Council tax bills to go up by more than £100 next year, No 10 confirms

Legalising assisted dying would force the NHS to cut services elsewhere, Wes Streeting has warned.

The Health Secretary said if a proposed Bill becomes law, his department would have to direct funds away from other services as it has not been included in its budget.

Mr Streeting, who opposes the draft legislation which has been brought forward by a Labour MP and which is due to be voted on for the first time later this month, told Times Radio today: “It would be a big change. There would be resource implications for doing it. And those choices would come at the expense of other choices.”

You can read the full story here. 

Sir Keir Starmer and Kemi Badenoch clashed for just the second time at PMQs today as the Tory leader focused her ammunition on potential council tax rises. 

Telegraph readers have been reacting to the exchanges in the comments section of today’s live blog: 

Businesses cannot afford the crippling rise in National Insurance Keir Starmer is imposing on them.

It means more small businesses shutting down, low growth, and fewer jobs.

Our economy can't afford Labour. pic.twitter.com/fFElCeGfnC

No 10 has now confirmed that the 5 per cent cap on council tax increases will remain in place next year. 

Kemi Badenoch had pressed Sir Keir Starmer on the issue at Prime Minister’s Questions but he failed to answer on whether the cap would be kept in place. 

The decision to keep the cap at 5 per cent - significantly above the current rate of inflation which is 1.7 per cent - means the average family is likely to see bills increase by more than £100 next April. 

Hospital league tables are a disastrous idea.

You do not improve standards by shaming hard-working NHS staff, damaging morale and adding unnecessary stress.

We should support - not scapegoat - our medics. That means giving them the resources they need to provide care for all.

Sir Keir Starmer refused to make more time available for MPs to debate an attempt to legalise assisted dying. 

MPs will debate the Terminally Ill Adults (End of Life) Bill for the first time on November 29. 

Sir Alec Shelbrooke, a Conservative MP, expressed concerns about the “short space of time” to discuss the Bill and asked the Government to commit to making two full days available in the House of Commons to look at the draft legislation. 

Sir Alec said: “Otherwise, Prime Minister, people like myself may decline a second reading over fear that we may not get to be able to debate these issues in full.”

But Sir Keir replied: “I do think there is sufficient time allocated to it but it is an important issue.” 

The Bill has been brought forward by Labour MP Kim Leadbeater under the Private Members’ Bill process. Legislation introduced by individual MPs still has to go through the same parliamentary stages as government proposed laws but less time is made available for them. 

They are typically only discussed in the Commons on Fridays. However, the order paper for the Commons is ultimately controlled by the government which means more time could in theory be allocated. 

Nigel Farage urged Sir Keir Starmer to proscribe Iran’s Islamic Revolutionary Guard Corp and suggested doing so would “mend some fences” with Donald Trump. 

The Reform leader said: “Has the time not come Prime Minister to proscribe what is so obviously a terrorist organisation and in doing so not just do the right thing but maybe mend some fences between this Government and the incoming presidency of Donald Trump’s given that the whole of his Cabinet have been so rude bout him over the last few years.” 

Sir Keir said: “I am glad to see the honourable member making a rare appearance back here in Britain. He has spent so much time in America recently, I was half expecting to see him on the immigration statistics when we see the next batch.”

He added: “The point he makes about Iran is a very serious point and we will work across the House and with our allies on  it. Obviously on the question of proscription we keep them under review.”

Sir Keir Starmer denied that the job he had offered Sue Gray to be his envoy for the nations and regions had been “invented”. 

It emerged yesterday that Ms Gray will not be taking up the offer. 

Tory MP Lincoln Jopp asked Sir Keir: “Now that Sue Gray has remarkably turned down the opportunity to be the Prime Minister’s special envoy to the nations, will the Prime Minister now finally admit that it was an invented job on taxpayers’ money for one of his cronies and if it wasn’t, is he going to hire a new one?” 

Sir Keir replied: “It wasn’t.”

