House of Commons Hansard Debates for 15 Mar 1993

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Mr. Sheerman : Unless the Minister was asleep when I made my speech, as he obviously is in his own, he should surely respond to those who have asked, including the hon. Member for Mid-Kent (Mr. Rowe), why such a scheme can be permissible in Scotland but not in England. He should explain why we in England and Wales cannot have cash payments. Why is such a system bureaucratic and cumbersome?

Mr. Burt : I have given the hon. Gentleman an assurance that I shall examine extremely carefully the possibility of introducing cash payments in future. At the moment, we are not convinced that it is the right thing to do. Some local authorities find ways of making small cash payments, and that may be the position in Scotland. It is for local authorities to ensure that they keep such payments within bounds.

Some hon. Members have asked whether moneys could be given to charities or trusts to enable them to do the work. When the full flexibility of community care is understood, some of the concerns expressed by Opposition Members will disappear. The objective of community care, and the way in which it can work with the ILF, is to enable local authorities to provide services up to a cost of £200 a week, with £300 available as extra top-up, but they need not be provided by the local authority. A local authority must simply ensure that £200-worth of services are provided, but that could be done through an independent provider. Indeed, the one provider could supply the £500-worth of services. The degree of individualisation and flexibility was not previously understood.

Opposition Members seem to be confused about the responsibilities of the 1993 fund and those of local authorities. The ILF did not remove any responsibilities from local authorities and nor does the1993 fund. The 1993 fund simply provides an additional option for a particular client group-- those aged between 16 and 65 years with care needs amounting to between £200 and £500 a week. People who do not fall into that group-- that is those over 65 or those with needs that amount to less than £200 or more than £500 a week--will remain the responsibility of the local authority. For the majority of the severely disabled who do not fall into the special group for whom the 1993 fund was intended, the local authority will consider with the client what is the best way of providing or buying in care services. It is untrue to suggest that authorities will opt to pay £800 or £1, 000 to place somebody in residential care when such expenditure, or less, could support that individual in the community.

In gist, if somebody is over 65 or is looking for care that will cost more than £500 a week, the local authority will be able to provide the individual care package that the ILF used to be able to supplement when community care did not exist. Opposition Members seem beset with the idea that our proposals should be considered outwith community care. They should understand that the community care individualisation package does the job for the vast majority of people who used to benefit from the ILF. That is why the concerns of Opposition Members are out of place.

In setting up the ILF extension and the 1993 fund, the Government are anxious to reassure those who are now on the ILF that they will be able to receive their new payments--the point was made by my hon. Friend the Member for Worcester--and notice nothing different--no change--except the name on the cheque. For the rest, the new fund

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will deal with a much smaller group of people, perhaps only 10 per authority, so the degree of bureaucratic difficulty will not be as great as Opposition Members suggest.

There have been dealings with local authorities. I am convinced that the system will be a great success. I am convinced that, just as Opposition Members have now admitted that they made an error in denying the success of the original ILF, in years to come they will recognise that they have made an error tonight and will acknowledge that this is a good Bill.

Question put and agreed to.

Bill accordingly read a Second time, and committed to a Standing Committee, pursuant to Standing Order No. 61 (Committal of Bills).

DISABILITY (GRANTS) BILL [ MONEY ]

Queen's Recommendation having been signified --

Resolved,

That for the purpose of any Act resulting from the Disability (Grants) Bill, it is expedient to authorise the payment out of money provided by Parliament of grants to

(a) the Independent Living (Extension) Fund established by a deed dated 25th February 1993 and made between the Secretary of State for Social Security of the one part and Robin Glover Wendt and John Fletcher Shepherd of the other part,

(b) the Independent Living (1993) Fund established by a deed of the same date made between the same parties, and

STATUTORY INSTRUMENTS, &c.

Motion made, and Question put forthwith pursuant to Standing Order No. 101(5) (Standing Committees on Statutory Instruments, &c.) and Order [26 February],

Highland and Islands Shipping Services

That the draft Undertaking by the Secretary of State for Scotland with the consent of Her Majesty's Treasury and of Orcargo Limited, which was laid before this House on 18th February, be approved.-- [Mr. Wood.]

Question agreed to.

