Politics - Simon Hoare MP

Why I’ve changed my stance on raising National Insurance

by Simon Hoare MP

I’d guess that there are not many people in North Dorset who do not know at least one person, a friend or family member perhaps, who is not waiting currently for an operation, scan or some other medical intervention.

I know from my inbox that the waiting lists are growing, and that people are worried. When will they get help? When will their pain be eradicated etc? It is for that reason that the Government had to act to inject extra resource into the NHS to cope with the Covid-generated backlog. I was concerned that we were breaking a manifesto commitment not to increase National Insurance contributions. But it was written in a different, pre-pandemic age. An analogue document for a digital age. Covid has changed so much. Those who know me know I am no ideological purist. Rather, I plant my flag as a confirmed and proud centre-ground pragmatist. Following the decades old Tory tradition of finding practical solutions to problems; not hogtied to dogma or ‘little red books’. So, the new money will go to the NHS and hopefully that will help tackle the mountain range like waiting list problem.

‘Flush with money’

But, as a Tory I also know that injecting money into anything, let alone such a vast public service as the NHS, can never be the end in itself. Listening to health commentators it is clear that outputs and productivity go up when money is at its tightest as every ounce of health benefit is squeezed from every pound. When an organisation is ‘flush with money’ it can often mean that financial rectitude and prudent management go out of the window at worst or take second place at best. We must therefore look to those who control the purse strings to ensure that the maximum benefit can be derived from this windfall cash injection. 150% of our entire GDP could go to health provision and it would still not be enough. Medical science is outpacing public financing. We must focus on productivity and outputs. It is in the patient’s interest to do so.

A skill shortage

Doctors and nurses do not grow on trees. It is not just a question of the money but also having the medical staff to deploy to use it. There is of course a moral dimension to skill-raiding from overseas, often depleting other countries of medical expertise. That said, and while there is a huge need for front line staff (let us not forget many of them are physically and mentally on their knees as a result of Covid), we will need to ensure there is a timely flexible response from the Home Office regarding visas and processing applications.

The Social Care timebomb

A big part of the NHS capacity crisis is the bedblocking that

occurs when patients no longer need acute care but are not able to return home without an integrated care package. As a result, they cannot be discharged. This often leads to “I plant my flag thousands of beds nationally being as a confirmed used for nonand proud medical care. That centre-ground pragmatist” is why we are trying to defuse the Social Care time-bomb before it detonates. Health and Social Care are two sides of the same coin. A major contributor to the problems of social care provision has been the disproportionate reductions in Government-provided funding to local government. It is local councils who know their communities and its needs better than Whitehall. I shall continue my advocacy for Local Government funding within Westminster to make that case.

Future of care

Two final points if I may? First, we now need to sculpt what we want adult social care to do and look like for the next 30-40 years. The model needs a radical overhaul to reflect the change in demographic demand. Second, we will at our peril forget that ‘social care’ is not ‘elderly care’. There is a huge and growing demand among children and young people for social care and they cannot be overlooked.