James Murray – 2022 Speech on the NHS Workforce
The speech made by James Murray, the Labour MP for Ealing North and Shadow Minister, in the House of Commons on 6 December 2022.
There can be no doubt that the NHS is in crisis. We have heard shocking stories today from hon. Members about what their constituents are having to endure. Each and every one of these deeply distressing stories helps to confirm the devastating impact of the Conservatives’ neglect of the NHS. Patients deserve so much better than this Government and everyone who works in the NHS deserves so much better, too, for the invaluable work they do.
We all know that from the experience we have in our constituencies, as we have heard so powerfully today. My hon. Friend the Member for West Ham (Ms Brown) spoke powerfully and in detail about the impact of vacancies in the NHS, particularly in maternity services, in her constituency and the surrounding areas. My hon. Friend the Member for Coventry North West (Taiwo Owatemi) spoke about the role of community pharmacists and the wider struggles that NHS workers face. She was speaking with particular authority, given her background in the NHS before becoming an MP. My hon. Friend the Member for Ilford South (Sam Tarry) spoke about the severe impact of vacancies and exhaustion in nursing after 12 years of the Conservatives.
My hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) spoke about the impact that workforce shortages were having, even before the pandemic, on crucial radiotherapy services in her constituency and beyond. My hon. Friend the Member for Streatham (Bell Ribeiro-Addy) spoke about the scale of the crisis that we face in NHS recruitment and retention. My hon. Friend the Member for Leeds East (Richard Burgon) rightly mentioned those shameful attacks by Conservative Ministers on nurses.
My hon. Friend the Member for Bristol South (Karin Smyth) spoke with great experience, having spent three decades working in the NHS, about the growing crisis of retention over the past decade. My hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) spoke about the NHS crisis and set it in the context of the Government’s unfair decision in the recent autumn statement. My hon. Friend the Member for Halifax (Holly Lynch) gave a wide-ranging and powerful speech that drew attention to the genuine sense of fear among people across the country at the prospect of not being able to access vital NHS services. My hon. Friend the Member for Wirral West (Margaret Greenwood) made it clear that the staffing crisis in the NHS is the failure of 12 years of the Conservatives.
Madam Deputy Speaker, that is the truth. The Conservatives have spent 12 years running down the NHS and letting our economy fall further and further behind, but, make no mistake, this is not inevitable. After 1997, Labour not only grew the economy 1.5 times the rate that the Conservatives subsequently managed, but delivered an NHS to be proud of, and we are proud of our record.
Although the challenges now are even greater than they were in the late ‘90s, if we take office at the next election, we will, again, deliver a modern, sustainable NHS that is fit for the future that we face. We know that, to make the NHS fit for the future, it needs a prescription of reform and sustainable funding from a growing economy. For our economy to grow, we need to start getting our public services back on track, too. As my hon. Friend the shadow Health Secretary set out, one of the first steps that a new Labour Government will take to get the NHS back on track is to deliver a workforce plan that addresses the root cause of the crisis it is in.
Under our plan, we would double the number of medical school places to 15,000 a year. We would double the number of district nurses qualifying each year. We would train 5,000 new health visitors a year and we would create 10,000 more nursing and midwifery clinical placements each year, too—all part of a long-term workforce plan for our NHS.
Steve Brine
On the doubling of the number of medical school places, can the hon. Gentleman tell me what the cost of that is, especially as the shadow Chancellor is so handily sitting next to him? It would be helpful for those of us on the Select Committee to put the price tag on that one.
James Murray
All the pledges that the Opposition make are fully costed and fully funded. [Interruption.] If the hon. Gentleman waits one second, I will address that point. Today is about political choices. It is not just a political choice of whether we invest in the NHS; it is a political choice of how we pay for it. That is why we have made it clear that, to pay for our NHS workforce expansion plan, Labour would abolish the unfair, outdated non-dom tax status. Non-dom tax status is passed down through people’s fathers and it costs the public purse £3.2 billion a year, while failing to support economic growth in the UK. Under the current arrangements, a small group of high-income people who live in the UK are able to avoid paying tax on their overseas income for up to 15 years. We would abolish that 200-year-old tax loophole and introduce a modern scheme for people who are genuinely living in the UK for short periods. We believe that if a person makes Britain their home, they should pay their taxes here.
Paul Bristow
My hon. Friend the Member for Winchester (Steve Brine) asked the hon. Gentleman a very specific question about the exact cost of doubling the number of places at medical school. Is the hon. Gentleman able to confirm the exact cost of that—not the non-dom cost, but the exact cost of doubling the number of medical places?
