Stuart Andrew

This Government are trying to tell the public that this Budget was all about taking tough decisions to deliver change, about raising taxes to support the NHS and about pursuing growth and backing business. Those are commendable aims, but it is simply not the reality of what was delivered in the autumn Budget. This was a Budget for benefits paid for by hard-working people. Last year, taxes were hiked by £40 billion, borrowing went up, inflation went up, unemployment went up and living standards fell, but at least we were promised by the Chancellor that this was a one-off. She categorically said that she would not be coming back for more. But like the promises made during the general election, that was just not true. Then, as Halloween approached, we had briefing after briefing, that infamous press conference, markets affected and consumer spending depressed, particularly in the hospitality sector, all leading to one Cabinet Minister reportedly saying that “The handling of this budget has been a disaster from start to finish.” I wonder who that could have been. Now we have another £26 billion in tax rises to fund more welfare, because the Prime Minister lacks the backbone to stand up to Labour MPs and make the real hard choices. At the previous Budget and spending review, big promises were made to the public about how the Labour Government would solve the challenges in the NHS through a financial settlement that they said would improve patient care, including by bringing waiting times back to the 18-week standard within five years. We warned at the time that that money would be swallowed up, in large part by decisions of the Government’s own making. The then chief financial officer of NHS England said that it would go almost entirely on pay awards, national insurance contributions and drug price increases. What does Labour actually have to show for that? Elective care waiting lists have fallen by less than 2% since October last year. Meanwhile, waiting lists for community health services and diagnostic scans are rising. Waits to start cancer treatment are increasing. Trauma and orthopaedic waits are up; ophthalmology—up; neurosurgery—up; gynaecology—up. Winter pressures are growing, and long waits in A&E have hit record highs. The truth is that the Labour Government do not have a plan for the NHS; they have fallen into the classic Labour trap of thinking that issuing a press release about cutting waiting lists will magically make it so, just because they are in charge. I am afraid that is not how government works. What has the Secretary of State been focused on? A top-down reorganisation of the NHS—which not only did he not tell anyone about before the election but he explicitly said he would not do. As Conservatives, we support the principle of cutting duplication, reducing bureaucracy and saving on administration costs. The House will remember that a recent Conservative Health Secretary, my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay), reduced in a single year the number of civil servants in the Department for Health and Social Care by around one in six. Let us be clear: this is yet another announcement made by the Government without any plan for delivery. For months, not one Minister has been able to answer any of our questions about how much NHS restructuring will cost or who will be expected to cover redundancy packages. For months, integrated care boards have been warning that frontline patient services were at risk because they simply do not have the money to do what is asked of them. For months, staff were left in limbo, not knowing whether their job would still exist or for how much longer. We welcome the fact that the Budget finally provided some clarity, but shifting money between years means significant risk. The NHS is already behind on its efficiency targets. If this reorganisation falls short of its goals—no small risk given the Government’s performance—there is an even more significant shortfall to make up in future years, which will hit patient care. There are other elements of the Budget that we welcome for the health service. Focusing on improving productivity is the right thing to do, but whether the extra investment will make any difference in the grand scheme of things remains to be seen. Neighbourhood health centres can be cautiously welcomed. They build on the great success of the Conservatives’ efforts to bring care closer to where people live through the community diagnostics centre programme. However, has Labour truly learned the lessons of all the private financial initiative deals that it botched back in the 2000s, which NHS trusts are still paying for decades later? Will the Government simply move resources around or will there be genuinely innovative new ways or working, joining up services and improving the patient care experience? I hope that it is the latter, because shuffling the deck chairs into new buildings will not deliver the benefits that patients deserve. Despite those few bright spots, it simply is not right for the Prime Minister, the Chancellor and others to justify this latest tax grab by saying that it is to protect the NHS. As the NHS Confederation noted, this year’s Budget did not have a health focus. That means that we are left with a lot of unanswered questions. The Office for Budget Responsibility specifically raised two risks to health spending. The first was the doctors’ strikes, which the Health Secretary has failed to resolve, despite making that sound very easy to do when he was in opposition. I will give him credit, because he did briefly end them, for a few short months, but only by caving in to the demands of the British Medical Association, in return for no productivity or modernisation reforms. We warned him that giving in to the trade unions would only see them come back for more—and indeed, here we are, with patients and taxpayers paying the price, and no end in sight. The OBR confirmed that strikes have already cost £500 million, and warned about further strikes. Now it has been confirmed, just before Christmas—the worst time of year for it—that the doctors are out again.