Motion made, and Question put forthwith pursuant to Standing Order No. 101(5) (Standing Committees on Statutory Instruments, &c.),

Official Secrets

That the draft Official Secrets Act 1989 (Prescription) (Amendment) Order 1993, which was laid before this House on 17th February, be approved.-- [Mr. Wood.]

Question agreed to.

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National Health Service (Charges)

10.1 pm

Mr. Bob Cryer (Bradford, South) : On a point of order, Madam Speaker. I understand that motions Nos. 5, 6 and 7 are to be taken simultaneously. They have not yet been considered by the Joint Committee on Statutory Instruments. You will appreciate that the timetabling of these statutory instruments for today is an imposition by the Government, not a request of the Opposition. It is quite unfair of the Government to impose them before the Select Committee set up by the House to examine statutory instruments and report back on any defects has had an opportunity to do its work. I hope that you, Madam Speaker, like me, will deprecate the Government's attitude in what is, in my view, a misuse of time and for denying the Committee the opportunity to do its work.

Madam Speaker : I have noted what the hon. Gentleman has said, but he will appreciate that the motions are in order--otherwise, they would not have appeared on the Order Paper for debate today. 10.2 pm

Mr. David Blunkett (Sheffield, Brightside) : I beg to move, That an humble Address be presented to Her Majesty, praying that the National Health Service (Optical Charges and Payments) Amendment Regulations 1993 (S.I., 1993, No. 418), dated 2nd March 1993, a copy of which was laid before this House on 2nd March, be annulled I understand that it will be convenient also to consider motion No. 6

That an humble Address be presented to Her Majesty, praying that the National Health Service (Dental Charges) Amendment Regulations 1993 (S.I., 1993, No. 419), dated 2nd March 1993, a copy of which was laid before this House on 2nd March, be annulled

and motion No. 7

That an humble Address be presented to Her Majesty, praying that the National Health Service (Charges for Drugs and Appliances) Amendment Regulations 1993 (S.I., 1993, No. 420), dated 2nd March 1993, a copy of which was laid before this House on 2nd March, be annulled.

I remind the House of the words you used, Madam Speaker, when you ruled on the manner in which the increases in charges had been announced to the world. You deprecated the way in which the Government had used the procedures of the House to make the announcement, without the opportunity to question Ministers on the regulations. Tonight, I deprecate the fact that the Secretary of State is not here, willing to answer for the Government questions about the increases.

We deprecate the substance of the announcement--the shameful and disgraceful increases in prescription charges, in charges for eye tests and spectacles, and in dental charges. The idea of charging the sick more in order to protect the rich more is a disgraceful act by a Government who have no morality. The increases hit at the most vulnerable people in the country--those who fall just above the income exemption levels or just outside the specific exemption levels. They and others would wish us tonight to question the Secretary of State if she were here, if she had bothered to turn up to defend Government policy, if she were not like Mary Poppins, leaving it to the No. 2 to answer for Government policy and if she were not ducking out of answering for what is a disgraceful act by a Government who know no shame. The Government are

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prepared, through increased prescriptions, to charge those suffering from cystic fibrosis, arachnoiditis, or chronic asthma or who--week in, week out--must take medication for blood pressure. When that matter was raised with the Minister of State on a recent edition of BBC's "Question Time", he had the temerity to mislead the studio audience and viewers about whether cystic fibrosis was exempt from charging policy. Only last week I received a letter from a Mr. Brian Mott, who wrote to the Minister asking him to put the record straight. I ask the Minister to do so tonight.

Those young adults--and thankfully there are more of them--who reach the age when they qualify for prescription charges, and who previously would have died but for medical science, are compelled, if they have any income over and above the stringent exemption limits, to pay charges. Is it not time that people suffering from debilitating and life-threatening diseases were exempt from paying? Is it not time that the Government had the courage to admit that they were wrong and to widen the exemption limits? Will the Government allay tonight the fear that, far from increasing the number of prescriptions on the exemption list, they have every intention, either in tomorrow's Budget or in the autumn Budget, of reducing the number? Will the Minister of State make it clear tonight that those rumours are incorrect and that the Government will not tax even more of those who are sick or in need of support or help or of remedial action in order to protect the rich? That is what it amounts to. One remains untouched by the regulations if one has a good job, good income, good health, good sight and good teeth--and one is lucky enough to have a family and friends who are also blessed in equal proportion in those respects. However, if one is in need of regular prescriptions or medication, one will be dealt with quite differently. Instead of the £14,000 a year gain that those earning more than £70,000 a year enjoy under Conservative tax changes, those most in need are taxed because they happen to be sick.

