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National Insurance Contributions Bill

I should like to say how pleased I am that my right hon. Friend the shadow Health Secretary has been able to extend the offer of support to the Government with this amendment. He seeks to be as helpful as an Opposition can be and to encourage the Government to live up to their coalition agreement promise to ensure real-terms growth for our national health service. As many of my hon. Friends have said, the NHS is absolutely at the top of our constituents' concerns and it is important that we ensure that we deliver a real-terms increase, particularly given the relatively high level of NHS inflation compared with mainstream inflation. I am sorry that, despite the hand of friendship being offered, the Minister felt that amendment 8 was ““a pointless exercise”” and ““unnecessary””. I thought that rather cruel. We think that the National Audit Office probably would be more than happy to undertake a study to find out how much money the Chancellor would need to add to the sum already committed in order to fulfil the Prime Minister's promise. Interestingly, the Minister said that he was confident that the Government ““will”” meet their commitment; he did not say that they ““have”” met it. Perhaps I am reading between the lines in a way that I should not, but it was almost as though the Minister was conceding, to a degree, that the sums allocated in the spending review do not fulfil that real-terms growth. I am sorry that the Minister did not address the two key points, and I would be more than happy to give way to him if he would care to address them. The first relates to the social care switch, whereby accounting and statistical opportunities have suddenly been taken to move a sum that had been and still is to be delivered by local authorities under the budget heading of the NHS—of course, social care will continue to be delivered by local authorities. Perhaps the Minister would like to confirm that that is the case. Therefore, to classify this money as part of the NHS growth is disingenuous in almost anybody's book. The second issue that, regrettably, the Minister did not address is inflation, which is quite high and rising. No wonder then that, as the shadow Health Secretary said, the Office for Budget Responsibility changed its definition of the deflator from 1.9% in June to 2.5% now. Again, the needle is being moved from real-terms growth, as was being claimed, to a real-terms cut for the national health service budget. When we combine those two elements, we see that we are talking about a £1.3 billion shortfall in real-terms growth. That is a serious sum and it affects all our constituents, which is why the amendment is so important. We believe that it could represent at least 12,000 nurses and 3,000 consultants, if we are generous about what that £1.3 billion represents. These health services affect each of our constituents, so I would be grateful if the Minister addressed those two issues.