This morning I had meetings with ministerial colleagues and others. In addition to duties in my house—[ Interruption ]—I am sorry, in this House. [ Laughter. ] You would have thought I’d got used to it by now. In addition to my duties in this House I shall have further meetings later today.
The number of clinical staff in our NHS since this Government came to power has gone up, and the number of managers is significantly down, but as my right hon. Friend the Health Secretary has said, we are not the slightest bit complacent. There are parts of our NHS where standards of care and standards of nursing are not acceptable. That is why we are introducing things like the friends and family test to ensure that all hospitals come up to the highest standards of the best.
Following the publication of the Leveson report last week, does my right hon. Friend agree that what we need is a strong, independent regulator, preferably without statutory underpinning?
I think this is a moment when we should try to maximise the amount of consensus in this House and in the country about what is required. Everyone agrees that we need strong, independent regulation along the lines that Leveson suggests. Everyone agrees that we need million-pound fines. Everyone agrees that we need prominent apologies and independently handled complaints. This is absolutely vital, and I have been encouraged by the meetings I have had with the editors of national newspapers that they will put in place that Leveson-compliant regulation. We should continue the cross-party talks and make sure that we can deliver a regulatory system of which this House, this country and, above all, the victims can be proud.
Let me join the Prime Minister in congratulating the Duke and Duchess of Cambridge on their very happy news. They have the best wishes not just of this House but of the whole country.
The Conservative party manifesto, published in April 2010, said that
“we will increase health spending in real terms every year.”
However, the head of the UK Statistics Authority says clearly and unequivocally that this has not happened. So what is today’s excuse?
This Government are putting £12.6 billion extra into the NHS. Let me quote the right hon. Gentleman the figures directly from the head of the Office for National Statistics. In real terms, spending in 2010 was £104.2 billion. In 2011, it was £104.3 billion in real terms. That is a real-terms increase, and I can tell the right hon. Gentleman that there will be further real-terms increases in 2012, in 2013 and in 2014, whereas there would be cuts under Labour.
Let me just say to the Prime Minister that, even by his standards, that was the most slippery answer we could possibly imagine. He is unbelievable. He has come to this House 26 times since he became Prime Minister and boasted about how he is increasing health spending every year of this Parliament—[Hon. Members: “Hear, hear!”] Government Members are cheering, but he has failed to meet that promise. This is not an argument between me and him; we have a ruling from the chair of the independent UK Statistics Authority who says that that has not happened. I would be grateful if the Department of Health could clarify the statements made. Instead of his usual bluster, why does he not just correct the record?
It is a very simple point. The spending figures for 2010 were set by the last Labour Government. Those are the figures we inherited. All the right hon. Gentleman is doing is proving that his Government were planning for an NHS cut. We have taken that figure in 2010, we have increased it in 2011 and we will increase it again in every year of this Parliament. People do not have to look at manifestos for a contrast; they can look at what Labour is doing in Wales. The Labour party is in charge in Wales, and it has cut the NHS in Wales by 8%. As a result, waiting times are up, waiting lists are down, quality is down. That is what you get with Labour and the NHS.
There is no point in him shaking his head and getting annoyed. He made a promise that he would keep the NHS budget rising in real terms in every year of this Parliament. Labour’s plan, which we set out at the election, was to increase the health budget in 2010-11, and he cut the budget. He knows the reality. Let me give him one more opportunity. He made a solemn promise to the British people of year-on-year increases in the health budget, including in 2010-11. He failed to meet the promise. Come on, why don’t you just admit it?
I do not know whether I need to remind the right hon. Gentleman that the general election was after the 2010 year had begun. This was Labour’s plan, and what we have done is increase the budget every year. If he does not believe that, perhaps he will listen to the Labour shadow Health Secretary, who gave an interview in the New Statesman, when he said, about the Tories:
“They’re not ring-fencing it. They’re increasing it.”
He went on:
“Cameron’s been saying it every week in the Commons: ‘Oh, the shadow health secretary wants to spend less on health than us.’”
The question was asked:
“Which is true, isn’t it?”
“Yes, it is true…that’s my point.”
There we have it, confirmed: it is official—Labour wants to cut our NHS. It would never be safe with them again.
