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Mr. Hall: Will the Minister give way?
Mr. Malone: I have already said that I do not intend to give way. My right hon. Friend the Secretary of State made it clear that that was part of an important strategy that he had put in place to tackle the winter problems that we knew we would be facing, and that is working extremely well.
In addition, nine extra high-dependency beds have been opened this month, a further 11 are funded to open in the year beginning April 1997 and an additional intensive care bed is to open in Warrington general hospital in April, following discussions between the Warrington Hospital NHS trust and North Cheshire health authority. I hoped that the hon. Gentleman would welcome that improvement in facilities in the area that he serves as a Member of Parliament.
Mr. Hall:
On a point of order, Mr. Deputy Speaker. In my speech, I recognised the fact that that extra bed was being provided and it is wrong for the Minister to suggest that I did not do so.
Mr. Deputy Speaker (Mr. Michael Morris):
Order. That is not a matter for the Chair.
Mr. Malone:
My hon. Friend the Member for Carshalton and Wallington (Mr. Forman) listed the achievements of the health service in his area. As he and I both know, that is a hard-pressed area for the health service in south London. I want to respond to his points.
With changes in the health service, when a reordering of services is needed to meet new clinical demands and needs, there will always be an on-going debate about the right balance of provision. I assure my hon. Friend that there is no suggestion that the Government are following a rigid template towards a conclusion. Of course, as change takes place we consider its effect on individual services; the provision of a higher-quality service is the watchword that governs those developments.
My hon. Friend also made a specific point about the chronically sick. He may care to note two points in that regard. First, the general improvements in primary care facilities in London as a whole, funded through the London implementation zone, are certainly helping to deal with the chronically sick. Secondly, my hon. Friend will understand and acknowledge that the National Health Service (Primary Care) Bill, currently in another place and shortly to come to the House, provides excellent opportunities for primary carers to do exactly as he suggested, and bring together innovative services to deal with special problems such as the chronically sick.
The hon. Member for Belfast, South (Rev. Martin Smyth) made several points, many of which centred on funding. I shall ensure that his other points are drawn to the attention of my right hon. and learned Friend the Secretary of State for Northern Ireland, but I want to respond to some of the funding points now. For 1997-98, £1.642 billion has been made available for health and
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The hon. Gentleman mentioned the comparison between Northern Ireland and the rest of the United Kingdom--and England in particular. We are spending about 15 per cent. more per capita on health and social care in Northern Ireland than in England. There have been various difficulties, not least in the present year, but the figures speak for themselves and reaffirm the Government's intention to continue to honour our commitment to the health service, despite adverse circumstances.
My hon. Friend the Member for High Peak (Mr. Hendry) spoke about fundholding. He was right to speak of the benefits of a system that the Labour party would simply sweep away. I am delighted to endorse what he said. As he pointed out, I visited his constituency on one or two occasions, and I have seen the innovations that are taking place there, not least the modern cottage hospitals that are often manned by primary carers.
The general practitioners' plans about which my hon. Friend spoke cannot be stifled by the Labour party--particularly because that party will never get into government--or by health authorities, because if, after the National Health Service (Primary Care) Bill becomes law, GPs propose plans to rearrange primary care services in my hon. Friend's constituency, there will be an automatic right to bring them to the Secretary of State for approval as pilots.
The hon. Member for Nottingham, East (Mr. Heppell) spoke about his constituents and funding. As I pointed out during the hon. Gentleman's speech, following three bids for special national funding, Nottingham health authority has been funded very generously in real terms for next year, receiving £500,000 of extra funding.
My hon. Friend the Member for Eastbourne (Mr. Waterson)--until recently my parliamentary private secretary, but now able to participate in these debates--pointed out that in his constituency there are pilots in purchasing that he knows would be abolished by a Labour Government. He was right to point that out, because those pilots are providing great benefits for his constituents.
The hon. Member for City of Durham asked about the trust business case. I can confirm that it was received by the NHS executive headquarters and by Her Majesty's Treasury in December 1996, and I hope that a decision to approve the full business case will be taken shortly. It is more likely to proceed with his active support than with the denigration that he tended to bring to the issue during the debate.
My hon. Friend the Member for Beckenham (Mr. Merchant) rightly pointed out that the Opposition were luxuriating in an idea of crisis. That was characteristic of their speeches, especially those of their Front-Bench spokesmen, which were devoid of policy content. My hon. Friend rightly pointed to good management initiatives in his constituency that were managing the pressure.
I shall ensure that the speech of the hon. Member for Ceredigion and Pembroke, North (Mr. Dafis) is drawn to the attention of my right hon. Friend the Secretary of State for Wales.
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Not only the House but the country could reasonably have expected to hear in this debate what the Labour party would seriously propose for the health service in the coming general election campaign. The truth is that nobody now believes the Labour party on health. To every interest group, it peddles high expectations that are shot down by the right hon. Member for Dunfermline, East (Mr. Brown). Even when the hon. Member for Islington, South and Finsbury (Mr. Smith) dines with the private sector, no new treatment that is canvassed is entirely ruled out. He nods his head and says that all is possible. He and other Labour spokesmen dine with the private sector to give it false assurances that Labour would be no threat.
I understand that the private sector has invested a considerable amount in Labour's shadow health team over the past two years. Just as one team goes out the door after pudding, a new one comes in for the first course of the next meal. In spite of all that, no one believes that the hon. Member for Islington, South and Finsbury will deliver. Every solution to the problems of the NHS suggested by Opposition Members in this debate has implied more cash, which Labour is not prepared to pledge.
Labour has made one firm pledge, which was alluded to by my hon. Friends. It pledged to abolish GP fundholding, but it could not even get that right. That policy is Labour's two-card trick. On almost the same day, Labour managed to get two headlines: "Labour set to scrap fundholding" in The Independent, and in Doctor magazine, "Labour promises to retain fundholding".
On NHS savings, which will be the sole visible means of support for the health service under a Labour Government, we hear a variety of things. We hear that the savings will be £100 million and that it will all come from bureaucracy--but from where? Will it be health authorities, trusts, GP practices, or practice managers? Again, part of the problem is that it is a two-faced policy. A headline in This Week said, "Managers will not lose jobs in £100 million drive says Smith". The head of Unison, Bob Abberley, said that he was pleased about Labour's move away from attacking NHS managers. However, today Labour has attacked people who do a first-class job of delivering quality care in the NHS--and delivering it in a way that Labour would never have thought possible.
We heard nothing of some of the plans that Labour used to trumpet. It used to talk about using part of the £100 million savings to reduce waiting times for cancer surgery. A British Medical Association spokesman--Labour is usually keen to talk about such people--said that cancer surgery was usually done pretty promptly and that it was not helpful to set zero waiting lists. A simple matter of its declared policy has turned out to be an own goal for Labour.
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