Budget Resolutions — House of Commons, 2017-03-08
Topic: Health
Margaret Olivia Hillier (Labour, Centre-left): Today’s Budget makes promises on NHS investment and on investing in education, and promises to tackle businesses rates and look at the security and dignity of work, to quote the Chancellor. We have had promises to put areas in charge of their local economic destiny. Those headlines may seem appealing, but I want to unpick the figures behind them, starting with the national health service The Public Accounts Committee has spent a lot of time in the past year and a half raising concerns about the underinvestment and lack of a sustainable plan for the NHS, particularly in the light of the increasing demand of a growing ageing population. The figures speak for themselves. We need look only at the financial data for NHS England trusts and clinical commissioning groups in the past few years. The deficit for trusts increased from £91 million in 2013-14 to a whopping £2.5 billion in 2015-16. There were huge shenanigans as the Department of Health struggled to ensure that the books balanced. The measures were criticised by the National Audit Office and the Comptroller and Auditor General as one-off and unsustainable, as even the permanent secretary acknowledged. The Public Accounts Committee is concerned about the funding. Any additional funding is welcome, but let us look at what the Chancellor has promised on social care. He promised £2 billion over three years—front loaded because £1 billion is available in 2017—but the Local Government Association, representing local authorities that have to spend the money on social care estimates that the current shortfall is £1.3 billion. Even the 2017 figure, then, is not enough, and it drops off after that It is an irony that this injection of cash follows a 10% reduction in social care funding since this Government came to power in 2010. The latest survey of local authority directors of social care says that only around a third believe that they can deliver their statutory duties this year—and it falls to 8% next year. Even with the injection of cash, I do not think that local government can have 100% confidence that social care can be delivered Let us look at the capital injection that the Chancellor promised for sustainability and transformation plans. That may be helpful—£300 million sounds like a lot of money—but if it is spread across the 44 STPs around England, it is very little to fund what might be needed. The fact that capital budgets were raided for resource funding in the last Budget settlement shows a contrary approach and a lack of planning. We keep seeing pots of money thrown at different parts of the NHS and social care system, but what we need is a long-term sustainable solution. I hope that the Treasury will watch closely as the Department of Health and local health bodies spend this money to make sure that it is spent as sustainably as possible. What we really need is that long-term settlement On education, I proudly represent the Borough of Hackney, which has excellent schools. We have some of the best results and some schools in the top 1% in the country. The Chancellor talks about focusing on the quality of our children’s education, but we are already doing that in Hackney—without a grammar school in sight. The focus on the creation of selective grammar schools is disappointing, partly because we can show what works in Hackney and other boroughs that have excellent education, but also because if we look at the existing free school programme, we see a real problem Let us debunk the myth that the Government are putting more money into education. Yes, they are in cash terms, but with pupil numbers increasing, this amounts to an effective cut per pupil of over 8%. That poses a key question about how the Government present their figures, as well as a key question about what price the Government place on choices In making this announcement, the concerns expressed in the NAO’s recent report on the capital funding of schools have not been taken into account. By 2015, the Department for Education had spent £1.8 billion on 305 free schools; winding back to what was promised, it was estimated that the Government would spend £900 million on 315 of them, so it has doubled in price already, and this compares with the total estimate for the existing programme of £9.7 billion by 2021 The Education Funding Agency is one of the biggest purchasers of land nationally. We have a property market going on, with land prices often increasing because of a bidding war in which the EFA plays a role. If, as my hon. Friend the Member for Leeds West (Rachel Reeves) highlighted, we measure this, we find that the cost of improving other schools is substantial. The estimated bill for returning all school buildings in England to a satisfactory or better condition—satisfactory rather than very good—is £6.7 billion, with an estimated further £7.1 billion to bring parts of school buildings up to satisfactory or good conditions. This applies to a school that might be generally good but has an area that needs attention. I recognise that more school places might be needed in some parts of the country, but free schools are not always located in the areas of the greatest demographic need, and there are too many of them.