my personal view about how we should move forward. The key point is that the NHS is free at the point of delivery, which means we pay with time. When something is free, people wait and there are massive queues. Of course, those queues have been massively exacerbated by the pandemic, which is why the backlogs are so big, but it is blindingly obvious that the pressure on the NHS is overwhelming. There is almost infinite demand on finite capacity.

    Labour Members will say in any election campaign, as we will. “We will do everything possible to increase capacity.” The Deputy Prime Minister and Health Secretary will, of course, do everything possible through her ABCD—ambulances, backlogs, care, doctors and dentists —strategy to improve outcomes in the NHS, but when we talk about funding the NHS, when we talk about the obligation to our grandchildren and the next generation, we have to be more radical, frankly.

    In my view, we need a core NHS that is free at the point of delivery, but as a country we need to drive up the use of the independent sector and of private healthcare from all those brilliant companies that are seeing take-up shoot through the roof because of the backlogs. I know some of this territory is difficult to talk about, but I will give three key reasons why we should go down this route. First, every single person who pays to go private is freeing up space on the backlog. They are also boosting NHS capacity.

    Secondly, this is standard in comparable countries. The Republic of Ireland, Australia and Germany have tax incentives for people to pay for their healthcare. There is an understanding that people who go to that trouble should have some kind of rebate, because they are doing everyone else a favour.

    Thirdly, this is already happening. The post-Beveridge revolution is happening, and it is happening silently. There has been a massive surge in the number of people paying privately for healthcare. The Guardian recently published figures estimating that one in 10 adults in the UK has paid for private healthcare in the past 12 months, primarily because of the backlogs. Use has surged, according to the Independent Healthcare Providers Network. The number of people paying for hip replacements was up 193% in January to March 2022 compared with January to March 2019, and the number of people paying for knee replacements was up 173%. This is a huge surge in the number of people paying privately. It is true that many of them will not have wanted to do so, and I am not suggesting that they will have been delighted. Of course, we all want everyone to be able to use the NHS without long waits—that is clearly the ideal scenario—but it is not deliverable any more, not least with the demographic pressures we face.

    We should look at the surging use of the independent sector and embrace it as a policy opportunity. Research from the Independent Healthcare Providers Network shows that 48% of people in this country will consider going private in the next 12 months because they know about the waits. This is about choice, and the most important thing is to have greater tax incentives for people to use the independent sector, so that people think about making a realistic choice. We should not settle for long waits for care any more. This is standard practice in comparable European and Australasian countries.

    To be very specific, going back to the OBR document I mentioned, as a country we face a huge liability for health and social care. We should target increasing the percentage of our healthcare spend that goes to the independent sector so that we have a better balance, more like the balance in comparable European countries. If we did that, we would get much better outcomes, we would have more choice and we would finally have a 21st-century healthcare system with diversity of provision, which is the best way forward.

    We should recognise that the revolution is happening, and it needs to happen with the Government’s backing and support.

  • James Murray – 2022 Speech on the Health and Social Care Levy (Repeal) Bill

    James Murray – 2022 Speech on the Health and Social Care Levy (Repeal) Bill

    The speech made by James Murray, the Labour MP for Ealing North, in the House of Commons on 11 October 2022.

    Just over a year ago, Opposition Members stood in this Chamber urging the Government to drop their plans to hike national insurance contributions and to introduce a new levy on working people and their jobs. It was not just my Opposition colleagues and me making the case against this tax rise; the Government were warned by so many others, from the Federation of Small Businesses to the British Chambers of Commerce, the CBI and the TUC. Ministers were warned from all sides of the harm that their approach would cause. The Government were warned by their own Back Benchers. Ministers at the time even warned themselves. The tax information impact note on the tax rise was signed off by the Minister who took the original legislation through Parliament, and that note said:

    “There may be an impact on family formation, stability or breakdown as individuals, who are currently just about managing financially, will see their disposable income reduce.”

    In relation to businesses, it said:

    “Behavioural effects are likely to be large, and these will include…business decisions around wage bills and recruitment.”

    Yet the Government pressed ahead with the tax rise, supported in the Lobby by the current Prime Minister and the Chancellor. The Government kept supporting it until the then Foreign Secretary became Prime Minister and decided to perform a U-turn.

    We welcome this U-turn, as it puts an end to a tax rise that we said was wrong from the very start. It is, of course, not the only U-turn that we have seen under this Prime Minister. Just last week the Government U-turned on their damaging and misguided plan to cut the top rate of tax for the very highest paid, so our current message to the Prime Minister and the Chancellor is to keep on U-turning.

    James Cartlidge (South Suffolk) (Con)

    Will the hon. Gentleman clarify something? Would he keep the social care cap and the spending on the backlog, and if so, given that he supports repeal, how would he fund that?

    James Murray

    The truth is that we are having this debate as part of a wider Government economic strategy that has caused economic chaos, and contains no plan for growth and no plan to fund public services. Even when we were discussing the original Bill last year, there was no plan for social care: there was no guarantee that a penny of the money would go into social care. So I will not take lectures from the hon. Gentleman.

    James Cartlidge rose—

    James Murray

    I am going to make some progress. I may let the hon. Gentleman intervene again in a few moments.

