Health and Social Care Levy Debate

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Department: HM Treasury

Health and Social Care Levy

Jake Berry Excerpts
1st reading
Wednesday 8th September 2021

(2 years, 6 months ago)

Commons Chamber
Read Full debate Health and Social Care Levy Act 2021 View all Health and Social Care Levy Act 2021 Debates Read Hansard Text Read Debate Ministerial Extracts
Jesse Norman Portrait Jesse Norman
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If I may, I will just proceed a little bit further, and then I will be happy to give way.

In order to pay for a significant increase in spending in a responsible and fair way, the Government have announced a new 1.25% health and social care levy based on national insurance contributions. This Ways and Means motion enables the Government to introduce the levy and temporarily to increase national insurance contribution rates until it takes effect.

Jake Berry Portrait Jake Berry (Rossendale and Darwen) (Con)
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Will my right hon. Friend tell the House how much the 1.25% increase in national insurance will cost the NHS on top of its current payroll?

Jesse Norman Portrait Jesse Norman
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My hon. Friend will be aware that public sector bodies have been adjusted for in the numbers that have been published, and therefore the numbers that have been published are net of the impact on the public sector.

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Rachel Reeves Portrait Rachel Reeves
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I think many councils and the people who work for them and provide social care at a local level will be incredibly worried about what they are hearing from this Government, which is that council costs are going to go up while they are getting no additional money.

Jake Berry Portrait Jake Berry
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Will the hon. Lady give way?

Rachel Reeves Portrait Rachel Reeves
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I will give way again in a moment, but I have taken a lot of interventions—a lot more than the Minister.

In contrast, who has been shielded by the Chancellor? Which types of income will be paying no additional tax after today? They include those who get their income from financial assets, stocks and shares, sales of property, pension income, annuity income, interest income, property rental income and inheritance income. Well, fancy that. I do not doubt that the champagne glasses were clinking in Mayfair last night toasting the Chancellor, but not in Mansfield, not in Middlesbrough, not in South Ribble and not in Thirsk either. Some 95% of the revenue the Government plan to raise from this tax bombshell comes from employment. What a contrast.

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Jake Berry Portrait Jake Berry (Rossendale and Darwen) (Con)
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Let me start by congratulating the Government on grappling with what I think is a very difficult issue—actually, it is probably “the” issue for our generation to deal with—of how we ensure that older people have dignity in their old age, and how we deal with an ageing population. However, I do not believe that the way in which we are proposing to do it, through national insurance contributions, is the correct way.

There are three reasons why I think this will be particularly damaging to areas such as the one that I represent. First, ours is an area with low incomes. The lower a person’s income, the more that person pays, as a proportion of that income, in national insurance contributions. The national insurance rate on incomes above £50,000—before these changes—is just 2%. So those on the lowest incomes pay the most proportionately in national insurance contributions.

Secondly, ours is an area with low property values. An £86,000 cap on contributions, or even a £100,000 asset floor, may be right for other parts of the country, but in my constituency, where the average property price is £170,000 or £180,000, by the time people hit that damping floor of £100,000, they would have had to pay the equivalent of 50% of their property value in care home fees.

Dehenna Davison Portrait Dehenna Davison (Bishop Auckland) (Con)
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I thank my right hon. Friend for raising an important issue, with which I too have been grappling since yesterday’s announcement. Does he agree that it would be wonderful to hear from the Government that they may consider looking at regional disparities in house prices when setting the floor?

Jake Berry Portrait Jake Berry
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What a brilliant suggestion—one that I was about to make myself. I think that the Government should think about both the £86,000 contribution and regional house prices when considering that damping floor.

Thirdly, ours is an area with historically high unemployment. National insurance, as we have all called it during election campaigns, is in fact a jobs tax. It is a disincentive to the creation of new jobs, and those already in work will see, for instance, pay rises suspended as the wage bill goes up for employers just for employing people in their businesses. That is why I think that national insurance is the wrong tax to use for the people in my constituency. They are hit just as hard by this appalling social care issue as people anywhere else, but, for us, I would have much preferred it if the Government had looked at income tax, which, as we heard from the Chair of the Treasury Select Committee himself—my right hon. Friend the Member for Central Devon (Mel Stride)— would be much less regressive.

Miriam Cates Portrait Miriam Cates (Penistone and Stocksbridge) (Con)
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My constituency has similar house prices, and I know that my constituents share these concerns. As for the point about income tax, the advantage of taking this tax from national insurance is that the cost is shared between workers and businesses, but smaller businesses will not pay, for reasons that the Minister has already given. Is this not a better way of sharing cost across business and employees, which will actually affect lower earners in our constituencies less than the income tax alternative?

