Dr Luke Evans (Hinckley and Bosworth) (Con) (Urgent Question): To
ask the Secretary of State for Health and Social Care if he will
make a statement on the impact of changes to employer national
insurance contributions on primary care providers, hospices and
care homes. The Minister for Secondary Care (Karin Smyth) I am
grateful to the hon. Member for asking this important question. It
gives me the opportunity to say to GPs, dentists, hospices and
every part of the...Request free trial
Dr (Hinckley and Bosworth)
(Con)
(Urgent Question): To ask the Secretary of State for Health and
Social Care if he will make a statement on the impact of changes
to employer national insurance contributions on primary care
providers, hospices and care homes.
The Minister for Secondary Care ()
I am grateful to the hon. Member for asking this important
question. It gives me the opportunity to say to GPs, dentists,
hospices and every part of the health and care system that will
be affected by changes to employer national insurance
contributions that this Government understand the pressures they
face and take their representations seriously. The Chancellor
took into account the impact of changes to national insurance
when she allocated an extra £26 billion to the Department of
Health and Social Care. There are well-established processes for
agreeing funding allocations across the system, and we are going
through those processes now with this issue in mind.
This Government inherited a £22 billion black hole in the public
finances, broken public services and a stagnant economy. Upon
taking office we were told that the deficit the previous
Government recklessly ran up in my Department alone would mean
delivering 20,000 fewer appointments a week instead of the 40,000
more we promised. The Chancellor and my right hon. Friend the
Secretary of State were not prepared to see further decline in
our NHS. That is why we put in an extra £1.8 billion to stop the
NHS going into reverse this year.
We built on that at the Budget, delivering the significant
investment that the NHS needs to get back on its feet, backing
staff with investment in modern technology, new scanners and new
surgical hubs, and rebuilding our crumbling primary and secondary
care estate. Alongside that, we delivered a real-terms increase
in core local government spending power of around 3.2%, which
will help to address the range of pressures facing the adult
social care sector, including £600 million in new grant funding
for social care. We are now working through exactly how that
money will be allocated, as per normal processes. As the
Secretary of State set out yesterday, we will ensure that every
pound is invested wisely to deliver the Government's priorities
and provide value to taxpayers.
The Department will set out further details on the allocation of
funding in due course, including through NHS planning guidance
and the usual consultations, including on the general practice
contract. As part of these processes, we will consider the impact
of changes announced to employer national insurance contributions
in a fair and open way over the next five months, before the
changes come into force in April 2025.
Dr Evans
I draw the House's attention to my declaration of interests.
Many in the health sector will have been pleased to hear the
announcement of the extra funding for the NHS, only for their joy
to be struck down by the realisation that a manifesto promise not
to raise national insurance contributions had been broken. That
was compounded further by the discovery that a raft of frontline
care providers—care homes, hospices, care charities, pharmacies
and GPs, to name but a few—will not be exempt from the NI rise,
leaving them with crippling staff bills and the threat of
closures and redundancies. The hospice sector expects the cost to
be £30 million—closures and redundancies. The initial assessment
of the cost to GPs is £260 million—closures and redundancies, at
the expense of 2.2 million appointments. For the care sector, the
changes will cost £2.4 billion, dwarfing the £600 million in
social care support that was announced. Does the Minister accept
that it is inevitable that council tax will have to rise to
support the increase in NICs?
For the first time, the National Pharmacy Association has
announced collective action. Its chair said:
“The sense of anger among pharmacy owners has been intensified
exponentially by the Budget, with its hike in national insurance
employers' contributions and the unfunded national living wage
increase, which has tipped even more pharmacies to the
brink.”
Will the Minister clarify who is exempt from NI? Will the
Government admit that they got it wrong and make a change? The
Prime Minister, Health Secretary and Chancellor have all said
that allocations will be made “in the usual way”. Will the
Minister clarify what the usual way is? Will mitigations be put
in black and white to the House and the public? Is this part of
the £20 billion, or new funding?
More importantly, will the Minister lay out a concrete timetable
for hospices, care homes, GPs, pharmacists and all other allied
health professionals, who are making decisions now? This seems to
be another example of a big headline from the Labour party but no
detail.
