House of Commons Hansard Debates for 14 May 1991

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their many priorities those to which they would apply waiting list money. Some chose to put it into a specific branch of paediatrics and others did not.

Mr. Cook : I am not making up a letter from Alderhey hospital. Not only have I seen that letter : I have seen the reply from North Manchester health authority, which properly and vigorously says that that authority has a contract with Alderhey hospital. The pricing of that contract is at less than half the premium that Alderhey now demands for each case of child heart surgery. North Manchester health authority says that Alderhey hospital must now admit those children on the basis of clinical need and priority, and not on the basis of the commercial price that Alderhey seeks.

Mr. Waldegrave : The hon. Gentleman does not understand. The hospitals told the districts that, if some of that waiting list money could be used for this specialty, extra wards could be brought back into use. There is nothing whatever wrong with that. It would not have threatened existing contracts, and more children could have been treated. I am sorry that the hon. Gentleman still does not understand that.

Mr. Cook : Apparently I am not the only one who does not understand the letter from Alderhey hospital ; nor does the general manager of North Manchester health authority. He lives closer to the scene than the Secretary of State, he deals regularly with Alderhey hospital, and he has negotiated a contract with it and is therefore better placed than the Secretary of State fully to understand the meaning of the letter, which states :

"It is not possible for us to guarantee that any children currently waiting will be treated in the financial year". There is only one way to understand the meaning of those words, which were addressed to districts who paid double the price. Such a double standard has no place in a public service.

Delays in children's heart surgery at Birmingham drove the Government into setting up the NHS review. Perhaps a two-tier list for children's heart surgery will finally discredit the outcome of that review and will demonstrate what happens when the national health service is run as a commercial business. Labour will scrap this market in health care and bring back into the local health service hospitals such as Alderhey which have gone it alone as trading enterprises. We will restore the NHS as a public service, as we have done before.

Before the Secretary of State tries his hand again at a historical novel and distorts the record of the last Labour Government, I shall tell him about that record. [Interruption.] I am happy to say that we do not intend to rewrite history. I shall quote from an answer received by my office on Friday from the Department of Health. The Secretary of State will recall that, during an earlier debate on the national health service, he taxed me with the claim that, under the Labour Government, there was only one year when there was a cut in real terms in spending on health. The Opposition asked his Department to provide us with the figures on the real terms volume expenditure on the health service. As the figures came from the right hon. Gentleman's office, I think that we can be sure that they have been pored over to cure them of any Labour bias.

I have to report to the House that the figures produced on Friday in Hansard show nothing of the sort that the right hon. Gentleman asserted. Under the Labour

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Government, there was a steady increase every year in volume spending. There is one year, however, in which health spending in real terms fell by 1 per cent., and that was 1979, the first year of the Conservative Government's term of office.

Mr. Waldegrave : The hon. Gentleman has been misled. If that has happened as a result of an answer from my Department, I apologise to him. The figures are clear. I know exactly the mistake into which the hon. Gentleman has fallen. If the figures are taken on the basis of a calendar year, which does not include the additional moneys that are produced regularly towards the end of the year--for example, pay review bodies--the result is that which the hon. Gentleman has described. However, the year-on -year figures, which have been published for many years, show only one year in the history of the health service when there was a revenue cut, and that was 1977-78.

Mr. Cook : I accept that the right hon. Gentleman genuinely did not seek to deceive the House, and really believed in what he said. Knowing the problem that there might be in convincing him of the reality, I have brought with me the relevant edition of Hansard. It-- [Interruption.] I am not surprised that the hon. Member for Esher (Mr. Taylor) is running backwards and forwards from his seat behind the Secretary of State to the Box, he being the right hon. Gentleman's Parliamentary Private Secretary.

At col. 491 on 8 May, there is an answer from the Under-Secretary of State for Health, who has been accused of misleading me. I wish to spring to his defence and to say that I have never known him deliberately to mislead. The figures are set against the years. The years are 1974-75 and 1975-76 through to 1989-90 and 1990-91. I think that the Secretary of State now has the answer in front of him. His Department provided financial year figures that do not record that which he suggested in our previous debate.

Sir Anthony Grant : Will the hon. Gentleman give way?

Mr. Cook : No ; this is a private quarrel.

Mr. Waldegrave : The figures show that there was only one year, 1977 -78, when there was a cut in spending.