    As I was saying, right now our message to the Prime Minister and the Chancellor is to keep on U-turning. They need to U-turn on their whole disastrous approach to the economy, which the Chancellor set out just over two weeks ago. That Budget—in all but name—was the most destructive, unfair and irresponsible fiscal announcement in a generation.

    The Prime Minister and the Chancellor should now U-turn on their decision to lift the cap on bankers’ bonuses. They should U-turn on their refusal to ask oil and gas giants to put some of their eye-watering excess profits towards helping keep to people’s energy bills down. They need to U-turn on their discredited, dangerous trickle-down approach to the economy. It is time for them to reverse their disastrous kamikaze Budget, which has unleashed an economic crisis that they made in Downing Street, and which working people are paying for through higher mortgages and prices.

    Alex Cunningham

    My hon. Friend says, rightly, that we support this particular U-turn, but is he not as perplexed as I am about where all this money will actually come from—or does he know that, rather than having a magic money tree, the Tories have a full orchard?

    James Murray

    My hon. Friend is right to point out that the Conservatives’ sums simply do not add up. However, you do not have to take our word for it, Mr Deputy Speaker. Just look at the markets: they have issued their own judgment on the Conservatives’ so-called economic plan, and they are not convinced.

    As we consider the repeal of the Health and Social Care Levy Act, it is important to remember how the Government’s decision to bring in this national insurance hike came to pass in the first place. Over the last 12 years under the Conservatives, we have been stuck in what the Chancellor himself rightly described last month as a “vicious cycle of stagnation”. With tax revenues stagnating under low growth, the Government made it clear that they felt the only way to raise more funds was to raise taxes on working people.

    On Second Reading of the legislation that is being repealed today, the then Chief Secretary to the Treasury tried to defend the Government’s approach, saying that this new charge would

    “enable the Government to provide additional funding to the NHS so that it can recover from the pandemic.”—[Official Report, 14 September 2021; Vol. 700, c. 843.]

    We argued at the time that if the Government felt that they had to raise taxes, those with the broadest shoulders should contribute more, but the Government refused. They pushed ahead with this tax rise on working people and their jobs, and they refused throughout the debate on the original legislation to ask those with the broadest shoulders to take more of the burden. Now, as they repeal the legislation for the national insurance increase, they have abandoned any attempt at fiscal responsibility altogether, with an economic approach that has borrowing at its heart.

    In a letter sent to the shadow Chancellor and the shadow Secretary of State for Health and Social Care on 22 September, the Economic Secretary to the Treasury wrote:

    “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.”

    Labour takes a different approach. Our pledges are fully and fairly funded. As the shadow Chancellor has set out, we would boost NHS investment by ending the outrageous non-dom tax loophole exploited by the super-rich. We will use money from what is saved by scrapping that arcane practice to double the number of district nurses qualifying every year, to train more than 5,000 health visitors, to create an additional 10,000 nursing and midwife placements every year and to double the number of medical students so that our NHS has the doctors it needs.

    Chris Philp

    I think I heard the shadow Chancellor on television a week or so ago saying that her proposals on non-doms would raise about £2 billion. The cost of this measure is about £15 billion, so where is the other £13 billion going to come from?

    James Murray

    The Minister must not have been listening carefully enough to the shadow Chancellor setting out Labour’s plans, because we have set out how we would scrap the non-dom status, which it is completely irresponsible to keep in the current context, and to use some of that money to set out our plans for investment in the NHS. The difference between the Government and the Opposition is that the Government make promises and use throwaway comments about how they might fund this with general taxation or through extra borrowing, whereas when we set out our pledges, we set out exactly what we will pay for. They are fully costed, fully funded and paid for through fairer taxation.

    James Cartlidge

    Will the hon. Gentleman give way?

    James Murray

    No, I am going to make some progress.

    We have set out that we will not borrow for day-to-day spending and that we will not ask working people who are already struggling to foot the bill. That is what we mean when we say we are the party of economic responsibility and the party of social justice. The Conservatives have shown themselves to be the party of a failed approach to the economy. After six so-called growth plans from the Government that have all failed, the drunken gamblers of Downing Street have rolled the dice one last time, putting their faith in the ideological mantra that if they just slash taxes and regulation, they will unleash business investment and growth. They believe that wealth is created only by a few at the top, when the truth is that it comes from the bottom up and from the middle out.

    The trickle-down economics of the Prime Minister and her Chancellor are wrong. Their approach will not work and it is not fair. It will hit working people’s spending power, undermining prospects for growth, and it ignores the need for the Government to be a partner for business to grow—something that is more important than ever with the turbulent, changing, challenging outlook that we face. That is why the next Labour Government would do things differently. We would bring together businesses and trade unions through a national economic council. We would support businesses to grow, through our modern industrial strategy, and we would use a national wealth fund to invest in the new green industries of the future. That is our approach to the British economy: pro-business, pro-worker, pro-growth.

    The Government are making the wrong calls again and again. They were wrong last year to introduce the national insurance rise on working people, just as they were wrong last month when they tried to cut tax for some of the highest paid in society and to hide the OBR report on their plans. We welcome the Government finally admitting that they were wrong to raise national insurance on working people and businesses in the middle of a cost of living crisis, but their wider economic approach is one that is characterised by ballooning borrowing and a discredited trickle-down approach to economic growth.