Sir Ed Davey asked Sir Keir Starmer whether the UK and European allies were considering ways to increase funding to Ukraine after US president-elect Donald Trump’s son posted on social media that Volodymyr Zelensky will soon “lose his allowance”.

Speaking at PMQs, the Liberal Democrat leader said: “A senior adviser to president-elect Trump, Donald Trump Jr, has shared a post on Instagram that declares that President Zelensky will soon, within the next few weeks, lose his allowance.

“If the Trump administration does withdraw support from our brave Ukrainian allies, will the UK and Europe step up to fill the gap? Will he seize frozen Russian assets, not just the interest, but the assets underlying that, so it can fund a huge boost to the Ukrainian forces in their fight against Putin’s war machine?”

Sir Keir Starmer said: “As he knows, we’ve been resolute and strong in our support for Ukraine in the face of Russian aggression and I have been speaking, as he will know, in recent weeks with other leaders about how we put Ukraine in the best and strongest possible position at this time and I will continue those discussions.”

Sir Ed Davey told Sir Keir Starmer that he had been contacted by GPs in his constituency who are very worried about the impact of the employer National Insurance rise. 

The leader of the Liberal Democrats said: “I hope he can think again. Will he at least exempt GPs, community pharmacists and other health and care providers from this tax rise?”

Sir Keir said: “I hear the point he makes and I understand the concern. We have made a huge investment in our NHS, the biggest ever investment in our NHS for many, many years and certainly almost all the people working in the NHS ar every, very pleased to see that investment in them and in their service. 

“On the question of GPs we will ensure they have got the resources that they need and the funding arrangements will be set out in the usual away later this year.” 

Kemi Badenoch said Labour’s “ideological Budget was designed to milk the private sector and hope nobody would notice”.

She said: “Now his Cabinet ministers are all queuing up for public sector bailouts to his tax mess. If he is going to bail out the public sector then can he tell us this: Does he think it is appropriate, as the Ministry for Housing has done, to approve a four day week for councils that is not flexible working but is actually part time work for full time pay?”

Sir Keir Starmer replied: “Questions based on what we are actually doing are usually better than fantasy questions made up.”

Kemi Badenoch said: “The fact is the rise in employers’ National Insurance is going to be a disaster for small businesses around the country.”

She referred to a woman called Kelly who had run an after school club business for more than 20 years which supports 500 families. In 2024 her National Insurance cost was about £10,000 but in April this will rise to £26,000.

The Tory leader said: “What is the Prime Minister’s message to Kelly and the 500 families her small business supports if it goes under?”

Sir Keir Starmer replied: “I would say this to Kelly: We inherited a very badly damaged economy, we inherited a £22 billion black hole and we were not prepared to continue with the fiction. I would say to Kelly that we are fixing the mess that we were left.”

Mrs Badenoch hit back and said: “He has nothing to offer except platitudes.”

Kemi Badenoch suggested Labour had failed to realise that its plans to increase employer National Insurance contributions would hurt care homes and hospices. 

She asked: “Did they not realise that care homes, GP surgeries, children’s nurseries, hospices and even charities have to pay employers’ National Insurance?” 

Sir Keir Starmer replied: “We have put more money into local authorities than they did in 14 years.” 

Kemi Badnoch said the Budget and the increase to National Insurance contributions for employers had created a “social care funding gap”. 

She asked Sir Keir Starmer: “How much extra does he expect local authorities to raise [to cover the gap]?” 

Sir Keir said: “It is all very well this knockabout but not actually listening to what I said three minutes ago is a bit of a fundamental failure of the Leader of the Opposition. I just said £600 million.”  

Kemi Badenoch started by focusing on Cop29.

The Tory leader said Sir Keir Starmer had made unilateral commitments on tackling climate change which will make life “more expensive for everyone back home”.

She then asked: “Speaking of making life more expensive, will the Prime Minister confirm that he will keep the cap on council tax?”