Well, really. I am quite dumbfounded by the hon. Gentleman's
response. I respect him for his professional practice, and he
knows the state of the NHS that we inherited from the previous
Government, as reported in Lord Darzi's report. He talks about
joy, but there was no joy when we inherited the mess they left
back in July. He talks about people being tipped to the brink,
and they absolutely were, as Lord Darzi made clear.
As I said, we will go through the allocation of additional
funding in the normal process, which will be faster than under
the previous Government because we are committed to giving the
sector much more certainty. The normal process, as the hon.
Gentleman should know from his time in government, is to go
through the mandate and the planning guidance and to talk to the
sector about the allocations due next April, as I said in my
opening statement.
(Calder Valley) (Lab)
Does my hon. Friend join me in welcoming the Opposition's new
interest in social care? Does she further agree that the problems
that social care faces owe more to the previous Government's
failure to do anything with Andrew Dilnot's 2011 report than they
do to anything that is happening now with national insurance?
My hon. Friend makes an excellent point. When I joined this House
in 2015, I remember that the first act of the new, non-coalition
Conservative Government was to take the legs from underneath that
social care commitment by postponing the Care Act 2014. They
cynically said at the time that they would bring it forward by
2020, which they thought would coincide with the next general
election. We all saw how that went.
Mr Speaker
I call the Liberal Democrat spokesperson.
(Mid Sussex) (LD)
The increase in employer national insurance contributions will
erode the very investment in the NHS that the Budget sought to
prioritise. Katie, a GP from Lindfield in Mid Sussex, wrote to me
saying that the NICs increases
“serve to directly undermine access and patient care.”
The Government have promised to recruit more GPs, but hiking
national insurance puts that pledge in jeopardy. Surgeries are
set to see eye-watering increases in staff costs, equivalent to
26,786 appointments in West Sussex alone. GPs will have no choice
but to cut services and staff numbers, and patients will pay the
price.
Does the Minister agree that stronger primary care, with faster
appointments and fewer people having to go to hospital, is better
for both the NHS and patients? If so, will she protect services
and press the Chancellor to end this GP penalty?
The hon. Lady makes an excellent point about the importance of
GPs and primary care to the wider sector. Immediately after
taking office this summer, we freed up the system to employ 1,000
extra GPs through the additional roles reimbursement scheme—which
the previous Government refused to implement—because we
recognised the need for that extra capacity. We will be talking
to general practice as part of the contract reforms over the next
few months, following the normal process, to determine
allocations for next year.
(York Central)
(Lab/Co-op)
If this Government's ambition, stemming from Lord Darzi's report,
is to be realised, significant investment is required not only in
primary care but in third sector organisations. However, these
organisations are concerned about the increased cost pressures on
their services. Will the Minister ensure that there is sufficient
support within the trickle-down approach, which the Department
will now have to apply, to maintain current service levels and
facilitate the urgently needed transition across health
services?
I respect my hon. Friend's expertise in this area. She is right,
and we understand that the pressures are real, which is why we
have committed to supporting the NHS and the social care system
with the additional funding that my right hon. Friend the
Secretary of State for Health and Social Care secured as part of
the Budget settlement.
We are also working closely with the NHS, in a new relationship,
to understand its needs. That is a dynamic conversation, because
we want to understand what is happening in local systems as we
continue to invest in them.
Mr Speaker
I call the Father of the House.
Sir (Gainsborough) (Con)
We all know that a lot of the debate on assisted dying revolves
around the lack of hospice places to help people pass in the best
way possible. Similarly, much of the debate on the NHS is about
the lack of care home spaces. Leaving aside the cross-party
name-calling, may I beg the Minister to consider exempting
hospices and care homes from this national insurance
increase?
I understand the right hon. Gentleman's point. As I have said, we
will continue our conversations with all affected providers in
the normal way.
(Bury St Edmunds and
Stowmarket) (Lab)
Does the Minister agree that the support that we will put in
place for general practice and, in particular, the community
health hubs that were recently announced, will be crucial to the
improvement in the health service that we urgently need?
I respect my hon. Friend's expertise and service to the national
health service. He will understand the need to make the shift
into neighbourhood health services. We have been clear that we
will ensure the NHS spends all its allocations in the most
effective way to enable that shift, as part of our 10-year
plan.
