National Insurance Contributions (Secondary Class 1 Contributions) Bill

I must draw the House’s attention to the fact that financial privilege is engaged by Lords amendments 1B, 5B and 8B. If the House agrees to any of those amendments, I will cause the customary entry waiving Commons financial privilege to be entered in the Journal. After Clause 1 Exemptions from the changes made by section 1: NHS and social care

13:42:00

I beg to move, That this House disagrees with Lords amendment 1B.

With this it will be convenient to consider the Government motions to disagree with Lords amendments 5B, 8B and 21B.

I welcome the opportunity to consider the new Lords amendments to the National Insurance Contributions (Secondary Class 1 Contributions) Bill. I start by repeating my thanks to Members of both Houses for their careful scrutiny and consideration of the Bill. Four new amendments have been made during consideration of the Bill in the other place, which we will seek to address today. As I reminded hon. Members last week, when we entered government, we inherited a fiscal situation that was completely unsustainable, and we have had to take difficult but necessary decisions to repair the public finances and rebuild our public services. The measures in the Bill represent some of the toughest of those decisions, but they, along with other measures in the Budget, have enabled us to restore fiscal responsibility and get public services back on their feet. The amendments from the other place before us today put at risk the funding that the Bill seeks to raise. Let me be clear again: to support the amendments is to support higher borrowing, lower spending or other tax rises. It is with that in mind that I turn to the first group of amendments: Lords amendments 1B, 5B and 8B. These amendments seek to create powers as part of the Bill to exempt certain groups from the changes to employer national insurance rates and threshold in the future, including exemptions for care providers, NHS GP practices, NHS-commissioned dentists and pharmacists, charitable providers of health and care and those providing hospice care. It also includes powers to exempt businesses or organisations with fewer than 25 full-time employees from the changes to the employer national insurance threshold.

I thank the Minister for giving way so early in his speech. I just want to understand very clearly why the Government think that the NHS, under the banner of NHS England, should—rightly, in my opinion—be exempt from national insurance contributions, but that other parts of the NHS, such as GP surgeries, dentists and hospice care, should not.

As I set out during consideration of Lords amendments last week, and, indeed, at pretty much every other stage of consideration of the Bill, the response to the changes in employer national insurance contributions that we are undertaking as a Government is in line with what the hon. Gentleman’s Government did with the health and social care levy in the previous Parliament—namely providing direct support for public employers, meaning central Government, local government and public corporations. That is the standard way in which support for employer national insurance contribution changes is responded to. As I have set out, the revenue raised from the measures in the Bill will play a critical role in repairing the public finances and rebuilding our public services. Clearly, any future changes that would exempt certain groups from paying national insurance would have cost implications, which, as I have made clear, would necessitate higher borrowing, lower spending or alternative revenue-raising measures. It is for that reason that I ask the House to support the Government’s position by disagreeing to amendments 1B, 5B and 8B.

The Commons’ disagreement to Lords amendment 1, debated last week, states that the amendment “interferes with the public revenue, and the Commons do not offer any further Reason.” Does the Minister not think that those we represent would—just perhaps—prefer to see their taxed income generously donated via spending on children’s hospices, rather than spent on an idiotic deal to spend millions of pounds on the Chagos islands?