Sir Keir replied: “She talks of the trip to Cop, I am very proud of the fact that we are restoring leadership on climate to this country.”

He added: “On the question of councils, she knows what the arrangements are.”

Mrs Badenoch said: “I think the House will have heard that the Prime Minister could neither confirm nor deny whether the cap on council tax was being raised.”

The first question Sir Keir Starmer faced at PMQs was about the threat posed to GPs by the Budget National Insurance increase. 

The Prime Minister said the Government had to take “touch decisions” - prompting groans from opposition MPs. 

He said he had “put forward a Budget with an extra £25.6 billion for the NHS and social care” and insisted GPs would be given the resources they need to stay afloat. 

Prime Minister’s Questions is now underway in the House of Commons. 

Sir Keir Starmer started by speaking of his “honour” at attending the Armistice Day commemorations in Paris on Monday this week. 

He also referenced his attendance at the Cop29 climate change summit in Baku, Azerbaijan yesterday. He said he had focused on “British energy security and the jobs of the future”. 

Wes Streeting’s proposed NHS changes are “reheated Blair-era reforms”, according to the Institute of Economic Affairs think tank. 

Dr Kristian Niemietz, the free market think tank’s editorial director, said: “These are reheated Blair-era reforms. In the early 2000s, the Blair government tried to shake up NHS performance by publishing ‘star ratings’ of NHS trusts that ranked them by performance, micro-managing underperforming ones, and giving high-performing ones ‘earned autonomy’. Those reforms had some success back in their day, but it is not quite clear what exactly Streeting’s measures would add to that now. 

“Streeting says that he wants NHS trusts to be run ‘as efficiently as global businesses’. There is ultimately only one way to achieve that, and that is to turn them into precisely that: businesses, which rely on patient satisfaction for their survival.”

Sir Keir Starmer will face Kemi Badenoch at Prime Minister’s Questions for the second time from noon today.

You will be able to watch the clash in the House of Commons at the top of this page.  

Diane Abbott claimed Wes Streeting’s NHS reforms were a “pretext for further and faster privatisation” of the health service. 

The veteran Labour MP tweeted: “Wes Streeting’s cascade of abuse of NHS managers and medics is a pretext for further and faster privatisation.”

She also said: “Just yesterday NHS chiefs told Streeting they have not been given sufficient resources to meet his waiting list targets. 

“They are right - they have not. Demanding unreachable targets when funds are inadequate will just deepen the crisis in the NHS.”

NHS staff are “feeling bruised and battered” after “14 years of austerity”, Wes Streeting told the NHS Providers conference in Liverpool.

“I know it won’t be easy to turn the tide but my message to you today is a message of hope,” he said.

The Health Secretary said the “challenge is huge but the prize is enormous”.

Concluding his remarks, he said: “The NHS is already living on borrowed time and if a Labour government can’t improve the NHS then it simply won’t survive.

“But if we get this right we can look back on our time with pride and say we were the generation that took the NHS from the worst crisis in its history, got it back on its feet and made it fit for the future.”

Wes Streeting said NHS trusts will no longer be treated as if they are all performing the same.

He said providers which are doing well will get more freedoms about how they spend their money but those which are judged to be doing poorly will be met with a “central grip” to challenge their performance.

He said: “If performance dips I reserve the right to take those freedoms away and for those judged to be persistently failing, we will act, going from zero consequences for failure to zero tolerance.”

The Health Secretary criticised the NHS for being too “hierarchical”.

Wes Streeting told an NHS Providers conference in Liverpool: “The NHS in 2024 is more hierarchical than almost any other organisation that I can think of. Even our armed forces... are less locked and centralised into command and control.”

He said that there was too much centralised control of the health service and he wanted to lead an NHS where power is “moved from the centre to the local and from the local to the citizen”.

He said that the centre should define the overall strategy for the health service and establish systems for accountability.

Wes Streeting said “tough choices” were made at the Budget in order to provide the NHS with more funding. 