Mr (Basildon and Billericay)
(Con)
A trustee of the Hamelin Trust, a not-for-profit provider of care
and support across Essex, has contacted me because he is
concerned about the £92,650 rise in national insurance that
Hamelin will have to pay because of the measures introduced by
the Government. He said:
“This will affect what they can do to support our communities and
subsequently put more pressure on the NHS and local authorities.
The impact on disabled people and older adults who rely on
regular, consistent, high-quality care will be profound.”
I do not believe that the Government intended to hammer the
disabled or older people who need care, so will the Minister
prove me right and look at the policy again?
The right hon. Gentleman was part of the last Government—I am
pleased to note that he is talking to his new constituents. The
£22 billion black hole and the report from Lord Darzi indicate
the fragility of the system we have inherited. We are ensuring
that vulnerable groups are supported through the allocations
provided to both the Department for Health and Social Care and
the Department for Work and Pensions.
(Welwyn Hatfield) (Lab)
When Labour came into government in July, every element of our
health service was in crisis. Since, then, we have announced
record investment in our national health service, but I am yet to
hear whether the Conservative party supports that record
investment. Does the Minister agree that the Government are
listening to health professionals, taking tough decisions and not
simply playing politics?
My hon. Friend makes an excellent point. We have still not heard
from the Opposition whether they agree with the extra investment
that has gone into the sector or with Lord Darzi's report that
diagnosed their legacy, including why they left that legacy and
the serious issues we now have to address.
(Twickenham) (LD)
Shooting Star children's hospice in Hampton serves children with
life-limiting conditions and supports their families not just in
my constituency but across south-west London and Surrey. With the
national insurance hike, it faces a bill of £200,000, on top of
all the inflationary costs that it has had to absorb. It is also
waiting for confirmation as to whether the children's hospice
grant, which this year provided it with £1.8 million, will
continue beyond April 2025. Will the Minister commit to making
hospices exempt from the NI rise, not just for nursing staff but
for all staff, and when will she be able to give Shooting Star
and other children's hospices confirmation on whether the
children's hospice grant will continue? They need to plan
now.
I commend the hon. Lady for raising the great work done by
hospices. We understand the pressures and the precarious
situation that many have been left in after 14 years of the last
Government. We are willing and keen to talk to representatives
from all types of hospice, and others. We are going through the
process of the allocations and we will be able to get back to
them as soon as possible.
Mr (Leeds South West and Morley)
(Lab)
Hundreds of my constituents in Leeds South West and Morley are
stuck on record long waiting lists, thanks to the Conservative
party. It is essential that we get those waiting lists down,
because they have profound effects on our economy and on the
health of those waiting. Will the Minister confirm that the
measures that we set out in the Budget will provide the
additional appointments needed to get those waiting lists
down?
My hon. Friend makes an excellent point. As I said in my response
to the hon. Member for Hinckley and Bosworth (Dr Evans), we faced
a situation where we were told that we would have to reduce
appointments by 20,000 a week. We have taken serious steps, and
my right hon. Friend the Secretary of State fought hard for our
Budget allocation so that we can have 40,000 extra appointments
as promised in our manifesto, which was overwhelmingly endorsed
by the British public. We are determined that we will bring
change to the system and tackle the waiting lists.
(Broadland and Fakenham)
(Con)
Increased taxes for hospices, care homes, GPs and pharmacies. Is
that a deliberate decision by the Labour Government or just a
cock-up?
We understand the precarious situation that hospices are in—the
precarious situation that they found themselves in before we came
to power— and we are committed to talking to them and other
affected providers. We will be going through the normal process
of allocations in the next few months.
(Halesowen) (Lab)
Many of my constituents continue to wait on record-long waiting
lists. Does the Minister agree that, before the Opposition throw
stones, we should remind the House that their spending plans
would have cut £15 billion from the NHS, which would have
completely shattered an already broken NHS?
Those Conservative Members who have held on to their seats—I have
been in that situation as well—know that the public, staff and
patients understand exactly what state they left the NHS in. That
is why they had such a disastrous election result. We are
determined to change the NHS and to make it fit for the 21st
century. Part of what we have done in this Budget through that
extra allocation, our conversations with those in the health and
social care system and our 10-year plan will do just that.