The right hon. Gentleman raised the question of hospices during last week’s debate on amendments from the other place. As I made clear at the time, although hospices do not receive support to meet the changes in employer national insurance contributions, we greatly value the work they do. I pointed to the wider support that the Government are giving the hospice sector—namely, the £100 million boost for adult and children’s hospices to ensure they have the best physical environment for care, and the £26 million revenue to support children and young people’s hospices. The right hon. Gentleman also referred to people giving to hospices, which are established as charities. Of course, the Government provide support for charities, including hospices, through the tax regime, which is among the most generous in the world, with tax reliefs for charities and their donors worth just over £6 billion for the tax year to April 2024. Lords amendment 21B would require the Government to conduct assessments on the economic and sectoral impacts of the Bill. As we have discussed previously, the Government have already published an assessment of this policy in a tax information and impact note published by His Majesty’s Revenue and Customs. That note sets out that, as a result of measures in the Bill, around 250,000 employers will see their secondary class 1 national insurance contributions liability decrease, and around 940,000 employers will see it increase. Around 820,000 employers will see no change. The Office for Budget Responsibility’s economic and fiscal outlook also sets out the expected macroeconomic impact of the changes to employer national insurance contributions on employment, growth and inflation. The Government and the OBR have therefore already set out the impacts of this policy change. The information provided is in line with other tax changes, and the Government do not intend to publish further assessments. However, we will of course continue to monitor the impact of these policies in the usual way. I hope that right hon. and hon. Members will understand why we are not supporting these amendments from the other place. The measures in the Bill will play a crucial role in fixing the public finances and getting public services back on their feet. The amendments require information that has already been provided, do not recognise other policies the Government have in place or, most seriously, seek to undermine the funding that the Bill will secure. I therefore respectfully propose that this House disagrees with these amendments, and urge all hon. and right hon. Members to support the Government on that disagreement.

I call the shadow Minister.

I rise on behalf of the official Opposition to support Lords amendments 1B, 5B, 8B and 21B. It feels like only last week that we were all here, but it is clear that our colleagues in the other place feel as strongly as the Opposition do about these amendments, as they have returned them to us with a similar aim once again. Lords amendments 1B, 5B and 8B seek to address two of the most serious consequences of the Bill that should concern and unite us all: that a rise in secondary class 1 national insurance could lead to a significant reduction in health and social care services, including our hospices, hitting the most vulnerable in our society; and could represent a complete hammer blow to the future aspirations and very survival of small businesses throughout the country. We all know that the Chancellor has an addiction to creating fiscal black holes. First she used a fictional black hole, discredited by the Office for Budget Responsibility, as an excuse for her manifesto-breaking tax rises. This has led to more black holes, only this time they are very real because they are being felt out there in the real economy. The Bill before us today will create black holes in the finances of hospices, GP practices, farms, fruit shops, butchers, bakeries and businesses of all shapes and sizes, but especially the very smallest.

Does the shadow Minister find it puzzling that the NHS will be exempt from these changes, yet the many services on which people depend for their health—dental services, social care and so on—will be hit by this rise in national insurance contributions? [Interruption.] No services will remain unaffected, so people will not experience the healthcare that they require.

It is rare that questions come with a musical accompaniment, but the right hon. Gentleman’s mobile ringtone made for a great effect. None the less, his point is the right one, which is that, whether it was intended or not, the rationale for the Bill is to “protect”—in the Government’s words—public services. I could say “bolster” public services if I were being generous. The fact is that the Government are taxing public services on which we all rely and he is absolutely right to emphasise that. Lords amendments 1B and 5B seek to provide the power to exempt from both prongs of attack of the Chancellor’s jobs tax: care providers, NHS GP practices, NHS-commissioned dentists, NHS-commissioned pharmacists, and charitable providers of health and social care, such as hospices. And it is hospices specifically that I want to speak more about today. Hospices are there at what, for many, will be the hardest moments of their lives. They provide vital physical and emotional support to individuals who are coming towards the final chapter of their lives and for their loved ones. In short, hospices are there to look after us at our most difficult time. So, whether through funding, charitable donations or legislation, they deserve our utmost support to continue in this task. However, as I set out in Committee, this disastrous jobs tax will cost hospices up to £30 million next year alone. Hospice UK has repeatedly warned this Government that the Bill risks a reduction in hospice services, which will lead only to even greater pressure on NHS palliative care services. Of the more than 200 hospices across our country, around 40 provide care for children. These are children who are living with terminal illness, many of whom have an all-too-limited time left in this world. The organisation Together for Short Lives estimates that the Labour Government’s decision to raise national insurance will add almost £5 million to the annual cost of providing care for seriously ill children and their families. Let us be clear: this will mean that every children’s hospice in England alone will need to spend an average of £140,000 more just to maintain services for the children in their care, after paying the additional tax that this Bill will impose. The Government cannot seriously be demanding that staff and volunteers at charitable children’s hospices—the very people who already give their heart and soul to look after sick and dying children—fundraise their share of £5 million next year alone just to keep their lights on and their doors open. At Treasury questions on 21 January, the Chancellor stated, in response to an excellent question from my Lincolnshire colleague, my right hon. Friend the Member for Gainsborough (Sir Edward Leigh), that the settlement for hospices announced by the Health and Social Care Secretary just before Christmas includes money to specifically “compensate” hospices for the national insurance increase. That is not correct, and I am pleased that at least this Minister has tried to acknowledge that point.