Jake Berry Portrait Jake Berry
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I thank my hon. Friend for making that point, but I do not agree with her. I do not think that we have to consign ourselves to one tax to deal with this issue. It is perfectly possible to put up income tax, which is a much fairer way of taxing people across the income scale, and, of course, picks up wealthy pensioners with very large pensions, picks up dividend income, and picks up rental income, which was mentioned from the Opposition Front Bench. It picks up all of our income, while at the same time allowing us to look at different ways to tax business. I have said before that I think we should have an online sales tax—an Amazon tax, as it is called—which the Treasury has previously said could release about £2 billion. That is not enough, but we could increase employers’ NI only, and we could increase corporation tax. This problem needs to be tackled with a cocktail of funding, not just one tax. But if we are to use just one tax, I do not believe that NI is the correct one.

Sammy Wilson Portrait Sammy Wilson (East Antrim) (DUP)
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Will the right hon. Gentleman give way?

Jake Berry Portrait Jake Berry
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No, I will not. I have already given way twice.

I congratulate the Government on trying to look at some of the concerns that many colleagues in northern constituencies have about low income, high unemployment and low property values, and I congratulate them on raising the floor to £100,000. I think that that goes some way towards dealing with the issues that concern many of us, although, certainly from my point of view, it does not solve them.

What also concerns me greatly is that this tax is not actually a health and social care tax; it is a Trojan horse for an NHS tax. The Government themselves say that in the first few years of this tax, nigh on 100% of it will go towards supporting the NHS. That is quite right, in that the NHS does need more money, but if it is an NHS tax, which will be hypothecated and listed on pay slips, we should call it that, rather than calling it a health and social care tax.

When the time comes to move the money from the NHS to health and social care, what Government of any political hue are going to cut £12 billion from the NHS budget? If we create an NHS tax, we have an NHS tax forever. It will never go down; it can only go up. No party is ever going to stand at an election saying, “I’ve got a good idea. Vote for me—I will cut the NHS tax.” I think there is a huge danger for us in creating such a hypothecated tax and listing it on people’s pay slips. It is fundamentally un-Conservative, and in the long term it will massively damage the prospects of our party, because we will never outbid the Labour party in the arms race of an NHS tax.

As a Conservative, I believe that the way to fund public services better is to grow the economy, to make the cake bigger. This change makes the cake smaller, because it is a jobs tax—and not even that: those who live in a low-wage, low-property-price, high-unemployment economy will get a smaller slice of it at the end of the day. They will have both a smaller cake and a smaller slice.

I hope that the Government will take the opportunity to think again. I welcome the new money for the NHS, but throwing other people’s money down a bottomless pit does not become a good idea if we put the NHS logo next to it. If we are going to fund the NHS, if we are going to give it more money, before the Government ask the House and us as Members of Parliament to approve that, they should show us the plan. We cannot measure the NHS by what goes into it; we have to measure it by what comes out at the other end.

For those reasons, with a heavy heart, I will not be supporting the Government this evening.

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Edward Leigh Portrait Sir Edward Leigh
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It is very nice to be intervened on by somebody who has no chance of forming a Government.

I am afraid that all this talk of a wealth tax or a tax on dividends does not even begin to meet the problem. If we have a wealth tax, what happens in respect of two old-age pensioners who have almost no income and just have a capital asset? Is it fair—

Jake Berry Portrait Jake Berry
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Does my right hon. Friend accept that this may be a fairer system if those in receipt of a pension but not working were asked to contribute to it in some way? Let us consider the position of people who are going to work in Tesco in Haslingden—it is in the constituency of my hon. Friend the Member for Hyndburn (Sara Britcliffe), but on the border with mine—and are struggling to buy school shoes for their kids or pay their mortgage. Why should they pay so that a relatively well-off pensioner does not have to?

Edward Leigh Portrait Sir Edward Leigh
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May I say to my right hon. Friend that he gave one of the best speeches this afternoon? It was thoughtful and incisive, and at least he is trying to develop an alternative argument. The Government—this is the problem with being in government—are faced with a crisis now and they have to find the money now. Regretfully, nobody has come up with a better plan than this. I am no toady to the Government, and I say to them that I do not think they can solve these problems by our constantly becoming a tax-and-spend party, as that is simply not going to wash.

