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involved in it, especially the campaign's chairman Tom Grimshaw and its secretary Brenda Stevenson. They have galvanised people into trying to save the local hospital. The campaign has all-party support and even local Tories are campaigning against their own Government because they recognise that the hospital must be saved.A week last Saturday 3,000 people turned up to link hands around the hospital to say that the Government must not touch it. More than 70,000 people have signed a petition. The Government's national health changes do not address the issues of decent hospital care in Manchester. We urge the Government to intervene now and tell the regional health authority, which meets on Tuesday, that it must throw out the plan and look to decent health care in our communities. That would ensure that Manchester people received the hospital service of which they had previously been proud.
7.26 pm
Mr. Jerry Hayes (Harlow) : I congratulate the hon. Member for Livingston (Mr. Cook), who is not in his place, on his courageous speech. It was courageous because the hon. Gentleman made it absolutely clear that spending on the health service will be at the top of Labour's agenda at the next general election. I do not know whether he has spoken to his hon. Friend the shadow Chief Secretary, but I do not think that she will be pleased by his proposals. The hon. Member for Oldham, West (Mr. Meacher), who is the shadow Social Security Minister, will not be pleased because we were told some weeks ago in a similar debate that pensions would be Labour's top priority. On 9 December 1990 the shadow Leader of the House told us that education would be Labour's top priority. The electorate and the House would like to know whether there will be so many priorities that they will be meaningless or whether the Opposition are making promises that they cannot possibly deliver.
On 20 April last year, which was my birthday, the hon. Member for Livingston pledged that a Labour Government would spend £3 billion on the national health service. What has changed, apart from the fact that in the past two years the Government have spent £6 billion on the NHS? It is therefore hardly surprising that socialist economists such as Professor Julian Le Grand, the founder of the Socialist Philosophy Group, said that the Conservative Government had promised an extra £3 billion for the next financial year. He says that it is difficult to imagine that Labour could do much better, given the other demands that Labour will undoubtedly face on taking office. Yesterday Opposition Members heard me quoting from the Labour campaign document on health spending. They said that the problems would not be solved and that finance could not be provided overnight. I give the Opposition credit for the fact that they have made it perfectly clear in that document and in the debate today that they will spend far more than this Government on the health service. However, they will not be spending it on patient care, on the poor devils in hospital. They will be spending it on bureaucracy, because that is Labour policy.
The Labour party will give us an army of quangos, a technology inspectorate, a health quality commission and a food standards agency. It is talking about regional councils to discuss the various quality controls within
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regional health authorities. Under the Labour party's proposals, quality will be built into contracts. I simply ask hon. Members to visit such places as Bromley, which is putting the contracts into place ; they are very impressive.The Labour party talks about value for money and quality--so why does it want to abolish the Audit Commission? What has that commission done for health authorities during the past six months? It has given each health authority a financial profile, something almost unheard of in the history of the NHS. It has provided a number of discussion documents that show where savings can be made to improve patient care. Through the changes and procedures suggested by the Audit Commission, about 300,000 additional operations could be provided without any additional cost. There could be savings of £30 million just by sorting out the heating problems and another £30 million through running an efficient telephone service. There is plenty of scope for bodies such as the Audit Commission, which is interested in value for money and in money being spent on patient care.
I want to go into some depth on what the Labour party is promising. We have the document, which says :
"Labour will require health authorities and health boards to give new priority to disease prevention and health promotion." Hooray. It continues :
"This health strategy will set targets to be achieved over a five-year period"--
hooray--
"such as a reduction in smoking, increased participation in exercise, and a narrowing of social inequalities of access to health care."
I agree with every word, but I do so because it happens to be Conservative party policy.
What heading has the Labour party given to that policy? It is "Promoting better health". Does not that ring a bell? Was not there a White Paper called "Promoting better health", which said all those things years ago? What was my hon. Friend the Member for Derbyshire, South (Mrs. Currie) saying when she was a junior Minister at the Department of Health? It was all that the Labour party is now saying in presenting its brand-new health promotion policy.