Mr. Cook : I shall read out the figures. In the financial year 1976- 77, total spending on the NHS was £18,617 million. In 1977-78, it was £18,889 million. In 1978-79 it was £19,606 million. The figures make it clear that there was no cut. There was a cut, however, in 1979-80. The Government are the people who tell us that their accounting methods are better than those that are to be found in the health service. They are the people who lecture managers that they are unable to obtain proper information and proper costings of operations in the health service. At the same time, they cannot agree on the terms of a parliamentary answer.

Mr. Waldegrave : I shall give the hon. Gentleman the gross total of NHS expenditure at 1991-92 prices. That is real prices. For 1975-76, the spending was £21,568 million. It was £21,689 million for 1976-77 and £21,155 million for 1977-78.

Several Hon. Members rose --

Mr. Speaker : Order. May we have one at a time--and would it not be a good idea if we got on with the debate?

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Mr. Waldegrave : I have been talking about the health expenditure figures. Is the hon. Member for Livingston (Mr. Cook) talking about the undivided departmental figures?

Mr. Cook : I am talking about the NHS total figure, with which column 491 of Hansard has provided me. If anyone has got the figures wrong, it is the Parliamentary Under-Secretary of State. You kindly suggested, Mr. Speaker, that, as we had plainly won this exchange, it was now time to move on. I was interested to note--

Sir Anthony Grant : Will the hon. Gentleman give way?

Mr. Cook : No, I will not. I was interested to note that on Friday--

Sir Anthony Grant rose --

Mr. Cook : No, I must press on.

Mr. Speaker : Order. I have already pointed out that a great many hon. Members wish to participate. This is becoming a kind of Committee stage.

Mr. Cook : On Friday-- [Interruption.] I must ask my hon. Friends to allow me to proceed.

On Friday, the Secretary of State produced a new illustration of the contrast between his Government and ours. He made a speech in which he attacked me as well as the Labour party--and vulgar stuff it was ; not the stuff of which he carved his intellectual reputation at All Souls. This was definitely gamma minus stuff. He said : "We have dramatically increased the numbers of doctors and nurses working in the NHS."

I am sorry to say that the right hon. Gentleman's ministerial colleagues have let him down again : they have produced the figures. Throughout the 1980s, the number of doctors increased by 18 per cent. That is a comfortable increase, for which I will not deny credit to Conservative Members. During the period of the last Labour Government, however, the number of doctors increased by 25 per cent.--and that was over five years, not 10. The rate of increase was three times as fast as the annual rate under the present Government. The right hon. Gentleman's colleagues have also been very helpful in providing the figures relating to nurses. If we take the increase in whole-time equivalents on the same basis, we find that, in the 10 years of the present Government's tenure, the number of nurses in our wards increased by 6 per cent.

Sir Nicholas Bonsor : What about the numbers?

Mr. Cook : I am talking about the numbers. Under the last Labour Government, the number increased by 14 per cent., at nearly four times the annual rate. The Secretary of State spoke of a "dramatic increase". What superlative--what hyperbole--would he find to describe the record of the last Labour Government, which is three or four times better than his Government's record?

Several Hon. Members rose--

Mr. Cook : I will not give way.

The question for the right hon. Gentleman is this : how can he hope, at the next general election, to persuade the voters that he will do any better next time round, when sitting beside him is a Chancellor who wants to rip £30

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billion out of public spending? Where will that £30 billion come from, and how much will come from the health budget?

At the next election, the electorate will have a clear choice between a Labour party that is committed to using the increase in revenue to restore the NHS and essential services, and a Conservative party that is committed to using it to pay for tax cuts. The need for that choice to be made could be seen clearly last night at King's College hospital in Camberwell. Yesterday evening, 14 people were admitted to the accident and emergency department. They had to remain lying on trolleys in the casualty room, because no beds could be found for them. Last November, the hospital closed 120 beds to meet the Secretary of State's deadline of 1 April for the elimination of the hospital's deficit. Those 14 people included an 89-year- old woman who was blind and had suffered a fall, and a 16-year-old boy who was vomiting blood. They were all lying on trolleys 9 in apart. That is the real price of underfunding of the health service. That is the real price being paid for the commercial priorities of this Government. And those are the people who cannot afford a 5p cut in the basic rate.