We have been spending money like there is no tomorrow. I know there is a pandemic on, but the furlough scheme is riddled with corruption. I know from massive anecdotal evidence in my constituency that many companies are ripping us off left, right and centre. So the Government have to have more of a vision that they articulate: that we accept that there is a pandemic, that the NHS is in crisis and that we have to do something about care homes, but we do have a plan to control public spending. I know that the Chief Secretary agrees with me, but he may not want to leap to the Dispatch Box to say that now, especially as a reshuffle is imminent.

There are innovative solutions we can use to try to encourage people to take more control of their healthcare. John Major was hardly a fanatical right-wing Conservative, but he offered tax relief to pensioners who took out healthcare—we have never even considered that. The argument could be made that rather than having arbitrary limits such as £86,000, we could base this on the value of the house. So there are alternatives available.

I wish to articulate one thing before I sit down, and it relates to state insurance. I am trying to develop an alternative plan in the future. We know what Germany does and we know that it has an excellent system. Lord Lilley argued yesterday in a paper, and the Dilnot commission argued, that there is an alternative to all this. The Government dismiss private insurance straightaway. It is true that private insurance companies will not take over this burden alone, because they cannot foresee how many people will be very frail and stay in care homes for a long time. But why can we not have a system by which we underwrite private insurance? The state would offer insurance. Once someone is of pensionable age, they would enter the scheme. There would be a modest charge on their home, based on the value of the home. The premium, on average, would be covered by the Government, not by the person. On average, it would be £16,000 a year and it would be the covered by the Government, but that individual would have that peace of mind. That is an innovative scheme. It was suggested by the Dilnot commission. I do not understand why the Government have simply just ruled it out and said, “We have looked at private insurance and it simply will not wash.”

Many of us will be supporting the Government tonight—I know it is a bit of a cliché to say, “With a heavy heart”. We will be doing so because we recognise that the NHS is in crisis. However, we say to the Government: “When you just pump more and more money into a socialist construct like the NHS, you get lower and lower productivity. So we want to look at outcomes. We don’t want to just accept this argument that we are in an arms race with the Labour party, because they will always offer more than us.” So we want some answers from the Government on serious plans for the future and on controlling waste and low productivity in the NHS. We want to know how much of this money will actually go into the care home system. We can then vote for the Government with an easier conscience.

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Ben Everitt Portrait Ben Everitt (Milton Keynes North) (Con)
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It is a pleasure to follow my hon. Friend the Member for Bolsover (Mark Fletcher), who made a typically thoughtful and energetic contribution. There was much to agree with there.

My hon. Friend the Member for Bishop Auckland (Dehenna Davison) quoted the words, “To lead is to choose”, and here we have no easy choices. Indeed, in our job we often have tough days in the office, and nights when we lose sleep thinking about a vote, a decision, the options and the choices that we have in front of us. However, in this speech I am going to look on the bright side. I am going to try to be optimistic, and pull out the good things from the situation and the hard choices that we face. One good thing is that owing to the timing of this, I only lost one night’s sleep, but I am going to be very positive about the policy itself as well. I am going to choose three things that I want to improve, and I am glad that the Chief Secretary to the Treasury is here to listen. Those three things are how the revenue is raised, the quantum and the period over which it is spent, and how it is spent.

There are never any good options for raising taxes, but I happen to think that raising taxes on having a job should possibly be at the bottom of the list when we look at new areas of income. We have spent billions on furlough, keeping people in jobs. That has been borrowed from future generations, and will be paid back. We have kept people in jobs. We have kept the economy going. We have kept the show on the road. We have avoided the economic death spiral of mass unemployment while we have all these additional rising pressures on spending on public services, including, of course, social care—the very problem that we are here to fix. There are, I think, other less bad options. My right hon. Friend the Member for Rossendale and Darwen (Jake Berry) suggested a cocktail of taxes and levies. Normally, I instinctively avoid complexity in taxation—

Jake Berry Portrait Jake Berry
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But not cocktails.

Ben Everitt Portrait Ben Everitt
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No—not cocktails!

We have to recognise that the simple option is not always the right one, and I look forward to the debates that will follow as this policy evolves.

As for the quantum and the period over which the revenue is spent, I must ask whether it is enough to fix the care sector. The hon. Member for Sheffield South East (Mr Betts), the Chairman of the Housing, Communities and Local Government Committee, referred to the previous report of the Health and Social Care Committee, which required an additional £3.6 billion for the sector. Are we going to get that, and is it going to go through at the right time? We need to solve the broken economics of running a care home, which mean that providers must fund the services off the back of private clients to subsidise the clients who are referred by local authorities. I think we need a big conversation about that as well.