The Labour document says that the Labour party will do even better than that. It states :
"The greater emphasis in our health strategy on health promotion will require new priority for primary care."
That sounds new. It continues :
"Labour will therefore renegotiate the GPs' contract to reduce the pressure which it puts on them to seek larger patient lists." I may be wrong, but I thought that patient lists had been going down consistently over the past few years. That is certainly what general practitioners say. I am pleased to say that most of them are happy with the new contract. My right hon. Friend the Secretary of State has said that he will sit down and talk to them about any areas of difficulty. There is dialogue between the British Medical Association and the Department of Health, and the Opposition should pay attention to that. The real gripe of general practitioners during the first negotiations was the very matters that the Labour party wants to promote. General practitioners complained that they had to take on health promotion tasks, the screening of 75-year-olds, and the provision of inoculations. It is precisely the sort of contradiction that I would expect from the Opposition.
The document says :
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"Labour will scrap the indicative drugs scheme which puts a cash budget on the drugs a GP can prescribe."Just a moment, did not the BMA and the Opposition shadow spokesman on health only late last year publicly admit that there was no cash constraint on the amount of prescribing? Have not the Audit Commission and a number of other independent bodies made it quite clear that we have saved more than £200 million in drug prescribing, which has gone directly to benefit patient care? Should not that be welcomed? It is certainly welcomed by general practitioners and by the BMA. However, the Labour party wants to scrap it. What will it put in its place? The document says :
"In its place we will encourage greater efficiency in prescribing by requiring"--
that is the key word--
"greater use of generic prescription."
If this Government introduced legislation requiring general practitioners to prescribe in a certain way, all hell would be let loose from the Opposition and the BMA.
The document also says that the Labour party
"will invest in the modernisation of our hospitals and tackle the backlog in maintenance and repairs--although we cannot expect to be able to put right overnight the neglect of years."
That is another fudge on the finances.
We have been talking about the trade unions, and it was interesting that yesterday the Labour party said that one of its great policy planks was that there would be beer and sandwiches at No. 10. There is nothing wrong with discussion and negotiation, but there is a price for that, and that price would be a statutory minimum wage. How much would that cost the NHS? We all know--it is a matter of public record--that it will cost £500 million. Where will that money come from?
Mr. Eric Martlew (Carlisle) : Will the hon. Gentleman give way?
Mr. Hayes : I am sorry, but I have only a minute left.
The document says that Labour recognises that the pay and conditions of certain health staff
"have worsened markedly under the Conservatives."
My hon. Friends have refuted that claim. The document continues : "We will halt this deterioration--and develop fairer and more rational ways of settling pay and conditions for those health service employees."
It will be done in smoke-filled rooms by the paymasters of the Labour party.
It is interesting to note that the document states :
"In order to end the efficiency trap, budget allocations to hospitals will be flexible. Total spending must remain within cash limits but the increased funding to which we are committed will be used to create a reserve at Regional or District level which can be released in the course of the financial year to those hospitals who have outperformed their agreed targets."
What financial control will be there? What financial management will be there? There will be absolutely none. That is why I say to the House that the Government have nothing to be ashamed of in their health policy, and that is why I support the Government amendment. 7.37 pm
Mr. Tom Clarke (Monklands, West) : I am delighted to join in the congratulations to my hon. Friend the Member for Neath (Mr. Hain), who made an excellent maiden
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speech. His constituents have every reason to be proud of him, as are we all in the Labour party. We look forward to many further speeches from him over the years.In a remarkable response to an intervention of mine, the Secretary of State asked where I was yesterday during health questions. I was at a meeting with one of his colleagues at the Ministry of Defence--a meeting that I had been trying to obtain since the beginning of winter--about an important matter in Twechar in my constituency. I should not have thought that the few brief moments that were given to community care as a result of the accident of one question being at the top of the list represented a considered debate on the Government's remarkable decision to ditch without ceremony sections 1, 2, 3 and 7 of the Disabled Persons (Services, Consultation and Representation) Act 1986.