(Aberdeenshire North and
Moray East) (SNP)
While Scotland's public sector is facing a £500 million bill for
the Chancellor's reckless national insurance hike, Scotland's
charities, including hospices, face a £75 million price tag under
these changes. The Budget simply cannot be balanced on the back
of Scotland's charities and hospices. This is a disgraceful
decision for which the Labour Government are rightly being
hounded. There is still time for them to do the right thing and
cover these costs—I agree with what the Father of the House said.
Will the Minister tell us whether they will do so?
The SNP has been in charge in Scotland for something like 20
years now—I forget exactly how long, but it seems like a very
long time. Again, the Scottish people gave us an excellent result
at the general election, and I am delighted to have so many
Scottish colleagues here with me now. However, the SNP has the
opportunity to make decisions in Scotland around health and
social care as well, so I suggest that they do a better job.
(Kingston upon Hull East)
(Lab)
It is disappointing to put it mildly that the Opposition
spokesperson was unable to mention the record funding committed
in the Budget.
Dr
It was in my opening line—
Mr Speaker
Order! The shadow Minister has been granted an urgent question.
He asks the questions; he does not answer them from the Front
Bench.
Does the Minister agree that it is also disappointing that the
Opposition ignore the fact that they completely disregarded and
ignored social care when they were in office?
Mr Speaker
The Government have no responsibility for that.
Well, I do agree with my hon. Friend. As I have said, when I
became a Member of Parliament in 2015, I remember very clearly
the absolute shock that I felt when the Conservatives immediately
announced that they were not going to meet the commitment that
they had made to implement the Care Act 2014 at that time, and we
are still playing catch-up on that issue.
(Berwickshire, Roxburgh and
Selkirk) (Con)
Doctors from Duns, Galashiels, Selkirk, Kelso and across the
Scottish Borders have contacted me about the impact that this
national insurance hike will have on their practices. They tell
me that the decision will be a huge retrograde step for primary
care, will have a huge financial impact on their practices, and
will undermine access to primary and patient care. Why have the
Labour Government made this choice to hammer local doctors?
As I have said, we have made a commitment to general practice and
primary care by releasing extra GPs into the system. We recognise
the situation in which GPs find themselves. I know this because I
worked with GP practices in my previous career. We need those
practices to be the foundation of our neighbourhood services,
which is why we will talk in the normal process about the
allocations over the next few months as part of the contract.
Mr (Sheffield South East)
(Lab)
If we are to reform the NHS, we need to move resources over time
into primary care. The reality is that GPs see at first instance
90% of patients, but receive only 8% of NHS funding. Will my hon.
Friend ensure that, in the settlement that is agreed with NHS
providers, particular attention is given to supporting GPs?
On the social care sector, when we help the hospices and social
care providers, which are charities and small organisations in
particular, can perhaps do so without subsidising some of the
hedge funds that are now investing heavily in social care? We do
not want to add to their profits while supporting the small
charities involved.
My hon. Friend has led fantastic work in previous Parliaments on
the health and social care system, which he understands very
well. He makes an excellent point about ensuring that additional
funding goes where we want it to, which is towards supporting our
constituents, particularly with social care. We have all seen the
situation over the last decade over so. Improving that is
critical to the urgent and emergency care system, and to the
dignity of those people who need the service. We will continue to
talk to them, and to local systems, about the impact of any
changes.
Mr (Orkney and Shetland)
(LD)
I hear what the Minister says about the Government wanting to
stop the NHS going into reverse, but that is exactly what risks
happening to GP practices in my constituency. I met with one on
Friday that told me that, as a consequence of having to find
extra funds for national insurance contributions, it will no
longer be able to make permanent a temporary support post, or
proceed with the recruitment of the extra GP that it wanted to
take on. There is a contradiction at the heart of the rules: GPs
are treated as private contractors, but if they were private
contractors, they would be eligible for employment allowance.
Because their work is entirely in the public sector, they cannot
get it. Surely something has to give.
The right hon. Gentleman tempts me to go into my previous career
working with GPs and their employment and contractual status, but
I will not do that now, Mr Speaker, as you would rightly curtail
me. GPs have a complicated contractual status that has been long
in the process. We understand the precariousness of primary care.
