Contribution
My Lords, I will speak to my Amendments 44, 45 and 46 and to Amendment 34 in the name of my noble friend Lord Jackson of Peterborough. I agree with everything that he said.
Primary care facilities have been hung out to dry. The Government have already acknowledged that the NHS should be exempted from the jobs tax. It is unfortunate that they have made the bizarre decision not to include other healthcare providers, such as GPs, pharmacies and dentists, which serve the same purpose as NHS providers.
We need to get to the bottom of two issues: first, why GPs, pharmacies and dental practices have not been included, as the NHS has, in the exemptions from the increase in employer national insurance contributions; and, secondly, why GPs, pharmacies and dentists will not benefit from any increase in the employment allowance.
The Chief Secretary to the Treasury told BBC “Question Time” in November:
“GP surgeries are privately-owned partnerships, they’re not part of the public sector”,
and
“they will therefore have to pay”.
However, GPs are recognised as public authorities in existing law, such as the Freedom of Information Act 2000. They may be privately owned partnerships, but that does not reflect how they operate. Not only that but because they are legally classed as public authorities, they will not be eligible for the increased employment allowance, so they will have to pay the full national insurance increase.
Section 2(1) of the National Insurance Contributions Act 2014 states:
“A person cannot qualify for an employment allowance for a tax year if, at any time in the tax year, the person is a public authority which is not a charity”.
Section 2(2) defines a public authority as
“any person whose activities involve, wholly or mainly, the performance of functions (whether or not in the United Kingdom) which are of a public nature”.
GP surgeries, whether they are privately owned partnerships or not, exclusively provide NHS services: their activities wholly involve the performance of public functions. The Minister confirmed last week that the employment allowance does not apply to charities, which my research confirms. Does he agree that the allowance should apply to these other vital services—pharmacies, dentists and GPs? That would be a simple change. Previous Conservative Governments recognised this. We fully funded and offset any increases in employment costs for GPs; this is acknowledged by the British Medical Association.
Given that the Institute of General Practice Management, which represents GP practice managers, estimates that the jobs tax will cost the average GP practice around £20,000 a year, it is all the more vital that we offset these costs by allowing GPs to receive the employment allowance, preferably at an increased rate of £20,000, as my amendment suggested. It may not be much but it might help with non-GP staff in surgeries, in pharmacies and in dentists. I am looking all the time at changes and concessions that might not cost the Government too much, but I do not get the feeling that the Government understand the difficulties that some of these sectors are in.
It is not just GPs that will suffer. Community Pharmacy England estimates the cost, as I think we already heard, at £50 million in total. That is part of the treble whammy that we heard about from my noble friend Lord Jackson. I am especially concerned about this because of the impact of these changes across the private-sector end of healthcare, because its work makes life easier for NHS services, reducing pressure on A&E and on other public health services.
I spoke to a local pharmacist yesterday. He is a worried man. He believes that when the new NICs charges come through, he will have too little left at the end of the period to invest in his shop and his vaccine services. So, he will be lacking the crucial application of capital to keep the business up to date and serviceable. He will also look to reduce hours. At present, he is open early and late, providing a superb service to the local community—indefatigable, as he was through Covid. I have to say that the pharmacy in my local Wiltshire village is already closing on Saturday, and it is a half-hour drive to another or to the local A&E. Multiply these types of decision by the hundreds of thousands of pharmacies, dentists and GP surgeries across the country, and you can see that the Government’s failure to compensate for the NICs increases is an act of self-harm. Can the Minister therefore confirm that, as a minimum, the Government will include GPs, pharmacies and dentists, who provide NHS services for the public benefit, in the employment allowance?