Now, let me try the Prime Minister on another fact, which I am sure he will be able to give to the House. Can he tell us how big an income tax cut he is giving next April to people earning over £1 million a year as a result of the reduction in the top rate of tax?
I am not surprised the right hon. Gentleman wants to get off health. That was the biggest own goal I think I have ever seen.
On the issue of the top rate of tax, when the right hon. Gentleman’s Government put it up to 50p, what it actually meant was that many fewer millionaires paid it, as a result of which the tax take suffered by £7 billion. I remind him that under this Government the top rate of tax will be higher in every year than any year when he was working in the Treasury.
I will give the right hon. Gentleman the answer, because of course he did not give it to us. Next April, everyone earning over £1 million will have a tax cut of £107,000 a year—£107,000 a year! [Interruption.] It is no good the Deputy Prime Minister shouting from a sedentary position: he went along with it—the party of Lloyd George!
The Prime Minister has not kept his promise on us all being in it together. Let us ask him about his central promise. Two years ago, he said that by 2015
“we will have balanced the books.”
Can he explain why he is so badly failing to keep that promise?
First, let me give the right hon. Gentleman the figures on the top rate of tax because it is important. In 2009-10, 16,000 people were earning more than £1 million, with a tax liability of £13 billion. In 2010-11, when the rate went up, this plummeted to 6,000 people with a tax liability of £6.5 billion. Therefore, his 50p election gambit cost the country £7 billion. When is he going to realise that setting tax rates is about raising money, not about punishing success? That is what Labour needs to understand.
In terms of the deficit, we have cut the Budget deficit by 25%, and the right hon. Gentleman will be getting an update on progress from the Chancellor in a minute, but let me ask the right hon. Gentleman this: how on earth can you deal with a borrowing problem by pledging to borrow more?
Let us be clear about the Prime Minister’s answer on the 50p rate. His answer to the problem of tax avoidance is to give the people doing it a tax cut. That is the answer he gave—give them another big giveaway. The reality that the Prime Minister could not get away from is that the deficit is going up, not down, on his watch. We all remember the posters, with his airbrushed face, saying,
“I’ll cut the deficit, not the NHS.”
The facts speak for themselves: he has cut the NHS and he is not cutting the deficit.
The right hon. Gentleman is 100% wrong: we are increasing spending on the NHS and we are cutting the deficit. Yes, we have cut the deficit by 25%, there are a million more private sector jobs, businesses are starting up at a higher rate than at any time in our history, this economy is on the right track, we are equipping Britain for the global race and, unlike the Labour party, we are on the side of people who work hard and want to do the right thing. And what is the right hon. Gentleman’s answer? More borrowing, more spending, more of the things that got us into the mess in the first place.
Three years ago, the NHS spent £500 million on Tamiflu without having seen all the data on effectiveness or safety. Given that, far from that being an isolated case, it is normal for the drugs industry to have almost complete control over the evidence base on which crucial public decisions are made, will the Prime Minister ask Roche to make available the full clinical study reports on Tamiflu, so that doctors, patients and taxpayers are not misled?
My hon. Friend does excellent work on behalf of the taxpayer, partly through all the good questions that he asks. He has raised an important issue, involving not only the cost to the taxpayer but the possible overstatement of benefits to patients. There needs to be more transparency in clinical trials data, and we are committed to ensuring that that happens. The European Medicine Agency’s work in this regard is supported, and from next year there will be a legal requirement to publish summary reports from clinical trials.
This week we learnt that, despite assurances that exhaustive checks were taking place, the UK Border Agency had made minimal attempts to trace 124,000 asylum seekers and migrants, and that 150 boxes of mail had been left unopened. Does that not demonstrate that the 20% cut in the agency’s budget has put our efforts to secure our borders at risk?
I think that this is a week in which to recognise that we said that we would cut immigration, and that, under this Government, net immigration is down by 25%. However, I want us to do far better in chasing up illegal overstayers and illegal migrants. Good work is being done in that respect, which also involves private sector organisations finding these people and getting them to leave. Of course we had to make reductions in the UKBA budget, as we have had to make them in all budgets, but the hon. Gentleman should have noticed by now that government these days is about getting more for less.
