A Plan for the NHS and Social Care

Part of the debate – in the House of Commons at 4:37 pm on 19 May 2021.

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Photo of Richard Graham Richard Graham Conservative, Gloucester 4:37, 19 May 2021

There is time enough today to focus on two things: first, a suggestion about how Members of Parliament can work most efficiently with their local NHS trusts; and, secondly, a look at hypothecation—in other words, a dedicated fund to help boost the ways of funding health and care in the future.

It is now 14 months since the leaders of the three NHS trusts, our director of public health, the leader and chief executive of our county council and the six Members of Parliament for Gloucestershire got together virtually—every week, and more recently, fortnightly—to cover all the issues involved in the pandemic. During this process, we have all had a much better understanding of the immense debt we owe them and their staff, GP surgeries and volunteers for all they have done to give my constituents in Gloucester and across the county a service and a vaccination that has given people reassurance and confidence, and I am very grateful for that. I believe that there are opportunities for other parts of the country to benefit from a similar form of partnership, because this resolves problems faster, acts as an early warning signal back to Government, communicates more effectively with our constituents and, ultimately, saves us all a lot of time in helping to get things done.

The second thing I would like to highlight, because inevitably we are going to need more money if we are to resolve the issue of social care, is the possibility of hypothecation. In March 2017, I wrote a paper for the then Chancellor the Exchequer, laying out the case that I and the then hon. Member for Grantham and Stamford made for using hypothecation as a means of linking increases in taxation directly to improved health and social care services. At that time, the Chancellor had already said to us that he would only look at it in more detail if we could find a reputable think-tank to advocate for it, as well as us. We therefore encouraged the King’s Fund to write a report, which it did, recommending hypothecation. The former permanent secretary of the Treasury, now Lord Macpherson in the other place, also agreed that this would be a huge step forward. The reason is this: ultimately, the national insurance fund is not used to insure anything or anyone in particular, but were it to become a health and care fund, with the self-employed and the employed contributing equally, and those who have passed retirement age also contributing, then there would be an opportunity for our constituents to realise that additional taxation into the fund would help them and their families.