James Murray
I thank the hon. Gentleman for his intervention. I have set out that scrapping the non-dom status would raise £3.2 billion, and that our workforce expansion plan would cost £1.6 billion, so we would be well able to afford that measure from the amount of money that we have raised from scrapping this outdated, unfair tax loophole.
Non-dom status should have no place in our modern tax system. It is unfair. When the Government are making working people pay more tax, it is simply wrong to allow wealthy people with overseas income to continue to benefit from an outdated tax break. It is also bad for UK business: the loophole prevents non-doms from being able to invest their foreign income in the UK, as bringing it here means it becomes liable for UK tax. Abolishing non-dom status would end that barrier to UK investment—and, as I have said, raise £3.2 billion, money we would use to put towards priorities including expanding the NHS workforce.
To be honest, we would have thought abolishing non-dom status, replacing it with a modern system and using the money to strengthen the NHS and economy would be a no-brainer. What is it about this Conservative Government, led by the right hon. Member for Richmond (Yorks) (Rishi Sunak), that makes them so reluctant to close that loophole? Last week, during the rushed debates on the Government’s autumn Finance Bill, I asked Treasury Ministers to confirm whether the Prime Minister had been consulted on the option of abolishing non-dom status and whether it was ever considered as an option for last week’s Finance bill. I also asked whether, when the current Prime Minister was Chancellor, he had ever recused himself from discussions on the matter, for obvious reasons.
I put these questions to Treasury Ministers on three separate occasions last week, but they refused each time even to acknowledge the questions, never mind answer them. For a Minister to overlook a set of questions once might be an oversight, but to ignore them three times looks like something else. Perhaps the Minister will today show that they have nothing to hide by answering the questions I have raised.
In the autumn statement and last week’s Finance Bill, the Chancellor chose to leave non-dom status untouched, while picking the pockets of working people, including nurses, with stealth taxes such as freezing income tax thresholds and pushing up council tax. Today, the Secretary of State for Health only mounted a brief defence of non-dom status; I wonder whether his colleague from the Treasury will, in her closing remarks, repeat some of the defences that Treasury Ministers tried to set out last week.
Last week, Ministers tied themselves in knots trying to find a justification for the £3.2 billion tax break for non-doms. They tried to pretend that the Government’s investment relief is working, when only 1% of non-doms invest their overseas income in the UK in any given year, and last week they tried to win praise for ending permanent non-dom status, while keeping quiet about the new loophole they created, which allows people to use trusts to retain non-dom benefits permanently.
The truth is that, unless the Conservatives vote with us today to abolish non-dom status once and for all, the British people will be clear that no amount of reason or common sense will get this Government to come round. The British people need a fresh start and a new Labour Government that would take those fairer choices on tax to support the stronger NHS we so desperately need.
The NHS is an achievement we share together as a country and one that we all have a personal relationship with. We all want to know that when we have medical symptoms, concerns or needs, the NHS will be there for us. We want to know it will be there as a publicly funded service, free at the point of use, able to provide us with the high-quality help we need. That is what I wanted to know in my early 20s, when I started to notice symptoms of what would later be diagnosed as myasthenia gravis, a rare neurological condition that caused muscle weakness throughout my body.
After the best care I could have hoped for from my brilliant consultant and his team and colleagues at the National Hospital for Neurology and Neurosurgery in Queen Square, I have been symptom-free for many years now, but the memory of first feeling those symptoms and then finding my way towards the right treatment sticks with me. I would never want anyone to feel symptoms like mine and not be sure whether the NHS would be there to help.
We all know stories like that. We all need the NHS to diagnose and treat us when we are worried. We all need to be able to turn to the NHS so that we get that treatment in good time. We all connect with the NHS through our own lives and the lives of our family and friends. That is why the NHS matters so much to us all and why we are so determined to deal with the crisis the NHS is facing and to make sure it is ready for the modern challenges we face.
At the heart of our vision for the country are stronger public services and stronger economic growth. We know that getting public services back on track will support a growing economy, which will in turn support modern, sustainable public services. Before us today we have a chance to end the unfair 200-year-old tax loophole, which lets a small number of people avoid tax on overseas income, and use the money saved to fund one of the biggest workforce expansion plans in the history of the NHS. That is the choice in front of us today, and I urge all MPs to do the right thing by backing our plan.