    The Prime Minister and her Chancellor are gambling with the livelihoods and wellbeing of people across the UK. Their gamble is dramatically worsening the cost of living crisis, with higher costs and mortgage payments for households across the country. It is shredding any reputation for economic competence the Conservatives might once have claimed to have, and it will fail to deliver the growth we need after 12 years of stagnation.

    Throughout the cost of living crisis, Labour has forced the Conservatives to U-turn time and again. By repealing the national insurance rise and levy and by halting their plans to cut the top rate of tax for the very highest paid, the Prime Minister and the Chancellor have shown that they have it within themselves to make a U-turn. Our message to them is clear: do not stop there. The Government must U-turn on their whole economic approach and reverse their disastrous kamikaze Budget. Our message to the British people is also clear: this is a Tory crisis that has been made in Downing Street and is being paid for by working people. Only Labour will fix the damage that the Tories are doing. Only Labour will deliver economic responsibility and social justice. Only Labour will be a Government that are on your side.

  • Chris Philp – 2022 Statement on the Health and Social Care Levy (Repeal) Bill

    Chris Philp – 2022 Statement on the Health and Social Care Levy (Repeal) Bill

    The statement made by Chris Philp, the Chief Secretary to the Treasury, in the House of Commons on 11 October 2022.

    I beg to move, That the Bill be now read a Second time.

    Let me start by reiterating that the central and defining mission of this Government is growth. This Government are completely and unashamedly committed to achieving that objective—economic growth. However, we are not committed to it simply for its own sake or for some abstract reason; we are committed to growth because of the impact it will have in so many ways on people’s lives.

    Growth brings higher wages, bringing prosperity to our constituents. Economic growth will create new and better-paid jobs and, critically, economic growth will create a sustainable tax base that will fund public services into the future. Without strong economic growth, we cannot have well-funded health services, education and police. It is quite clear that, with economic growth, everyone benefits—not in some trickle-down sense, but because it will elevate salaries for everybody, create jobs the length and breadth of the United Kingdom, and generate the tax income that will fund our public services.

    Crucially, this growth agenda set out by the Chancellor two or three weeks ago will pursue growth in a way that is fiscally responsible, and on 31 October—in just under three weeks’ time—the Chancellor will set out in detail how that will take place, buttressed by a full scoring and forecast produced by the Office for Budget Responsibility.

    The growth plan announced by the Chancellor just a fortnight ago is crafted to achieve 2.5% growth year on year. It aims to do so in a host of different ways. First, it will do so through lower taxation, because with lower taxation we incentivise companies to invest, we incentivise people to get into work, and we encourage companies and high-potential individuals to choose to locate in the United Kingdom as opposed to somewhere else. Many successful companies, and indeed successful people, have a choice about where they locate, where they do business and where they work, and by having internationally competitive rates of personal and corporate taxation we are encouraging them to make the choice to locate in the United Kingdom, all of which improves and increases economic growth.

    There is of course more to the growth plan than just that. We are working on infrastructure—whether road, rail or energy infrastructure—and speeding up its development, as well as supporting skilled employment, removing barriers to investment, getting the housing market moving and removing obstacles, such as the recent IR35 changes that have caused difficulties for many self-employed people and contractors. Critically, the growth plan has moved at pace to help both households and businesses with the terrible crisis posed by Putin’s illegal invasion of Ukraine and its consequences for energy bills.

    Just a few weeks ago, households and businesses in the United Kingdom were faced with the realistic prospect of domestic energy bills going up to £5,000, £6,000 or even £7,000 per year. The energy price guarantee takes that possibility off the table, not just for six months but for two years, ensuring that the average household will pay no more than £2,500.

    Peter Grant (Glenrothes) (SNP)

    Does the Minister accept that, regardless of what the Government have done, my constituents can expect to pay double for their energy bills this year compared with what they paid last year?

    Chris Philp

    The energy price guarantee ensures that the average household pays no more than £2,500 a year. The hon. Gentleman is correct that that is higher than average bills this time last year, and that is why the comprehensive package was put in place earlier this year. It amounts to a further £37 billion, and ensures that households on the lower one third of incomes receive £1,200 per year, which pretty much fills the gap that he described. The energy price guarantee, combined with that £37 billion intervention, is the kind of thing we can do as a Union and as a United Kingdom. It is the kind of thing we can do together that would be so much harder apart, and that is one of the benefits of our precious Union. There is a lot more in the growth plan, but I will not labour the point because we are here to talk about the health and social care levy.

    Hywel Williams (Arfon) (PC)

    Growth in Wales has for a long time—for many decades before and after devolution—been based partly on the idea of attracting high-worth individuals to invest in Wales. The mixed result of that gives me pause for thought as to that strategy. Does it do the same for the Minister?

    Chris Philp

    We will deliver growth if we encourage people across the whole income spectrum—people doing jobs on lower incomes, those on higher incomes, businesses big and small alike. We need to encourage the entire economy, which is why tax cuts in the growth plan are broadly based, like the tax cut we are debating now. We need to encourage them all, which includes companies and people who are internationally mobile. I used to be technology Minister, and most technology businesses have a choice about where they locate. They are very internationally mobile. They could go to New York, San Francisco, Singapore—they could go anywhere in the world. We need to ensure that every part of the United Kingdom is attractive to such businesses, and the growth plan intends to create those conditions that make us attractive as a nation.

