The boost to health and care spending is needed, but troubling details, and unfairness, remain
In 2019, in his first speech as prime minister, Boris Johnson promised to fix the crisis in social care “once and for all”. Two years later, a plan has arrived as part of a mishmash announcement that also tries to address the enormous problem of demand facing the NHS, and rising anger about intergenerational unfairness. The best part of Tuesday’s news is the money: around £12bn a year to be shared between health and social care for each of the next three years. This is likely to be a broadly popular measure; polls show that the public is willing to stump up taxes to pay for a better service. And the NHS desperately needs it, with waiting lists at their highest ever levels in England.
To achieve this, the prime minister has calculated that his MPs, and voters, will swallow the pill of broken manifesto promises. This includes the announcement that the pensions triple lock will be removed next year, as well as the 1.25% rise in national insurance contributions plus 1.25% from employers that (along with a tax on dividends) is the mechanism chosen to deliver new funding. With the proposed cut to universal credit, 2.5 million working families will shell out £1,300 a year. From 2023-24 when government systems have been updated, payslips will show a “health and care levy”, including those of workers over the state pension age (who until now have been exempt from NI). By branding the portion of the new money that will be channelled to the devolved administrations a “union dividend”, the government hopes to bind them to the UK.