There is only one good consequence of the events of the past month : the Secretary of State and his changes have put the health service back in the centre of the stage. Some of his colleagues may well doubt whether that was wise, because the NHS occupies the fault line between our values and theirs. It is clear that some activities are too important to be left to the market, that there are some public services that are not just fairer but more efficient when they are planned to meet social needs and not driven by chasing market forces.

It is because, as hon. Members have just shown, they are incapable of understanding that the NHS is not safe in their hands. That is why the electorate now have a clear choice between losing their NHS under this Government or renewing it under a Labour Government.

4.20 pm

The Secretary of State for Health (Mr. William Waldegrave) : I beg to move, to leave out from "House" to the end of the Question and to add instead thereof :

"welcomes the progressive implementation of the Government's reforms of the National Health Service, coupled with substantial increases in resources for the National Health Service and in the numbers of patients treated since 1979 ; looks forward to the benefits of these reforms being spread more widely so that services everywhere are brought up to the standards of the best, especially with the further development of National Health Service trusts and fundholding practices ; notes that district health authorities and general practitioner fundholding practices will both give priority to patient's clinical needs ; welcomes the determination of the new National Health Service trusts to get to grips with long-standing management problems ; supports the new role of district health authorities as guardians of the public health, accountable for arranging comprehensive care for their local residents ; and endorses the Government's intention to set out a new agenda for the National Health Service which concentrates more than ever on improving the health of the people."

As the sound and fury of political debate declines for a moment, commentators are beginning to see that there are two issues on which the Labour party has staked out its ground. First it claims that its members would be better than we are at producing resources. Secondly, it claims that it would be better at getting those resources to where

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they are needed within whatever constraints are imposed. Both sides are agreed that this service will remain cash limited.

The Labour party remains in trouble about money, as usual. The anxiety of the right hon. and learned Member for Monklands, East (Mr. Smith) to appear respectable in the City has completely undermined the series of costed and uncosted, bogus and less bogus pledges made by his hon. Friend the Member for Livingston (Mr. Cook). Every lobby which writes to them gets a nod and a wink, indicating that there will be more money for its particular cause.

The pit into which the right hon. and learned Member for Monklands, East, with the able assistance of the Leader of the Opposition, has now dug the Labour party was demonstrated to listeners to "Today" yesterday, I think, when the right hon. and learned Member for Monklands, East was comprehensively carved up by my right hon. and learned Friend the Chief Secretary to the Treasury. We simply do not now know what Labour Members mean by their spending pledges, and it is increasingly clear that neither do they.

First, our record in office is better than Labour's. Labour increased spending on health by about 1.5 per cent. in real terms ; we have increased it by about 3.2 per cent. in real terms. We have done better than Labour said that it would have done in 1987 had it been elected. The Labour party promised an increase of 3 per cent. in real terms in 1987 and we have provided a 3.5 per cent. increase in real terms since 1987. Both in the reality and in the promises, our word has more reason to be trusted by the electorate then Labour's. Furthermore, as has already been pointed out, the hon. Member for Livingston has failed to achieve what many Labour Back Benchers might feel it was his duty to achieve--to place the health service among the principal priorities of the Labour party in the run-up to the next election.

Why should anyone believe that the hon. Member for Livingston would be any better in dealing with the right hon. and learned Member for Monklands, East if Labour were in power than he has been in opposition? He has not won the argument with his right hon. and learned Friend in opposition and he would not win it if Labour were in power. It is far more likely that, if the Labour party were to find itself in power, events would be just as they were last time. I stand completely firmly on the figures, which show that, in 1977-78, Labour cut spending on the health service in real terms and cut the capital spend throughout its period in office.

When I last raised that matter with the hon. Member for Livingston--it clearly distresses him to have to remember what happened when Labour was in power--he said, rather lamely, that he had voted against the 1975 White Paper. Well, his memory deceives him. He did not. He abstained. Some of the Opposition Members below the Gangway were more consistent. They voted against it all right. But the hon. Member for Livingston was not to be found in the House on that occasion. That once again shows that, when the crunch comes, and when faced with the equivalent--this is what we must and will prevent--of the right hon. Member for Leeds, East (Mr. Healey) charging about the Treasury again cutting everything to ribbons, the hon. Gentleman will not be there on the night.

Sir Anthony Grant : I wish to refer to the Labour party's record--my right hon. Friend will recall that the hon.