Raising prescription charges by eight times the rate of inflation--2,100 per cent. since 1979--in the course of 15 changes was done after a promise by the former Prime Minister, the guru of the new right, who on 18 April 1979 said :

"We have no intention to raise prescription charges."

Pardon my bad English, but those were the words of the former Prime Minister. In the same speech she said :

"Let me make it clear that the Conservative party has no plans for new NHS charges."

Will the Minister of State repeat the former Prime Minister's promise?

We are mindful tonight that the Government are on the point of breaking a second promise. Having broken their promise not to increase prescription charges from 20p, they are undoubtedly looking--and have already made it clear from the Treasury--to increase charges so that those receiving NHS treatment will pay for the service rather than taxpayers as a whole.

Why is the Secretary of State not prepared to respond tonight? The answer is simple. Just over 20 years ago, in "Poverty Pamphlet No. 8", she made her position clear. She spelt out why it was that people could not afford the 20p that they were then asked to pay towards their prescriptions. She quoted one mother as saying :

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"It's a waste of his time and mine".

She was referring to visiting the doctor, because the family could not afford it. The pamphlet went on to say :

"one harassed mother said Eight mothers said that they could not afford the twenty pence prescription charge, and were shopping around the market for home-made cures for minor ailments.' "

Those are not my words ; they are the words of the Secretary of State, who is so timorous--so unusually timorous ; so remarkably timorous--that she will not stand up and answer those questions at the end of my speech. I am delighted that the Secretary of State has turned up, albeit late--less like Mary Poppins than like Cinderella at the ball.

Millions of people are concerned about the changes that we are discussing tonight, and about the way in which they are expected to pay the price of the Conservative Government's failure to deal with the economy. The Government have had to raise charges rather than taxes ; they are unwilling to fund from general taxation what should rightly be a benefit for those who need medication most. Not only have they failed to keep promises and to protect people who need the occasional prescription ; they have failed to protect those who need multiple regular prescriptions, week in, week out. That is why we are praying against the regulations.

A 50p increase per prescription may seem very little to people who earn vast sums out of the hard work of others. It may seem very little to Conservative Members. For many people, however, it will represent a major burden on their income. Three or four prescriptions will constitute a large imposition on those who are struggling just above income support levels, with just enough income to keep their families together. Such people are often on part-time earnings.

The Parliamentary Under-Secretary for Health (Mr. Tim Yeo) : What about the poll tax in Sheffield?

Mr. Blunkett : All that we get from Conservative Members are cheap remarks about people paying their poll tax. The poll tax and the prescription charge have one thing in common : they do not take from the rich, but they load disadvantages on to the poor. They are an alternative form of taxation. The most regressive taxation taxes those in specific need of medication while alleviating the position of those who could well afford to pay for that medication. It is worse than that, however. It is nonsensical in itself for someone receiving one form of exemption to be exempt from everything, and for those who are not exempt to have to pay everything. Why should people suffering from cystic fibrosis not be exempt, while those suffering from ailments that are already exempt find that everything else falls into place?

Only this morning, I received a letter from a Mrs. Forbes of Aberdeen. Her son, aged 28, has cystic fibrosis, and is struggling for life. She is fortunate, because he is exempt--not because of the major life-threatening ailment from which he suffers, but because of a related problem that enables him to receive prescriptions. It is nonsensical ; everyone knows that. The system needs to be changed, and the amounts that people are paying need to be frozen. Tonight, however, we are debating a 50p increase, and the draconian weighting of that increase on those who can least afford it.