The importance of community care and of that Act is all the more necessary because of what has been happening to the health service. Listening to the exchanges during this debate, one would think that it is not just a question of having a two-tier health service, although it certainly is. There are actually two health services--one is in the imaginations of Conservative Members and the other is the reality with which hon. Members deal day after day.
We know the problems. We know that my hon. Friend the Member for Strathkelvin and Bearsden (Mr. Galbraith) presented a petition organised by Health Alert to save the West Middlesex hospital. Lest it be thought that I am concentrating on important English matters, I should add that people in my constituency would not recognise the health service that the Secretary of State described this afternoon.
Mr. John Marshall : Will the hon. Gentleman give way?
Mr. Clarke : I will not give way as time is short.
My constituents are fully aware of the case of the 71-year-old woman who was refused admission to two hospitals and subsequently died. They are aware of possible closures not just of wards but of hospitals in and serving my constituency--for instance, Stobhill, where ear, nose and throat, neurology and maternity units may be closed. Patients in my constituency--and those who visit them--will then face much longer journeys to hospitals further away than necessary to find proper health provision.
My constituents are worried about debate over the future of Gartloch hospital. The Greater Glasgow health board appears to be taking decisions about psychiatric hospitals and psychiatric provision without bearing in mind the importance of community care. My constituents are also worried about the future of Stonyetts and Birdston, and they are not alone in their concern. They know that it is not enough for society to concentrate on the demands of the health service, important though they are, at the expense of the 90 per cent. of our people in the community whose rights and needs must also be respected.
This is why I am appalled--I cannot disguise my anger--at the way in which the Government have responded to the Disabled Persons (Services, Consultation and Representation) Act 1986. We were told by one Minister after another--including the former Prime Minister, the right hon. Member for Finchley (Mrs. Thatcher), and the present Prime Minister--that the Government's aim was to accept the will of both Houses and to implement that
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Act when resources became available. As a Minister with responsibility for the disabled, the present Prime Minister, speaking of the implementation of the Act in stages, said :"This should help to make progress towards establishing such a timetable."- -[ Official Report, March 1987 ; Vol. 112, c. 157. ] Until the announcement was sneaked in on the Friday before the Easter recess by a junior Minister in another place, we all accepted that that was the Government's intention. As Chief Secretary to the Treasury, the Prime Minister also said :
"The Act of 1986 was originally passed upon the premise that it would be brought into action over a period."--[ Official Report, 29 October 1987 ; Vol. 121, c. 441. ]
This spectacular U-turn has yet to be explained by any Minister. The Minister for Health seeks to argue, and has argued elsewhere, that after the enormous amount of consultation which took place before the 1986 Act was introduced--far more consultation than the one week between the Government's White Paper on community care and the Bill that followed it-- it is not necessary to implement all its sections. The consultation preceding the 1986 Act meant that sections 1, 2 and 3 provided the right of advocacy and assessment ; and section 7 meant that people leaving long-stay psychiatric hospitals would be entitled to assessment and were assured that the House would attempt to reduce the number of people released from such hospitals into non-existent community care--often into cardboard cities. The approach to community care embodied in the 1986 Act, to which the House gave a great deal of credence, has been abandoned, and we cannot and will not be convinced that the community care sections of the Government's National Health Service and Community Care Act transcend what we tried to achieve in 1986--they do not and they cannot.
During the passage of the National Health Service and Community Care Act and the Children Act 1989--the latter also featured in the junior Minister's reply in another place--it was never said that the Government were planning to drop these vital sections because they were covered by those two subsequent Acts. The Government intend not just to postpone but to abandon community care until 1993. We cannot pretend that the 1986 Act was never passed.
