Budget Resolutions

Steff Aquarone Excerpts

Tuesday 2nd December 2025 Commons Chamber

[Helen Morgan]

We would all welcome that kind of innovative, community-led approach to improve local health services across the country.

The commitment to set up 250 neighbourhood health centres in communities by 2025 is clearly a welcome step, but there are 543 constituencies in England, so many communities will remain under-served. For example, my own constituency of North Shropshire is part of the pilot for neighbourhood health centres, for which we are grateful, but the numbers indicate that there may be only one neighbourhood health centre, although the constituency has five market towns, spread over a large distance and with different catchment areas. It is not one neighbourhood. Investment in our general practices is essential to ensure that people can continue to access primary care when they need it.

Neighbourhood health is not just about buildings—it is about how teams operate—but when so many local practices are constrained by the physical space in which they must work, buildings are an important part of the puzzle. There is a danger that rural and coastal communities continue to remain under-served and isolated, unable to access services that may be many miles away and only reachable by private car.

[Steff Aquarone (North Norfolk) (LD)]

My hon. Friend and I both represent rural constituencies that face similar challenges. Businesses in North Norfolk already face extra struggles to stay afloat, including training and retaining staff, finding affordable premises, and even things as simple as getting a strong and reliable phone and internet connection. Does she share my frustration that rather than tackling those problems, last week’s Budget has just lumbered rural businesses with more tax, more costs and more stress for the future?

[Helen Morgan]

I share my hon. Friend’s frustration.

Perhaps the most glaring and alarming omission of all in this Budget is that the words “adult social care” do not appear. The sector is already stretched to breaking point and is now suffering from the Government’s 2024 hike in employer national insurance contributions, which is unfunded for most businesses operating in that sector. The pressure is clearly reflected in the Association of Directors of Adult Social Services’ 2025 spring survey, which found that three quarters of directors have only

“partial or no confidence that their budgets are sufficient to meet their legal duties for prevention and wellbeing.”

That is not only terrible for disabled and vulnerable people; it is a disaster for the NHS. One in seven hospital beds are taken by someone who should be discharged but for whom there is no appropriate social care package. The situation could not be more pressing.

We need the cross-party talks to move far more quickly. As we have heard, there has been only one meeting, back in September, and there are no current plans for further engagement. I ask Ministers to ask the Prime Minister to lead those talks and to treat them with the seriousness and urgency that they deserve. We also need a solution to provide the social care beds needed to stop a devastating winter crisis; 2028 is too late for that.

In addition to spiralling NIC costs, there is increasing demand and huge staff shortages in the sector. With an immigration policy that is clearly designed to disincentivise overseas workers in this area, there is no clear plan to ensure how those vacancies will be filled. In formulating their 10-year workforce plan, the Liberal Democrats urge the Government to introduce a funded and higher minimum wage for carers, and a new royal college of care workers to improve training and career progression and to give carers the recognition that they deserve.

When social care is not available, family carers must step in to fill the need. A fairer deal for family carers, such as guaranteeing more respite care and introducing paid carer’s leave, would enable many to continue caring for longer at home. We want to see more support for young carers in school by introducing a young carers pupil premium. These are simple but potentially transformational steps in supporting the millions of carers without whom our health service would collapse.

Winter is quickly closing in, and there are signs that the annual winter crisis could be even worse this year, having already become a year-round permacrisis. The Budget should have funded an emergency package to prevent A&Es collapsing this winter. Liberal Democrats have called for 1,000 extra hospital beds, emergency social care places to free up places in hospitals, a recruitment and retention drive to increase the number of out-of-hours GPs, and a qualified clinician in every A&E waiting room to protect patients who are at risk but stuck on trollies. Without those measures, there is a significant risk of another winter of harrowing scenes of corridor care and ambulances queuing outside hospitals, which should have no place in our society.

Let us take a step back and ask what this Budget really means for the NHS. The topic of today’s debate is investment and renewal, but this Budget means cost pressures are left unaddressed and reforms that are confused and disorientating. Inflation is forecast to run higher than the budget set by the Department of Health and Social Care back in March 2025 for the spending review. As a result, average real-terms growth in departmental budgets has shrunk by 0.1% since then.

The OBR notes that spending on branded medicines alone is expected to rise by 25%—an extra £3.3 billion—between 2025-26 and 2028-29. For context, that is equivalent to the budget for maternity care in England. Yesterday’s recent agreement confirms that it will be at least that sum, and possibly as much as another £6 billion a year, which is an eye-watering amount. Industrial action could add a further £1.2 billion by 2028-29. It is hard to see what would be left to repair our GP services, expand social care or take any of the other measures needed to lift the NHS off the floor.

On top of that, we have no clarity on the impact of the reorganisation of NHS England and ICBs. The Chair of the Public Accounts Committee has warned that the Department has removed

“a key piece of machinery without articulating a clear plan for what comes next”

and compared the reforms with those of HS2.

The 10-year plan sets out a vision that Liberal Democrats share, but it is missing any clear explanation of how it will be funded within the spending review settlement. Nowhere, across 170 pages, is there a credible costing or delivery plan. Five months on, we still have no idea whether the Government can deliver the essential reforms that they have promised. Unless the Government adopt a genuine “spend to save” approach, investing now to prevent greater costs and worse outcomes later, we are at risk of seeing only managed decline, mounting pressure and the continued loss of faith in the health service.

Rather than Labour’s unfair tax rises, we have set out a number of fair ways to fund our public services properly. Most importantly, this Government are refusing properly to fix our broken relationship with Europe. We are calling for a new EU-UK customs union, which could raise more than £25 billion a year. The Government would have plenty of time to put the deal in place by 2030, raising billions in extra tax revenue in a fair way after 2030. We have also called for a targeted windfall tax on the big banks, which would raise £30 billion in total by 2030.

Let me take this opportunity to say to the Government that if we are to rescue the NHS, they must tackle the crisis at its front door and at its back door. That means investing in public health and early access to community services, including GPs, pharmacists and dentists, so that fewer people need to go to hospital in the first place. It also means fixing the crisis in social care to stop so many people being stuck in hospital beds. Only these measures can bring down waiting lists, improve the quality of care and help people live longer, healthier lives. The NHS needs transformational change; the Government must wake up from their complacency, or it will be patients who pay the price.