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Question
Evans questioned the impact of NIC increases on frontline healthcare providers like GPs and hospices, citing costs, closures, redundancies, and potential impacts on social care. He also inquired about exemptions from NI contributions, requested clear mitigations and a concrete timetable for allocations.
Minister reply
Karin Smyth responded by acknowledging the challenges inherited but emphasised that the Government is committed to providing certainty through normal allocation processes faster than under previous governments. She stated that they are going through the mandate and planning guidance to determine next April’s allocations.
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Question
Fenton-Glynn welcomed the Opposition's interest in social care, pointing out that problems stem more from previous governments' neglect of recommendations like Andrew Dilnot's 2011 report.
Minister reply
Karin Smyth agreed with Fenton-Glynn, noting the previous government’s postponement of the Care Act and its impact on delaying necessary reforms.
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Question
Bennett raised concerns about GP surgeries facing significant cost increases due to NIC hikes, potentially leading to service cuts and staff reductions.
Minister reply
Karin Smyth acknowledged the importance of primary care and highlighted that her government had enabled 1,000 extra GPs through additional roles reimbursement schemes. She promised further contract reforms in talks with general practice over the next few months.
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Question
Maskell asked for assurance that third sector organisations will receive sufficient support to maintain current service levels and facilitate transitions within health services.
Minister reply
Karin Smyth confirmed the Government’s commitment to supporting NHS and social care through additional funding, while maintaining close dialogue with these providers.
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Question
Leigh urged consideration for exempting hospices and care homes from national insurance increases due to their critical role in end-of-life care.
Minister reply
Karin Smyth indicated that conversations with affected providers will continue through normal processes.
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Question
Does the Minister agree that support for general practice and community health hubs will be crucial to improving the NHS?
Minister reply
The minister acknowledges the importance of supporting general practice and shifting towards neighbourhood health services as part of their 10-year plan.
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Question
Will the Government reconsider the national insurance rise affecting disabled people, older adults, and care providers?
Minister reply
The minister states that the government is aware of the situation but cites a £22 billion black hole in the system inherited from previous governments. They are supporting vulnerable groups through departmental allocations.
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Question
Does the Minister agree that the government is listening to health professionals and taking tough decisions?
Minister reply
The minister agrees with her hon. Friend's point, emphasising that they have not heard from the opposition on whether they support extra investment in the NHS.
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Question
Will the Minister commit to exempting children’s hospices from the national insurance rise and confirm continuation of the Children’s Hospice Grant?
Minister reply
The minister is willing to talk with representatives of hospices but emphasises that they are going through a process of allocations.
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Question
Will the measures announced in the Budget provide additional appointments needed to reduce waiting lists?
Minister reply
The minister confirms that they will provide 40,000 extra appointments per week as promised in their manifesto.
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Question
Is the national insurance hike for hospices, care homes, GPs, and pharmacies a deliberate decision by the Labour Government?
Minister reply
The minister acknowledges the precarious situation that these providers find themselves in and commits to talking with them through the allocation process.
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Question
Does the Minister agree that before criticising, we should remember that Conservative plans would have cut £15 billion from NHS funding?
Minister reply
The minister agrees with her hon. Friend's point and emphasises their commitment to changing the NHS.
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Question
Will the Minister cover the costs for Scotland’s charities and hospices affected by the national insurance hike?
Minister reply
The minister emphasises that the SNP has been in charge of Scotland for about 20 years, suggesting they make decisions regarding health and social care.
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Question
It is disappointing that the Opposition spokesperson did not mention record funding committed in the Budget.
Minister reply
The minister agrees with her hon. Friend, recalling the Conservatives' failure to meet their commitment regarding the Care Act 2014.
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Question
Why have the Labour Government made this choice to hammer local doctors with a national insurance hike?
Minister reply
The minister states that they are committed to general practice by releasing extra GPs into the system and will continue discussions on allocations.
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Question
Will my hon. Friend ensure that settlement with NHS providers supports GPs?
Minister reply
The minister agrees to support GPs, emphasising the need for more funding towards primary care and social care.
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Question
He met with a GP practice in his constituency that cannot afford to make permanent a temporary support post or proceed with the recruitment of an extra GP due to the need for additional funds for national insurance contributions. He asked if something can be done about this issue.
Minister reply
The Minister stated that she would not delve into the complicated contractual status of GPs but acknowledged their importance and noted they will continue discussions on allocations for the following year.
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Question
He asked if his hon. Friend could assure him that this Government would avoid a piecemeal approach to fixing the NHS and bring forward a long-term plan.
Minister reply
The Minister responded by saying they are committed to avoiding short-term fixes, committing extra funding in the Budget, and launching their 10-year plan.
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Question
He mentioned that charities such as Shooting Star and Demelza children’s hospices are facing problems due to an ill-thought-through Budget, asking when something will be done about it.
Minister reply
The Minister replied that she does not know whether the right hon. Gentleman agrees with the extra funding committed by the Government but acknowledged their efforts in addressing concerns through normal processes.
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Question
She asked if the additional NHS funding committed should be used to come up with a proper plan for social care across the UK that does not follow the flawed approach in Scotland.
Minister reply
The Minister said she was pleased to see her hon. Friend and noted that Scottish Labour has an excellent point regarding the actions taken in Holyrood.
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Question
He mentioned a hospice's chief executive who informed him that additional national insurance contributions will cost the hospice £250,000 a year. He asked for reassurance.
Minister reply
The Minister agreed with the right hon. Gentleman about the hospices' great work and stated they are mindful of hospices’ concerns, continuing to talk with them.