The Prime Minister will be aware that Portsmouth has been the home of the Royal Navy and a working dockyard for more than 500 years. Given that the Business Secretary appears to have prejudged the findings of a study of the future of shipbuilding, what reassurance can the Prime Minister give me—and 1,500 shipbuilders—that Portsmouth will remain integral to the building and export of warships, and will continue to be the base port for our future surface fleet?
My hon. Friend quite rightly speaks up for Portsmouth, which is and will continue to be an excellent home for the Royal Navy. The Navy is fully committed to Portsmouth, and, whatever decision is made on the future of shipbuilding, the Navy will remain a major employer in the city, not least once the new carriers arrive in Portsmouth in a few years’ time. I am sure that my hon. Friend will also welcome the recently announced enterprise zone on the Gosport peninsula, a £25 million package which could create up to 1,200 jobs.
We are doing everything that we can to tackle child poverty, and according to some estimates it has come down. What we have specifically done is increase the element of child tax credit that goes to the poorest families.
In the wake of the criminal convictions of staff who repeatedly abused people living at Winterbourne View hospital, is it not time that those who take the fees, employ the staff and then supervise those staff were themselves held to account through the creation of a new offence of corporate neglect?
I have listened very carefully to what my right hon. Friend has said. There have indeed been some appalling instances of completely unacceptable levels of care. Of course people working in such organisations are fully subject to the law, as they should be, and if the law has been broken, the proper consequences should follow.
One of the main industrial issues in my constituency, and indeed throughout the United Kingdom of Great Britain and Northern Ireland, is the price of electricity. What action is the Prime Minister taking to mitigate spiralling costs, especially in Northern Ireland?
For consumers, we have announced our plan to ensure that companies put people on the lowest available tariff, which I think has been warmly welcomed throughout the House and throughout the country. For business, given that there is an issue with the energy-intensive industries, the Government have announced their intention to exempt such industries from contract-for-difference costs under electricity market reform. That is subject to state aid clearance and further consultation, but I think it shows that the Government are working hard to help those industries and ensure that they continue to compete and succeed in Britain.
The whole House does indeed join the Prime Minister in congratulating the Duke and Duchess of Cambridge on their excellent good news. Will the Prime Minister please confirm to the House that the Commonwealth has at last agreed—after many of us have been asking for this for years—to change the rules on royal succession? Will the Prime Minister undertake to bring a Bill before the House very soon, so that if this baby is a girl she can follow in the footsteps of her much-loved great-grandmother and become our Queen?
I am very grateful to my hon. Friend for her question. I think I can answer positively on all the points she made. At the Perth Commonwealth conference, I chaired a meeting of the Prime Ministers of all the different realms and we agreed we should bring forward legislation to deal with this issue. All the realms have now agreed to do that. We will introduce legislation into this House very shortly. It will write down in law what we agreed back in 2011: that if the Duke and Duchess of Cambridge’s first child is a girl, she can one day be our Queen. That is the key point. But it is important to explain that the changes will apply to a child born after the date of the Perth announcement of last year even if the birth is before the legislation is passed. I hope it will not take long—certainly not nine months—to pass this legislation, but, just in case, there would not be a problem.
I welcome the Government’s commitment to increase their efforts to tackle tax avoidance. Starbucks has now caved in to public pressure and announced that it will review its tax arrangements in the UK, so naming and shaming clearly works. Surely it is time to stop companies engaged in tax avoidance hiding behind taxpayer confidentiality. Will the Prime Minister now commit to publishing the names of the companies found by Her Majesty’s Revenue and Customs to have avoided paying their fair share of tax?
I very much welcome the right hon. Lady’s initiative on this and her Committee’s work, and I thank her for her warm words of support for what the Government have done thus far. We have recovered £29 billion of additional revenues from large businesses in the last six years, including £4 billion in the last four years from transfer pricing inquiries alone, which is one of the issues the press has covered in detail. I am certainly committed to doing everything we can to look at all the options to make sure that companies pay their taxes properly, and I agree with what the right hon. Lady said about public, and even some political, pressure. On some occasions I myself have made one or two remarks on this subject that were seen as rather controversial. It is important that people feel that companies meet their responsibilities and pay their taxes.
Will my right hon. Friend do everything he can to ensure that education, health and social services work together to commission services jointly, in order to ensure that the very welcome reforms in the forthcoming children and families Bill will be workable on the ground?
