Hansard

No—I recognise that the uplift that we have given to GP services is challenging, but it aligns with the recommendations from the review body on doctors’ and dentists’ remuneration. I am looking at what more I can do as I look to shift the resource and the balance of care from secondary care services into primary and community care services, and I continue to engage with the British Medical Association and with Dr Morrison and others on that point.

The decision, however, strikes at the heart of our GP practices being able to employ an additional receptionist to cope with the additional lists in some areas, or an additional advanced nurse practitioner. Those are the staff who can help to deliver the services that we need in communities, and that is why the increase is such a regressive step.

Having to wait until May 2025 for confirmation is—as I heard when I was at Leith surgery this morning—too late for our independent contractors such as GPs. They will have to make hiring decisions now without knowing how much those staff will ultimately cost. Many of those contractors are ineligible for the employment allowance, ironically as a direct result of the work that they provide for the NHS, so they will bear the full brunt of the change. That is the case not only in Scotland, but across the UK. However, in Scotland, we recognise the importance of our independent contracting partners, even if Labour’s budget fails to do so.

While the impact on health and social care is profound, the changes to national insurance will impact on all areas of the public sector in Scotland. The Convention of Scottish Local Authorities estimates that the impact on local government will be £265 million, after accounting for the impact on teachers’ pay. Our police service will face increased costs of more than £25 million, our prison service will face an additional £6 million bill, and our Fire and Rescue Service will face further costs of more than £5 million.

Scotland’s universities and colleges will see cost increases of £60 million, and for those helping the most vulnerable in our communities, the additional costs will bring significant anxiety and growing concern after years of cost pressures posed by the pandemic and the ensuing cost of living crisis.

Social care services will be particularly penalised by the chancellor’s decisions, facing costs of more than £84 million—a move that Donald Macaskill, the chief executive of Scottish Care, whose event some of us were at on Friday, has called

“the straw that breaks the camel’s back”.

The Scottish Council for Voluntary Organisations has estimated that the third sector—that vital network of charities, social enterprises and grass-roots community groups that work to support our population’s wellbeing—will now have to send an additional £75 million to the UK Exchequer each year. That begs the question why, when faced with a need to increase revenue, the chancellor did not ask those with the broadest shoulders to contribute more. Why did she decide to balance the budget on the backs of charities, care providers, hospices and health services?

It is clear that although the financial impact to Scotland’s public sector is extensive—reaching more than £500 million—the wider non-financial costs to services and our economy might be far greater. Ivan McKee will speak about that in his closing speech.

Those challenges were avoidable. The Scottish Government will do everything that it can to protect its public services and the voluntary sector, but we cannot do that without the means. Had the UK Government chosen to discuss the possibility of raising employer national insurance contributions with the devolved Governments, we could have helped it to understand the challenges for Scotland. We are now, unfortunately, past that point.

The folly of Labour’s position in its amendment today is stark. The cost to the directly funded public sector is more than £500 million. It is even greater when we consider that the UK Government refuses to protect GPs, social care providers and others. The ridiculous and unsustainable folly of Labour’s position in Scotland is that the 1 per cent real-terms increase to our block grant is to pay for it, but the costs outweigh the available funds.

Once again, it all boils down to Scottish Labour asking Scottish public services to pay for a bad UK decision. What a shameful position it has got itself into, where it will sell out our Scottish public services to fill the UK Treasury’s coffers. This Government will not stand for it, and I ask the Parliament to support our motion to ensure that we send a message that we will not stand for the sell-out of our public services.

I move,

That the Parliament believes that the UK Government should fully reimburse the over £500 million costs of employer national insurance contributions to the delivery of public services in Scotland as a result of the UK Autumn Statement; recognises that, if the Chancellor of the Exchequer does not fully reimburse these costs, it will have a detrimental impact on the services that the people of Scotland rely on, and notes with concern the wider impact of the increase in employer national insurance contributions on the education, hospice and charitable sectors, not least for those who deliver services such as social care.