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Mr. Smith: As the hon. Lady knows, we have identified an immediate £100 million which, as a start,

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we shall take from the system's bureaucratic costs. I believe that more money will be available by reducing bureaucracy after that start has been made. The early target is £100 million. I believe that that money can be better spent on patient care.

The answer to many of the problems that we are seeing lies, first, in recognising that there is a crisis. It would help if the Government would admit that they are facing some problems. It would help also if they would stop being quite so complacent and smug as the Secretary of State can sometimes be. Secondly, they need to end internal market procedures, with the distortions that they bring to patient care.

Thirdly, we need to bring back strategic thinking and preparation into the health service. Fourthly, we need to end the inequity between patients that we all too often see. Fifthly, we need to divert money from wasteful bureaucracy and transfer it into patient care. That is the way forward.

The chairman of the BMA council put it rather well on 11 October. This is the leading voice of the medical profession, not the Labour party's voice. He said:

"We are facing the most difficult winter in the NHS since the internal market was introduced."

It is not as though the Government were not warned. He continued:

"We need to reform the market, eliminate the perverse effects of competition, restore co-operation and stability to hospital and community health services and begin the task of rebuilding a comprehensive national service where patients' clinical needs come first".

I do not disagree with any of his sentiments.

What Sandy Macara could not say, but the British people can, is that there is a sixth requirement in order to restore and rescue the NHS, and that is a Labour Government. Labour created the national health service--even the Prime Minister had to accept that this afternoon--in the teeth of opposition from the Conservative party, and a Labour Government will rescue and renew it. The Labour party will fulfil its fundamental aim of restoring the NHS so that it is run not as a commercial business flooded with paperwork--as it has become under the present Government--but as a public service that puts patients first.

4.35 pm

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

"notes that the National Health Service is providing high quality care to more patients than ever before; congratulates the dedication and professionalism of the National Health Service's staff during the recent cold weather which has placed exceptional demands upon them; believes that the National Health Service requires a growing budget for patient care and therefore welcomes the Health Service Guarantee given by the Prime Minister to increase spending on the National Health Service in real terms in each of the next five years, including an extra £1.6 billion for patient care in 1997-98; and believes that this guarantee reinforces the Government's consistent record of investment in the National Health Service and its professional staff."

The speech by the hon. Member for Islington, South and Finsbury (Mr. Smith) shows why Labour is about to lose the fifth general election in a row. The hon. Gentleman seems to believe that all that is required of him on these occasions is to parade a few individual cases

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that are supported by incomplete facts, make a half-researched charge about the Government's record, wave a shroud, repeat the mantra that Labour will abolish the internal market and base metal will be transformed into gold. He thinks that Labour's claims will be vindicated by that process. His predecessor, the hon. Member for Peckham (Ms Harman), never carried conviction when she had the job. We expected more and better of the hon. Gentleman, but we have been disappointed every time he has come to the Dispatch Box, and we were disappointed again this afternoon.

Labour's approach is best summarised by referring to the war of Jennifer's ear, which was the technique that discredited Labour in the run-up to the last election. It did not work: Labour Members were found out then, and they will be found out again. If they want to be taken seriously on health, they should say what they would do about it. So far, they have shown a taste for the politics of the gutter. They play on public emotions and fear, run down the efforts of the dedicated professional staff of the health service and cover the whole concoction with a thin veneer of synthetic concern. They believe that that will suffice in place of a health policy. It is the politics of perpetual opposition, which is clearly what the hon. Gentleman is preparing for.

I shall consider the issues raised by Labour from the Dispatch Box, and I shall begin with paediatric intensive care. In its press release, Labour says:

"Over 400 children turned away".

That is a grotesque misrepresentation of the facts, and it is specifically designed to cause maximum concern and alarm among parents of young children.

The facts about what has actually happened in paediatric intensive care are clear. Last spring, I assured the House that we would increase the total number of places available for paediatric intensive care, and that is what we have done. There were then 249 beds in paediatric intensive care and high-dependency care, and there are now 279 beds--as I said in May there would be by this time this year. I apologise to the hon. Member for Islington, South and Finsbury if he was not provided with those figures. He has my assurance that he will be provided with them if he asks a further parliamentary question. I gave the House an assurance in May that those beds would be provided, and provided they have been. The Government have nothing to conceal on paediatric intensive care.

Mr. John Gunnell (Morley and Leeds, South): Are those beds going to the regions in which they were promised? I do not think so. I do not think that the Leeds paediatric intensive care unit, about which we have had correspondence, has had the increase that was anticipated. When I visited that unit a year ago it had five beds, but it could have accommodated six at a squeeze. The Secretary of State says that it now has six beds, but it had that capacity before; has it the resources to take care of six beds?

Madam Deputy Speaker (Dame Janet Fookes): Order. The hon. Gentleman's question is becoming far too long for an intervention.

Mr. Dorrell: I published the commitments that the Government had given in May last year. There is a

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published document on the record. If the hon. Gentleman tables a question about the availability of paediatric intensive care and high-dependency care by region, we will provide the information and he can test it against the undertakings that were given at that time. If he again studies the document that I published in May, he should also note the emphasis that I placed on the availability of both bed space and proper retrieval systems, providing ambulances to take children needing intensive care who are in hospitals that cannot provide beds to meet their needs to the hospitals that are best able to meet those needs.

This afternoon, the Leader of the Opposition said from the Dispatch Box that I had given an assurance that every child who needed intensive care would be provided with it in the hospital to which that child reported. I never gave that assurance, and the fact is that no responsible Health Secretary could ever give it. Such an assurance would not be supported by the paediatric intensivists who know how to deliver high-quality care to children in that condition. The service that they want to deliver is based on specialist paediatric intensive care units with proper ambulance services to take children to the units best placed to meet their needs. That is the assurance that I gave the House in May, and it is the assurance that the Government are in the process of delivering.

The doctor whom the Prime Minister quoted at Prime Minister's Question Time is the chairman of the Paediatric Intensive Care Society--the leader of the group of doctors responsible for delivering this service. Let me repeat his words:

"I don't think this should be subject to party political point scoring. To look at something in isolation as they"--

the Labour party--

"are apparently attempting to do is wrong, because it doesn't give the whole picture."

The Opposition motion seeks an all-party approach to some of the key health issues. I accept that, because what I have set out to do in paediatric intensive care is deliver the pledge that I gave the House last spring. I believe that the best measure of the delivery of that pledge is that no child--

Mr. Bayley: Will the Secretary of State give way?

Mr. Dorrell: I will finish this point before I give way to the hon. Gentleman. His Front Benchers allege that his party is interested in paediatric intensive care, and I am replying to their concerns.

Last May, I gave the House an assurance that we would establish a proper basis for the provision of paediatric intensive care. Since 1 December, when we established the computer bed clearance system that I undertook to deliver then, not one child has had a need for intensive care confirmed by a clinician and then not been offered bed space. Indeed, since that date 40 cases have been referred to the emergency bed service, and on each occasion we were able to offer at least two paediatric intensive care units to accept the transfer--not just one, but two. I believe that such a paediatric intensive care service, delivered through the national health service, can be seen to be addressing the real needs of children who require intensive care.

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I might have hoped that, if the Labour party was seriously interested in the issue, it would--rather than seeking to make cheap party points--welcome the improvement in the quality of the delivery of the service for which the Government have been responsible over the past 12 months.

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