My hon. Friend makes a very important point. We need to get away from the idea of Government—or, indeed, local government—operating in silos with different budgets and different Departments not working together. My hon. Friend represents a Swindon constituency, and I know that Swindon borough council has taken huge steps in bringing the various agencies together, particularly in the area of problem families, and I commend them for the work they do.
Whatever announcements the Chancellor makes on pension tax relief shortly, is it not a fact that when this Government came to power, they made changes to pension tax relief that gave a tax cut of £1.6 billion to people earning more than £150,000? [Interruption.] I see that the Chancellor has to give the Prime Minister his crib sheet.
I am afraid the hon. Lady is wrong. We inherited a plan to raise £4 billion in taxes from the wealthiest people, and we raised that further. My right hon. Friend the Chancellor will make some further announcements in a moment.
The north-east of Scotland makes a major contribution to the UK economy through the offshore oil and gas industry. Will the Prime Minister commit to maximise investment in the industry so we get the maximum number of jobs and the maximum energy security and taxation for the future of this country?
My hon. Friend rightly speaks up for the North sea industry and for everyone who works in it in Scotland. I have been incredibly impressed when I have visited Aberdeen to see the health of and the wealth generated by that industry. What we have done, on decommissioning and on new field allowances, has helped to bring some certainty, and we should keep working on that to make sure that we recover as much oil and gas from the North sea as possible and make the most of this precious national asset.
I think the hon. Gentleman was describing the situation in Wales, where Labour has put in place an 8% cut. Let me tell him what is actually happening in the NHS in England: we have got 1,350 extra clinical staff; we have taken down the number of managers by 6,700; mixed-sex accommodation is right down; the cancer drugs fund is making sure that many more people get access to those drugs; waiting times are down; the number of people waiting a long time is down; and the number of people waiting longer than 52 weeks to start treatment is at its lowest level since records began. He should be supporting this Government for their health policy and telling his Front Benchers to stop cutting the NHS.
Does my right hon. Friend recall receiving a visit at No. 10 from the pupils of Market Field special school, which had been nicknamed “shed city” as there were so many demountables on its site? Does he share my delight that Essex county council has allocated £8.4 million to build a new school, and may I thank him for his support for that campaign?
I am very grateful to my hon. Friend for his question. I am a very big supporter of Britain’s special schools; I think they provide an absolutely vital service for parents and for children who have those special and sometimes quite acute needs. I am proud of the fact that this Government have invested in special schools and they are doing such a good job, including in his constituency.
Following the Government’s new funding formula for universities this year, student admissions dropped by more than 50,000. Despite meeting its target, the university of Wolverhampton—my local university—suffered a cut in its core allocation and has been told that there will be another cut next year. What guarantees can the Prime Minister give that universities such as Wolverhampton’s will not suffer year-on-year reductions in student numbers as a result of this new formula?
The whole point is that this Government took difficult decisions to make sure we could maintain the number of people going to our universities, and the question really goes right back to the Labour party: if you don’t support a proper system of student contributions, how on earth are you going to pay for our universities? We have set out our plans, and they are actually working well. You don’t start paying back money until you earn £21,000, and you don’t start paying back in full until you earn £35,000. We have a method for making sure we invest in our universities; the Labour party has not got a clue.
Naomi House children’s hospice, which serves my constituency, receives just 10% of its funding from the Department of Health, whereas adult hospices receive rather more. This is especially difficult because as private institutions hospices have to pay for all prescriptions. Will the Prime Minister look again at the reasons for the different treatment of children’s and adult hospices, and meet me and Professor Aziz to discuss the different funding levels that they attract?
I am very happy to discuss this issue with my hon. Friend. For many years, my family used a children’s hospice in Oxford that got absolutely no state support at all. What this Government have done is continue with the £10 million going annually to support children’s hospices, and this year we have added an extra £720,000. However, what we want to put in place, and what we are discussing with the providers of both adult and children’s hospices, is a per-patient funding system that would be for all hospices. I think that would bring a greater logic and consistency to how we support this absolutely essential part of both our health service and, I would argue, our big society.
