Opposition parties have urged the prime minister to exempt hospices and other providers of health services from the increase in National Insurance contributions.
The NHS and rest of the public sector will be shielded from April’s tax rise – but that does not cover private hospices, care homes and pharmacies.
Conservative leader Kemi Badenoch and Liberal Democrat leader Sir Ed Davey both called on the government to back an exemption in a Commons vote but Labour MPs voted against the move.
But Sir Keir Starmer said hospices and other organisations had already received extra support and the tax rise was needed to invest in the NHS.
During Prime Minister’s Questions, Badenoch said her party would support a move to exempt hospices, pharmacies and care providers from the National Insurance increase.
In response to her calls for the government to do the same, Sir Keir said the Conservatives wanted the “benefits” of the tax rise “but they can’t say how they’re going to pay for it”.
He added: “We’ve already invested £100m for adult and children’s hospices, an additional £26m in funding through the children’s hospices grant.”
Sir Ed asked the PM for reassurances that Labour MPs would not be told to vote against a Liberal Democrat proposal to exempt providers of NHS services from the National Insurance increase in the Commons later.
He said GPs, dentists, community pharmacists and care homes were all “deeply worried” about the rise.
Sir Keir said it was only because of the changes announced in October’s Budget that the government could “put record amounts” in the NHS.
“It isn’t right to simply oppose the measures we had to take to raise the money and at the same time say… that he wants the benefits of the increase in funding for the NHS,” he added.
In a vote following PMQs, MPs opposed an exemption from the increase for GPs, hospices, care homes, pharmacies and dentists by 307 to 182.
From April the rate of national insurance contributions for employers will rise from 13.8% to 15%.
Hospices, which care for people at the end of their life, are free to use but unlike the NHS they receive only a third of their funding from the government, relying on charity contributions for the rest.
In December, the government announced hospices in England would get more than £100m of extra funding but the majority of this is ringfenced for capital spending on things like improving buildings, rather than day-to-day spending.
Care homes have warned extra funding provided by the government does not cover the tax rise and that some providers could be forced to close.
Earlier this week, the National Pharmacy Association urged its thousands of members to cut opening hours and services in protest over funding, with the National Insurance rise one of the pressures faced by the sector.
