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Mr. Chris Smith: It would help if the right hon. Gentleman and his Government had not already broken that pledge. The Red Book shows that they have.
Mr. Dorrell: The hon. Gentleman keeps saying that, but it is absolute nonsense. The Red Book sets out clearly--I can give the hon. Gentleman the correct reference--a budget that represents real growth year by year, throughout the three years of that spending
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programme. Furthermore, I can give a commitment that there will be real growth of the health service budget through not only the three years of that spending programme but the remaining years of the next Parliament. That is the commitment that we have given and delivered through 18 years. We give the same commitment for the five years of the next Parliament and the Labour party will not match it.
Ms Jean Corston (Bristol, East) rose--
Mr. Dorrell: I will give way when I have finished dealing with the hon. Member for Islington, South and Finsbury on funding.
When Colin Brown was writing in one of the health service magazines recently, he said that the Labour party
Ms Corston:
Does the Secretary of State accept that the people of Bristol will judge the Government on their record, not just on the rhetoric of Front-Bench spokesmen? On the night of 5 January, 10 patients at Bristol royal infirmary were asked to get out of their beds after 10 o'clock at night because their beds were needed for other patients who were waiting on trolleys. One of them was a man in his 80s. The patients were sent home in taxis or relatives were asked to collect them, sometimes as late as 2 am when the temperature was minus 2 deg. That has received widespread publicity in Bristol and has caused a great deal of anger. Is the right hon. Gentleman surprised that people do not believe him when he denies that the health service is in crisis?
Mr. Dorrell:
It is not me they will not believe; it is the Labour party. The hon. Lady is trying to make me return to discussing individual cases. I will not do that. The challenge for the Labour party is to demonstrate how it will deliver a health service that matches the Government's pledge.
It is not only a matter of total spending levels. There is worse to come when one thinks about the implications for the health service of the commitments that Labour has given. As I said at Question Time, the Labour party is committed to abolishing compulsory competitive tendering in the NHS. Such tendering is currently estimated to save £90 million on the health budget. Within the budget, which will not be growing because the right hon. Member for Dunfermline, East will not allow it, the Labour party has to earmark £90 million to pay off its trade union paymasters through the abolition of compulsory competitive tendering.
The Labour party is also committed to the introduction of a minimum wage. When the right hon. Member for Livingston (Mr. Cook) held the health brief, he was honest enough to admit that that had a cost attached to it. He put that cost at about £500 million. I look forward to hearing the up-to-date estimate from the hon. Member for Islington, South and Finsbury. The hon. Gentleman was
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The cost of that commitment is an important element in the choice that the electorate have to make. If the hon. Gentleman has not thought of that, I look forward to the correspondence that will enable us to develop a figure that we can then debate. We can then know whether that commitment will be a sensible use of health service money and whether it reflects a sensible priority in the frozen budget that the hon. Gentleman will have to put up with.
An issue that will be of considerable concern to many of my hon. Friends and their constituents is what is to happen to the private finance initiative. The Government have made it clear within their spending plans that they are determined to deliver a major investment programme for the national health service through the PFI. We have already signed up 43 schemes with a total spend of £317 million. A further 28 schemes have been approved with a total value of £309 million. There are 150 schemes being worked up by individual trusts under the PFI. The health service investment programme for the period ahead is £2.1 billion, to be provided by private sector partners through the private finance initiative.
Mr. Toby Jessel (Twickenham):
Is my right hon. Friend willing to comment on the private finance initiative in relation to West Middlesex University hospital, which, as he and the Under-Secretary are well aware, is a matter of eager and enthusiastic interest to my hon. Friend the Member for Brentford and Isleworth (Mr. Deva) and to me? We very much hope that the scheme can go ahead lickety-spit without delay. Can he give us any encouragement on that matter, which is important for our constituents, so that the existing, old hospital can be replaced?
Mr. Dorrell:
My hon. Friend is right to raise his constituents' concerns about that hospital. He will know that it is one of the many schemes that local managers are preparing to meet real local need with health authority support and that the Government are determined to see carried through to projects that modernise the capital stock of the health service. I can give him every encouragement that the Government are determined to carry that through.
The question whose answer my hon. Friend and his constituents will want to hear from the hon. Member for Islington, South and Finsbury is: what would be the implications of a Labour Government for that investment programme, which is valued at a lot more than £2 billion to the future of the national health service? Will the hon. Gentleman carry on with the private finance initiative, in which case he will have to eat mountains of words--both his own and those of his hon. Friends--or will he honour those words and scrap the schemes, so that they too have to be financed out of the frozen budget that the right hon. Member for Dunfermline, East will not let him increase?
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I know what is being said to the electorate in my home town of Worcester on that subject--once again, by the right hon. Member for Livingston. The hon. Member for Islington, South and Finsbury ought to have a word with the right hon. Member for Livingston, as when the latter travels around the country he appears to be rather too honest for his hon. Friend's good.
When the right hon. Member for Livingston recently visited Worcester, he made it crystal clear that, if the Worcester scheme went ahead before election day, as I know the citizens of Worcester hope, Labour would honour it; but if the contract was not signed by election day, it would go out the window. Bad luck to the citizens of Worcester. For them, the slogans are, "Vote Labour. Ditch your local hospital scheme" and "Vote Labour. Cancel your hospital project". Those are the slogans on which the hon. Member for Islington, South and Finsbury will go to the country, because he has no public capital--the right hon. Member for Dunfermline, East will not provide it--and he is not committed to the future of the private finance initiative, so he will not get it from that source either.
Every scheme that is not signed up before election day will be out the window, because the right hon. Member for Dunfermline, East can offer no hope that the schemes will go ahead. It is a good vote-winning message for the Tory party: "Vote Labour. Ditch your local hospital".
Mr. Gunnell:
The Secretary of State has told us about the 43 schemes totalling £317 million. Can he tell me in how many of those schemes work has started, which scheme is most advanced and how much money has been spent on it?
Mr. Dorrell:
Thirty-two have been finished.
The final question is one that Labour has invented for itself. It goes to the heart of the structure of the modern national health service. When we introduced local management, the Opposition fought us every inch of the way. The present Opposition Chief Whip said that Labour was
Mr. Chris Smith:
Before we move too rapidly away from the private finance initiative, will the Secretary of State confirm one or two things? First, he told the House more than a year ago that every month from then on he would announce a major new hospital scheme under the PFI. Will he admit that no such hospital has been confirmed in that intervening period? Secondly, will he confirm that in the case of the Norfolk and Norwich hospital, which was announced by the Chancellor of the Exchequer in the Budget and was the only major hospital scheme supposedly signed up under the PFI, although the contract with the contractors has been signed, the finance has not yet been finalised? Will the right hon. Gentleman also draw a conclusion from that about how much trust the people of Worcester or anywhere else can put in this
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"should fight again to keep the Tory promise alive for future years so that he"--
the hon. Member for Islington, South and Finsbury--
"can promise that every year, year on year, Labour will increase spending on the national health service in real terms. I bet he can't."
Well Colin, no bets, because that is a pledge that the right hon. Member for Dunfermline, East (Mr. Brown) will not allow the Labour party to make.
"implacably opposed to the provisions for hospital trusts outlined in the White Paper."--[Official Report, 11 December 1989; Vol. 163, c. 696.]
The present Labour spokesman on education said, "We will abolish trusts."
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