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Constitutional Change

Mr. Bill Walker accordingly presented a Bill to provide for the holding of a referendum on any constitutional change approved by Parliament.: And the same was read the First time; and ordered to be read a Second time upon Friday 14 February and to be printed [Bill 96.]

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Opposition Day

[4th Allotted Day]

National Health Service

Madam Speaker: I have selected the amendment standing in the name of the Prime Minister.

3.40 pm

Mr. Simon Hughes (Southwark and Bermondsey): I beg to move,

That this House believes that, of the many improvements the NHS needs, immediate priorities should include the reinstatement of free dental and eye checks, a freeze on all finance-driven bed, hospital and service closures which represent a reduction of service to patients pending the first report of an open and independent assessment of national health demand and provision, a move to three year contracts between health authorities and boards and health providers and the immediate scrapping of local NHS pay bargaining.

Parliament is, of course, entitled to debate the state of the national health service at any time. But--and above all just before a general election--it strikes us that politicians should also be obliged to say how they would improve it. Public experience and perception is that, however good the NHS may be most of the time, sadly we cannot guarantee that it will be there to do what we need whenever we need it. We cannot at present in the United Kingdom rely on the NHS to do what it was set up to do. That leads my colleagues and me to the conclusion that, sadly, the NHS is not safe in the Government's hands. We also believe that the NHS would not be safe in a Labour Government's hands.

On the basis of agreed commitments given by the Conservative party, the Labour party and ourselves, we believe that the best guarantee for the NHS after the next general election would be for its management to be in our hands. [Interruption.] The hon. Member for Bolsover (Mr. Skinner) grunts--if he looked at the spending commitments and was honest about admitting the facts, I am sure that he would agree with us. I cannot believe that the hon. Gentleman is happy with his party's current policy.

My colleagues and I also believe that all the Irish parties represented in this Parliament and the Welsh and Scottish Nationalist parties would, like us, be willing and able to vote for a more significant commitment to the NHS than either the Tory or the Labour party.

Mr. David Shaw (Dover): I respect the fact that the hon. Gentleman is trying to identify some party differences over this subject. But does he not accept that two thirds of the health service has been built by a Conservative Government at one time or another and that two thirds of the hospitals and all the capital projects in this country were built by Conservative Governments? Is not the health service a Conservative success?

Mr. Hughes: The NHS is bigger than all of us. In previous speeches I have paid tribute to the Tory successes and progress in the NHS. I am happy to do so again--I have no problem with that. The NHS is what it is today owing to the efforts of three parties. A member of one of those parties devised and proposed it during the

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war: our party, the Liberal party. A Labour Government enacted it in the post-war Parliament; they did so with our support, opposed by the Tories. The Tory party has often given it extra resources. I shall not argue with the hon. Gentleman about that, because I accept his point. The issue is the current state of the NHS, and where we go from here.

Mr. Dennis Skinner (Bolsover): It is true that the Liberal Democrats voted against the income tax cut.

Mr. Hughes: Two years running.

Mr. Skinner: Two years running, as the hon. Gentleman says. We should get the record straight. The Liberal Democrats voted against the last income tax cut, which would have produced £1.8 billion extra to spend on the national health service and education. I did the same. However, the hon. Gentleman will recall that there were three further votes that night on measures to spend money. The Liberal Democrats voted against the reduction in income tax, thereby saving money for the health service and education--or so they said--and then proceeded to get rid of that money by voting against the airport tax and the increase in petrol tax.

I told the Liberal Democrats that I was being consistent, because I voted against the income tax cut. I wanted to provide £1.8 billion, but they and the other rag, tag and bobtails went into the Lobby to spend the money that they had tried to save for the health service. I have never seen so much hypocrisy in one night as I saw on that occasion.

Mr. Hughes: The hon. Gentleman is good at blustering.

Mr. Skinner: It is true.

Mr. Hughes: No, it is not true. Like all good stories, the hon. Gentleman's story is partly true and partly untrue. The truth is that we voted against the income tax reductions two years running. The figure he used was correct: it was about £1.8 billion. So that he does not accuse me of misrepresenting him, I have to say that we proposed that that money should go on education.

Mr. Skinner: Why did he vote against the airport tax?

Mr. Hughes: The hon. Gentleman should listen.

We have also costed--I will willingly give him the figures--the other Budget proposals that we voted for. As I shall set out later, our proposals for the health service--

Mr. D. N. Campbell-Savours (Workington): The hon. Gentleman has not answered my hon. Friend's question.