GPs are crucial to our plans for developing the health service,
and we will discuss with them, in the normal process, the
allocations for the following year.
(Dartford) (Lab)
Last month's Budget finally gave my constituents hope that there
will be an NHS that works for them. Will my hon. Friend assure me
that this Government will avoid the sticking-plaster, piecemeal
approach of the last Government, and bring forward a long-term
plan to fix the NHS for the future?
My hon. Friend is right: getting away from short-term fixes and
sticking plasters is exactly what we are attempting to do. That
is why we put in the extra security of extra GPs over the summer,
committed to extra funding in the Budget, and launched our
10-year plan. I encourage all hon. Members and their constituents
to submit their views to that exercise at change.nhs.uk.
Sir (Herne Bay and Sandwich)
(Con)
Dr Aleksandra of the Ash surgery in my constituency
is one of a number of GPs who have pointed out to me the
deleterious effects of an ill-thought-through Budget. In
addition, charities such as Shooting Star and Demelza children's
hospices are facing problems now. They cannot wait for
discussions through the normal channels while this cock-up is put
right. When will something be done about it, please?
The right hon. Gentleman says that it is an ill-thought-through
Budget. I do not know whether he agrees or disagrees with the
extra funding that the Government have committed to the NHS after
the disaster of the last 14 years.
(Paisley and Renfrewshire
South) (Lab)
This morning, we learned that the Scottish Government have wasted
£28 million of taxpayers' money on the flawed, ill-conceived
National Care Service (Scotland) Bill, which did not command the
support of almost any of the stakeholders needed to pass it. Does
my hon. Friend agree that the additional funding for the NHS that
has been committed to in our Labour Budget should be used to come
up with a proper plan for social care across the UK that does not
follow the flawed approach in Scotland?
I am so pleased to see my hon. Friend in her place. As I said to
the hon. Member for Aberdeenshire North and Moray East (), the SNP has been in charge
of Scotland for a very long time. We have certainly missed having
a Scottish Labour voice in this place. She makes an excellent
point and shines some sunlight in this place on the actions that
have been taken up in Holyrood.
(Salisbury) (Con)
Julia's House hospice does amazing work across Wiltshire and
Dorset, but its chief executive Martin Edwards came to Parliament
on Tuesday to tell me that the additional national insurance
contributions will cost the hospice £250,000 a year. For that
hospice, and Naomi House, which does similar good work, the
changes are a significant concern. I know that the people of
Wiltshire and Dorset will do as much as they can to raise
additional funds, but will the Minister reflect on that
unexpected gap and offer some reassurance?
I agree with the right hon. Gentleman that his hospice, and the
hospices in many of our constituencies, do great work. We are
aware of the precarious situation that they have been in for a
number of years, and we want to ensure that they are fully part
of end of life care. He will know from his time in the Treasury
that there are complicated processes, both in the Treasury and in
the Department of Health and Social Care. When I talk about the
normal processes for allocating money, I think he understands
that well. We are mindful of hospices' concerns, and we will
continue to talk with them.
(Shipley) (Lab)
Between 2013 and 2023, during the Conservatives' time in
government, the number of general practices fell from 8,044 to
6,419. Does my hon. Friend agree that it is a bit rich for the
Conservatives to pretend now that they care so much about general
practice, given that 1,600 practices closed on their watch?
My hon. Friend brings a great deal of expertise to the House from
her work in social care, so she knows and understands the
precarious nature of the sector, which we cannot stress enough. I
do not know whether the Conservatives have actually read the
report by Lord Darzi, but that report and its appendices give a
really clear idea and diagnosis of the state in which the NHS and
social care system was left. It will take a long time to rebuild
it, and the sustainability of general practice and primary care
is particularly problematic. That is why we took those actions in
the summer, and why we will continue to support them and build up
a neighbourhood health service.
(Harrow East) (Con)
The Minister will understand that GPs are private contractors to
the health service, as are pharmacists, hospices and many
wonderful charities. The Government have decided to ensure that
the public sector is protected from the national insurance
increase. All that the Minister—or her Secretary of State—needs
to do is agree that all the suppliers to the national health
service are also protected, which would safeguard their position.