    Alex Cunningham (Stockton North) (Lab)

    The Minister seems to have mentioned everything except the need for a healthy workforce. Local authorities spend £1.2 billion every year on social care needs caused by smoking, and that will get more expensive if the Government fail to address the issue of tobacco. This morning the Health and Social Care Secretary hinted that she will do less, not more, to tackle the dangers of smoking. Will the Minister join me and press her to bring forward the tobacco control plan, to help protect the health of the nation and save health and social care costs?

    Chris Philp

    I do not think I should trespass into the realm of my right hon. Friend the Secretary of State for Health and Social Care and Deputy Prime Minister. She will make her own views and policy on that issue without intervention from me. We are ensuring that the NHS is well funded so that it can provide the treatment our constituents need. Our commitment to NHS funding is undiminished.

    Let me turn to the Bill, which repeals the health and social care levy. Members will recall that the health and social care levy was originally announced in September last year, and the Health and Social Care Levy Act 2021 received Royal Assent on 20 October last year. The levy had two phases: first, a temporary 1.25% increase for employers and employees in the current tax year; and then from April 2023 a formal surcharge of 1.25%, which would have affected not just those of working age but also those of state pension age. The Bill repeals that Act with elegant simplicity. Clause 1 states simply:

    “The Health and Social Care Levy Act 2021 is repealed.”

    James Cartlidge (South Suffolk) (Con)

    This is my first opportunity to congratulate the Chief Secretary on his appointment. What he said on the energy support for my constituents and all our constituents is very important, and I very much welcome that. However, on repealing the levy, he is of course aware that one of the most important things that it was going to fund was the welcome cap on care costs introduced by the Government, which had been promised by successive Governments with many a White Paper and many a Green Paper. How will we now pay for that?

    Chris Philp

    I thank my hon. Friend for his kind words. We are long-standing colleagues, and I look forward to working with him for many years to come. To be clear, the funding that was to be provided via the levy for both health and social care, which in the case of social care amounted to £5.4 billion over the three-year spending review period, is completely unaltered. There is no change to that funding at all.

    My hon. Friend asked about funding for social care. The funding envelope for all public services will be set out by my right hon. Friend the Chancellor on 31 October via his medium-term fiscal plan. We will ensure that we are responsible custodians of the public finances by sticking to the spending plan set out in spending review 2021. We will be disciplined about doing that. We will ensure that we generally exercise spending restraint, mindful of the fact that we cannot have public spending forever increasing at faster and faster rates. We will be disciplined about how we manage the public finances.

    I also point to economic growth. If, or rather when, we are successful in delivering the growth plan’s mission to elevate trend growth from 1.5% to 2.5%, with an extra 1% per annum over a consistent period of time—for example, five years—by the fifth year that additional growth will deliver about £47 billion of extra tax revenue, as set out in the table on page 27 of the Blue Book that accompanied the growth plan. I hope that gives my hon. Friend a hint about our thinking, but really the medium-term financial plan on 31 October will provide the most complete answer.

    Hywel Williams

    The Chief Secretary is being generous with his time. I should say that the table on page 27 shows a target, rather than anything that will stand closer examination. However, in respect of the decision to increase national insurance to pay for social policy—in England, I might add—the Welsh Government had no say whatsoever, just as they had no say in the now paused policy of scrapping the additional rate of income tax. Does the Minister not think that the Welsh Government, who are, after all, responsible for social care in Wales, warrant consultation on a fundamental matter such as this?

    Chris Philp

    I do not think that the Government in Wales complained too loudly when they were provided with extra money to fund social care in Wales. On the hon. Member’s point about page 27 of the growth plan, he is right that it is a target, but it is a target accompanied by a plan to deliver it. There is a clear path to how we will achieve the increase in growth that I referred to.

    Let me return to the repeal of the health and social care levy. To be clear, the Bill will repeal the legislation from last year, reversing the temporary increase in national insurance contributions from 6 November—in just a few weeks’ time. Additionally, it will ensure that no new levy comes into force in April 2023. Members will understand that it takes a little time for His Majesty’s Revenue and Customs and businesses to prepare their systems for such tax changes. That is why we chose 6 November as the date of implementation, but that will ensure that the extra money gets into people’s pockets as quickly as possible.

    That brings me to the rationale for why we are repealing the levy. First, it is so that people can keep more of their own money, particularly at this time when that is so critical with the cost of living. In Treasury questions earlier today, many Members on both sides of the House referred to the cost of living challenges, most of which follow from Putin’s illegal invasion of Ukraine. By reducing this tax and urgently alleviating the tax burden on our constituents, that will immediately assist with cost of living pressures. I am not saying that it will solve them, but it will certainly assist with them.

    John Glen (Salisbury) (Con)

    I, too, congratulate my right hon. Friend on his new role.

    I acknowledge the narrative of growth and the therapeutic effect of the combination of supply-side reforms and tax cuts to generate growth. My concern is the interval between his assertions today and the medium-term fiscal strategy that will be announced on 31 October, and the markets’ confidence in that interval. Today we see a welcome announcement by the International Monetary Fund on the enhancement to growth, but we also see reference to the enduring effect of inflation. We have also seen in recent weeks the effect of interest rate changes on the cost of living challenges for families up and down this country. Will my right hon. Friend please take account of the interaction of those two conflicting realities?