When I visited staff at the much-loved St Barnabas hospice in Lincoln, which provides excellent palliative care, they told me that they are losing £300,000 a year. In the debates on assisted dying, we all agree that we want more palliative care. I just cannot understand the logic of what the Government are doing. I make one last appeal to them not to load this extra cost on to hospices.

My right hon. Friend has raised that matter at every single opportunity that he has been afforded, and he is right to stand up not just for St Barnabas, but for all hospices. However, I have to say that St Barnabas holds a particular place in the hearts of people in Lincolnshire. I know, as a Lincolnshire Member of Parliament, that it has been around for 40 years, employs 300 staff and treats more than 12,000 people across our county every single year. The fact that it is going to be hit with a cost worth hundreds of thousands of pounds for no good reason is unacceptable. I pay tribute to my right hon. Friend the Father of the House for raising that point so consistently. I hope that the Government will listen to him. The settlement announced does not compensate St Barnabas, or any hospice, for the damage that the Government are doing, not least because we know that much of this money cannot be spent on facing down the additional running costs that this tax hike will bring. There is £100 million of capital funding, which has been set aside for buildings and equipment. Although that funding is welcome, it will not fill the national insurance blackhole that the Chancellor has created for the hospice sector, and she should not suggest otherwise. Today the Government have a chance to exempt hospices and other key areas of our health and social care sector from this tax hike, by accepting Lords amendments 1B and 5B. In addition, Lords amendment 8B seeks to provide the power to exempt the smallest businesses—those with fewer than 25 full-time employees—from the proposed cut to the threshold at which an employer is required to pay secondary class 1 national insurance. The Chancellor has spoken a lot about growth, but growth has been consistently downgraded since she took office. Something that we, as Conservatives, know, and that she, as a socialist, does not know, is that that is because economic growth cannot come from the Floor of the House of Commons; it comes from the factory floors and bustling high street shop floors in each of our constituencies. It comes not from state-created quangos such as GB Energy, but from individuals who had an idea, stuck it out, made it work and saw it through. It comes from people in this country who, by seeking a better life through enterprise, create the jobs and services that make our country strong. Those small businesses are being hammered, but not just by the national insurance hike. In less than a year they have already seen: business rates relief cut from 75% to 40%; aspiration penalised with changes to business property relief; and crippling new red tape through the Employment Rights Bill, adding a staggering £5 billion in additional costs. This is a potent and damaging combination of costs that many fear will mark the end. Lords amendment 8B gives the Government another chance today to change their approach, to throw our smallest businesses a lifeline—a chance of survival. Finally, while our smallest businesses require specific attention, I made it clear last week that, sadly, this Bill does not discriminate. It will hit business groups of all types, across all sectors, in all parts of our country—from charities to cafés, from pharmacies to children’s nurseries and special educational needs and disabilities transport. We must understand the impact the Bill will have. That is why Lords amendment 21B requires the Chancellor to carry out a review of the impact of the Bill on a range of sectors of our economy within six months of its passing into law. I urge Members to support the amendment. Tomorrow the Chancellor will come to this House to launch her latest attempt to reverse as much as possible of the damage of her Hallowe’en Budget of horrors. Despite the hopes and dreams of business owners across the country, we can be sure that her emergency Budget will not include scrapping this awful Bill. It is incumbent on all of us in this place to work to protect and support the most vulnerable in our society, and to take decisions that drive growth, backing the people out there who make it happen. They are the people who will be hit hardest by the Bill. The Government must change course.

