Health and Care Staffing Costs: Employer NI Contributions

5. What recent assessment he has made of the potential impact of proposed changes to employer national insurance contributions on staffing costs for health and care providers.

The leadership shown by the Chancellor has enabled her and the Government to fix the foundations of the public finances and fill the £22 billion black hole left by the previous Government. The decisions that she took meant that she was able to provide this Department with an extra £26 billion and a real-terms increase in core local government spending power by about 3.2%. That was the right decision for the right reasons in the national interest, and I am taking into consideration pressures on all parts of health and social care before making final allocations for the year ahead.

In North East Fife, we have a particular issue with access to dental surgeries, especially with the recent closure of a surgery in Leven. Difficulties stem from recruitment from abroad as a result of visa changes and also simply from practices going private and coming out of the system. Obviously, the NHS is devolved in Scotland, but does the Secretary of State agree that putting staffing under further strain from increasing national insurance contributions will only make things worse for dentists? What in his conversations is he doing to ensure that dentists get the support that they need?

It is because the Chancellor took the decisions that she did in the Budget that my Department has received £26 billion to reform and improve health and social care. As I said before the general election, all parts of the United Kingdom suffered under the previous Conservative Government, which is why I am sure that Members from across Scotland will welcome the extra £1.5 billion this year and £3.4 billion next year—the biggest funding increase since devolution. I am sure that the SNP Government will welcome the increase, and they certainly have no excuses now for not acting.

Fourteen years of neglect have left hospices in a perilous condition. They are dealing with the rise in national insurance contributions, pay and other cost pressures, so I welcome the fact that the Secretary of State is putting in place measures to ensure that the funding recovers. Will he assure me that integrated care boards not only will pass on that recovery from the increased costs to hospices, but will help them catch up from the Tory years of neglect of the whole sector?

I am grateful to my hon. Friend for her question. I am looking carefully at the pressures on hospices. In fact, only last Friday I visited Saint Francis hospice, which serves my constituents and people right across east London and west and south Essex. I saw at first hand the brilliant work it is doing on end of life care, but also the pressures it is under, and I am taking those pressures into account before deciding allocations for the year ahead.

I have tried repeatedly through written parliamentary questions to get an answer to this without success, so I will try asking it face to face: will the Secretary of State tell the House how much his Chancellor’s changes to national insurance contributions will cost the NHS?

The hon. Member talks about the employer national insurance contributions as if they were a burden on the NHS. It is thanks to the decisions taken by the Chancellor that we can invest £26 billion in health and social care. The Conservatives welcome the investment but oppose the means of raising it. Do they support the investment or not? They cannot duck the question; they have to answer.

The right hon. Member speaks of ducking questions, but it is worrying that three weeks after the Budget he still does not know, or will not tell the House, how much it will cost the NHS. Of course, changes to national insurance contributions affect not just the NHS directly, but suppliers, contractors, charities and other NHS care providers. I know you are a great supporter of your local air ambulance service, Mr Speaker, as I am of the Lincs & Notts air ambulance, which now needs to raise £70,000 extra just to fund this Government’s ill-advised changes to NICs. That £70,000 is a lot of cakes to sell, cars to wash and fun runs to complete, and that is just one example of pressures placed on lifesaving services right across the country. Will the Minister confirm that he will meet the Chancellor, explain the disastrous effects of the policy and insist that she reverses it?

Again, we have not yet announced how we are allocating the budget for the year ahead, but I remind the Conservatives that it is thanks to the choices the Chancellor made in her Budget that she is able to invest £26 billion in health and social care. Would they cut the £26 billion this Labour Government are investing in the NHS? If not, how would they pay for it? Welcome to opposition.

We come to the Liberal Democrat spokesperson.

Hospices provide essential care for people at the most difficult point of their life, and they are usually only partially funded by the NHS. Hospice UK says that real-terms funding has fallen by £47 million since 2022, and hospices are struggling with this hike in national insurance contributions. Hope House children’s hospice in North Shropshire estimates that it will cost £178,000. Will the Secretary of State commit to either exempting hospices from the NICs increase or ensure that they are funded to cover those additional costs?

I am grateful to the Liberal Democrat spokesperson for her question. I pay tribute to the children’s hospice in her constituency and, indeed, to Haven House children’s hospice, which serves my constituency.

And Derian House children’s hospice.

And indeed your very own local hospice, Mr Speaker—I am sure that will appear on the record. I am particularly thankful for the advocacy we have received from Hospice UK and charities such as Together for Short Lives and others that are making their voices heard about the pressures on the system. I say to all hospices across the country that I am taking those pressures into account before deciding allocations for the year ahead, because I want to ensure that everyone, whatever their age, receives access to the timely and good-quality end of life care, palliative care and, of course, support for people with life-limiting conditions that all of them deserve.