    Chris Philp

    I thank my hon. Friend for his question. I pay tribute to him for his extraordinary service as City Minister. I think I am right in saying that he is the longest-serving City Minister ever—I think it was four years—and, I should say, he is the best to date. I pay tribute to him for his long and distinguished service.

    My hon. Friend raised a couple of points. One was the interaction between the announcements and the OBR’s scoring. There was a desire to get the growth plan done quickly and with a sense of urgency, and the energy price guarantee was something we wanted to do straight away. Families were genuinely worried. They had huge anxiety about the prospect of facing £6,000 or £7,000 bills this winter. We wanted to take that off the table immediately. We also wanted to alleviate the tax burden that we are discussing today as quickly as we could. By doing this so quickly, assuming the Bill passes, on 6 November—in just a few weeks’ time—our constituents will be alleviated of this burden at this time of cost of living challenges.

    As companies make decisions about where to invest—in the UK or elsewhere—they can do so in the knowledge that corporation tax in the UK will remain low. That is why we acted so quickly. I do, however, recognise my hon. Friend’s point about the need for market confidence, and that is why my right hon. Friend the Chancellor announced just yesterday that the medium-term fiscal plan would be brought forward from 23 November to 31 October. He recognised exactly the point that my hon. Friend made and similar points made by my right hon. Friend the Member for Central Devon (Mel Stride), the Chair of the Treasury Committee.

    The point about inflation came up repeatedly in Treasury questions earlier. We should be clear that we are in a global interest rate up cycle. In, for example, the United States of America, base rates set by the Federal Reserve have increased by three percentage points this year—from 0.25% in January to 3.25% now. The equivalent interest rate set by the Bank of England, the base rate, has also increased, but only by two percentage points from 0.25% to 2.25%. So we have seen higher base rate increases in the USA in the year to date than we have here. As a consequence, the base rate in the USA is a full percentage point higher than in the United Kingdom, and we should keep that international context firmly in mind.

    As I explained, we are repealing the levy so that people can keep more of their own money and so that we can help with the cost of living challenges at this time as a matter of urgency on 6 November and not delay any longer. I and the Chancellor think it is also important to boost incentives to work. We want to make sure that working is as attractive as possible and, by lowering the taxes on work, I believe that we will do that.

    Steve Brine (Winchester) (Con)

    I add my voice to those who have welcomed my right hon. Friend to his role. I think he will do a good job.

    Here is what is worrying me. Yes, we want work to pay, but we also want work to be available. There are lots of vacancies in the labour market, but there are also labour shortages. Lots of people, as we have heard today, are economically inactive, many of them because they are on the NHS waiting list. As my right hon. Friend the Chief Secretary will know, the first part of the levy was to fund the catch-up programme. I was in my local hospital on Friday to see how we are getting on with the catch-up programme. We are still waiting for news of our elective hub at the Royal Hampshire County Hospital in Winchester, which would help with the catch-up and get people back into the workforce. Is that affected by my voting for this repeal today?

    Chris Philp

    I can categorically assure my hon. Friend that that is not affected. The £8 billion that was allocated over the spending review period to catch up on the elective backlog is completely unchanged by this measure, and the funding for social care—£5.4 billion over three years—is also unaffected. The rest of the money, because that is not all of it, will continue to be available to the Department of Health and Social Care to spend on the NHS and social care precisely as was intended. As a result of repealing the Health and Social Care Levy Act 2021, not a single penny less will go to social care or the NHS, or in particular the elective programme that he refers to. I cannot answer on Winchester hospital, but I am sure that the Health Secretary would be delighted to discuss that with him.

    My hon. Friend also made a good point about vacancies. We have a lot of vacancies in the economy. Earlier this year, I believe for the first time in history, there were more vacancies than there were people in unemployment. If we are keen to tackle poverty and help people into a more prosperous future, getting them off benefits and into work is clearly the answer.

    Karin Smyth (Bristol South) (Lab)

    To follow on from the former Health Minister, the hon. Member for Winchester (Steve Brine), if it is true that the levy was essentially not needed for the social care reforms and the catch-up, and that everything is still staying, will the Minister tell us what advice he has had from the DHSC about what it will not do now that, presumably, there is less money for the other things that it was going to do?

    Chris Philp

    The funding provided by the Treasury to the DHSC is completely unchanged as a result of the reversal of the NIC increase. That applies both to the money that was essentially hypothecated to the DHSC and its other budget. It is completely unaffected, so we are not moving money from one part of the health service budget to backfill something else. The complete health service budget is unchanged. There is not a penny less for the health service in any way as a result of the changes, but we are changing the way we fund the expenditure. Instead of funding it from the health and social care levy, it will be funded differently, partly by general taxation and other means, which will be set out in the medium-term fiscal plan. However, not a single penny less will go to the health service as a result of this change.

    Several hon. Members rose—

    Chris Philp

    I am spoilt for choice; I will start with my hon. Friend the Member for South Suffolk (James Cartlidge).

    James Cartlidge

    I am lucky to have a second intervention already. I know that as a former businessman, the Minister cares passionately about growth, and I respect that. However, as a businessman, he must also know that the single most important factor for business is confidence and stability. When we speak to businesses at the moment, we hear that they are worried about the lack of stability. They want certainty and confidence. He needs to explain the basic question about the £17 billion of revenue from the levy to fund social care and the NHS. If the levy is going, surely that implies that borrowing fills the gap or some other change fiscally. Is it the case that that will be confirmed on the 31st?