We are told that the Government believe in citizens' rights and voluntarism and that they are prepared to listen to the views of others. Is it any surprise that the Spastics Society, Age Concern, the Royal Association for Disability and Rehabilitation, the Scottish Society for the Mentally Handicapped and many other organisations are shocked by the Government's decision and the manner in which it was announced ? Is it any surprise that Sir Brian Rix of MENCAP has said that it was a disastrous decision ? Grass roots members and supporters of these organisations, and the 6.5 million people with disabilities and their carers--the blind, deaf and elderly people with disabilities who cannot express their views and who believe the Government's promises of choice and independence in which advocacy plays a vital part--are equally appalled. Mary and Albert Coyle, constituents of mine, know that their son Gerard, who is 36 years old and mentally handicapped, will not now have the advocacy, representation and assessment which they thought he had been promised by the House and which they saw as crucial to the future of their child and to that of many others suffering from mental handicaps.
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The House will return to these issues, but before those major debates take place--the issue will not go away--it is only right that the anger of such people should be expressed today. Millions of disabled people and their carers want the House to express its repugnance at an exercise in intellectual arrogance and abuse of temporary power by the Government which must be rejected.7.47 pm
Mr. Alistair Burt (Bury, North) : No matter how often we debate the national health service and whatever our debates are ostensibly about-- whatever reforms and new ideas may be under consideration in the motion-- they always seem to resolve themselves around two arguments advanced by the Opposition. First, they say that they should be trusted with the health service because they always spend more than the Tories ever could or would want to. Secondly, they draw attention to the way in which, as they see it, the Tories have looked after the health service, claiming that that is evidence of that fact that the Tories reform plans will fail and that the Opposition would do everything better.
We can bandy statistics across the Chamber until the cows come home ; we can use global statistics which people may or may not choose to believe. But by examining what happens in a local district health authority we can start to peel away some of the falsehoods and see what has actually happened. In doing so, we can see that the two arguments on which the Labour party relies are false and useless. Let us relate the first argument, to do with Labour's expenditure, to my constituency of Bury. The only time when expenditure on the NHS in Bury has fallen was under a Labour Government. Between 1974 and 1979, it fell by 2 per cent. Bury had needed a new hospital for about 100 years. It was the only part of the north-west district that had not had a new general hospital in 100 years, but one could not be built under Labour because of reductions in capital expenditure. Those cuts in expenditure and that way of looking after the finance of the health service was mirrored elsewhere in the country. Under the Conservative Government NHS funding as a proportion of GDP has grown twice as fast as it did under Labour. So there is no argument about finance. There has been no greater or longer lasting deceit practised on the British people than the Labour party's claim that funding is better under a Labour Government.
Labour's second argument is that the way in which the Tories look after the NHS shows just how much we care. In answer to the hon. Member for Monklands, West (Mr. Clarke), who believes that we live in a world of our imagination, I shall read out some facts about the Bury district health authority. If the hon. Gentleman thinks that they are in my imagination he can come to my constituency, talk to the consultants, ring up the district general manager and query any one of the facts that I shall spend about four minutes reading out. The past 10 years or so have seen substantial developments in the services provided by Bury health authority. Those developments have affected almost every sphere of activity and that momentum is set to continue in the foreseeable future. There has been a massive increase in the funds made available, and at the same time the authority has been praised for the high quality of service provided.
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The improvements include extra doctors in hospitals. There has been an increase of 43 per cent. in the number of doctors employed, and the additional consultant specialists appointed include those in accident and emergency, anaesthetics, paediactrics, obstetrics and gynaecology, radiology, geriatrics, psychiatry, pathology, ear, nose and throat, adult health and orthopaedics. Those people exist. They are flesh and blood. They can be met, touched and spoken to. They are not figments of my imagination.In the past decade the number of nurses in Bury has increased from 875 to 1,181. There has been an increase of 45 per cent. in professional and technical staff such as physiotherapists and occupational therapists, from 145 to 214.
