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6.7 pm
John Mann (Bassetlaw): I have attempted to glean more information about the hard choices perceived by the Opposition. That is difficult because they are reserving judgment, so I took the liberty of examining the websites of their Treasury Front-Bench team. Only two have websites. That of the hon. Member for Arundel and South Downs (Mr. Flight) is called the Flight Site, but, unfortunately, it crashed repeatedly, so I could not judge his views.
Luckily, however, the website of the hon. Member for Aylesbury (Mr. Lidington) was available. Unfortunately, I could find no comment on the Budget, health, taxation or national insurance contributions, but there was a questionnaire that his voters could use for giving feedback. [Hon. Members: "On the Budget?"] Not quite. There were several questions eliciting voters' views on immigration, but none on the Budget. I therefore propose that he add to his website a question or two on the Budget asking whether his electorate are in favour of it and prepared to pay the additional national insurance contributions.
My website outlines my view. It spells out that I will use my vote for the NHS. The electorate in Bassetlaw are very clear about where I stand on the issue. I have gone beyond the website in letting the local population know my views on the Budget and the hard choices. I hope that the hon. Member for Aylesbury will do likewise. I commend him on his questionnaire, which is well laid out. This is an ideal opportunity for him to do that. I have asked my researcher to monitor his website daily over the next week to see whether those questions are added. Perhaps we could have an analysis of the results as well.
Chris Grayling (Epsom and Ewell): In the hon. Gentleman's efforts to find out the views of the people of Bassetlaw, has he asked them whether they believe that the extra money on national insurance will actually transform the national health service? The evidence of the opinion polls is that people have profound doubts that it will make a difference.
John Mann: Of course I ask that. I note that the hon. Gentleman has a website, too; I should have investigated
it for good hints and tips. As I listen to the debate, I seem to be living in virtual reality but, yes, I do go out in Bassetlaw.Indeed, this very week, the huts that were put up as wards for Bassetlaw hospital in 1938 are being knocked down. On the eve of the Budget, in a presentation to the Bassetlaw chamber of commerce, the general manager of the hospital outlined her vision of what the hospital would be like if the resources were available—the additional provision of acute services and the use of the land on which those huts have stood since 1938. She had some answers, but what did the Bassetlaw chamber of commerce have to say? Its president, as a business man, described it as "A fair Budget".
Like the right hon. Member for Charnwood (Mr. Dorrell), I should, of course, as a shareholder and a former director of a business, declare an interest because of the implications for employers' national insurance; but I also have an interest in the corporation tax reduction. For me, profitability means that I shall receive a greater net benefit due to the reduction in corporation tax this year than the total net increase even if the higher national insurance contributions had already been in force for a year.
Of course, the capital gains tax change for budding entrepreneurs such as myself, the right hon. Member for Charnwood and others is phenomenal: the difference for entrepreneurs in my constituency, or anywhere in the country, is formidable. I have not sold my shares, although I have an offer for them. I do only one job at a time; as an MP, I do not want two jobs. It is almost embarrassing when we consider the difference that the Chancellor and the Government have made for entrepreneurs through successive Budgets—Budgets for entrepreneurship.
Of course, employers never want to pay more, but what are the alternatives? Let us consider them, because they have not been spelt out. There are various European models for increased taxation. Each takes more of the national income in taxation than we do, however that is dressed up. We might call them the European continental model. It has not been adopted by the Government. Some people may suggest that it is a good model, but, despite the nuances in some of the remarks of Opposition Front-Bench Members, I have not heard that from them yet.
Another model is the American one, which is extremely interesting. There appears to be a presumption in the debate that employees and employers in the United States do not pay for their health service through taxation. That is true. In the United States, 45 per cent. of small businesses do not offer their employees private medical insurance. That possibility is not open to the 45 per cent. of employees who earn less than $7 an hour. That is one of the fundamental problems of the US health care system.
I offer the House an example using a theoretical company. I note that the shadow Chancellor, as a Minister, employed five special advisers. If the company was American, we could call it "Special Advisers Inc.", but I shall discuss the American model later. A UK company might be called "Special Advisers Ltd."
What would be the cost to the right hon. and learned Gentleman, as an employer of five employees, of the increase in employers' national insurance contributions? It would be less than half the cheapest rate that BUPA
quoted me for insurance for such a company. BUPA offers a cut-price version, because it relies on the national health service. It has no accident or emergency facilities and there are all sorts of get-outs.How could I get a cut price? I should have to make a judgment about the special advisers. Currently, there are 19 of them among the Tories—11.6 per cent. of the parliamentary Conservative party were special advisers. I took an average age of 38. I thought that to take a higher age would be unfair, because, as we all know, with the American model of private health insurance, the older people are, the worse it is.
Furthermore, in the American system, people with mental health problems cannot obtain the same insurance and they have to pay more. Discrimination against those with mental health problems has been debated in Congress during the past few weeks.
Chris Grayling: The hon. Gentleman's exposition is fascinating, but I am uncertain why he is giving it: as he will be aware, the shadow Health Secretary has said clearly that we are not considering the American model.
John Mann: At present, the Conservatives do not appear to be considering any model—not the higher-tax, European continental model, not the American model and not the UK model. I have not yet seen a new model, although I am sure that one will emerge.
Mr. Stephen O'Brien (Eddisbury): Who is in government?
John Mann: We are in government. We have made the decisions and, as I said earlier, I applaud them—so does the population. However, it is fair to discuss these points in a major debate on health and the funding of an expanded and improved health service. I am sure that everyone concurs that we want that. The debate is about how best to achieve it.
I want to turn to the American model—Special Advisers Inc. In the American system, those 19 employees—the 11.6 per cent.—would join a union. In America, 99 per cent. of large employers have a collective bargaining agreement with a union. I picked an American union at random; it was the first website to come up when I checked—
Mr. Deputy Speaker (Sir Michael Lord): Order. The hon. Gentleman is straying rather wide of the mark; he should come back more specifically to the matter before the House.
John Mann: I wanted to develop the point that five options are available. Employers and employees in America pay for the funding of the health system through the collective bargaining agreement—each pays part of the cost. In principle, there is no difference between that and the changes to national insurance contributions that have been made in this country—employees and employers both pay. Anyone who suggests that the American model is different is highly misguided.
Mr. Kevan Jones (North Durham): The shadow Chancellor might not have referred to private health care, but the shadow health spokesman clearly did. Does my
hon. Friend agree that, in the United States, people in work have access to health care, but when they fall on hard times—if they are made redundant or their family circumstances change—they no longer have access to the private health schemes to which he referred? It is estimated that about 40 million Americans are not covered by any health insurance at all.
John Mann: In the United States, 45 per cent. of workers on low wages are not offered medical insurance. The co-chair of the American social security commission, Daniel Moynihan, proposes that the retirement age should be raised to 70. That seems rather extreme because most people suggest an age between 65 and 67, but he does co-chair the commission.
That is another alternative: we could raise the retirement age, and stop people receiving their pensions. That would be one way to solve some of the NHS funding problems in this country. It is an alternative that I entirely reject, but it is part of the debate currently under way in the United States. On average US pensioners, spend 21 per cent. of their income on health care.
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