    Chris Philp

    Yes, it is. My hon. Friend is asking entirely reasonable questions, but we have to look at this issue in the round across the entirety of public expenditure. The Chancellor will set that out in detail on 31 October to the House, accompanied by the OBR scoring.

    Alex Cunningham

    The hon. Member for South Suffolk (James Cartlidge) has made this point: if £17 billion is being removed from the Exchequer, how can we have all that extra spending on the NHS and on social care if there is no additional taxation?

    Chris Philp

    As I pointed out, we will set that out on the 31st. The Chancellor has a number of measures in mind to make sure, over the medium term, that this is fully funded, and critically, so that we can do this and the other things in the growth plan—this is obviously only one measure among many—to make sure that we get debt falling as a proportion of GDP. Hon. Members are asking entirely reasonable questions, but the point of the medium-term fiscal plan, and the details that will accompany it on 31 October, is to answer precisely those questions.

    Let me set out the benefits that the move will confer on employees earning more than £12,570 and self-employed people earning more than £11,909. The average saving for people in work who are earning more than those thresholds will be approximately £330 next year. Combined with the increase in the threshold that took effect last July, the saving for the average worker earning above those thresholds will be £500 next year. That will clearly be welcome at a time of economic challenge. Moreover, almost a million businesses—920,000—will get an average tax cut of just a shade under £10,000 next year: £9,600, to be precise. That will be very welcome indeed.

    It is worth being clear that the increase in the threshold that was put through a few months ago means that people on lower incomes pay very little in national insurance or income tax these days. I am sure that Members of this House who want to see the burden of taxation made as light as possible, particularly for those with lower incomes, will strongly welcome the increase in the threshold. It follows the very substantial increases in the income tax threshold over the past 12 years, from about £6,500 back in 2010 to £12,500 today, which have lifted people on the lowest incomes out of national insurance and out of income tax entirely.

    I have already made the point that the reversal of the levy is part of a much wider plan. Over the coming days and weeks, my colleagues the Secretaries of State for various Departments will announce further supply-side measures to stimulate growth in our economy, including by making the planning system faster, making sure that business regulations are not unduly onerous, improving childcare, addressing questions concerned with immigration and agricultural productivity, and improving digital infrastructure. As I have said, we will do so in a way that makes sure that debt over GDP falls over the medium term.

    Alex Cunningham

    Will the Chief Secretary give way?

    Chris Philp

    I was about to finish, but as the hon. Member is an old friend, I will give way one last time.

    Alex Cunningham

    I am grateful; I enjoyed my time dealing with justice issues opposite the right hon. Member. Twelve years ago, one of his predecessors—a Lib Dem, in fact—cancelled the new hospital for Stockton. The need for one is far greater than ever and the Chief Secretary seems very capable of splashing the cash, so will he finally approve funding for a new hospital in Stockton?

    Chris Philp

    The Government have a commitment, which we stand by, to build I think 40 new hospitals in the coming years. Of course, the details of that programme are in the hands of my right hon. Friend the Secretary of State for Health and Social Care. I am sure she would be happy to discuss a hospital for Stockton with the hon. Member, who is an eloquent advocate for his home town, as ever.

    Making sure that we act in a fiscally responsible way is a responsibility that falls partly on me as Chief Secretary. I have already said that we intend to stick to the limits set out a year ago in the comprehensive spending review—a three-year spending review, of which we are in the first year. We will exercise restraint in public expenditure, because we simply cannot have a state that continues to consume ever larger proportions of national income. Of course we need to make sure that public services are properly funded, but we need to do so in a way that does not impose excessively onerous burdens on taxpayers—our constituents who work hard day in, day out to earn a living and pay their taxes.

    Growing our economy is our central and defining mission. The United Kingdom needs a Government who are wholeheartedly and unequivocally committed to economic growth. We stand committed to growth in a way that the anti-growth coalition arrayed against us does not. This Government have a very clear growth plan. The reversal of the levy and of the temporary national insurance increase is an important part of that growth plan, which is at the heart of this Government’s mission. I commend the Bill to the House.

  • Chi Onwurah – 2022 Speech on Bowel Conditions

    Chi Onwurah – 2022 Speech on Bowel Conditions

    The speech made by Chi Onwurah, the Labour MP for Newcastle upon Tyne Central, in the House of Lords on 11 October 2022.

    I beg to move,

    That leave be given to bring in a Bill to require the Government to publish an assessment of incidences of bowel conditions and diseases, including an assessment of geographical and socioeconomic disparities.

    We have a hidden epidemic—a hidden epidemic that this Government are making no attempt to understand, and a hidden epidemic that is devastating the lives of many in Newcastle Central: a hidden epidemic of bowel disease and bowel conditions in the north-east.

    Bowel conditions are not a sexy subject; needing the loo rarely is, though it can be a source of humour. I know that children are always fascinated to learn that there was a curtain around your Chair, Mr Deputy Speaker, for over 600 years to enable Speakers to relieve themselves during long sessions. Fortunately, we have moved on since then, but there is still a curtain around bowel conditions. That is why we are all so grateful for the much missed and tireless “Bowel Babe”, Dame Deborah James, who did so much to tackle the stigma surrounding the diagnosis and care of people with bowel diseases.