14:00:00

I call the Liberal Democrat spokesperson.

I rise to speak to Lords amendments 1B, 5B, 8B and 21B. Even before the Budget, there were rumours that the Government were thinking of introducing a hike to national insurance contributions. We Liberal Democrats issued a stark warning to the Government. We challenged them at Prime Minister’s questions and in questions to the Deputy Prime Minister, saying that if they went ahead and introduced these changes, social care providers up and down the land would be hit incredibly hard. The Government cannot say that they were not warned. We warned them, even before they made the announcement. In the many long debates that we have had in the Chamber since the Budget, we have consistently made the case that health and care providers should be exempted from this change. The Government say that they want to make the national health service a neighbourhood health service; we heard this just an hour ago from the Secretary of State for Health and Social Care. They also say that they want to take services out of hospitals and on to the high street, but this tax hammers the very providers of the neighbourhood community services on which the NHS relies. It is GPs, dentists, pharmacists, hospices and care providers who hold up our community care, and prop up our NHS, so that it does not fall over. Government Ministers have said on many occasions that they have increased funding to social care, but the additional funding announced in the Budget is dwarfed by the rise in national insurance contributions. As other Members have highlighted, the Government have said that they have given more funding to hospices, but that funding is for capital projects. There is no point having another hospice building or hospice bed if there are no staff to look after the people lying in them. We know that we have to fix the front door to the NHS—our GPs and dentists—but we have to fix the back door to our NHS too, which is social care. On hospices, there is nowhere else for the people in them to go. People look for support from hospices so that they can die in dignity, with independence, in a setting of their choice, surrounded by their loved ones—not in the sterile environment of a hospital ward or, worse, a busy corridor or ambulance parked outside. We need our GPs, dentists, hospices, pharmacists and care providers to survive and thrive if we are to end the crisis in our NHS. The Lords in their wisdom have not sent back an amendment that simply asks for an exemption. They have put in a very clever tweak that asks that the Government to adopt a Henry VIII power. That is not something the Liberal Democrats would normally support, but on this occasion it would give Ministers the power to choose if and when they want to exempt health and care providers from the rise. That way, when we get this enormous growth booming in our economy—when we see the success that we all hope to see—a Minister could choose to exempt health and care providers and give them the cash injection that they need. I urge the Government to support this measure. Amendment 8B provides a power to exempt small businesses from the changes. Small businesses are the engine of our economy and of growth. They are the very organisations that prop up our high streets. They are the glue that hold our communities together. The Government have raised the employment allowance for microbusinesses, but they have not put other provisions in place to support small businesses. While our small businesses can be the engine of growth, they are screaming out about the number of obligations being put on them, with the NICs changes, business rates bills going up and the new obligations under the Employment Rights Bill. It is all happening at once, and they say that they are overwhelmed. I support amendment 8B, which would give the Government the power to exempt small businesses. I am also in favour of Lords amendment 21B on an impact assessment. As Ministers remind us, there is a tax and spend announcement coming, but looking at the impact of the provisions, this is less about tax and spend and more about the overwhelming impact on small businesses, which are really struggling right now. Many of them still have covid loans, and many are struggling with access to finance. Many owners are remortgaging their homes to prop up a new business. This change has come out of the blue. Small businesses have not been able to plan ahead for it, and many of them are fearful about what will happen. I fear that if the measures go ahead, in a matter of days, we will start to see shop fronts boarded up on high streets up and down the land.

I was going to call Sir Roger Gale, but he is no longer bobbing—ah, I call him now.

