Health and Social Care Levy

My hon. Friend
the Member for Bolsover (Mark Fletcher) rightly said that to govern is to choose. One of the reasons for the result of the last general election was that voters knew that this Government were more likely to make the difficult choices that were needed. The choices we have to make are not always between the good and the perfect. Many of them involve choosing the less bad option. As a Conservative, I believe that raising taxes is certainly a bad option. It clearly breaches a manifesto pledge, and it is both economically and morally wrong. It is economically wrong because higher taxes will dampen growth and prosperity in the longer term, and it is morally wrong because it means taking money away from those who have worked hard, to be spent elsewhere. That needs to be kept to a minimum.

However, if raising taxation is a bad option, surely the alternative—not acting—is far, far worse. Not acting would mean allowing the backlogs that have built up in the NHS through the pandemic to continue. That would put people’s early diagnoses at risk and delay treatments further, clearly endangering lives. It would mean not reforming social care, despite there being almost universal agreement that that reform is long overdue. Government after Government have promised to take this on, to reform social care and to put it on a sustainable footing financially. There have been endless reviews, but each time they have ended up in the “too difficult” box.

How many of us can go for a week without getting an email from a constituent about social care, whether it is about the quality of social care, access to social care, top-up fees, their ability to pay or the fear that they will have to sell everything they have worked hard and saved for all their life? That is why something needs to be done. If we agree that action is needed and that we need more money to be spent on the NHS to clear the backlog and reform social care, the only decision we have to take is how we pay for it.

In the long term, borrowing to pay for this is not a sensible option. There are very few taxes that can raise anything like enough money to meet the challenges we face. Of course this could be put on VAT, but that is clearly a much more regressive option that would place a disproportionate burden on the least well off. There have been various fanciful ideas from some Opposition Back Benchers that basically suggested that someone else should pay for it, or that there was a hidden pot of money that could be raided. It is not there! The fairest way is to have a levy on national insurance contributions, sharing the cost between employees, employers, the self-employed and those who get income from dividends, so that those who earn more pay more.

I think the shadow Chancellor suggested that this could be funded by charges on the sale of land, property and shares, but the truth is that combined revenues from all stamp duties on land, property and shares comes to about £15 billion, which is nothing like enough to pay for what is needed. So national insurance is the fairest option. Gordon Brown was right, on this one occasion, that it is the most regressive option—