    Bowel ill health has a significant impact on my constituents, leading to lives lost and stoma surgery, which requires ongoing care and support. Like Members across the House, my primary concern is the wellbeing of my constituents. That is why I, like so many of us, attended the “Stomas in Parliament” event in July, to better understand the impact of stomas on constituents’ lives. It is also why in July, I visited Richard Brady, consultant colorectal surgeon at Newcastle Clinical Research Facility, to see how they are trialling innovative surgical products from the company Coloplast that reduce the burden of leakage on stoma wearers. It was fascinating to hear and see the reality of stoma wearing and changing, but I also learnt of the difficulties confronting so many patients in Newcastle and the north-east.

    One person living with a colostomy told me that he felt invisible to Government. One who has had inflammatory bowel disease since she was 16 and, later, ulcerative colitis has “lost count” of the number of medications and surgeries she has had. Another living with stage 3 bowel cancer explained the frustration and embarrassment they felt in public spaces when a toilet was not available in shops. One patient said that, during the first few months following her ileostomy, her stoma nurse felt like her only friend. Another said that she felt as though the world was crashing down when she was diagnosed with colorectal cancer after experiencing no symptoms, and one person living with a stoma told me that his condition made him fear leaving the house, thus isolating him from the people he loved and the things he loved to do. The lived experiences of those with bowel disease can be very distressing.

    Bowel disease comes in many forms. There is colon cancer, inflammatory bowel disease, Crohn’s disease, diverticulitis, gastroenteritis, diverticular disease, colitis, ileus and many more. All these conditions impact patients differently, and each presents its own challenges.

    The north-east appears uniquely vulnerable to bowel ill health. Scientists believe that that is because we have the perfect storm of contributory factors. According to The BMJ, the north-east has the highest rate of ulcerative colitis in the country, and the UK as a whole has the highest rate in Europe. The north-east also has the highest rates of colorectal cancer in the UK, with 646 patients diagnosed per 100,000 people—14% higher than London. The UK also has one of the lowest survival rates of colorectal cancer in high-income countries.

    Diverticulitis, in which tiny bulges in the colon wall become inflamed, leading to severe pain, is another condition linked with many social factors that are more prevalent in the north-east. One is smoking; 13% of people in the north-east smoke, which is the highest rate in England. Another is obesity. In the north-east, 34% of adults are obese, which is the joint highest rate in England, and 29% of year 6 children are obese—the second highest rate in England.

    Another critical factor is economic deprivation, to which the north-east is particularly vulnerable following 12 years of Conservative economic mismanagement and neglect. Two in five children in the north-east live in poverty—the highest rate of any UK region. According to a recent Survation poll, a third of people in the north-east are worried that they might have to use a food bank—the highest proportion in the country. Access to primary care is also a factor, and can be linked to poverty: when a person works two jobs to make ends meet, it is harder to get to the doctor’s. Other factors include Celtic heritage, lack of exposure to sunlight, and a diet high in animal fat. The consequence of all these factors combined is that the north-east suffers from higher rates of bowel ill health. Despite that, it has lower rates of screening uptake. That means more advanced cases, and higher rates of stomas that result in ongoing care demands and have a significant impact on people’s quality of life.

    As I have said, Newcastle Hospitals NHS Foundation Trust is a centre for innovative bowel disease treatment, and patients cross the Pennines for its support, but the Government need to do much more to highlight and address the unacceptable regional disparities in bowel illness. In answer to my parliamentary questions, the Department of Health and Social Care told me that it makes no assessment of regional disparities in the prevalence of bowel disease. The Bill would make patients living with these conditions visible in the NHS and in Government datasets, which would aid treatment and help to identify areas with a higher prevalence of a condition.

    The Government also told me that there were just under 2,000 newly formed stomas in 2021, but analysis of NHS patient activity data suggests that the true number is around eight times higher, at between 160,000 and 200,000. The Government simply do not know what is happening. We need legislation to better understand, identify, prevent and address bowel conditions, so that we can better target investment, and focus resources on reducing inequity across the UK. My Bowel Conditions (Assessment) Bill would be the first step in addressing the issue, not only for my constituents, but for the country.

    The Bill would provide for the statutory collection and reporting of statistics by region and by socioeconomic indices. This data would be invaluable to all those involved in the treatment of bowel conditions. More importantly, it would help in supporting existing patients, and contribute towards prevention and diagnosis of future patients. Better understanding will save lives.

    The Bill would force the Government to assess, and ultimately address, the inequalities that have grown over 12 years of Tory neglect. Twelve years of Government mismanagement have resulted in record waiting lists for care, and chronic staff shortages. Cancer waiting times worsened in every one of those years prior to the pandemic, and according to Bowel Cancer UK, England is also poorer at diagnosing cancers at an early, more treatable stage than the best performing countries. That is why the next Labour Government will undertake one of the biggest expansions of the NHS workforce, and will produce a long-term workforce plan for the NHS.

    People living with bowel conditions deserve to live in dignity. For this to happen, we need the stories and voices of patients to be heard by the Government. The Bill will make that patient living with a stoma who said that he felt invisible visible to the NHS, to integrated care boards, to the Department of Health and Social Care, and to the Government. I hope that the Bill progresses today, so that we can finally address this hidden epidemic, which affects and cuts short the life of so many in the north-east.