Thank you, Madam Deputy Speaker. I naively assumed that, having already been called twice today, I had to take my place in the pecking order. I want to come back briefly to hospices. This is a very serious issue, and I do not think that the Minister or the Government understand the deleterious effect of the change on care for some of the sickest people in the land, both in adult hospices and children’s hospices. I have listened very carefully—twice now—to the Minister’s response about giving this and giving that, but they are giving with one hand and taking away more with the other. The net result will be a reduction in staff. This is a straightforward tax on jobs. Without dedicated, caring staff, who do jobs that frankly most of us would not begin to know how to do, the health service will not function. There are children living in and being serviced by Demelza House, Shooting Star and all the other children’s hospices. The Pilgrims Hospices in Thanet and Canterbury will not be able to afford to recruit and or pay the staff that they need. Hospice care is an integral part of the health service. The point was made by my right hon. Friend the Member for Gainsborough (Sir Edward Leigh) and others that hospice care is part of the health service and should be treated as part of the NHS. [Interruption.] My right hon. Friend asks from a sedentary position, “Where are all the Labour Members?” The answer is that they will be in the Lobby, voting against these measures, but they are not here listening to the debate. It saddens me to have to say it, but in this instance, their absence speaks volumes. Quite simply, they do not care.

The Lords amendments seek to address a clear, present and insurmountable financial challenge for significant elements of health and social care delivery in all our communities. The Government say, in the most spurious and disingenuous way, as though they did not understand their role in the health service, that social care providers, GPs, dentists and pharmacies are contractors. How they are dealt with by His Majesty’s Revenue and Customs is irrelevant. It is the role that they fulfil in our society and in the delivery of health and social care services that is at stake. These are not contractors that can go and develop new markets somewhere else. Their market is exclusively within the NHS and health and social care up and down these islands. Many properly commercial businesses will not manage to pivot their way out of this attack from Labour—and GP practices, pharmacies, care providers, nurseries and hospices certainly will not. I want to mention hospices. When Macmillan Cancer Support speaks, no matter what colour our rosette, we should listen. It has highlighted clearly what the measures mean for end-of-life care. There have been 15 years of chaos in the United Kingdom, most of it economic; there has been the lost decade of Brexit, and its catastrophic effect on the UK’s economy and the material welfare of people up and down these islands. I ask: who can we blame? Who is culpable? Who has their fingerprints all over it? Not terminally ill children in hospices, who will, as a result of the Bill, suffer as a result of the debilitating effect on the care with which they are provided. The Minister and his Government could do a simple thing: give hospices a derogation from the grasping hand of the Bill, and protect children in the worst imaginable circumstances. From the outset, the Government’s fiscal misadventure has been met with opprobrium from all manner of sections of the economy and society, but they have held firm. I pay tribute to the Minister; he fronts up here every time with a smile, and does his best to defend what he has to. That is his job, and I do not judge him for that, but the bottom line is that the Government have yielded, not to children in hospitals, or to people trying to deliver social care and free up hospital beds by preventing delayed discharge, but to the bankers by restoring their bonuses, and to the non-doms who want all the benefits of living in this country but do not want to pay for it. That speaks volumes about what a Labour Government in this day and age are all about.

I hope that I can have this intervention without a musical interlude. I apologise to you, Madam Deputy Speaker, for having my phone switched on. Will the hon. Member accept that not only are services likely to be affected, as he has outlined, but the Government’s aim of raising additional revenue will be affected as well? As he pointed out, they have given in to the bankers and non-doms because of the fear of losing revenue. Anecdotally, we know that many businesses, whether those supporting the national health service or other small businesses, will cut back on the number of staff that they employ because they cannot afford them, and that will lead to a loss of national insurance and tax contributions. It could be an own goal for the Government if they cause pain to businesses but do not get any revenue from it.