Why are we debating the issue on the eve of the Budget? The answer is simple : the Government are not prepared

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--as they were not when they made the announcement--to stand up in the light of day and the public arena, knowing that they will be reported, and argue their case. They know that that case is wrong ; they know that the charge should not be levied, and that they are being unfair to those who are least able to defend themselves. 10.14 pm

The Minister for Health (Dr. Brian Mawhinney) : From 1 April the National Health Service (Charges for Drugs and Appliances) Amendment Regulations 1993, the National Health Service (Dental Charges) Amendment Regulations 1993 and their Scottish equivalents introduce responsible increases in NHS prescription charges and in the maximum and proportional charges for dental treatment. Those charges will be paid only by people who can afford to contribute to the cost of their treatment and medication.

The existing wide-ranging exemptions and remission for people who cannot afford prescription charges are unchanged. No child, no expectant or nursing mother, no state retirement pensioner and no one on income support or family credit pays a charge. They and the people who get free prescriptions because they are exempt on medical grounds or are on a low income are unaffected by the 50p increase. I shall set the regulations in context. NHS spending is at an all-time high. The gross provision for 1993- 94 is over £37 billion, a real terms increase over this year and up by 61 per cent. in real terms since 1978-79. To put it another way, we are spending just over £100 million a day on the national health service. That amounts to £649 for every man, woman and child compared in equivalent constant prices with £417 when the last Labour Government left office. In 1992-93, £19 of every £20 spent on the NHS will be met from taxes and national insurance contributions. It is estimated that less than 4 per cent. will be met from all the charges in the NHS put together. Nevertheless, that 4 per cent. is not insignificant in terms of better patient care. From 1 April the proposed increase in prescription charges from £3.75 to £4.25 will raise about £278 million a year for the NHS in England alone. Opposition Members may be interested to know that that would fund the building of about seven 300-bed district general hospitals and their running costs, or over 70,000 hip replacement operations or more than 45,000 coronary artery bypass grafts.

Mr. Thomas Graham (Renfrew, West and Inverclyde) : Not long ago I wrote to the Minister about a constituent with a chronic disease. The reply that I got only a week or so ago was basically that if the Government gave her an exemption they would need to exempt people with cancer, with dialysis problems, with diabetes--the lot. Does not the Minister realise that our hospital bill will increase if people cannot afford the medicine that will keep them out of hospital? An increase of 50p will deny proper medicine to people on low wages and they will end up in hospital costing £600 to £2,000 a week. Is that the way that the Minister want to go?

Dr. Mawhinney : Of course, there must be some truth in the hon. Gentleman's general proposition, but he was not listening to me. I said that those on low income were exempt from charges. Therefore, the hon. Gentleman's point is not valid.

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On average, people who pay prescription charges receive six items a year on prescription. The new prescription charge, which is still much less than the average total cost of a prescribed item to the NHS, will cost such people £3 a year more than they are paying this year. For the minority who pay charges and who are heavier than average users of prescribed items, the prescription prepayment certificates offer real savings. The new proposed cost of four-monthly and annual prescription prepayment certificates will be £22 and £60 respectively. As hon. Members know, other charges will be increased by a percentage similar to the rise in prescription charges. Perhaps Opposition Members would like to suggest which of our planned improvements in NHS services next year they would like to cut to make up the shortfall. Such cuts would take place without providing any benefit for the least-well-off because they do not pay prescription charges. The charging structure recognises people's differing ability to pay. Four out of every five prescribed items are now dispensed free--more than at any time since the Labour Government reintroduced prescription charges in 1968. When Labour last left power in 1979, only three out of five prescriptions were dispensed free.

We propose to increase the maximum charge for a course of dental treatment which starts on or after 1 April this year from £225 to £250. I noticed that the hon. Member for Sheffield, Brightside (Mr. Blunkett) did not mention dental charges, so I am grateful to him for his support on this aspect of the regulations. That increase will affect less than 1 per cent. of adult courses of treatment. At the same time, the proportion that a patient contributes to the cost of a course of dental treatment will increase from 75 to 80 per cent. Increases in the proportional and maximum charges for dental treatment will raise an estimated £17 million for the national health service in England in 1993-94 and about £25 million in a full year. And £25 million is equivalent to the annual cost of about 250 general dental practitioners.