    Question put and agreed to.

    Ordered,

    That Chi Onwurah, Liz Twist, Mary Kelly Foy, Catherine McKinnell, Kate Osborne, Mrs Sharon Hodgson, Mrs Emma Lewell-Buck, Ian Lavery, Ian Mearns and Grahame Morris present the Bill.

    Chi Onwurah accordingly presented the Bill.

  • Eluned Morgan – 2022 Statement on Emergency Care Services for Winter in Wales

    Eluned Morgan – 2022 Statement on Emergency Care Services for Winter in Wales

    The statement made by Eluned Morgan, the Minister for Health and Social Services, on 11 October 2022.

    I am pleased to update Members on our planning approach to support resilient urgent and emergency care services this winter.

    It is likely the winter period will present additional challenges to an already stretched urgent and emergency care system if there are increases in prevalence of both COVID-19 and influenza, and within the context of the cost of living and energy crises. Members will know there are plans in progress focusing on COVID-19 and influenza vaccination, and additional support for vulnerable people most likely to feel the impact of rising costs this winter.

    Planning for seasonal peaks in pressure is a year-round exercise and development of interventions that will enable additional resilience commenced many months ago. Additionally, a winter planning framework has been issued to NHS Wales organisations and Regional Partnership Boards to support them to plan and deliver resilient urgent and emergency care services this winter.

    Since Spring 2022, Health Boards have been working with partners to develop local urgent and emergency care plans focused on a small number of priorities set by the Welsh Government that will support people to access the right care, in the right place, first time. To support consistency and harness momentum, the winter planning framework sets out expectations for Health Boards to work with partners to build on these priorities and develop enhanced interventions for the winter period. These priorities include:

      • A national communications campaign to raise awareness of NHS 111 Wales, encouraging the public to use the 111 service as a first port of call for free, trusted health information to help ensure they access the right service, first time;
      • Optimising the role of third sector services to improve experience and outcomes for vulnerable people who access care in Emergency Departments or hospitals;
      • Increasing opportunities for people with urgent care complaints to be assessed and treated away from the Emergency Department and within Urgent Primary Care Centres;
      • £3m for the recruitment of 100 new ambulance clinicians expected to be operational by the end of December;
      • Increasing emergency ambulance response capacity through implementation of new staff rosters to deliver efficiency equivalent to around 70 whole time equivalents;
      • Reducing long ambulance patient handover delays to improve experience and unlock ambulance capacity;
      • A further £2m has been made available for health boards to improve their emergency department environments, to enhance patient experiences this winter; and
      • Extending same day emergency care services to seven-day accessibility to help people who may have ordinarily been admitted to hospital to return home to sleep in their own bed.

    In addition, Health Boards and Local Authorities have developed plans to increase community bed or bed equivalent capacity ahead of the winter period. These plans will aim to deliver additional step down to recover provision and community responses through a shared endeavour amongst partners.

    This additional capacity will be delivered alongside additional measures to boost the community care workforce, and is a key element of our enhanced winter planning approach. It will support people to return home or to their local communities when ready and as a consequence it should improve timeliness of care in other parts of the urgent and emergency care system.

    I expect Health Boards to work collaboratively with partners through Regional Partnership Boards to refine plans, drawing on learning from the previous winter and the ongoing challenges of the pandemic, with a focus on patient safety and wellbeing.

    Health Boards will be expected to submit winter resilience plans to their respective Boards for approval, and a review of each Health Board’s plan will form part of Welsh Government Integrated Quality Planning and Delivery meetings in October.

    I will provide Members with further updates throughout the winter period.

  • Eluned Morgan – 2022 Comments on Reducing Bowel Cancer Screening Age

    Eluned Morgan – 2022 Comments on Reducing Bowel Cancer Screening Age

    The comments made by Eluned Morgan, the Welsh Minister for Health and Social Services, on 4 October 2022.

    It is great to see the next phase of our plan to widen access to bowel cancer screening come into effect.

    We have previously introduced the more user-friendly test and started inviting those aged 58-59. This next phase of the programme widens access to those aged 55-57.

    This move will help us to identity more bowel cancer cases early and support improvement in survival rates.

    I’m also pleased to see that more people are taking part in the programme and that the uptake rate now meets the expected standard.
    In future, we plan to continue to optimise the programme by lowering the age range to 50 and increasing the sensitivity of the test until we come into line with UK recommendations.

  • Nadhim Zahawi – 2022 Comments about Moderna Vaccine

    Nadhim Zahawi – 2022 Comments about Moderna Vaccine

    The comments made by Nadhim Zahawi, the Chancellor of the Duchy of Lancaster, on 10 October 2022.

    In an interview yesterday I misspoke and said the Moderna vaccine protects against Covid and flu. What I meant to say was that Moderna is bivalent, which means it protects against both variants of Covid. You still need your flu vaccine too so please get jabbed if you’re eligible.

  • Keir Starmer – 2022 Comments on World Mental Health Day

    Keir Starmer – 2022 Comments on World Mental Health Day

    The comments made by Keir Starmer, the Leader of the Opposition, on 10 October 2022.

    On World Mental Health Day, it’s important to remember there is no shame in finding life hard at times and for saying so.
    But too many people are waiting too long for help they desperately need.
    A Labour government would guarantee mental health treatment within a month.