I agree entirely. This is a £24 billion fiscal drag that is intended to create growth. Work that one out if you can, because it is beyond my ken. The Government will not make derogations for key elements of health and social care, because the benefit of the £24 billion drag on the economy that the right hon. Gentleman pointed out is, after compensation, already down £10 billion. If they compensate the people who they definitely should, such as GPs, pharmacies, care providers and hospices, that would take it down to somewhere around £7 billion or £8 billion. What type of Chancellor and Treasury orthodoxy says, “We place a £24 billion burden on the economy in exchange for an £8 billion return for the Treasury”? It is absolutely catastrophic. It is misadventure writ large, and it has Labour as its logo.

The hon. Member highlighted the comments by the Office for Budget Responsibility, which said that the £24 billion is, in fact, only £10 billion once behaviour change is accounted for. If the Government were to agree to the exemption that we seek, the figure could be only £8 billion. Does he agree that there are much fairer ways of raising that revenue, such as by putting a digital services tax on the big online media giants and gaming companies?

The hon. Member raises two excellent examples of what could be done to raise the funding that the Government need in a just way. Let us not forget that Labour knew fine what it was walking into when it won the election. We told it, as did the Liberal Democrats and the media—the Tories were a bit quiet on the issue, right enough—that there would be an £18 billion black hole if it stuck to Tory tax and spending policy. This is on Labour. The hon. Member mentioned two examples of excellent and just ways to raise funding. Similarly, the Government could apply Scottish income tax thresholds to the whole of the UK, giving most people a pay rise and raising £16 billion into the bargain. They could raise £40 billion from a 1% wealth tax on assets over £10 million. There are a range of other measures that they could take, such as raising £30 billion by rejoining the single market—not very many people in here talk about that.

14:15:00

The Government persist in their tendentious references to additional funding, all of which is capital and none of which can soften the blow of the measures contained in the Bill. They do not want to support, in particular, Lords amendment 21B, because they would rather continue to cloak the effect that the Bill will have on care services and contractor elements of the national health service up and down these islands, and the effect that it will have on the real economy, which Labour is a stranger to.

I am just flummoxed by the Government’s approach to the Bill. Clause 1 raises employer national insurance from 13.8% to 15%. Almost more damagingly, clause 2 reduces the threshold at which they start paying it from £9,100 to just £5,000. The Government know how damaging this measure is for healthcare. We can see that because they have taken action to exempt the NHS from it. That will cost billions of pounds, because healthcare providers cannot just diversify as other sections of the economy might be able to. They cannot raise prices. A general practitioner’s customer is the state, and prices are fixed by the Treasury. As a result, the Government know exactly what the impact of this proposal will be on hospices. We have already heard that without an exemption, they will face an additional £30 million of costs every year as a result of these changes. When the Bill was first announced, I assumed that there had been an oversight by the Treasury and that it would be addressed as the Bill progressed. But both last week and this week, the Lords have moved to fix what was originally considered to be perhaps an oversight. Today’s decision to seek to reverse Lords amendments 1B and 5B in particular demonstrates beyond doubt that it is not an oversight but a deliberate decision taken by Labour to penalise hospices for the care of the dying, and to do what with that money? We may be in the obscene position in a few weeks’ time of funding for state-assisted dying being raised by taxing palliative care. This is absolute madness. If Members wanted any other reason why they should not support the Government, that is an overwhelming one. I make one last reference to the emptiness of the Government Benches. There are now two Labour Members sitting there who are not required to be—[Interruption.] I take it back, there is only one. That indicates to me that Labour Members do not want to be associated with the Bill. They will scurry through the Lobby later, but they are not brave enough to stand up and defend the decision of their Government.