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Member for Livingston (Mr. Cook) was too nervous to give way to me in his speech on this point. Whatever the figures were, is my right hon. Friend aware that, in the last year of the Labour Government, at the famous Addenbrooke's hospital in my constituency, wards were closed, cancer operations had to be postponed, surgeons' records were taken over by militant trade unionists and many poor people were deprived of the services that they wanted by the behaviour of the Labour Government's supporters?

Mr. Waldegrave : The Labour party talks about a two-tier service, but when it left office, the Confederation of Health Service Employees and the National Union of Public Employees were deciding what was an emergency admission.

The truth is that no serious commentator outside believes--I have quoted Professor Julian Le Grand to the House before and I shall quote him again because he is such an objective commentator on these matters--that Labour would be able to do better than we have done on overall resources for health. That argument, as one of my hon. Friends said earlier during Question Time today, is dead. It is unlikely that the 3.5 per cent. growth which we have achieved would be bettered by the Labour party. It has never been bettered in the past.

As Peter Kellner--not a commentator friendly to my party--recently warned, the Labour party should be steered away from the reef of criticising our health spending record because, he thought, our spending had kept up with GDP. I can tell Peter Kellner that we have done better than that. The share of GDP spent on the NHS in the United Kingdom in 1978-79 was 4.7 per cent. It is now, in 1991, 5.7 per cent.--a full percentage point increase. We are spending on health a bigger share of a bigger national product than ever Labour would or could.

Mr. Christopher Gill (Ludlow) : Is the essential point not how much the Government spend, which is a lot more than it ever was, nor how much the Opposition promise that they will spend, but how that money is managed? Will my right hon. Friend take this opportunity to tell the Opposition that there is not one patient who cannot see a doctor or who, having been to see a doctor, has not received the drugs that he requires, and that there is not one person who, having been to hospital, has not been entirely satisfied with his treatment, service and attention?

Mr. Waldegrave : My hon. Friend is right. As there is no real argument between us on resources, we then have to concentrate on how best to get the money to the patients, and that is what I shall deal with in the latter part of my speech.

It was only because I was a little surprised that the British Medical Association seemed not to have remembered the Labour party's dreadful spending record on health that I delivered a mild rebuke to it for appearing to join in the party political debate somewhat in favour of the Opposition last week. It would have been an odd alliance, since Bevan-- whose great biographer, the right hon. Member for Blaenau Gwent (Mr. Foot), is with us--described the BMA as "an organised sabotage" and "a squalid political conspiracy". Barbara Castle, in her characteristically more moderate language, said that there was

"a lovelessness about that bunch that made me sick."

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Luckily, since then, the BMA has made it clear that nothing it said was to be taken as any kind of alliance with the Labour party ; it was just inadvertent that it gave its press conference the day before the local elections. Therefore, that matter can be laid to rest. There is no contest on funding. As my hon. Friend the Member for Ludlow (Mr. Gill) rightly said, the argument is about how the money is spent. For a party which is not able to commit itself to an overall increase in terms resources for health, Labour has made some extremely dangerous and irresponsible spending pledges.

For example, I calculate that at least £175 million will be needed for the minimum wage pledge, and that may be on the low side. It will be £175 million only if Labour can restrain other trade unionists from maintaining differentials and many--for example, the electricians--have made it clear that that is not on.

As no real increase will come from Labour, that £175 million will have to come from patient care--it amounts to the annual revenues of about six district hospitals. As my right hon. Friend the Prime Minister said at Question Time, Labour is choosing to throw away about £150 million- worth of savings by doing away with competitive tendering, which amounts to the annual revenues of about another five district hospitals, making 11 in total. That is what happens if one says yes to every lobby before one has secured the resources with which to pay for the pledges.

There is a long list--one might call it the nods and winks list--of all the things that Labour has said that it would do when any lobby has come to see them, although it has been careful not to cost them. That long list of things will produce cuts in patient care or it will mean that a large number of disgruntled lobbies will find that Labour's pledges meant nothing. The latter is the likeliest outcome. Against that background of no more money, we must work out how we can get the money to where patients need it. In the past week or so, another element has been added by the Labour party, which says that not only will money go out of patient care to pay for its friends in COHSE, NUPE and the rest but it will take money out of the pockets of most of the professionals in the health service.