As with prescription charges, only those who can afford to do so are asked to contribute towards the cost of their dental treatment. All treatment to those under 18 years of age is free and some 21 per cent. of adult courses of treatment are free. Many others on low incomes get treatment at reduced rates. We are seeking to encourage a positive attitude and changed habits to dental care through the provision of free dental treatment for children and the continuing care which the new contract for dentists introduced for all adults. Since the introduction of the new contract, more people are coming forward for dental treatment and registering with a dentist. Adult registrations at 31 January were more than 21 million, an increase of 3.3 per cent. since 1 July 1992. More courses of treatment are being undertaken on these people. That does not sound to me like a system under which people are so scared of charges that they put off going to the dentist.

Finally, the National Health Service (Optical Charges and Payments) Amendment Regulations 1993, together with their Scottish equivalents, increase the value of optical vouchers by an average of 2.75 per cent. Once again this increase is in excess of the current rate of inflation and should preserve the real terms value of the vouchers. About 34 per cent. of the population are entitled to optical vouchers, including children under 16, students under 19, people on income support or family credit,

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others on low incomes and people who need certain complex lenses. Expenditure on the optical voucher scheme costs the NHS about £100 million a year.

Mr. Jimmy Boyce (Rotherham) : Will the Minister be kind enough to explain to the House what he means by "low income" before people have to pay?

Dr. Mawhinney : I think that the hon. Gentleman knows the answer to that question. It relates to qualification for existing social security benefits.

Last year, from 1 April, we carried out a wholesale redefinition of voucher bands. This increased the value of voucher A, the most common voucher, by over 20 per cent. and the majority of customers are considerably better off.

The hon. Member for Brightside set out the Opposition's current position on prescription charges. Year by year during the 1980s the Opposition attacked the Government for asking the limited number of people who actually pay prescription charges to contribute more. Year by year, the hon. Member for Livingston (Mr. Cook) attempted to convince the world that he was outraged. Year by year he won his sound bite on the evening news, so when the time came to write the election manifestos, Conservative Members rushed to have a look at what the Opposition would say and see how they would use this opportunity to put their principles into practice. We looked for their pledge to reverse the rises in prescription charges which they had so vehemently opposed. We looked in vain. Labour devoted two pages of its manifesto to health, but, in all that space, it had precisely nothing to say about prescription charges. The hon. Member for Brightside had nothing to say about them this evening. He was but a poor, pale imitation of the hon. Member for Livingston--and we know where he progressed to.

Of course, in their manifesto, the Opposition were willing to remove £500 million from patient care to fund the minimum wage proposals, so beloved of their union sponsors, but even they baulked at having to remove another £240 million by scrapping prescription charges. Unless the hon. Member for Brightside is able to do better than he has this evening, the pages of his speech and all the words that he will pour forth in sound bites tomorrow and in the weeks to come will wind up in the same paper shredder as the words of the hon. Member for Livingston. The hon. Member for Brightside is trying to have it both ways--outrage but no guts to make a commitment that he would reverse the changes that we are announcing tonight. All Governments have to make choices. We are committed to increasing spending on the NHS and our record is significantly better that than of the Opposition. However, we also have to balance the needs of the service against finite resources. Available resources should be directed at the greater need. The charges for dental treatment and prescriptions, which will apply from 1 April, are a small but nevertheless important contribution towards the funding of the NHS and will continue to be paid only by those who can afford that contribution.

The public understand the usefulness of a limited additional contribution to the NHS from those who can afford it. Their concern is not to engage in party political point scoring, especially of the spurious type so beloved of

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Labour politicians, but to have the best possible national health service. Those who share the public concern should vote against the motions.

10.27 pm

Ms Liz Lynne (Rochdale) : I welcome the chance to debate the issues, but not the increases in prescription or dental charges. I welcome the increase in the value of the voucher, although it does not go far enough.

This is the 15th rise in prescription charges since 1979. There has been a horrendous increase of 2,000 per cent., a 13 per cent. increase on current levels and, at the same time, an increase of only 1 per cent. in real terms in the whole national health service budget. How can the Government justify a 13 per cent. increase in prescription charges but a real terms increase of only 1 per cent. in the NHS budget? So much for the NHS being free at the point of delivery.

