The £12bn-a-year tax hike to rescue the NHS and social care has been backed by MPs, but ministers were warned they would have to “relax all immigration requirements” to make the plan a reality.
In a highly unusual move, the health and social care levy is expected to clear all its Commons stages in a single day, even though the national insurance rise will not kick in until next April.
Just six Conservative MPs opposed the legislation at its second reading, only one more than in the first vote on the motion last week – despite several voicing strong opposition.
One Tory MP, John Baron, said he could not support a bill that would “cost jobs” while also lowering pay and resulting in higher prices.
John Redwood, a former cabinet minister, said of the tax increase: “This is too soon … to start breaking the economy. The growth rate almost disappeared in the last month.”
And another Conservative backbencher, Craig Mackinlay, said: “My sadness is we are just reaching for the tax lever. That’s not what Conservatives do. We are going to end up with a tax take at the highest level of GDP for 70 years.”
Jeremy Hunt, the Conservative former health secretary, criticised Labour and the Liberal Democrats for refusing to back the tax rise – but warned that a “workforce plan” was also needed.
“If you put an extra £8bn into the NHS but you don’t have £8bn worth of additional doctors and nurses to do the extra treatments, the risk is that that money will hit the ground without touching the sides,” he told ministers.
Mr Hunt pointed to experts warning that 4,000 more doctors and 18,000 more nurses will be needed, adding: “But we have not had any workforce plan.
“I suspect, in the short term, we will have to relax all the immigration requirements for doctors and nurses, which is not great for developing countries but may well be our only choice.”
Although the plan is billed as a measure aimed at ending the social care crisis, only £5.4bn of the £36bn to be raised over three years is for care, with the NHS grabbing around £25bn, and £6bn going to the devolved governments.
Furthermore, the Treasury acknowledged that the £5.4bn is largely for “implementing” the new caps and floors, and for ensuring that local councils pay more to those providing residential care.
Lifetime care payments will be capped at £86,000 from October 2023, to allow homeowners facing “catastrophic” care costs for conditions such as dementia to pass on their properties to their children.
No one with assets below £20,000 will pay any social care costs – but, although there is a “floor” of £100,000, people with assets between £20,000 and that amount will contribute on a sliding scale.
The Liberal Democrats warned that the October 2023 date for the care cap would cause a “massive cliff edge” as people “avoid coming forward for care” before that date in order to avoid bills.
But Steve Barclay, the Treasury chief secretary, said the levy would “provide the additional funding to the NHS so that it can recover from the pandemic”.
He added: “In addition, our social care plan will create a dramatically expanded safety net for people in their later life.”