I am not sure whether Opposition Members are aware of this fact. We have dramatically increased doctors' and nurses' pay, as well as increasing their numbers. Instead of cutting their pay, as Labour did, we have put a considerable number of nurses into tax and national insurance brackets in which they would lose cash under Labour's proposals. Every GP and virtually every qualified doctor would lose considerable amounts. On the national insurance change alone, a top consultant would lose about £7,000 plus many thousands of pounds--

Mr. Robin Cook : With a merit award.

Mr. Waldegrave : On a merit award. I was talking about a top consultant. The tax proposals would lose the consultant many thousands more.

Mr. Tony Marlow (Northampton, North) rose--

Mr. Waldegrave : I shall complete these remarks and then give way to my hon. Friend.

Therefore, the hon. Member for Livingston owes professionals in the health service a further commitment, which he will not be able to fund. Is he going to make good

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their pre-tax pay to make up for the money which his hon. Friends will take out of the pockets of those professionals? That is what he is saying to them. Virtually all senior professionals in the health service will lose money under the Labour party's proposals.

Mr. James Couchman (Gillingham) : My right hon. Friend mentioned the fact that doctors will suffer under the proposals that Labour has revealed in the past week. Is he aware also that grade H and I ward sisters, who are towards the top end of the scale in London, will lose, because they earn between £20,000 and £22,000 a year?

Mr. Waldegrave : My hon. Friend is absolutely right. Those nurses deserve that money, and I am proud that I am part of the Government who have begun to put nurses' pay on a proper and reasonable footing. I shall return to the subject of the real cuts that the Labour party made in nurses' pay during its last period in power.

Mr. Ronnie Campbell (Blyth Valley) rose--

Mr. Waldegrave : I shall give the hon. Gentleman the information, as he seems impatient for it. Nurses' pay was cut by 21 per cent. and doctors' pay by 14 per cent. under Labour. Not only do they face the prospect of further cuts in their real pay, as that was delivered by the last Labour Government, but under the "caring party", on that lower pay they will lose large sums of money in national insurance and tax which the hon. Member for Livingston is signally failing to promise to replace by increasing their pay.

Mr. Ronnie Campbell : The Minister will be aware that the Northumberland ambulance service is now a trust. Is he further aware that the chief executive of that trust

Mr. Dennis Skinner (Bolsover) : What, the spiv?

Mr. Campbell : Yes, the spiv and the personnel manager have given themselves 40 and 60 per cent. increases in their wages.

Mr. Waldegrave : If the management of that service deliver better patient care to the people of the neighbourhood by having more paramedics, which is what they will do, and by having better services, they will have earned that pay.

We see clearly the usual argument from Labour ; it wants to get it across to the public that everything will be paid for by "the rich". When we come down to it, who are "the rich"? They are the senior staff nurses and the doctors who have just qualified. Those are the people whom Labour will hit.

The argument is not, therefore, about the overall spending of money ; it is about the deployment of money. It has been easy for me to demonstrate in recent weeks that Labour has nothing to say about how to reform the systems in the health service for spending money to get services to patients better. Labour has set itself apart from modern thinking in all western European and other countries about the development and management of public services.

Throughout the western world--not just in Britain--people are seeking new ways of devolving management ; that is what the NHS trusts are about. They are seeking new ways of getting cost comparisons and incentives for efficiency ; that is what the whole internal market is about. Nothing in the health service is costed in the way that it

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will be in future. Nobody knows how best to apply the money. Labour is against that. Finally, it is against providing real power to those who will use it most directly for patients and not for the defence of vested interests. Labour is simply defending the system which was designed in the late 1940s. It is defending vested interests and it has nothing to say on how to develop our great service for the future.

The Independent got it exactly right. It wrote :

"Although theoretically the British public loves the NHS we all know that it has been run too much for the benefit of producers rather than consumers and too frequently cannot deliver a decent quality of service. By introducing some elements of the market into the system the Government's reform will apply real tangible pressure for greater efficiency. Labour's own ideas for reform are essentially cosmetic."

That is exactly right.

More brutally, The Times put it as follows :

"The fear must be that in demolishing the new system Labour would be handing the service back to the tender mercies of NUPE, NALGO and the BMA."

So little to say--

Mr. Nigel Spearing (Newham, South) : Leaving aside the proper interests of collective bargaining, is the right hon. Gentleman trying to say that the health service has been run for the benefit of the doctors, the nurses, the secretaries and the people who work in the service, who are notoriously underpaid? That is what he just tried to say.

