Contribution
No; I have to keep going.
I accept that some issues, such as hospital capacity, can only be dealt with by spending, but we do not need to reinvent the wheel; we need to learn from other countries. The Health Secretary, who I admire for his apparent radical zeal—although we have not seen much evidence of it—studied Australia, for instance. Let me break the national taboo on “our NHS”, our religion. There are other countries that are like ourselves but which deliver much better—incomparably superior—health outcomes. It is my personal belief, and I think I am about the only person who has said this year after year, that we should adopt Australia’s social insurance model. There is nothing wrong with encouraging private provision in health. Is that some great heresy? Is it some sort of right-wing philosophy? Well, it is followed by France, Germany, Australia and the Netherlands, and all those other countries produce much better health outcomes.
Australia slowly developed a hybrid system of state and private health insurance. Everyone has universal public health insurance, but workers are encouraged to purchase private health insurance on top of that. My point is that, with a ballooning, ageing population, yes, we have to spend more on health, but we have to get people to put more of their own money into health; and they must be assured that, having put their money in, they will not just end up at the back of a queue, because they have personal rights and are committed to this health service.
For instance, the average cost of a treatment-only plan for a 20-year-old in Australia is just £23.14 a month, and comprehensive cover starts at £31 a month. That cost rises to £109 per month for a 70-year-old. People earning less than £119,000 can claim rebates to reduce the cost of health insurance, and higher earners without insurance pay a surcharge of between 1% and 1.5%. Research commissioned by Australia’s Department of Health shows that the cost to the taxpayer would be greater without the rebates, because there would be increased stress on the public system.
The health outcomes are noticeable. Australia has one of the lowest rates of avoidable mortality among the developed nations. Its cancer survival rates are several percentage points higher than the UK’s, and stroke and heart attack mortality rates are several points lower. It is not perfect, of course, and not everything can be imported from other countries, but Australia’s system shows that there are other models.
We must have a national debate about how, with an ageing population, we can produce the kind of health outcomes that people desire. There is a cumulative effect: in 2022, the Australian Government debt was 70% of GDP. In other words, it is running a tight, well-run ship. That is a country much like us—but the UK has already, even before this Budget, reached a staggering 104% debt in the same year. We are going broke because we do not have the courage, on either side of the aisle, to think from first principles. I am making this argument as much to those on my own Benches as I am to the Government. This situation simply cannot go on and on, otherwise people will start talking about charging or giving tax relief for private health insurance.
We have to have a fundamental debate about the whole structure of health, and the Health Secretary has the good will of people across the House and across the country to start thinking big and thinking of new ideas. If he can find a way forward and improve health outcomes, he will go down in history as one of the greatest Health Secretaries we have ever had.
The second fundamental problem we have is the ballooning benefits system, particularly when it comes to incapacity. It is trapping more and more people in dependence. We need a culture of the necessity of work. We have 4 million people on incapacity benefit, and two thirds of them—recent joiners—are claiming mental illness. The situation is out of control. Work should always pay more than benefits. I would have liked to have heard more from the Chancellor about how she is going to attack the benefits system and incapacity, which is gradually reducing the Government into penury.