Speeches by Dean.

“I cannot proceed with my speech without putting on record my admiration for the hon. Member for Penistone and Stocksbridge (Dr Tidball). She made a courageous and passionate speech, and I hope that all Members listened to it very carefully. Let me start on a personal note. My dad is currently receiving PIP. He has been…”

“I join the Leader of the House in congratulating the Deputy Speakers on their birthdays, and in celebrating our armed forces. Earlier this year, when the Secretary of State for Work and Pensions announced the welfare reforms, her argument to this House was that they were all about getting people back into work. That ar…”

“It is about prioritisation, basically. If we could see a breakdown of prioritisation by Departments that would be really appreciated. I also wanted to move on to the things that are obviously outside the scope of the zero-based review, but some have argued—indeed, last week the Institute for Government argued that we s…”

“So it is taken into consideration. Another example is the non-structural tax reliefs that are out there. There is an argument that they should be taken into consideration when making these assumptions. You will be aware that many of these reliefs are not properly reviewed. I think there are about 1,200, and only about …”

“So we may see a zero-based review of tax reliefs in the future.”

“Is that realistic, though? Given the significant underperformance of the NHS in terms of productivity for a long time now, and not without the efforts of people trying to fix it, is it realistic that you are going to be able to meet any of the Government’s objectives on the NHS, with that productivity being where it is…”

“I guess the question is not just about whether it is easy or difficult; it is also about whether what you have set out to do will be enough. I think that it is about 3% real-terms growth that you have predicted and that is assuming that the 2% inflation figure holds as well. But that is actually down on the post-war av…”

“Because of the demand pressures. Even though it is more money, and it is absolutely welcome, such is the pressure and demand on the NHS, and such are the productivity problems that have been allowed to fester for so long, it may not be enough. Given its significant role in the spending review, it could sink the rest of…”

“But would we not then have expected to have seen a higher relative capital spend in the NHS? It was not as significant as other Departments. If you do that, you will be able to invest in the sorts of equipment and bed capacity that might go to fix the productivity problem. But also, R&D spend was, I think, down overall…”

“It is where the capital is spent, though, isn’t it? We mentioned crumbling infrastructure and we know we need to fix our hospitals. I would love my hospital to be fixed sooner than it is planned to be, but that is not hugely productivity enhancing. It has some effect, but there is other stuff that we could be spending …”

“Another big productivity issue is about patient flow and a lot of that has to do with adult social care. Clearly, the reforms are not going to be here anytime soon. I think the review by Baroness Casey is only just beginning and will not report back, in an interim fashion, until next year. Is that a major risk to the s…”

“Lots of people have looked at it before, so this is not a novel thing that social care is a problem. Lots of people looked at it in depth before and lots of people in the industry would argue that we do not need to wait three years to work out what to do. We just need to start making decisions and get on with it.”

“We are going to focus on a specific Department now—health. We had a striking statistic last week that about 90% of the real-terms increase in day-to-day spending spent by Whitehall, which is quite specific, is going to the Department of Health and Social Care. We have also heard in the past on this Committee from the G…”

“Chief Secretary, we have spoken a bit about the process of a zero-based spending review already, but I am quite interested in the effect of it as well. When the Institute for Government were in front of us last week, they said that it was hard to see much evidence of how it led to important decisions. I think what they…”

“Was that perhaps a disappointment to you in the process, then? A zero-based review has not happened in a very long time. Presumably, as things move on, you are not going to be able to say, “Well, that’s what the last Government did.” It will be stuff that you have chosen to continue with. Now, really, was the moment of…”

“There are lots of big Government programmes. Are all of them effective enough to deserve to carry on?”

“We would probably appreciate more detail in follow-up because it was a real moment for change, as was pitched to the electorate last year, and a lot of the things that you have said so far feel like they are at the fringes of things. I think it would be useful to see the evidence of big change. Moving beyond that, slig…”

“Sorry, that was to Professor Lawrence first. But we will come to you, Professor Wachter.”

“Professor Wachter, do you want to build on that point? Given that the Competition and Markets Authority has just been taken over by somebody who was previously very high up in Amazon, I am not encouraged that this kind of action is going to be taken. Would you agree or disagree?”

“The thing I am getting at is that it might feel like a benevolent power in the market now, but standard economics tells us we should be very distrustful of any individual companies that have this amount of power. You have seen their appetite for acquiring competitors. In recent times, we have seen tech companies taken …”