How many more people will be put off going to their general practitioner for a prescription? The pharmaceutical industry has said that increases could be dangerous because many patients will have to choose between which prescription they collect. I know of people in my constituency who have already had to choose between painkillers and antibiotics. Of course, they opt for the painkillers because they want to kill the pain, but they are storing up problems for the future. If they do not take the antibiotics, they will cause long-term problems which will cost the health service more. The Government's attitude is, therefore, very short-sighted.

The Minister has just said that those who cannot afford to pay will not pay, but I disagree. Many people on very low incomes will not be able to afford to pay. They will not be included in the exemptions and they are not included at the moment. For example, students who receive loans are not exempt. Many students do not get free prescriptions, free eye tests or any of the other free services that they used to get. Certain people on invalidity benefit, for example, will not get free prescriptions.

The citizens advice bureaux brought the case of a constituent to my attention. He has to have medication to thin his blood and he cannot get that medication free. The medical exemptions were probably good enough when they were drawn up in 1968, but they must now be changed. I urge the Government to look at the matter seriously and to extend the list of medical exemptions to cover the advances in medicine in the past few years. My constituent might then be included in such a list of exemptions.

I know that the drugs bill is large--nobody disputes that. I know that the Government have said that we cannot afford the present drugs bill. Perhaps we should consider other areas, such as

over-prescribing. I know that the Minister has done some work on that, which I welcome. Some general practitioners over-prescribe and issue repeat prescriptions far too often. GPs should also consider referring people for alternative medicine instead of putting them on to particular drugs. I understand that GPs can already do that under extra-contractual referrals, but I believe that many GPs are not aware that they can do that and I should like the Government to make GPs more aware that alternative medicine is available. That could mean that a patient could be referred for chiropractic, for example, instead of being given drugs.

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Dental charges are up by 6.7 per cent. I know that that increase is not as great as the increase in prescription charges and I suppose that we should be grateful for small mercies ; personally, I do not think that we should be. The patient's contribution is up from 75 per cent. to 80 per cent. As the Minister said, the maximum payable has increased from £225 to £250. In the past few years, NHS dentistry has been damaged beyond repair. Some dentists already refuse to take NHS patients. The regulations will make it even more difficult for patients to get treatment.

I have heard of a child in my constituency--I am looking into the case at the moment, so I do not know how true it is--who has been refused NHS treatment for a brace. She is a fairly young child and her father has brought the case to my attention. These regulations will not help patients to go to the dentist. Many people refuse to go to the dentist now for check -ups because they cannot afford it. Then we turn to vouchers for glasses. The Federation of Ophthalmic and Dispensing Opticians, in a survey in 1992, found that the cheapest spectacles were £38.55 inclusive of VAT. The voucher was £23.70 and has gone up to £24.40. Where is the £14.15 to come from for those who need glasses and who are supposed to be getting them free? The voucher does not cover the cost of the spectacles. A mother in my constituency has talked for the past few years to me and to anyone who will listen about her daughter, who keeps falling and breaking her glasses. She can get them repaired, but the voucher does not cover the cost completely. Each time her daughter falls and breaks her spectacles, she has to go to the optician and top up the money over and above the voucher. That is not good enough.

Dr. Mawhinney : May I point out to the hon. Lady that the most recent survey of spectacle retailers showed that 50 per cent. of retailers were able to offer spectacles at within the voucher value?

Ms Lynne : But 50 per cent. is nothing like enough. If one does not live in a constituency where--

Mr. Graham : Does the hon. Lady realise that I represent a rural constituency and that if my people had to keep running into the centre of town for prescriptions, they would pay pounds and pounds in transport costs --if they were lucky enough to get a bus in the first place?

Ms Lynne : I take the hon. Gentleman's point.

The Under-Secretary of State for Health said in 1991 that people would not have to top up. I gather that he meant that they would not have to top up at all. On 11 December 1991, in the Committee that considered the National Health Service regulations, the Under-Secretary said :

"The hon. Gentleman also sought reassurance that voucher values would be sufficient to permit anyone holding a voucher to have access to the purchase of spectacles without needing to pay a supplement. That is, indeed, the Government's view."--[ Official Report, Second Standing Committee on Statutory Instruments, &c., 11 December 1991 ; c. 14.]