Mr. Hughes: I am answering his question.

Our proposals for the health service will mean extra expenditure that has not already been spent or given away on anything else. The hon. Member for Bolsover is embarrassed, because he voted with us on the income tax reduction. The reality is that our party, unlike the Labour

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party, is willing to make significant further investment in education and health, which is why we are proud of our record, and will be happy to defend it today.

Rev. Martin Smyth (Belfast, South) rose--

Mr. Campbell-Savours: Will the hon. Gentleman give way?

Mr. Hughes: I give way to the hon. Member for Belfast, South (Rev. Martin Smyth).

Mr. Campbell-Savours: Perhaps the hon. Gentleman will give way after the hon. Member for Belfast, South has intervened.

Mr. Hughes: I may give way once more, but then I want to make progress.

Rev. Martin Smyth: I appreciate the hon. Member giving way. I understand his response to the hon. Member for Dover (Mr. Shaw), but does he accept that he was only partially right? The bulk of the hospitals in Northern Ireland were built under a devolved Administration, and have been run down ever since.

Mr. Hughes: Not only do I accept the hon. Gentleman's point, but I share his view that the budget for the national health service in Northern Ireland would be better allocated and run by people there following a democratic debate in Northern Ireland rather than in the House. One of the frustrations of Parliament is that we have hardly any time to debate public welfare issues for Northern Ireland--far less time than for Scotland and Wales. The people of Northern Ireland rightfully agree.

Mr. Campbell-Savours: May I press the hon. Gentleman on the issue raised by my hon. Friend the Member for Bolsover? He says that the Liberal Democrats voted in three Divisions to spend £700 million, and in another Division voted to save £1.8 billion. There is a shortfall of £1.1 billion. Is the hon. Gentleman saying that that £1.1 billion would cover all the expenditure commitments that the Liberal Democrats have made in debates on education and the health service? Can I tie him down on those figures? Does he understand them?

Mr. Hughes: I understand them, and I am happy to answer the question.

No, we are not tied to that figure. We have made a commitment to put an extra £2 billion into the education service. I shall outline our commitment to the health service in a moment. If the hon. Gentleman has not already seen them, I will happily send him our costed manifestos for the last election and for the coming one, so that he can see exactly where we would raise the money and where we would spend it.

The debate is timely because the position is similar in each of the four countries of the United Kingdom. The NHS is under pressure; those in the NHS, and the people who use it, feel insecure; and the NHS needs further investment. However, as I tried to point out in reply to the hon. Member for Dover (Mr. Shaw), there is a much more important question than whether the NHS is safe in

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a particular party's hands at a particular point in history. That question is, are the public safe in the hands of the NHS today?

That should be the test of whether we are supporting the service efficiently. Can we give a guarantee to the hon. Gentleman's family, my family and the families and friends of hon. Members and their constituents that, when we need it, the NHS will be able to deliver the care that it is there to deliver, without sending people home when they should be operated on, or sending them around the country when they should be admitted to their local hospitals?

We all know that it is not normally through the failing of any individual--although, of course, individuals fail in the NHS, as in any walk of life--that the service is not up to the job. The fact is that, when competent, well-trained, experienced NHS staff become demoralised, overstretched and under-resourced, they are not good for anyone's health. If the NHS is to be a service fit for patients to rely on, adequate staff and facilities need to be there so that patients can rely on them as well.

The task of all politicians in the United Kingdom--and of the Government of the United Kingdom, whoever they are--is not to ensure that we can "sort of" respond to the NHS crisis of the moment and plaster over the long-term structural cracks, but to insure the NHS for now, and to start securing it for the future.

If we are to be honest with the public, we must admit that there will be no one-election wonder. There is and can be no miracle cure. Demand is rising, costs are escalating, and a national debate is needed about how much health care we can fund and how best we can fund it. That debate will, of course, take place in politics, but it must also take place outside and beyond politics. It is not a moment too late to start it now. [Interruption.]

The Minister may mutter, but, in a recent letter to me, the Secretary of State said that he

"would welcome greater cross-party consensus on the major issues in the NHS."

I agree that more consensus is necessary, as do the public, the commentators and the professionals. On behalf of my party, I give a pledge to work with anyone and everyone to obtain the maximum possible agreement that will secure the future of the NHS. The NHS is much more important than any divisions along party lines.

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