Otherwise, care homes will close down, pharmacies will close
down, and hospices will not be able to provide their services. My
constituency has the wonderful St Luke's hospice, which does
brilliant work—I helped to found it back in the 1980s—and which
has told me that it will have to reduce services drastically as a
result of the changes. Whenever nurses and other medical
practitioners get a pay rise, those suppliers have had to cope
without being given the money to fund that pay rise. They need to
be protected from that as well.
I thank the hon. Gentleman for his comments and for supporting
his local hospice. He is an experienced parliamentarian; he knows
that this is not simple and that the provider landscape is
complicated. As we heard from my hon. Friend the Member for
Sheffield South East (Mr Betts), large private equity companies
own many social care providers. We want to ensure that any
additional funding from the Budget goes exactly where it needs to
be: supporting patients—our constituents—where they live and need
care. That is why, over the next few months, we will continue to
talk to providers in the usual way about the allocation of those
funds.
(North Herefordshire)
(Green)
Since the Budget, I have been contacted by GPs, care providers
and charities in my constituency, all expressing concern about
the impact of the rise in employer NICs on their ability to serve
the most vulnerable in our community. Will the Minister
reconsider the change by finding a way to exempt the charitable
sector in the same way as the public sector? I have written to
Ministers and tabled early-day motions on this issue. Will she
take this opportunity to assure the charitable sector that it
will not be impacted by the measure?
The hon. Lady tempts me to make specific commitments, which I am
not prepared to do, as I am sure she understands. She is right
that people are expressing concerns about some of these
decisions. That is because they are in such a precarious
situation as a result of what we have inherited from the past 14
years. As the Prime Minister and the rest of the Government have
been clear throughout the election and afterwards, we have a
10-year plan because it will take a long time to fix the
foundations and build up the sector to make it more resilient and
sustain it for the future. We want to fix those foundations, and
we will talk closely with everyone affected over the coming
months, but this will take a long time. Those providers are
precarious because of the mess that we inherited.
(Brigg and Immingham)
(Con)
Earlier this week, I received a letter from the Lincolnshire and
Nottinghamshire air ambulance, a charitable healthcare provider.
The national insurance changes will add £70,000 a year to its
costs, and if it is forced to close, lives will be lost. May I
urge the Minister—I know she will want to protect this service—to
do all she can to ensure that that air ambulance and others
across the country are not hit by this tax?
I assure the hon. Gentleman that since we were elected, the
Government have already taken action to secure extra investment
in the health and social care system, and we are committed to
building a thriving health and social care system for the rest of
the 21st century.
Mr (Newbury) (LD)
A rural pharmacy—one of the few remaining in my
constituency—derives 90% of its turnover from providing NHS
services. Will the Minister consider giving pharmacists for whom
NHS services account for such a large proportion of their work an
exemption from the NICs rises? What assessment have the
Government made of the impact on the continuing delivery of
programmes such as Pharmacy First if pharmacists have to shut
their doors?
The hon. Gentleman makes an excellent point about pharmacies. We
absolutely understand their importance, both in urban
constituencies such as mine and in rural areas. I remember from
when I became an MP in 2015 the changes that the previous
Government made to the pharmacy contract, and I am aware of the
precarious situation that pharmacists have been in. We will
continue to talk to them as part of the normal process, but we
understand how important they are to building a neighbourhood
service and to the future of the NHS.
Dame (West Worcestershire)
(Con)
Acorns children's hospice, St Richard's hospice and GPs, care
homes and pharmacies across West Worcestershire have all been in
touch with concerns about the extra cost burden that the
Government have imposed on them. Can the Minister explain how it
fits in with her strategic plans to slap extra cost on the
community sector while rebating the NHS trust sector?
I am sure that all those hospices, which do great work, were also
in touch with the hon. Lady when she was part of the previous
Government. She will know from her time on the Treasury Committee
that following the Budget, we go through the planning guidance
and have conversations with all core contracted sectors. That is
part of the normal process. We are absolutely committed to
building back the foundations of the NHS and social care system,
making it fit for the 21st century and creating a 10-year plan to
which we want everyone to contribute. Community and neighbourhood
systems are a fundamental part of that.
