National Insurance Contributions Bill

Lord Hunt of Kings Heath Excerpts

Monday 14th March 2011 Lords Chamber

Moved by

[Lord McKenzie of Luton]

1: Clause 3, page 2, line 5, leave out ““50”” and insert ““50, or such greater percentage as is necessary to ensure that the National Health Service allocation will grow in real terms year on year””

[Lord McKenzie of Luton]

My Lords, we return to the issue of the NHS allocation from the National Insurance Fund. The specifics of the amendment require the percentage of the product of the additional primary percentage rate to be either 50 per cent or such greater percentage as would ensure that the allocation increases in real terms. In essence, the purpose of the amendment is to stop the NHS being short-changed. It is a variation on the theme of the amendments in the other place that required the NAO to report on what sums would be required for this to be achieved. When this was debated in the other place, the Minister offered two arguments against this approach. The first was that the spending on health is set by the spending review and is not affected by the NHS allocation. The second was that the Government would anyway normally expect contributions to the fund to rise broadly in line with earnings. The Minister, Mr Gauke, said:

“In any case, the amount allocated to the health service from national insurance contributions would, other factors being equal, be expected to grow in line with earnings and therefore grow in real terms every year under the terms of the Bill”.—[Official Report, Commons, 13/1/11; col. 475.]

If that is what the Minister’s colleagues believe, perhaps he will say what part that judgment played in the spending review allocation.

However, it would seem that the Minister’s colleague is mistaken. In Committee, the noble Lord, Lord Sassoon, helpfully pointed out Appendix 6 to the GAD report on the 2011 benefits uprating order, which shows the NHS allocation reducing in 2011-12 in comparison to the current year. This outcome is based on assumptions that the number of jobs in the economy would remain the same over the two years and that earnings are expected to increase by 2.1 per cent. This would suggest that, as regards Mr Gauke’s premise, the NHS allocation should rise by some £400 million and not fall. Overall, therefore, it seems that the NHS allocation for 2011-12 has been short-changed by £600 million. Why?

As was pointed out in Committee, in keeping the NHS allocation of the additional national insurance to just 1 per cent, the Government appear to have overlooked the changes to the various thresholds, which were policy changes designed to mitigate, in part, the effect of the national insurance increases. We have debated some of these during our consideration of this Bill. Will the Minister confirm that the effect of the reduction in the UEL from April 2011 and a significant increase in the primary threshold means that, for primary contributions, the band of earnings for 2011-12 on which the 2.05 per cent NHS allocation could be made is cut by something like £2,800 a year, although the 2 per cent rate, just 1 per cent of which is allocated, starts £1,350 earlier? Subject to further adjustments to the thresholds, that will mean a recurring diminution in the amount of the NHS allocation and an equal and opposite benefit to the fund.

Perhaps in dealing with the point, the Minister will say what the coalition Government’s policy objective is in respect of this allocation. Is it to maintain the allocation in real terms or to let it drift? How, if at all, is the projected allocation taken into account in determining the overall resources for the NHS?

We persist in these matters not just as a narrow question of arithmetic but because of our concern for the NHS and what is happening to it. We are concerned that the BMA reports a gap between government rhetoric about protecting front-line staff and the reality on the ground and that the recent comprehensive survey of healthcare cuts found that more than 50,000 doctors, nurses, midwives and other NHS staff are due to lose their jobs. I do not propose to cite at length the improvement brought about to the NHS under the previous Labour Government, but we note the coalition agreement’s pledge:

“We will guarantee that health spending increases in real terms in each year of the Parliament”.

However, in a devastating analysis in Committee in another place, my right honourable friend John Healey MP blew apart the Government’s claims that their plans represented a real-terms increase, particularly because of updated inflation forecasts and the allocation of funding from the NHS budget to cover social care budget shortfalls of local authorities. Of course, there are other pressures from the VAT increase, which the King’s Fund has estimated will cost the NHS some £300 million a year.

We know that the Government have not rebutted this analysis and that they are on course to break the coalition pledge of a real-terms increase in funding. Instead, they are heading for a real-terms cut. Despite the fact that the Prime Minister promised to protect NHS capital investment, that, too, is being cut by 17.4 per cent over four years. In the circumstances, it is surprising to say the least that the NHS allocation from the National Insurance Fund is not being maintained, at least in real terms. This is what the amendment seeks and I beg to move.