The Health Secretary said: “We stand by our decision to prioritise the health service. Healthy businesses depend on a healthy workforce and a strong economy depends on a strong NHS.”  

But he said reform needed to do “a lot more heavy lifting” in the health service.

Wes Streeting rejected the suggestion that NHS performance league tables would demoralise staff. 

He said he believed staff would “appreciate the honesty”. 

He told the NHS Providers conference in Liverpool: “A culture that puts sparing political blushes or protecting the reputation of the NHS above protecting the interests of patients is one that stifles inconvenient truths being spoken to power, that silences whistleblowers and ultimately puts patient safety at risk.” 

The Health Secretary said he believed that “honesty is the best policy”. 

Wes Streeting is now on his feet in Liverpool as he addresses the NHS Providers conference and sets out his plans for health service reform.

The Health Secretary said the NHS has “not been able to meet its most important promises to patients since 2015” as he highlighted lengthy waiting lists for both physical and mental healthcare.

The Liberal Democrats said Wes Streeting needed to provide hospices with “urgent clarity” over the funding they will receive in 2025. 

The Health Secretary said this morning that hospices would not be given an exemption from a National Insurance increase but signalled grant funding could rise to help mitigate the impact of the Budget tax raid (see the post below at 08.48). 

Mr Streeting said an announcement on hospice funding for the next financial year will be made before Christmas. 

Helen Morgan, the Lib Dems’ health and care spokesperson, said: “We need urgent clarity on what extra funding hospices will receive and whether it will fully cover the cost of the National Insurance tax hike.

“Many hospices are already on the brink and this tax hike risks pushing them over the edge. The simplest thing would be for the Government to listen to hospices and exempt them from this tax rise.

“It’s not too late for ministers to swallow their pride and admit they’ve got this wrong.”

Wes Streeting will set out his plans for health service reform when he addresses an NHS Providers conference in Liverpool later this morning. 

We are expecting the Health Secretary to deliver his address just before 10.30am. 

You will be able to watch the speech live at the top of the page.

New league tables designed to drive up standards in the NHS could “demoralise” staff and lead to “short term target chasing”, Britain’s most senior A&E doctor has warned.

Dr Adrian Boyle, the president of the Royal College of Emergency Medicine, said the new accountability measure could hurt morale, with knock-on effects for recruitment and retention, writes Amy Gibbons.

The Health Secretary will use a speech this morning at the NHS Providers conference in Liverpool to announce that hospitals and other providers will be assessed on performance and placed in public league tables.

Asked if he was worried about the impact on staff morale, Dr Boyle told BBC Radio 4’s Today programme: “Yes, I’m also concerned that it will lead to short-term target chasing...

“We’ve got some really serious problems around with our estate, our capital planning, our IT, and we haven’t seen any reform of the interface around social care and NHS work. And there’s a real danger if people just start focusing on the league tables they won’t put the effort into trying to sort out those really serious problems that we’ve got.”

He said measuring good and bad performance in the NHS was “surprisingly hard”, adding: “There is a risk that this will demoralise staff, and you will see that in poorly performing areas recruitment and retention of staff - and that will go right down to a clinical staff - will become even harder.”

Hospices will not be given an exemption from Rachel Reeves’ Budget tax raid on National Insurance, Wes Streeting said. 

But the Health Secretary signalled hospices could be given more funding to help mitigate the impact of the decision to increase employer National Insurance contributions. 

Asked if he could confirm that hospices would be given an exemption from the rise amid warnings it could force some to close, Mr Streeting told the BBC: “There won’t be an exemption in that way but one of the reasons that I haven’t yet announced the allocation for hospices is I am looking very carefully at what we can do through the hospice grant to recognise that pressure and also recognise the underlying challenge… about the balance of state and statutory funding versus charitable contributions.”

Asked when he would be able to confirm hospice funding for next year, Mr Streeting said: “We will make an announcement on the hospice grant before Christmas because I recognise that people need to be able to make decisions about the next financial year.”

