Lord Livermore (Lab)

My Lords, I will address the amendment tabled by the noble Lord, Lord Jackson of Peterborough, which seeks to prevent commencement of the Bill until an impact assessment is published for community pharmacies. Delaying its commencement would reduce the revenue generated from it and require either higher borrowing, lower public spending or alternative revenue-raising measures. The Government carefully consider the impacts of all policies, including the changes to employer national insurance. As I have said before, an assessment of the policy has been published by HMRC in its tax information and impact note. Further, the OBR’s Economic and Fiscal Outlook sets out the expected macroeconomic impact of the changes to employer national insurance contributions. The Government and the OBR have therefore already set out the impacts of the policy change. This approach is in line with previous changes to national insurance and taxation and the Government do not intend to provide further impact assessments. I turn to the amendments tabled by the noble Baroness, Lady Neville-Rolfe, and the noble Lord, Lord Altrincham, which seek to increase the employment allowance for those employed in primary care, including in GP surgeries, dentist surgeries and pharmacies. The distinction between those in the public sector who will be compensated and those who will not follows existing practice and is the same as the distinction that the previous Government used for their health and social care levy. The noble Baroness, Lady Neville-Rolfe, asked specifically about eligibility for the employment allowance. Eligibility is not determined by sector but depends on the make-up of an individual business’s work. HMRC guidance explains that this is based on whether an organisation is doing 50% or more of its work in the public sector. It is therefore down to individual organisations to determine their eligibility for any given year. The employment allowance was introduced in 2014 by the previous Government. This Government have not changed the eligibility rules on the employment allowance in any way, beyond removing the £100,000 threshold. The revenue raised from the measures in the Bill will play a critical role in restoring economic stability and funding the NHS. As a result of measures in the Bill and the wider Budget measures, the NHS will receive over £20 billion extra over two years to deliver 40,000 extra elective appointments a week. Primary care providers—in general practice, dentistry, pharmacy and eyecare—are important independent contractors which provide nearly £20 billion-worth of NHS services. Every year, the Government consult each sector about what services it provides, and what money it is entitled to in return under its contract. As in previous years, this will be dealt with as part of that process. The Government have announced a proposed £889 million uplift for general practice in 2025-26 and have set out the proposed areas of reform which will help us to deliver on our manifesto commitments. This is the largest uplift to GP funding since the beginning of the five-year framework and means that we are reversing the recent trend, with a rising share of total NHS resources going to general practice. We have started consulting with the General Practitioners Committee England of the British Medical Association on the 2025-26 GP contract and will consider a range of proposed policy changes. These will be announced in the usual way, following the close of the consultation later this year. The Department of Health has entered into consultation with Community Pharmacy England regarding the 2024-25 and 2025-26 funding contractual framework. The final funding settlement will be announced in the usual way following this consultation. The NHS in England invests around £3 billion on dentistry every year. NHS pharmaceutical, ophthalmic and dental allocations for integrated care systems for 2025-26 have been published alongside NHS planning guidance. In light of these points, I respectfully ask noble Lords not to press their amendments.