You do not need any convincing of this, Madam Deputy Speaker, but were you to, the Lords amendments demonstrate why we need a House of Lords. They are the ones standing up and delivering the amendments that this Government are trying to wriggle out of this afternoon. Amendments 1B and 5B, which the Government are trying to derogate from, are essential for our care services. The financial strain that the Government’s national insurance contributions will put on the care sector is astronomical—some predictions are of around £2.4 billion on social care alone. Ultimately, that will lead to reductions in services and, unfortunately, closures, especially in the hospice sector. The Minister has repeated what he and other Ministers have said on many occasions: they are giving a certain amount of money to the hospice sector, but as Opposition colleagues have stated, that is capital spending. What they desperately need is revenue spending to cover the cost of the rise in national insurance contributions.

Is the hon. Gentleman concerned that the Government patently do not understand whole-system cost, which is a key element of fiscal policy? When care providers—whether hospices, in-home care providers or social providers—fall over as a result of these measures, as they will, those costs will get picked up by the rest of the system, and that will have a net cost to the Treasury.

The hon. Gentleman makes an excellent point, which has been made by Opposition Members on numerous occasions. It does not surprise me that Labour Members do not understand the economy. I did hope that they would understand the care sector, which has been telling them time and again that this national insurance increase will hit it disproportionately and cause it to reduce and, indeed, close services. I think of Phyllis Tuckwell hospice in the centre of Farnham in my constituency, which is fortunately going through a multimillion pound rebuild as we speak, but when it reopens, it will be hit by these national insurance contributions and will have to make decisions about what services it can provide to my constituency and the surrounding areas of Surrey and northern Hampshire. Likewise, on Friday I will see Shooting Star children’s hospice, which is a fabulous children’s hospice that I have visited on a number of occasions. What is galling to me is that I see photographs of Labour Members turning up to Shooting Star and similar hospices, putting their arms around people and saying what a wonderful job they are doing, but later today they will walk through the Division Lobby to take money away from them. What hypocrisy. We already know that there are workforce challenges in the care sector, and especially in the hospice sector, so why on earth are the Government targeting those sectors for raising national insurance contributions? As Opposition Members have mentioned, this is not an abstract cost that will hit some sort of nebulous business; this is a cost that will hit patients and, in the hospice sector, those who are dying, because care will be taken from them. It is a tax on community care. It is a tax on dying. The Labour Government should be ashamed that they are bringing this in.

We have rightly concentrated a great deal on children’s hospices, and I still hope that at the 11th hour the Government, as a socialist Government, may have some compassion and give some ground. But the other area, which we have not touched on enough, is the independent care providers who are providing services in people’s homes. They will not be able to employ the people that they need—they cannot do so now—even if they can get them. That inevitably means that those cared for will end up in hospital, at still greater cost to the health service.

My right hon. Friend makes an excellent point, echoing one made by the hon. Member for Angus and Perthshire Glens (Dave Doogan). That is correct: there will inevitably be a net cost to the Exchequer because of this policy. He is right that home care has not been touched on but will be affected. Home care companies in my constituency will not be able to expand their staff, which is vital to meeting people’s needs. Pharmacies, which we have not touched on a lot, are in the same position. A few weeks back, I visited Badgerswood pharmacy in Headley in my constituency, and I was told that the measure will hit it hard and cause a real problem in service delivery for my constituents. This measure will not only have a massive effect on those businesses—GPs, pharmacies, the hospice sector and the home care sector—on the economy, because there will be a net cost, and on patients, who will not receive the services in the wider NHS family that they deserve, but it runs entirely contrary to the Government’s stated policy of wanting to bring healthcare close to home and close to the community. Although they are exempting acute hospital care, which takes place away from the community, they are taxing the bit that they say they want to expand. It is totally illogical, even on the Government’s own policy. I hope that the Government have an 11th hour change of heart, either today or at the emergency Budget tomorrow, because it is vital that we support these sectors. We see with Lords amendment 21B that the proof of the pudding is in the eating, as it were. If the Government were so convinced that their policy was the right, just, fair and proper one, they would allow a review to go ahead so that we could see its impact. The fact that Government Members will be walking through the Division Lobby to hide this policy from the British people tells us all that we need to know: they know that this policy does not stand up to scrutiny, and they are running from it.