Is the Prime Minister aware that Amazon, a global company, turned over £3.3 billion in the UK this year, paid not a single penny in corporation tax and yet was rewarded with a £10 million grant from the Scottish National party Government in Scotland? Does that not demonstrate that both our Prime Minister and our First Minister stand up for the wrong people? When will this Government move away from punishing the poorest in society and focus on those who avoid and evade?
The point I would make to the hon. Gentleman is that there is common ground between us, which is that we want those large multinational companies to pay proper taxes here in the UK. We believe that you do that by having low tax rates—and we have reduced the rate of corporation tax—and ensuring that they declare their income properly. On the specific issue of transfer payments, some companies have been pursuing rather strange practices to pretend that their revenues are not delivered here in the UK to run down their tax bills. As I have said, in the past four years we have recovered £4 billion in tax revenue in that way, but the Treasury and the HMRC very much know that there is more we can do.
Residents of Suffolk Coastal were very excited when the Energy Bill was published last week, because it gives a potential green light to the building of Sizewell C nuclear power station and many jobs. Will the Prime Minister commit to continuing to invest in apprenticeships and skills training so that Suffolk people can get the jobs that will be created?
My hon. Friend is absolutely right. The presentation of the Energy Bill to Parliament means that we can get out there and sell to all the energy companies the clear and stable framework that the UK has for offshore wind, nuclear, renewables and gas. It is a very positive development and there is a huge amount of potential pent-up investment, and we need to ensure that that results in British jobs and British apprenticeships. The Government are fully committed to making that happen.
The Prime Minister obviously believes that within the Leveson report there lurks something that is bonkers. Given that, how would he characterise the views of his Planning Minister—the Under-Secretary of State for Communities and Local Government, Nick Boles—who has just said that over the coming months and years tens of thousands of new homes will have to be built on greenfield sites?
Let me deal with the question about the Planning Minister first. It is absolutely clear that yes, we should build on brownfield land and try to deal with the problem of empty homes, but we need a frank conversation about the need to build more flats and houses so that we do not have the situation we currently have, whereby if people do not have help from the bank of mum and dad they are in their mid-30s before they buy their first home or flat. I do not think that is acceptable in our country, so all credit to the Planning Minister for trying to fix the problem.
On the question of Leveson, I think there is a wide agreement about what a new regulatory system ought to look like. It is set out there in black and white in Leveson, and we need to challenge the press to introduce it. If they do not, we will obviously have to take further action.
With more men in work than ever before, more women in work than ever before, a deficit that has been cut by 25% and interest rates at historic lows, does my right hon. Friend agree that the Opposition’s plan B—code for more debt—would jeopardise all those achievements?
My hon. Friend is entirely right; we are making progress. Of course it is tough when there are so many economic headwinds against us, but with 1 million more private sector jobs, the deficit down by 25% and a record number of businesses starting up last year, we are on the right track. It is quite clear that plan B stands for bankruptcy—that is what Labour would give us.
Last but not least, I call Ann Clwyd.
A universal health care system free at the point of delivery is what the overwhelming majority of the British people want and something to which I remain firmly committed. However, there are increasing complaints about nurses who fail to show care and compassion to their patients. What exactly will the Prime Minister do about that?
The right hon. Lady speaks for the whole House and the whole country in raising this issue. I know how painful what she witnessed in her own life and her own family must have been. I am, as she is, a massive fan of our national health service and an enormous fan of the fact that it is free at the point of use and that we do not produce a credit card when we go to hospital. My family has had extraordinary care from our NHS, but we do not do our NHS or our nurses any favours if we do not point out that there are some very real problems in parts of our health and care system.
As a constituency MP, I see quite a few letters—particularly elderly people and their relatives—who are not getting the sort of care that is appropriate in hospitals. I set up a nursing care quality forum that I have attended myself to discuss these issues with nurses and nurse leaders. There is no silver bullet and no magic wand, but some simple steps, such as asking every hospital to carry out a friends and family test, asking the patients and the staff whether they would be happy for their family or friends to be treated in that hospital, can make a real difference. So can hourly rounding, which is not something to do with statistics but the idea that the nurse should be there by the bedside of elderly patients once an hour checking that they have had water and something to eat, that they do not have bedsores and that they are properly looked after. We should not have to dictate those things, but a proper conversation with our nurses—who are angels to a vast degree—can get the situation sorted out for all our relatives.