As for capital expenditure on buildings and the like, during the past 10 years or so more than £25 million has been spent on new and improved buildings. They range from new theatres, new wards and out-patient departments to all the necessary support facilities required, such as kitchens and theatre supply units. The new phase 1 development of Fairfield general hospital cost £10 million and provided new wards for the elderly, children and ear nose and throat patients. A new ante-natal clinic was provided together with a new theatre. The developments continue with a current building programme of £2.5 million which was celebrated in the local newspaper under the headline, "Health Service Cash Bonanza". That programme includes a new purpose-designed obstetric theatre which was recently opened by the Under-Secretary of State for Health, my hon. Friend the Member for Loughborough (Mr. Dorrell), upgraded maternity and gynaecology wards costing £1.1 million, upgraded wards for the mentally ill and extensions and improvements to health centres.
In the Bury health authority no beds have been lost for financial reasons. There has been an increase in the number of beds which has led to an increase in the number of people being treated. There has been an increase of 55 per cent. in the number of patients admitted to hospital and a massive increase of 160 per cent. in the number of day patients.
In 1979, the health authority's budget was £12 million, and in 1990 it had risen to £34 million which represents 19 per cent. real growth in contrast with the 2 per cent. loss in real terms which occurred under the last Labour Administration.
I shall read out some figures relating to the number of patients treated. They are all real people. In 1978-79, a total of 17,780 in-patients were treated and there were 1,575 day cases. In 1985 the number of in-patients had risen to 20,778 and day cases to 2,731. This year it is estimated that there will be 27,600 in-patients treated and 4,100 day cases. That represents a total increase in 10 years of 55 per cent. in the number of in -patients treated and 160 per cent. in the number of day cases treated.
In February 1990 there were 1,303 people on waiting lists in Bury. By February 1991 that figure had reduced by 300. The numbers waiting between one and two years in February 1990 was 104. In February 1991 that figure had decreased to seven. In 1990 the number of people waiting more than two years for treatment was 36. In 1991 that number had been reduced to zero.
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I am sorry to have taken five minutes to quote all those figures to stress that no party or Government intent on destroying the health service would provide a district health authority with a record such as that. There is no evidence in my health authority to suggest the lack of care on which the Labour party based its argument. All the efforts that have produced improvements in my constituency, the ethos behind them and the competitive tendering which has produced money that has gone into patient care have been fought every step of the way by the Opposition. That is how much they care about the health service. Their attitude is to say, "Leave it as it is. It is all right. It does not matter. Trust us."It is sad that we spend our time tossing jibes to and fro to deal with the falsities put about by Opposition Members when we know the truth. There is only one health service ; it has its good parts and its bad parts. It has its problems, and it has people who wait too long for treatment. It has bad hospitals that need tidying up and people who travel too far, but, above all, it has a dedicated staff who want to improve it. There is no mileage for anybody, whether they are doctors, administrators or politicians, in making things worse. Many people put in a lot of time and effort. Those who work in the health service, whether they are GPs like my father or hospital doctors like my brother, resent the continual efforts that are made to denigrate and run down the health service. The Opposition do not appreciate that that goes home to people who are working in the health service and trying to improve it.
We should spend more time talking about matters that the community health director in Bury dealt with in his excellent annual survey. He wrote :
"lung cancer and coronary heart disease are the consequence of an unhealthy lifestyle and many potential years of life are lost because of socially acceptable lifestyles committed to cigarette smoking, an over-indulgence of alcohol, promiscuity, etc. The effects of such lifestyles even threaten and prejudice during pregnancy the chances of a healthy fit baby. Whilst on the one hand we spend vast sums of money as a nation treating or subsidising the effect of these diseases we also, as consumers, spend equally vast sums of money encouraging the habits--albeit with health warnings".
We should be talking more about preventive medicine and the things that really matter.
In conclusion, it is rather sad that when we have a Government with a national and local record in the health service such as I have described, and when we have the efforts that the Government have put in, we have at the same time a cynical Opposition who cannot even bring themselves to spit out through clenched teeth any acknowledgment of success and instead commit them-selves to twisting the facts and pretending falsely and pathetically that under some new red dawn everything will be put right.