(Ceredigion Preseli) (PC)
GPs, pharmacies and social care homes from across Ceredigion
Preseli have contacted me to express their concerns about the
impact of the policy changes surrounding employer national
insurance contributions. It is essential that they are supported
with the cost that comes from this policy. The Minister has
suggested that there might be additional support for some of them
through the usual systems. Will she clarify whether that will
mean funding being found from the Department's budget, or whether
there will be additional new money from the Treasury? That would
have certain ramifications for the Welsh Government and whether
they get additional Barnett formula funding.
I understand the concerns of the providers that have come to the
hon. Gentleman, and he is right to raise them in this place. As
he knows, health and social care is devolved to the Welsh
Government, and there has been much benefit already from the
Barnett consequentials of the Budget. We will continue to talk to
the devolved regions—in, may I say, a much more co-operative way
than the previous Government did—to ensure that we have a good
system across the entire United Kingdom.
(Keighley and Ilkley)
(Con)
In a tweet to the Health Secretary, Caroline Rayment, who is the
clinical lead for the Wharfedale and Silsden community
partnership, said,
“you came to our practice in June and told us you wanted to
support the family Dr. Costs for the NMW and NI will come to
approx £50k—we are a small practice of 7000 patients—how is this
helping us?”
Can the Minister answer Caroline's question?
I am not abreast of all the Health Secretary's tweets and the
responses to them, but Caroline makes a point that has been made
by many people in the Chamber today, as well as a number of
providers. As I said in my opening statement, we understand the
precarious situation that those providers have been put in
because of the failures of the past 14 years and the £22 billion
black hole that the Government have inherited. As my hon. Friend
the Member for Shipley () said, general practice has
been put in a precarious situation over the past 14 years, with
thousands of practices going bust and giving back their
contracts. That is a situation that we promised the British
public we would change, and we will do so.
(West Suffolk) (Con)
In Suffolk, the national insurance increase creates £11 million
of additional pressures on adult social care alone. I do not
think the Minister understands that she is not just engaged in
some party political knockabout with Conservative Members; GPs,
hospices, care homes and pharmacies are watching this debate and
are looking to the Minister for answers. They know that this
problem was caused by the Government's tax rise, which is being
implemented without a plan for them, so can she tell them when a
solution is going to be brought forward by the Government? When
are they going to get reassurance about their future?
The hon. Gentleman may or may not think that this is political
knockabout, but I was very clear in my opening statement that we
understand the pressures that the sector is under. We understand
the mess that we inherited, and we are fixing it. We are working
with social care, GPs, providers and hospices that are affected
by any changes in the Budget, and we will continue to talk to
them in the usual way. We are committed to doing this faster than
the last Government did it. Under the last Government, planning
guidance and commitments to the NHS were always running late—they
were always playing catch-up. We are committed to making sure
that the sector is much more sustainable, so that it can do the
important job we are asking it to do.
Madam Deputy Speaker (Ms )
I call .
(Strangford) (DUP)
Thank you, Madam Deputy Speaker. As Members know, I am the last
person —when I am called, the debate is almost over.
Will the Minister confirm whether consideration has been given to
the fact that the rise in national insurance contributions will
not affect the NHS as a whole, as the block grant for us in
Northern Ireland will cover it? However, GP practices in my
constituency of Strangford will suffer, and unlike high street
businesses or manufacturing, they cannot increase prices to cover
that impending rise, leaving practices with no option other than
to reduce hours in order to stay solvent. Does the Minister agree
that this is the last thing already overstretched GP practices
need, and will she commit to take this issue back to the Treasury
for reconsideration as it relates to healthcare businesses such
as GPs, dentists and pharmacies?
As the hon. Gentleman knows, health and social care is a devolved
issue. We will continue to work closely with all the devolved
areas, because we think that that is important, unlike the last
Labour Government—the last Conservative Government. [Laughter.] I
slipped there—I almost got through.
We absolutely understand the precarious nature of general
practice and, in particular, I understand the really serious
issues around health and social care in Northern Ireland. The
hon. Gentleman knows that, and he makes a good case for the
sector. We want to ensure that it supports people in Northern
Ireland with the good primary and community care they deserve.
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