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National Insurance Contributions Bill

I beg to move amendment 8, page 2, line 2, at end insert 'The National Audit Office shall report to Parliament by the time of Royal Assent on the Finance Act 2011 on the sum that would be required from the product of additional rates in order for the health service allocation to grow in real terms in every year.'. It is good once again to face the Exchequer Secretary across the Dispatch Box, although not so good to do so from the Opposition side and with him on the Government side. However, he is a serious Minister doing a serious job. He showed that in the way he responded to my right hon. Friend the Member for Delyn (Mr Hanson) and the debate on the first group of amendments. I hope that the Exchequer Secretary will feel that amendment 8 and the amendments that were not selected were intended to be helpful to the Government. With them, we are offering to him, his boss the Chancellor and his colleagues in government the opportunity to act to prove to the public that they will honour the promises the Government made about protecting NHS funding and ensuring it sees a real funding increase each year, not a real cut. The Bill and national insurance contributions legislation more generally are about raising and allocating national insurance funds and contributions paid into that fund. The NHS has had a special place in that legislation certainly since 2002, when we decided to move, from April 2003, to raise an extra 1% on earnings above £43,800 and to allocate all that extra income to the health service and the NHS. The amendments we tabled, including amendment 8, give the Government the chance to do the right thing by the NHS and the British people. Amendment 8 in particular lays the groundwork for the Exchequer Secretary and his colleague the Chancellor to make the right decisions in order to honour their promises in the Budget. There were big improvements as a result of Labour's investment in the NHS over the past decade-51,000 extra doctors, 98,000 extra nurses, patient satisfaction at an all-time high-and it is hard to remember that in 1997 there were more than 280,000 people waiting more than six months to get into hospital for the operations they needed. I make that point to explain the broader context to amendment 8, as I am conscious that the House is debating a relatively narrow provision. The House will see that we refer in the amendment to health service allocations growing "in real terms in every year." As a result of the strength of support for the NHS after 13 years of Labour in government-a recognition of the special place that the NHS has in the hearts of the British people and of the enormous improvements that people had seen-the Conservatives took the view, as they went into the election and came into government, that they needed to protect, or try to protect, some of the improvements for which Labour had been responsible. That was why we heard the now Prime Minister-then Leader of the Opposition-say to the Royal College of Physicians back in January: "We are the only party committed to protecting NHS spending." "I'll cut the deficit, not the NHS," he said. "Unlike us," he argued, Labour "have not committed to protecting areas of the health budget such as public health and capital investment," although of course capital investment over the spending review will be cut by more than 17%. Indeed, we saw those very phrases-"I'll cut the deficit, not the NHS"-on the Conservative party's posters during the election campaign, with the Prime Minister's smiling, air-brushed face on them. Importantly, that personal commitment found its way into the coalition's programme as a formal pledge. Indeed, the coalition agreement said: "We will guarantee that health spending increases in real terms in each year of the Parliament". When the Minister's boss, the Chancellor, delivered his spending review statement on 20 October, one of the few flourishes in his speech came when he said: "This coalition Government made a commitment to protect the NHS and increase health spending every year. Today we honour that commitment in full. Total health spending will rise each year over and above inflation."-[ Official Report, 20 October 2010; Vol. 516, c. 959.] However, I spent a little time in the hon. Gentleman's position as a Treasury Minister, and I know that the devil is often in the detail of spending reviews. Despite what the Chancellor said, the problem is that when we looked at table 2.3 of the Green Book, on page 44, we saw that a significant slice of the money for the NHS in England had to be spent not on NHS services but on social care, in an attempt to plug a big hole in social care funding and stave off some of the prospective cuts for some of the most vulnerable people. That means that, instead of the full allocation of funding being spent on the NHS, £0.8 billion will have to be spent on social care next year, with £0.9 billion spent the following year, £1.1 billion the year after and £1.2 billion in 2014-15. The problem-this is what the terms of the amendment refer to-is that when we take out the double-counting of money for the NHS and social care, instead of the 0.1% increase in NHS funding for next year promised by the Chancellor, there will be a 0.6% cut, or a shortfall of £700 million. In other words, the Government are breaking the promise that was solemnly made by the Prime Minister, set out in the coalition agreement and repeated on the Floor of the House by the Chancellor when he delivered the spending review.