7.58 pm
Mr. David Hinchliffe (Wakefield) : I made the mistake of blinking during the Secretary of State's half-hour speech, and missed his reference- -which cannot have been more than one sentence--to community care. I thought that the debate was concerned with the health service and community care, and I am sorry that the Secretary of State has such contempt for the important issue of community care that he could not be bothered to refer to it in some detail.
An answer that I received from the Under-Secretary of State for Health on 24 January said :
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"We are firmly committed to a policy of community care which enables elderly and disabled people, with appropriate support, to live in their own homes or in small homely settings in the community for as long as this is feasible and sensible."--[ Official Report, 24 January 1991 ; Vol. 184, c. 295.]Frankly, the Government have an excellent record on words about community care, but their deeds are different. Their record on community care is shameful.
I wish to stick to the question of community care because, with the honourable exception of my hon. Friend the Member for Monklands, West (Mr. Clarke) and the Labour Front Bench, it has not so far tonight received the attention that it deserves.
During the 12 years that the Government have been in power, they have operated a programme of emptying the large psychiatric hospitals. There has been a reduction in the number of homes for children and for mentally handicapped people and in the number of geriatric wards. The Government were committed to reducing institutional care but, at the same time, there has been a distinct revival of the institutional model of care in the private sector. During the last 10 years, there has been a 4 per cent. reduction in the number of places in local authority homes for elderly people. There has been a 316 per cent. increase in the number of places in private residential care homes. In my area of Yorkshire, there has been an increase of almost 1,000 per cent. in the number of private nursing beds. The argument is that the number of elderly people has increased but, according to the Library, the number has increased in the same period by only 9.5 per cent.
The Audit Commission told the Griffiths committee that a quarter of the people living in private care homes could have been accommodated in the community with the appropriate support. Only a few weeks ago, evidence was given to the Select Committee on Health by a series of directors of social services who said that, in their areas, about 50 per cent. of the people living in private care homes could and should have been accommodated in the community with the appropriate support.
The Government's record is one of placing in institutional care people who do not need and do not want to be there. They are the Government of institutions, who are in no way committed to genuine community care which involves caring for people in their own homes and neighbourhoods.
It is interesting that the Government have pursued policies geared to reducing the support available to people who wanted to live independently in the community. My hon. Friend the Member for Monklands, West referred to the appalling treatment of his much valued Disabled Persons (Services, Consultation and Representation) Act 1986. If we consider the Government's record on local authority personal and social services, it is clear that they have pulled the rug from under the feet of people who wanted to remain at home and be independent. Underfunding of the national health service means that supportive health services such as district nurses and bath attendants have been withdrawn from people who wanted to remain at home but were forced to enter into care.
There have been huge reductions in the rate support grant. I asked the Library for an estimate of the reductions in that grant during the administration of the present Government as far as they affected the personal social services. I was staggered to learn that the reductions in the budget from the 1979 level of local authority expenditure on personal social services total about £6 billion. The
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Government say that they are committed to community care, but they have taken from local authorities that £6 billion, which should have been spent on home help services, day care services, meals on wheels and a range of supportive services which should be available to enable people to live independently in their own homes. My area has suffered as much as any other.There is a problem with the nonsense of the standard spending assessment. I have spoken to Conservative Members who do not understand how the SSAs are worked out. Last year, Wakefield social services spent £4.5 million above its spending assessment. If it had had to abide by it, it would have had to reduce services drastically, scrapping provision for child protection in some instances. This year, it is £3 million above its SSA. Yesterday, I asked the deputy director of social services to tell me what it would mean if the authority had to cut that £3 million. It could mean closing four homes for aged persons and two children's homes, and reducing by 10 per cent. a fundamental part of community care--the home help service.
