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Mr. Jacques Arnold (Gravesham): Will the hon. Lady give way on that point?
Ms Harman: It is simply the private finance panel putting on the A list the projects to which it will devote most attention because they are more likely to attract private capital. It is quite wrong for the Government, who seem unable to say what their priorities are for capital building in the NHS--they are unable to answer that question--to abdicate their responsibility for deciding priorities in the private sector. That is what has happened, and all the hospitals which desperately need capital work but are on the B list will want to know why.
Ms Harman: That highlights another problem for the NHS, because, with the capital budget slashed, the only place to which hospitals can turn for money is the private sector, and the private sector will be able to dictate the terms. We have always argued that, where private capital can serve the public interest in public services, it should do so, but we have always made it clear that the NHS must not be privatised. It is totally unacceptable that the Government are going down the path whereby not only will the private sector own the land and the buildings but it will run the hospital and employ the staff.
The Secretary of State has said--he makes this conditional, of course--that in the overwhelming majority of cases he will stop short of privatising clinical services, but that is all code and a smokescreen because he refuses to say what he means by "clinical services". It is a moving boundary. He has already made it clear that he does not think that anaesthesia, radiography, chiropody and pathology are clinical services, because he is already putting them out to market testing. In Scotland, the Stonehaven hospital contract is to include the private sector running the hospital and employing the staff.
Mr. Arnold:
Will the hon. Lady give way?
Ms Harman:
Those who work in our hospitals know, as we do, that the health care team needs to work together as a team. When a patient arriving at hospital finds that the receptionist, admissions officer, radiographer and blood-testing pathologist are all employed by, for example, a Swiss company and not the NHS, the Secretary of State
Mr. Dorrell:
The hon. Lady said that I did not define what I meant by clinical and clinical support services. I happily concede that all the services that she describes are clinical and clinical support services. I have made that clear many times before. I hope that the hon. Lady will also make it clear that the documents on market testing underline the fact that those services can be secured other than from NHS employees only where there is clinical support for such a change. That was set out clearly in the market testing documents and it is set out equally clearly in all the documents surrounding the private finance initiative.
Ms Harman:
When patients arrive at the hospital and find that the receptionist, the admissions clerk and the pathologist are all employed by a private company, they will know that this is not the NHS as they want it to be or as it used to be, and that it will have been privatised. The Secretary of State constantly tries to define conditions that he can then meet so as to justify his creeping privatisation, but people in this country know precisely what he is up to, and they are not in the least fooled by it. They know that with this fragmentation, the NHS health care team will be destroyed.
Mr. Arnold:
Will the hon. Lady give way?
Ms Harman:
Let me make it absolutely clear that there is no difference in the position that I am taking and the one taken by my hon. Friend the shadow Chancellor or my right hon. Friend the Leader of the Opposition. Under the Tories, private finance is intended not to top up the public purse but to replace it. It is not a public-private partnership but a private takeover. It is not a private finance initiative, but a privatisation initiative. The Tories are not only privatising the supply side of the NHS--
Mr. Arnold:
Will the hon. Lady give way?
Mr. Deputy Speaker (Mr. Michael Morris):
Order. The hon. Member for Gravesham (Mr. Arnold) may find it frustrating, but it is clear that the hon. Lady is not giving way to him.
Ms Harman:
I would have expected the hon. Member for Gravesham (Mr. Arnold) to intervene during the speech by the Secretary of State and to ask why his hospital's private finance project was on the B list. He probably did not even know about it. The B list is secret and the hon. Gentleman will have some explaining to do.
Mr. Arnold:
Will the hon. Lady give way?
Ms Harman:
Not only are the Tories privatising the supply side of the NHS--
Mr. Arnold:
On a point of order, Mr. Deputy Speaker. The hon. Lady referred earlier to my hospital and she has now referred to it again, yet she does not have the courage to give way.
Mr. Deputy Speaker:
That is not a point of order for the Chair.
Ms Harman:
If the hon. Member for Gravesham catches your eye later in the debate, Mr. Deputy Speaker, so that
The Tories are not only privatising the supply side of the NHS but pushing more and more people out of the NHS into the private sector. We have already seen what happened to NHS dentistry. First, charges were pushed up so high that one could not tell whether one was on the NHS or going private; secondly, there were fewer and fewer dentists doing NHS work so one had to go private. It has been the same story with long-term care.
Mr. Arnold:
Will the hon. Lady give way?
Ms Harman:
If the hon. Gentleman wants to intervene to ask me about his hospital, I will give way and then tell him about it.
Mr. Arnold:
The hon. Lady referred to the replacement hospital for the Dartford and Gravesham area which is on the list for the PFI. Is she aware that four major consortiums are bidding to build that hospital? Does she support the PFI for that purpose? If not, does she have a commitment from the shadow Chancellor to put up £100 million to build the hospital in one phase, which is what all the consortiums want to do? What is more, they would build the hospital in the correct place--Darenth park--which the NHS would not have done.
Ms Harman:
The hon. Gentleman does not seem to have understood what has happened in the Budget. He talks about his hopes for his hospital, but I can tell him two things today. First, the chances of any hospital getting capital work done on it are reduced as a result of the Budget and the cuts in NHS capital funding. Secondly, although the hon. Gentleman's hospital is on the private finance panel's list of NHS-PFI projects, it is not on the A list but on the B list, which means lower priority. The hon. Gentleman should complain to the Secretary of State about the fact that his hospital is on the B list in the endless search for private finance.
It has been the same story with long-term care, as my hon. Friends the Members for Halifax (Mrs. Mahon) and for Wallasey (Ms Eagle) mentioned. The Budget announcement on long-term care is an inadequate response which is designed to hide the Government's betrayal of a generation of elderly people. The Budget announcement will not stop elderly people having to sell their homes to pay for long-term residential care. Even the Secretary of State has not been able to claim that. The announcement is a quick short-term reaction to a long-term problem which the Government have helped to create and which they have failed to address.
With the average house worth £67,000, the new £16,000 capital disregard will not safeguard the homes of elderly people who believed that they had been promised care from the cradle to the grave. It will not remove elderly people's fear of losing almost everything that they have worked for a lifetime to build up and which the Prime Minister told them they could pass on to their children.
Ms Eagle:
On a point of order, Mr. Deputy Speaker. Is it in order for a Back Bencher, the hon. Member for Gravesham (Mr. Arnold), to consult the civil servants' Box, presumably about his hospital?
Mr. Deputy Speaker:
The Chair has no knowledge of what any hon. Member is consulting anybody about. Such consultation is, however, unusual.
Ms Harman:
The hon. Member for Gravesham is trying to find out why his hospital is on the B list and why he was
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