By Jane Kirby,Michael Howie

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Rachel Reeves is said to be mulling tax rises on the middle classes after warning “the world has changed”.

Whitehall sources have apparently indicated the Treasury is examining options for adding VAT to services currently exempt, including private healthcare and financial services.

One source told the Daily Mail: “Raising the headline VAT rate is going to be very difficult after all the promises that have been made.

“But there are ways of broadening the VAT base that could raise significant sums. We have already seen that with VAT on private school fees – you could now see it with private medical insurance and some of the other items that are exempt.”

However Health Secretary Wes Streeting on Tuesday ruled out the Government imposing VAT on private healthcare in the autumn Budget.

Asked on Times Radio on Tuesday whether it was a “good idea”, he said: “No, and the Government won’t be doing it.”

Mr Streeting was asked about newspaper reports that the Government was examining options for adding VAT to services that were currently exempt, including private healthcare.

He said this was “not something the Government is looking to do” and later told the BBC: “It’s not happening.”

The Chancellor used her Labour party conference speech on Monday to The Chancellor to warn of “harsh global headwinds” as she hinted at further tax rises to come in the Budget.

Ahead of her keynote speech in Liverpool Ms Reeves had warned that “the world has changed” since she promised business chiefs she would not repeat the tax raid of her first budget.

“I think everyone can see in the last year that the world has changed, and we’re not immune to that change,” the Chancellor told BBC Radio 4’s Today programme.

“Whether it is wars in Europe and the Middle East, whether it is increased barriers to trade because of tariffs coming from the United States, whether it is the global cost of borrowing, we’re not immune to any of those things.

“It’s very important that we maintain those commitments to economic stability because we rely on people to buy Government debt to be able to finance the things that we’re doing as a country.

“I wish it wasn’t so, but I am Chancellor in the world as it is, not the world that I might wish it to be.”

Experts have said Ms Reeves will have to increase taxes or cut spending to fill a black hole in her budget, which the National Institute of Economic and Social Research has estimated could be as much as £50 billion.

Meanwhile, Sir Keir Starmer will use his leader’s speech to seek to unite a fractious party and a divided country behind him in a battle for the “soul” of the UK.

The Prime Minister will take aim at Nigel Farage’s Reform UK and the “politics of grievance”, promising instead “a land of dignity and respect”.

But after a turbulent period for his leadership, Sir Keir will warn that further difficult choices will be needed on the path to “national renewal”.

The speech comes at a challenging moment for the Prime Minister following speculation about a challenge to his leadership fuelled by criticism from Greater Manchester mayor Andy Burnham – although he insisted on Monday he believes Sir Keir is the right man for the job.

Meanwhile, Mr Farage’s party continues to enjoy a comfortable advantage in the polls, and Labour faces a battle to keep its promises on taxation, spending and immigration.

The Prime Minister will say: “We can all see our country faces a choice, a defining choice.

“Britain stands at a fork in the road. We can choose decency. Or we can choose division.

“Renewal or decline. A country – proud of its values, in control of its future or one that succumbs, against the grain of our history, to the politics of grievance.”

Sir Keir will compare the challenge facing Labour now to Clement Attlee’s administration in 1945 as it rebuilt Britain from the ruins of the Second World War.

The Prime Minister will say: “It is a test. A fight for the soul of our country, every bit as big as rebuilding Britain after the war, and we must all rise to this challenge.

“And yet we need to be clear that our path, the path of renewal, it’s long, it’s difficult, it requires decisions that are not cost-free or easy. Decisions that will not always be comfortable for our party.

“Yet at the end of this hard road there will be a new country, a fairer country, a land of dignity and respect.

“Everyone seen, everyone valued, wealth creation in every single community, working people in control of their public services, the mindless bureaucracy that chokes enterprise, removed – so we can build and keep on building.”

Sir Keir believes Britain can “unite around a common good”.

“That’s my ambition, the purpose of this government,” he will say.

“End decline, reform our public services, grow our economy from the grassroots.”

Sir Keir will promise a technological revolution for the NHS, with a new “online hospital” for patients in England aimed at cutting waiting lists and providing quicker treatment and advice.

The scheme, which will begin operating in 2027, will deliver up to 8.5 million extra NHS appointments in its first three years, Labour claimed.

Those who use the service will be able to access and track prescriptions, be referred for scans and tests, and receive clinical advice on managing their condition.

Patients who require a physical test or a procedure will be able to book them on the NHS app at a nearby hospital, surgical hub or community diagnostic centre.

Sir Keir will describe it as “a new chapter in the story of our NHS, harnessing the future, patients in control”.

Conservative Party chairman Kevin Hollinrake will say: “Keir Starmer calls this a fork in the road, but he’s already driven Britain into a cul-de-sac of chaos.

“Families are fighting to cope with higher bills, higher taxes on their jobs and higher mortgage rates whilst his doom loop Chancellor is secretly plotting to pile tax upon tax, debt upon debt, which will further grind the economy down and shatter the public’s trust.”

Before the Prime Minister’s speech, Health Secretary Wes Streeting will claim there is an “existential threat” facing the NHS from Reform.

He will also set out social care funding plans and stress the need for NHS modernisation and the embrace of new technology.

“Our health service and our social care services need to change with the times, in order to ride the wave of that revolution, rather than see our people victims of it,” he said ahead of his speech.