Alongside such cuts at local authority level in community support for elderly and disabled people, the Government have pressed money hand over fist into private institutional provision, in a huge explosion following the extension of supplementary benefit payments in 1981. When I see broadcasts by the Conservative party like that last week saying, "How much does a Labour councillor cost you?", it makes me think, "How much does a Conservative councillor cost you?" He cuts the home help service, day care centres and meals on wheels and ends up driving elderly or disabled people into private institutional day care, at a huge cost to the taxpayer. That is what a Conservative councillor costs us.
There should be a huge redirection of resources away from institutional care into independent living in the community. We must ensure that, when the new Labour Government come to power shortly, we turn on its head the central thrust of this Government's community care policy, which has been to push people into institutional private sector care.
We must transform residential care from the present warehousing provision that exists in so many private care homes. There must be more sheltered housing to give people semi-independence facilities if they need some care provision. Crucially, there must be a substantial redirection of public resources away from residential care into preventative provision within the community.
There is a need for a progressive reduction in the income support budget and the redirection of that budget to local authority community services, to voluntary organisations and to health authorities to fund a massive expansion in support and assistance within the local community.
Only today I obtained some interesting figures from the Library. I asked specifically how much money had been spent on income support to individuals going into private care homes during the past 10 years. I mentioned that the Government had removed £6 billion in personal social services funding from local authorities, thereby reducing the services available to people in their own homes and forcing them in many instances into care. The figures provided by the Library show that the amount spent on income support for people in private care homes during
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that period is roughly equivalent to the £6 billion spent in putting people--many of whom do not need or want to be there--into private institutional care.Unlike the Conservative Member who accused the Labour authorities of throwing money at a solution, I believe that public resources are going in the wrong direction. The Government are spending money on the wrong things, and it should be completely redirected. I am talking not about huge additional costs, but about the appropriate use of existing resources. When talking about health or community care, we must deal above all with the human cost of the failure to enable individuals to retain self- determination, their independence and their pride.
8.8 pm
Mr. John Butterfill (Bournemouth, West) : The hon. Member for Wakefield (Mr. Hinchliffe) knows that I share his concern for community care and the provision of social services. He has perhaps done the House a disservice by suggesting that spending on social services has decreased under this Government. During the past 12 years, spending has increased by 52 per cent. and, at the same time, there has been a massive increase in expenditure through income support for those who are, sadly, resident in old people's homes. During the lifetime of the Conservative Government, that expenditure has increased from £10 million to £1 billion. There is no question but that resources are provided. It is sad that the Labour party constantly suggests that the Government do not care and do not provide money. The reality is different.
The Labour party's latest policy document suggests that a Labour Government would massively increase the resources available to the national health service. Clearly the hon. Member for Derby, South (Mrs. Beckett) does not believe that the health service is a spending priority and she is unlikely to provide the necessary money, even if Labour can find it.
No one believes that the Labour party is not sincere in wanting to improve the health service, but its record must speak for itself. When Labour was last in power, waiting lists increased by 48 per cent., the hospital building programme was suspended and in real terms doctors' pay decreased by 14 per cent. and nurses' pay by 21 per cent. The Labour party's ethos is that it cannot manage the health service efficiently ; it concentrates its well-meaning efforts on the wrong items and it does not deliver the goods to the public. The few reforms the Labour party has come up with recently-- such as getting rid of competitive tendering, which will cost £135 million, and bringing in a statutory minimum wage, which will cost £500 million--will do nothing for the health service except increase costs. The money that the Labour party proposes to spend on statutory minimum wages alone would be the price of 20 district general hospitals.
I should willingly give way to the hon. Member for Birmingham, Perry Barr (Mr. Rooker) if he will say which 20 hospitals he will close to pay for his daft minimum wage proposals. Or will he create the money out of thin air? He could not create it before. The hon. Gentleman will not rise from his seat.
Mr. Hinchliffe rose--
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Mr. Butterfill : If the hon. Gentleman will excuse me, I shall not give way generally, because of the tight time limits. I should willingly give way to the hon. Member for Perry Barr, but he does not seem anxious to take up my offer.
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