THE Bishop of London, the Rt Revd Sarah Mullally, has implored the Government to produce a detailed and clearly funded health and social-care plan, and to respond to the “serious issue” of NHS staff shortages and retention.

A healthy population led to a growing economy, she said.

Bishop Mullally was speaking during the third reading of the Health and Social Care Levy (Repeal) Bill in the House of Lords on Monday.

This Bill repeals the Health and Social Care Levy Act 2021, meaning that the 1.25 per cent Health and Social Care Levy will not come into force from 6 April 2023. The Bill also reduces the National Insurance contributions for the 2022-23 tax year, which effectively removes the temporary 1.25 percentage point increase in the Act for the remainder of the current tax year.

Bishop Mullally, a former Chief Nursing Officer, questioned the implications of this on the sustainability of health and social care. “This is about funding a service well with a long-term view, so that those who work hard to care for us have the resources to do the job. . . This is about a thriving economy, because, without a healthy population, we will not have an economy that grows.”

She pointed out that the levy had been introduced by the then Financial Secretary to the Treasury, because it would not be possible to fund it from existing tax revenues and it would be irresponsible to do so through borrowing.

“This uncertainty about the direction does not inspire confidence that the Government have a sustainable plan to fund health and social care,” she told the House, asking the Minister for a clear and detailed breakdown of how the tax cut would be funded. She also asked whether the £500-million government health plan for patients was additional funding, or part of the cost of maintaining the level of spending in the department after the levy was cut.

Bishop Mullally continued: “If we are concerned about the sustainability of health and social care funding, we must be even more concerned about the sustainability of the workforce. They are the bedrock of this sector. . . There is a very serious issue, particularly around retention.”

She quoted Nuffield Foundation research that reported that 40,000 nurses had left the workforce this year. The Government’s response — that they were halfway to meeting the target of 50,000 additional nurses — was not “being felt in the NHS, nor that the loss is being kept up with”, she said.

“Almost as many nurses are leaving the sector as are joining, resulting in the loss of valuable expertise. This is an inefficient and expensive approach to staffing, and one that sees people as expendable.”

Asking for assurances from the Government, she continued: “We are in the midst of a cost-of-living crisis, of which the health and social care workforce are at the centre. They are not exempt because they look after us. In fact, they are feeling some of the worst effects. One in four hospitals has foodbanks set up for nurses.”

Ultimately, the most effective way to guarantee the sustainability of health- and social-care funding was to reduce the need for it, the Bishop said; again, she asked the Government to confirm whether they would publish the “long-awaited and desperately required” health disparities White Paper (News, 14 October).

Bishop Mullally concluded: “I am concerned that, without a long-term plan for sustainable funding for health and social care and plans that ensure effective public health to reduce health inequalities, it will in fact be the most vulnerable who will suffer.”

Responding on behalf of the Government, Viscount Younger of Leckie said that the money which the Treasury had set aside to replace the levy “will be in cash or nominal terms. This is because the budgets were announced last year at the spending review and are now fixed on that basis until 2024-25.” He suggested that the £500-million health-plan would “bolster the social care workforce”.

About NHS staff shortages, he said: “I do not have all the answers today,” he said, nor about the health disparities White Paper, but he intended to write to the Bishop to give her “chapter and verse” on where it was, he said.