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Question
She pointed out that during the Conservatives’ time in government, 1,600 general practices closed. She asked if my hon. Friend agrees with this.
Minister reply
The Minister acknowledged the precarious nature of the sector and stated they are rebuilding it based on Lord Darzi's report.
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Question
He suggested that all suppliers to the NHS should be protected from national insurance increases as public sector entities are.
Minister reply
The Minister stated they want additional funding to support patients where they live and need care, and will continue talking with providers.
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Question
She asked the Minister to reconsider exempting the charitable sector from national insurance increases.
Minister reply
The Minister noted that people are expressing concerns and will continue talking with affected providers over coming months.
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Question
He mentioned a letter from the Lincolnshire and Nottinghamshire air ambulance, facing increased costs due to national insurance changes. He asked for assurance that such services will be protected.
Minister reply
The Minister assured the hon. Gentleman of their commitment to securing extra investment in health and social care.
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Question
He asked if the Minister would consider giving pharmacists an exemption from NICs rises, given that 90% of a rural pharmacy’s turnover comes from NHS services.
Minister reply
The Minister stated they understand pharmacies' importance and will continue talking to them as part of normal processes.
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Question
Acorns children’s hospice, St Richard’s hospice and GPs, care homes and pharmacies across West Worcestershire have all been in touch with concerns about the extra cost burden that the Government have imposed on them. Can the Minister explain how it fits in with her strategic plans to slap extra cost on the community sector while rebating the NHS trust sector?
Minister reply
I am sure that all those hospices, which do great work, were also in touch with the hon. Lady when she was part of the previous Government. She will know from her time on the Treasury Committee that following the Budget, we go through the planning guidance and have conversations with all core contracted sectors. That is part of the normal process. We are absolutely committed to building back the foundations of the NHS and social care system, making it fit for the 21st century and creating a 10-year plan to which we want everyone to contribute. Community and neighbourhood systems are a fundamental part of that.
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Question
GPs, pharmacies and social care homes from across Ceredigion Preseli have contacted me to express their concerns about the impact of the policy changes surrounding employer national insurance contributions. It is essential that they are supported with the cost that comes from this policy. The Minister has suggested that there might be additional support for some of them through the usual systems. Will she clarify whether that will mean funding being found from the Department’s budget, or whether there will be additional new money from the Treasury? That would have certain ramifications for the Welsh Government and whether they get additional Barnett formula funding.
Minister reply
I understand the concerns of the providers that have come to the hon. Gentleman, and he is right to raise them in this place. As he knows, health and social care is devolved to the Welsh Government, and there has been much benefit already from the Barnett consequentials of the Budget. We will continue to talk to the devolved regions—in, may I say, a much more co-operative way than the previous Government did—to ensure that we have a good system across the entire United Kingdom.
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Question
In a tweet to the Health Secretary, Caroline Rayment, who is the clinical lead for the Wharfedale and Silsden community partnership, said, 'you came to our practice in June and told us you wanted to support the family Dr. Costs for the NMW and NI will come to approx £50k—we are a small practice of 7000 patients—how is this helping us?' Can the Minister answer Caroline’s question?
Minister reply
I am not abreast of all the Health Secretary’s tweets and the responses to them, but Caroline makes a point that has been made by many people in the Chamber today, as well as a number of providers. As I said in my opening statement, we understand the precarious situation that those providers have been put in because of the failures of the past 14 years and the £22 billion black hole that the Government have inherited. As my hon. Friend the Member for Shipley (Anna Dixon) said, general practice has been put in a precarious situation over the past 14 years, with thousands of practices going bust and giving back their contracts. That is a situation that we promised the British public we would change, and we will do so.
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Question
In Suffolk, the national insurance increase creates £11 million of additional pressures on adult social care alone. I do not think the Minister understands that she is not just engaged in some party political knockabout with Conservative Members; GPs, hospices, care homes and pharmacies are watching this debate and are looking to the Minister for answers. They know that this problem was caused by the Government’s tax rise, which is being implemented without a plan for them, so can she tell them when a solution is going forward by the Government? When are they going to get reassurance about their future?
Minister reply
The hon. Gentleman may or may not think that this is political knockabout, but I was very clear in my opening statement that we understand the pressures that the sector is under. We understand the mess that we inherited, and we are fixing it. We are working with social care, GPs, providers and hospices that are affected by any changes in the Budget, and we will continue to talk to them in the usual way. We are committed to doing this faster than the last Government did it. Under the last Government, planning guidance and commitments to the NHS were always running late—they were always playing catch-up. We are committed to making sure that the sector is much more sustainable, so that it can do the important job we are asking it to do.
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Question
Will the Minister confirm whether consideration has been given to the fact that the rise in national insurance contributions will not affect the NHS as a whole, as the block grant for us in Northern Ireland will cover it? However, GP practices in my constituency of Strangford will suffer, and unlike high street businesses or manufacturing, they cannot increase prices to cover that impending rise, leaving practices with no option other than to reduce hours in order to stay solvent. Does the Minister agree that this is the last thing already overstretched GP practices need, and will she commit to take this issue back to the Treasury for reconsideration as it relates to healthcare businesses such as GPs, dentists and pharmacies?
Minister reply
As the hon. Gentleman knows, health and social care is a devolved issue. We will continue to work closely with all the devolved areas, because we think that that is important, unlike the last Labour Government—the last Conservative Government. [Laughter.] I slipped there—I almost got through. We absolutely understand the precarious nature of general practice and, in particular, I understand the really serious issues around health and social care in Northern Ireland. The hon. Gentleman knows that, and he makes a good case for the sector. We want to ensure that it supports people in Northern Ireland with the good primary and community care they deserve.