Mr. Waldegrave : The hon. Gentleman knows exactly what I am saying. He knows that I believe that the service should be run for the benefit of patients and that those who simply represent the interests of the collective within it are not serving the best interests of the patients. It is that kind of argument which has led to putting off, for year after year after year, the decisions that have to be taken in London and that should be taken for the benefit of the health service throughout the country.

Labour has nothing to say itself on how to reform the structure and to make the systems more efficient. Therefore, I find myself in the happy position of defending a radical and forward-looking reform, aimed at revitalising a great public service, while Labour is left behind, carping, criticising and doing its best simply to scare people.

Mr. Marlow : On the point about scaring people, the way that the Labour party has been behaving over the past few months is reprehensible-- [Interruption.] Yes, the Labour party is picking on those who understand these things least and who are most vulnerable. It is reprehensible.

I do not know whether my right hon. Friend has visited Monmouth during the by-election, but a pamphlet is being stuck through people's letter-boxes saying that the Labour party will prevent the local hospital from opting out of the national health service. As I understand it, if a hospital becomes a hospital management trust, it stays four square within the NHS. Will my right hon. Friend make that clear to the hon. Member for Livingston (Mr. Cook) so that he can get in touch with people at the printing presses tonight to put out another leaflet to let the people of Monmouth know what the reality is?

Mr. Waldegrave : Any such leaflet would be disgraceful and would contain a lie. There is no opting out of the NHS, and anybody who issues leaflets suggesting the contrary is simply misleading the public.

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Mrs. Margaret Ewing (Moray) : Will the right hon. Gentleman give way?

Mr. Waldegrave : No, I have given way enough.

I want to deal now with the two main points of carping that Labour, left in our wake, has undertaken in the past two weeks. The first relates to general practitioner fund holding. We believe in giving more power to general practitioners. That is why we started the fund-holding experiment, which put general practitioners in charge of how NHS money is spent for their patients.

On this issue, the Labour party--not uncharacteristically for that party, although it is a little more characteristic of the Liberal party--is facing in two exactly contradictory directions. On the one hand, the Labour party says that it is opposed to the principle of fund holding, on the grounds that it creates what Labour calls a two-tier system. On the other hand, the Labour party is in favour of allowing non-fund-holding GPs to make greater use of

extra-contractual referrals--a facility that makes it easier for GPs to shop around to secure the best treatment for their patients. In other words, the Labour party is in favour of fund holding in one case but against it in another. That is typical.

Mr. Ronnie Campbell : Will the right hon. Gentleman give way?

Mr. Waldegrave : No. We have had enough contributions from the hon. Gentleman on this occasion.

How is it that the freedoms exercised by a fund-holding GP are devices, while the freedoms exercised by a non-fund-holding GP using his extra- contractual referrals are not? On this matter, the Labour party needs to get its thinking straight. Does it, or does it not, want GPs to have greater clout on behalf of their patients? I do. I want GPs in the NHS to have the same sort of clout on behalf of their patients as do those looking after people who can afford to go for private health care.

Many of Labour's supporters are clear about what they want to see. Let me quote, for example, Dr. David Colin Thome , who stood as the Labour parliamentary candidate in Warrington, South in the 1983 election :

"The reason I find fund-holding attractive is not purchasing, although that is important. I am really excited because it will make us a better provider by reskilling us in clinical medicine and by developing a concept of one- stop medicine. Instead of saying that we want the best deals from hospitals, we shall soon be asking why we need to refer to the hospital in the first place."

Many of Labour's most knowledgeable supporters know that Labour has got it wrong on GP fund holding. In a New Statesman interview, on 22 March, Julian Le Grand called on Labour to give fund holding more of a run. He said :

"There are many, including some politically unsympathetic to the present Government, who are excited by the idea, for they see it as an opportunity not only to obtain more control over other parts of the health system, but also to gain freedom to try out many of their less conventional ideas that the NHS bureaucracy has previously stifled."

Exactly.

How long will it take the Labour party to recognise that it is wrong? It said, first of all, that no one would be interested in the scheme. Already, we have 1,700 general practitioners involved. Then Labour said that there would be great problems because the budgets would be insufficient. Now it has had to abandon that case. We have 7.5 per cent. of the population covered, with perfectly

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