With the leave of the House, I will respond briefly to some of the comments made by Opposition Members. Although I feel that the Liberal Democrat spokesperson, the hon. Member for St Albans (Daisy Cooper), will not support us on the Bill, I none the less recognise that she seems to support the extra funding that we put into public services in terms of GPs, dentists, hospices commissioned by the NHS and so on. Although she will not agree with the difficult decision that we have taken to raise that funding, I got the impression that she supports our spending on those public services. I turn to the official Opposition. The shadow Minister, the hon. Member for Grantham and Bourne (Gareth Davies), claimed that very small businesses will feel the greatest impact from the changes in the Bill. I can only conclude, therefore, that he has not read the Bill, because he would have seen that we are doubling the employment allowance to £10,500, with the result that the very smallest businesses will not pay any national insurance contributions at all when they are employing up to four people earning the national living wage. More widely, the shadow Minister and many of his Opposition colleagues refuse to take any responsibility whatever for the state of the public finances or the public services after 14 years of the Conservative party being in control. They also resisted the opportunity to acknowledge that the approach we are taking in government to compensate the public sector for changes in employer national insurance contributions is the same one that the previous Government took with the health and social care levy. That came up time and again, and even when the shadow Minister was intervened on, he missed the opportunity to acknowledge that our approach is the same one that he and his colleagues took in government. The amendments from the other place would require information that has already been provided. Either they do not recognise other policies that the Government have in place, or—most seriously—they would undermine the funding that the Bill will secure. Let me be clear: to support the amendments that create exemptions is also to support higher borrowing, lower spending or other tax rises. I therefore ask the House to support the Government’s position by disagreeing to Lords amendments 1B, 5B, 8B and 21B. Question put, That this House disagrees with Lords amendment 1B.

140|14:28|312|190|The House divided:|Question accordingly agreed to.||0|0

14:42:00

After Clause 2

Exemptions from the changes made by section 2: NHS and social care

Motion made, and Question put, That this House disagrees with Lords amendment 5B.—(James Murray.)

141|14:42|311|192|The House divided:|Question accordingly agreed to.||0|0

Clause 2

Secondary threshold for secondary Class 1 contributions

Motion made, and Question put, That this House disagrees with Lords amendment 8B.—(James Murray.)

142|14:53|313|194|The House divided:|Question accordingly agreed to.||0|0

After Clause 3

Motion made, and Question put, That this House disagrees with Lords amendment 21B.—(James Murray.)

143|15:05|314|196|The House divided:|Question accordingly agreed to.||0|0

Motion made, and Question put forthwith (Standing Order No. 83H(2)), That a Committee be appointed to draw up Reasons to be assigned to the Lords for disagreeing to their amendments 1B, 5B, 8B and 21B;

That James Murray, Christian Wakeford, Alistair Strathern, Chris Vince, Joe Morris, Gareth Davies and Will Forster be members of the Committee;

That James Murray be the Chair of the Committee;

That three be the quorum of the Committee.

That the Committee do withdraw immediately.—(Anna Turley.)

Non-Domestic Rating (Multipliers and Private Schools) Bill (changed to Non-Domestic Rating (Multipliers) Bill) (Programme) (No. 2)

That the following provisions shall apply to the Non-Domestic Rating (Multipliers and Private Schools) Bill (changed to Non-Domestic Rating (Multipliers) Bill) for the purpose of supplementing the Order of 25 November 2024 (Non-Domestic Rating (Multipliers and Private Schools) Bill (Programme)):

(1) Proceedings on consideration of Lords Amendments shall (so far as not previously concluded) be brought to a conclusion two hours after their commencement.

(2) Any further Message from the Lords may be considered forthwith without any Question being put.

(3) Proceedings on any further Message from the Lords shall (so far as not previously concluded) be brought to a conclusion one hour after their commencement.—(Anna Turley.)