Good NHS leaders will be given financial incentives to take over poor performing trusts, Wes Streeting said.

Asked if strong candidates would be offered higher salaries to work in challenging organisations, the Health Secretary said: “Absolutely. Where we have got the worst performing areas and areas that have been consistently challenged… because of wider system pressures, we will incentivise the best leaders to go into those areas.”

He added: “I am very comfortable with paying exceptional leaders good salaries to go in and do a great job.

“What I am not prepared to do is pay high salaries for poor performance and to pay people off only for them to turn up somewhere else.”

Wes Streeting said the “guilty secret” of the NHS is poor senior managers earning six figures who are “managed out” of one job only to then be re-hired in another part of the health service. 

The Health Secretary said such people were “rotten apples” and “rotten apples are unacceptable” as he vowed to get rid of them permanently. 

He told the BBC Radio 4 Today programme: “Where we have poorly performing senior managers I will make no apology for managing those people out because people know, and this is the guilty secret of the NHS, there are very senior managers who are paid on average, let’s not forget, £145,000 a year who are managed out, given a pay off in one trust and then reincarnate in another NHS trust. 

“Those might be the rotten apples and I want to recognise that there are some outstanding leaders right across the NHS but those rotten apples are unacceptable and give the rest of the profession a bad name so we have got to manage those out as well as investing in leadership development training and crucially setting free the highest performers so we have less top down, less centralisation, less management by diktat from the centre.” 

Wes Streeting said the public should have confidence that the Government can turn the health service around. 

The Health Secretary told Sky News: “The NHS is broken but it is not beaten and what we are doing as a Government on both investment and reform should give people the confidence that we can turn this around and make sure that the NHS, publicly-funded, free at the point of use that has been there for us for the last 76 years will be there for in the next century. 

“But we have got to get this right because if we fail then the NHS will not have a future.”  

Ranking hospitals and other NHS providers in new performance league tables will not result in “more tick boxes and more bureaucracy”, the Health Secretary insisted. 

Wes Streeting said the Government’s reforms would actually mean “less of that”. 

He told Sky News: “There are lots of people working in the NHS who when they see the headlines around league tables and transparency might assume therefore more targets, more tick boxes and more bureaucracy. 

“Actually what we want to do is to have less of that and a real focus on the things that really matter in terms of patient care, patient safety and good quality outcomes.”

Poor performance has “too often been tolerated in the NHS” and that has to change, Wes Streeting said this morning. 

The Health Secretary said he would “make no apology” for wanting to “manage out the worst” managers in the health service. 

He told Sky News: “I want to support great leaders, I want to develop great leaders, because they can be the difference between high performance and great patient care or poor performance and poor patient safety. 

“When we talk about very senior managers, I will make no apology whatsoever for wanting the best and for wanting to incentivise the best leaders going into some of the most challenging areas. 

“But I also make no apology for wanting to manage out the worst, as we would in any other workplace, in any other business or any other context but where poor performance has too often been tolerated in the NHS and what happens with that merry go round of poor managers is they get made redundant or managed out, given a pay off in one area and they pop up in another area and there have been too many examples of that too.”    

The public “rightly expect” the Government to get rid of NHS leaders who are consistent poor performers, Wes Streeting said this morning. 

He said senior managers who are “just not up to it” will be “managed out” of the health service under new Government reforms. 

The Health Secretary told Sky News: “Where people consistently fall short and where they are just not up to it, then we will manage out poor performance as well. 

“I think that is what the public rightly expect. They want to know that the investment that is going into the NHS will be put to good use in a well-led, well-managed NHS that delivers great patient outcomes and that is part of the package we are announcing today, just one of a number of reform announcements we will be making in the coming weeks and months.”    

The Health Secretary will use a speech this morning at the NHS Providers conference in Liverpool to unveil plans to axe poor leaders. He will also announce hospitals and other providers will ranked in public league tables.