Obviously it is not the Government's view any more, because the Minister refers to a figure of 50 per cent. Do the Minister and the Secretary of State think that the vouchers will cover costs in all cases? I doubt whether the hon. Gentleman could stand up at the Dispatch Box and say that, in every case, the voucher would cover the cost of spectacles.

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There is real fear that people will not be able to get the treatment that they need. They will not be able to get their prescriptions. In many cases, they will not be able to get the dental care or the eye care that they need.

On 11 March 1993, Virginia Bottomley herself--[ Hon. Members :-- "Order"."]--the Secretary of State for Health said :

"above all, the NHS will continue to offer care on the basis of need, not ability to pay."

I hope that the Government take that into account, because if the regulations go through tonight, that will certainly not be the case. 10.37 pm

Mr. Jerry Hayes (Harlow) : It is always a joy to follow the hon. Member for Rochdale (Ms Lynne). Whatever she tells the House, she tells it with great aplomb. The trouble is that she never tells us very much. It was most interesting to hear what the hon. Lady had to say. I refer her to a document that her party published in February 1992, entitled "Restoring the Nation's Health". The sum total of the Liberal Democrats' views on prescription charges can be paraphrased thus : the total abolition of charges is not necessarily desirable. So I ask the hon. Lady, "What is the Liberal Democrats' policy?" Never mind the Liberal Democrats ; let us deal with those on the Opposition Front Bench. A great thing happened to this nation last week. Mr. Yentob of the BBC made the cataclysmic announcement that "Eldorado" would be taken from our screens. Some of us occasionally switched on at 7 o'clock in the evening and watched totally inadequate, totally hopeless people limping from crisis to crisis, without any idea of what on earth they were doing. Where will we look now to make us look adequate? I suggest that we look at the health team on the Opposition Front Bench. I cannot attack their policy on prescriptions because I do not know what their policy is, and if I do not know what their policy is, I know that they do not know what their policy is.

In the run-up to the general election, the hon. Member for Livingston (Mr. Cook) said that Labour would freeze prescription charges and that, over time, they would decline in value.

Mr. Paul Flynn (Newport, West) : On a point of order, Madam Deputy Speaker. This is a specific debate about the Government's proposals and has nothing to do with Opposition policies. Many hon. Members wish to catch your eye to talk about the specific proposals before us. The hon. Member for Harlow (Mr. Hayes) has spoken for some minutes now without mentioning the Government's proposals.

Madam Deputy Speaker (Dame Janet Fookes) : I usually allow a little latitude, but the word is "little". I am sure that that point will be taken on board.

Mr. Hayes : I always obey your rulings in these matters, Madam Deputy Speaker. In my constituency of Harlow, we live in a nuclear free zone. Obviously the Opposition Front Bench lives in a policy-free zone.

I was simply trying to constrast what Opposition Members have been saying with Government policy. That is a perfectly fair and reasonable thing to do. The Opposition spokesman did not tell us what the Opposition were going to do.

Mr. Ron Davies (Caerphilly) : Order.

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Mr. Hayes : The Opposition are praying against the regulations. They should have the courage to tell us what they are going to do. The House and the general public deserve an answer, but we have not heard an answer tonight.

What did we hear from the hon. Member for Sheffield, Brightside (Mr. Blunkett) tonight? Perhaps he, or one of his colleagues, will tell us later what the Opposition will do. Would they freeze prescription charges or abolish them? Would they bring more money into the health service? Or is the hon. Gentleman going to continue, as the press reports that he is, to attack my right hon. Friend the Secretary of State for Health?

In the Financial Times the hon. Member for Brightside accused my right hon. Friend the Secretary of State for Health for caving in to the Treasury. He said that the Government were prepared to tax the sick, not the rich. Therefore, according to the hon. Member for Brightside, my right hon. Friend is caving in to the Treasury. The proposals in the regulations involve £278 million. Is that money going to the Treasury? No, it is going directly to health care and directly to the patients. As my hon. Friend the Minister said so eloquently a moment ago, it will go to hospitals, into coronary bypasses and into reduced waiting lists. [Interruption.] I am sorry. The hon. Member for Brightside may have said something about a policy. Is he attacking that amount of money?

The Opposition always talk about cuts. I talk about them as well. I remember the cuts in the pay of doctors and nurses under the last Labour Government.

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