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Mr. Anthony Coombs (Wyre Forest): The hon. Lady cannot get away with being so evasive about GP
fundholders. As of next year, 100 per cent. of the people in my constituency will be treated by GP fundholders and, as a result, they will receive a far better standard of primary health care than ever before. They will want to know, just as we do, whether the Labour party would abolish GP fundholding for those who are gaining so many benefits from it. Is the answer yes or no?
Ms Harman: I am glad that the hon. Gentleman is so interested in the policies that will be pursued under a Labour Government, and he will certainly hear of the discussions that we are having with GPs, both fundholders and non-fundholders, to sort out the mess that the Tory Government have created. I am surprised that he has not risen to his feet today to complain about the problems caused to his constituents in the west midlands because, in that region, one in five hospital beds have been closed in the past five years, the number of nurses has been cut by 12 per cent. and the number of managers has gone up by 310 per cent.
Mr. Coombs: What is the answer? [Interruption.]
Mr. Deputy Speaker: Order. It is no good thehon. Member for Wyre Forest (Mr. Coombs) saying, "What is the answer?" when the hon. Lady is giving her answer. He may not like the answer, but that is not my responsibility.
Ms Harman: It used to be a fundamental principle that NHS patients would be entitled to the best medical treatment, irrespective of where they lived, but now managers in each region are deciding on the ground of cost what will and will not be available on the NHS.
Two years ago, only four health authorities were excluding treatment from the NHS. Now 40 health authorities, one third of all the authorities in the country, are rationing, so people have to be careful where they become ill. Do not get brittle bones in Dorset, because the health authority is stopping screening for osteoporosis there. Do not get infected wisdom teeth in Hertfordshire or Kingston and Richmond, because the health authority will not take them out there. Health care has become a lottery, depending on where people live.
Dame Elaine Kellett-Bowman:
On a point of order, Mr. Deputy Speaker. Is it in order for the hon. Member for Peckham (Ms Harman), the Labour Front-Bench spokeswoman, to practise sex discrimination--in the debate, she has given way only to men and not to women?
Mr. Deputy Speaker:
That is not a matter for the occupant of the Chair, but I am sure that the hon. Lady's point of order will have been noted by Madam Speaker.
Ms Harman:
It was not sex discrimination that made me not respond to the hon. Lady's intervention: it was kindness.
The problem is that, when people cannot get the treatment that they need on the NHS, they have to go private or go without. Again, we see the Government strategy of creeping privatisation at work. Again, it used to be a fundamental principle that the NHS provided not just for illness, but for a wide range of health care needs, but now services are being pushed one by one into the private sector.
Take dentistry. When people go to an NHS dentist, they pay so much, now that the charges have gone up, that they think they have gone private anyway. First, charges are pushed up so high that people can hardly tell the difference between the public and the private sector; then fewer and fewer dentists do NHS work, so more and more people end up having to go private.
Take long-term nursing care. The Government close long-stay wards and force people into the private sector. People used to receive treatment free and now they have to pay. It is no wonder that private health care is growing. These are the facts. There are now 28 per cent. fewer NHS hospital beds than there were 15 years ago, but there are66 per cent. more private hospital beds than there were 15 years ago.
That, however, is just the start. The Government want to go further. They are handing public health services over to private organisations through market testing, the private finance initiative and making the NHS buy services in the private sector. Their privatisation strategy is about not just putting out services to the private sector, but changing the basic ethos of what is left of the NHS, so it is no longer doctors and nurses who decide how people are treated: it is accountants and bureaucrats put in by the Tories.
If people want to know where so much NHS money has gone in the past five years, I shall tell them. It has gone on accountants, on senior managers, on their company cars and on their form filling. The number of managers has increased from 5,000 five years ago to 23,000 today. At the same time, 50,000 staff have been cut from our wards. These are the Tory priorities for our health services: more people to count the cost of care, fewer people to provide that care. They are not, however, the priorities of the British people, who are totally opposed to the privatisation of the NHS.
The Secretary of State for Health, for all he protests--as he will, no doubt, today--that he is the friend of the NHS, is nothing more than the presentable face of privatisation. I should like to ask him some simple questions about where he stands. First, on the casualty crisis, does he agree with this statement:
Does he believe that that is unacceptable? That statement was made by the former Secretary of State for Health, the right hon. Member for Sutton Coldfield (Sir N. Fowler). If the Secretary of State agrees with that statement, which he says he does, and I welcome that, why does he not implement--
Sir Norman Fowler (Sutton Coldfield):
The hon. Lady has just quoted my words, so I think that I am entitled to ask her the further question: does she welcome the steps that the Government have taken to create new emergency wards at Good Hope hospital, to provide new nurses and to modernise the accident and emergency unit?
Ms Harman:
No, I do not--[Hon. Members: "Oh."] Will hon. Members listen? I do not welcome those steps
Mr. Robin Corbett (Birmingham, Erdington):
I thank my hon. Friend for coming to Good Hope hospital in north Birmingham. May I confirm that none of the so-called beds opened when the Secretary of State for Health was walking down the corridor is new--they are reopened beds? There is no money available for an admissions ward alongside the accident and emergency unit. It will be a year before building on that ward can be started, even if it can be funded. May I confirm that the money that is now being spent on refurbishing the accident and emergency unit is not new or extra money, but money that the regional health authority already had and had allocated for that purpose?
Ms Harman:
My hon. Friend's points demonstrate that the Government's response to the crisis facing patients is to produce bogus statistics and false solutions. Why does not the Secretary of State produce a real solution to the casualty crisis and act now?
There are many ways in which the NHS could improve the service that it provides. New technology offers unprecedented opportunities so that, for example, a doctor in Sheffield can examine a patient in London. New drugs and treatment, such as hormone replacement therapy for brittle bones, offer new hope to many women. New screening techniques can prevent and detect serious diseases, such as cystic fibrosis, and new ways of delivering care to people in their own homes can revolutionise medical treatment.
Rebuilding the NHS after the Tories will be a challenge, but its staff--the doctors, nurses and all the other staff--have repeatedly shown their commitment to the NHS as a public service. They have shown their ability to deliver high-quality care, despite the Tories. Labour will bring together staff, patients and the community to draw on their views, to create not division but consensus and to plan for the future of health care.
We will transfer the £1.5 billion that the Government waste on bureaucracy to front-line services--to doctors and nurses and not to accountants and managers. We will end the unfair system whereby treatment is dependent on which GP is purchasing the health care rather than on the clinical needs of the patient. We will end the lottery of long-term nursing care, which means that the care received and the price paid depend on where one lives. Our NHS will concentrate on the patient, not on the costs.
The NHS has great potential, which Labour in government will unlock. The next general election will decide the future of our health service. Already we have an NHS in which there are hospitals without trolleys, patients without beds and wards without nurses. The Tories have a hidden agenda for a fifth term that will destroy our NHS for good. The Secretary of State's friends give the game away. Roy Lilley, Tory health expert, called the NHS
David Green, of the Institute for Economic Affairs, said that the NHS
"I believe that it is unacceptable that people entering the hospital through the accident and emergency unit should be kept waiting for hour after hour on a trolley"?
"I can tell you there are no new beds being opened. We are simply re-opening beds that have been closed through lack of staff resources."
"the rump of the remaining nationalised industries and an overburdened bureaucracy".
24 Jan 1996 : Column 380
"breeds a childlike reliance. It has to go."
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