Spending Review: Health and Social Care

Edward Argar Excerpts

Thursday 12th June 2025 Commons Chamber

[Edward Argar (Melton and Syston) (Con)]

Yesterday, yet again, we saw the Chancellor do what the Labour party always does: default to high spending, more borrowing and higher taxes, leaving the public finances vulnerable. The Minister has spoken of additional funding for the NHS. To use the same comparison as the NHS England chief executive, the NHS budget will now be roughly the equivalent of the entire GDP of Portugal, yet we are still none the wiser as to how the Government actually intend to use most of the money—there is no real detail and no real plan. Just last September, the Prime Minister pledged that there would be no more money without reform. Despite the Minister’s words, that is exactly what the Government have done. There is still no plan for reform, and the Secretary of State is unwilling to set out the bold reforms that are needed.

Despite 14 years in opposition and nearly one year in government, the Labour party has failed to come up with a plan for the NHS, with the exception of the abolition of NHS England, which will not happen for years and appears to be delayed and in chaos. Ministers respond to every written parliamentary question about it by saying they cannot set out the savings, how the people will change or how the structure will change at this stage—yet again, there is still no plan. We have been very clear that where the Government are wrong, we will oppose it, but where they get something right, we will work constructively with them. That includes reform, but there is still no reform for us even to consider supporting.

Can the Minister tell us where the £29 billion she set out will be spent? The chief executive of the NHS Confederation said yesterday that increases in NHS staff pay will

“account for a large proportion”

of the funding increase. The former NHS chief financial officer echoed that view at the Health and Social Care Committee in January, saying that pretty much all the last tranche of additional spending was absorbed by pay rises, national insurance and inflation. Can the Minister confirm how much the pay offers from the independent pay review bodies, alongside increased national insurance, will cost, how much of this funding will have to go to cover that and how much will actually make it to the frontline to improve patient services?

The Minister touched on the aim of meeting the NHS 18-week target for hospital waiting times within this Parliament. Of course, we wish the Government well in achieving that and hope they succeed, but just yesterday The Times reported that internal departmental modelling showed they are not on track and could only come close to meeting the target with “implausible” and “over-optimistic” assumptions. The independent Institute for Fiscal Studies agreed. Can the Minister set out how the Government will meet that target? Again, where is the plan? We need a plan, not empty rhetoric.

It is clear that the NHS needs reforms, not just more funding, so when will the 10-year plan finally be published? Will it be before the one-year anniversary of the Labour party being in government? Will it be like their elective reform plan: simply a reheat of the plan that Sajid Javid brought forward in 2022, with nothing new? The Secretary of State needs to be more ambitious—words that I suspect will never be echoed by the Prime Minister or his team in No. 10.

The capital budget remains broadly flat in real terms from this year onwards. The Minister has said she wishes to continue with the new hospitals programme and invest in technology to boost productivity, but it is unclear how that can be achieved with this settlement. These are not my warnings but those of respected independent think-tanks, including the Nuffield Trust and the King’s Fund. The Chancellor’s plan is clear—indeed, not one Treasury Minister has ruled it out: more tax rises are coming.

Finally, and importantly, we have seen social care largely neglected again by this Government. There were just two sentences about it in a four-page statement. Social care deserves better. The Minister knows very well that we cannot improve the NHS without social care working well. Earlier today I met with social care providers. They want to see reform, yet the Government have apparently abandoned cross-party talks on social care reform for an independent commission led by the very able Baroness Casey, who is still doing her Home Office work on grooming gangs and is yet to be full time on this commission, which has a deeply unambitious finishing time of 2028. When will Baroness Casey be full time on the commission? These providers were clear that they want a seat at the table when better care funds are distributed by the NHS—they want to have their voices heard in decision making on that funding. Will the Minister agree to that?

Finally, the Chief Secretary to the Treasury said he has modelled his assumptions on continued trends in local government finance and local government precepts —in other words, a 5% uplift in the precept. However, a large number of counties are now controlled by Reform—whose Members are, as ever, notably absent from the Chamber when we talk about health and social care—who have pledged no tax rises whatsoever in their councils. If they do that, what is the Minister’s plan to make sure social care is funded? As ever, the Government have gone for the headline announcement, but sadly without a plan, without delivery and with no real reform to benefit patients.

[Karin Smyth]

I am entirely unclear, after that run-through of a number of different issues, whether the Conservatives welcome the extra investment in the NHS or oppose it. We know they oppose the means of funding it, but after that, I have no idea. At some point, they have to make up their mind whether they support that extra investment or not. As I said in my statement, if they do not, what out of the list of the improvements that we have already made would they not do?

As Lord Darzi made clear, under the Conservatives’ watch for 14 years the NHS was broken. Staff were left with out-of-date equipment and unable to do the job they needed to do. We agreed with Lord Darzi’s diagnosis, but Conservative Members have still not said whether they agree with it, or apologised for the state they left the system in. I do not know whether the right hon. Member for Melton and Syston (Edward Argar) has not been able to read the elective reform plan or the urgent emergency care plan that we published recently. It is up to him to read those plans properly and try to understand what is happening.

The right hon. Gentleman has started to do my job for me again, because he cites various think-tanks and people who have said that this cannot be done. Well, I can tell him that we were told, for example, that waiting lists would not drop in April because of seasonality, but we have shown—by keeping a relentless focus on the system, working closely with leaders on the frontline and being clear with officials in the Department—that it can be done. That is what we heard this morning.

We are taking a relentless approach to spending, line by line, throughout the NHS and the Department of Health and Social Care. We have rolled up our sleeves and we will not accept putting more and more taxpayers’ money into a leaky system, which is what happened under the right hon. Gentleman’s Government. If he had read the patient satisfaction survey, he would know that taxpayers across the country, in all our constituencies, love the NHS. They understand that the Tory party broke it and that it will take long time to fix. They also know that they are paying more taxes for it and getting a worse service, and they expect us to do much better. That is what we have already shown we are doing, and what we will continue to do.

I have outlined the capital that is going into the new hospital programme, which we are committed to, and we have already seen increases in diagnostic capability and surgical hubs throughout our constituencies. We will continue to do more of that. I agree with the right hon. Gentleman that it is critical to ensure that social care is supported alongside the NHS. That is why £4 billion is going into social care through our colleagues in the Ministry of Housing, Communities and Local Government, and as he knows, Louise Casey will publish her interim report next year.

We are clear that fiscal responsibility does not stop at the Treasury or down in Victoria Street with the Department of Health and Social Care. It is important that everybody in the NHS is aware that we are determined to fix the NHS and put it back on a sustained footing. There is record investment; that is our commitment to people, and I know from the people I worked with in the health service over many years that they are determined to make it better. Morale sank to an all-time low under the Conservative party, but we are raising that morale, and we will continue to work with the system to make sure that it is fit for the future.