Let us turn to how the money is spent. The additional funding must be supported by meaningful reform. We must address the issue of funding allocation, and the allocation of responsibility within the sector. Currently, the system is set up to incentivise referrals. The system is split between local authorities, care providers and the NHS.

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Steve Barclay Portrait The Chief Secretary to the Treasury (Steve Barclay)
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Let me first thank hon. and right hon. Members for their thoughtful and constructive contributions to today’s debate.

Yesterday, the Prime Minister set out a series of necessary steps to tackle the covid backlogs, reform adult social care and bring the health and social care system closer together on a long-term, sustainable footing. As the House well knows, the pandemic has put unprecedented pressure on the NHS. The number of patients waiting for elective surgery and routine treatment in England is now at a record high of 5.5 million. If left unchecked, that could reach 13 million, an issue of concern across the House. At the same time, this country is facing a long-standing challenge to the social care system. Typically, around one in seven must pay over £100,000 for care, with bills falling indiscriminately on some of the sickest and most vulnerable in society.

The Government’s response, the plan we have debated today, means an investment of £36 billion in the health and social care system over the next three years. Patients across the country will benefit from the biggest catch-up programme in the history of the NHS. The social care system will finally be reformed, ending unpredictable and catastrophic care costs faced by thousands and making the system fairer for all. I gently say to the shadow Chief Secretary to the Treasury, the hon. Member for Houghton and Sunderland South (Bridget Phillipson), who said a moment ago that this is not the right time, that many times in this House people have highlighted the urgency of acting both on the covid backlog and on social care.

Jake Berry Portrait Jake Berry
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My right hon. Friend has helpfully said that one in seven—I believe that is what he said—people currently in the care system pay over £100,000. Could he just say in absolute numbers how many that is, in any given year or period he chooses? If he does not have the information with him tonight or cannot get it from the Box, can he write to me with that information and put a copy in the House of Commons Library before we have our next debate?

Steve Barclay Portrait Steve Barclay
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I am glad my right hon. Friend highlights that point. Let me address it in two ways, because it goes to the crux of his remarks in the debate. We have set out, as was referred to even by critics of the Government, the illustrative analysis of the impact of this from a distributional point of view, with lower-income households being the largest net beneficiaries. We have also said that we will say more on that, because it will evolve by 2023, when those of state age who are working come within scope. Obviously, the distributional analysis will change.

Let me take head on my right hon. Friend’s central concern, which was that his constituents in Rossendale and Darwen, because of lower housing costs, will be disproportionately impacted. First, if one looks at London, the Evening Standard, for example, is concerned that 14% will pay the lion’s share of the cost because that is where the highest concentration of higher tax payers are. For his constituents, one key aspect of the reform is that, through the cap, it ends the unpredictability of costs. If I look at the north-east of England, the Resolution Foundation found that only 29% of individuals aged over 70 have sufficient eligible assets that they will not receive any state support. The point is that the uplifting in the means test, which my right hon. Friend the Chancellor set out, again benefits those parts of the country he was championing.

Jake Berry Portrait Jake Berry
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Will my right hon. Friend give way?

Steve Barclay Portrait Steve Barclay
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I have just given way and addressed my right hon. Friend’s points head on. Let me, in turn, address head on the points raised by the shadow Chancellor, the hon. Member for Leeds West (Rachel Reeves).

In the shadow Chancellor’s speech, she said that she opposed the levy despite, as a number of Members pointed out, the previous Labour Government taking a similar approach in 2002-03, because she supports taxing wealth. The problem with that is that only a broad-based tax base, such as income tax, VAT or national insurance contributions, can raise the sums needed for such a significant investment. Again, that was a point made by critics of the Government, including my good friend, my hon. Friend the Member for Wycombe (Mr Baker). It could not be raised by taxes on wealth. Currently £6 billion is raised from inheritance tax, £8.7 billion from capital gains tax and £12.3 billion from property transaction tax. Indeed, that case was demolished by the Chair of the Treasury Committee, my right hon. Friend the Member for Central Devon (Mel Stride), as well as by my hon. Friends the Members for Dudley South (Mike Wood) and for Thirsk and Malton (Kevin Hollinrake), who highlighted that to raise the revenue required requires a broad-based approach.