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4.7 pm

The Minister for Health (Mr. Gerald Malone): I beg to move, To leave out from "House" to the end of the Question and to add instead thereof:

"is committed to the National Health Service as a public service, promoting health and offering increasing volumes of high-quality health care on the basis of need regardless of the ability to pay; and welcomes the Government's continuing commitment to real terms increases in NHS spending year by year.".

I listened with interest, and mounting incredulity, to the speech of the hon. Member for Southwark and Bermondsey (Mr. Hughes). If we required any further evidence that Liberal Democrats perhaps live on another planet, he has absolutely provided it. We shall now have a health service that is simultaneously "inside", "outside" and "beyond" politics--whatever that may mean.

The hon. Gentleman's wish list of wishful thinking does not sit very comfortably with his ambitions--which I read in my copy of Nursing Times and Nursing Mirror. In the event of a hung Parliament, he will apparently have a difficult choice to make, as he wants to be either a Health Minister or mayor of London. It is always good for him to be ambitious, and it is clear that he and his party are once again preparing for government, as they did--under instructions from the right hon. Member for Tweeddale, Ettrick and Lauderdale (Sir D. Steel)--in the general elections of 1979, 1983, 1987 and 1992. However, if the hon. Gentleman is wondering about his job prospects in a hung Parliament after the next election, he is wasting his time.

I thought it odd--I think that the House will find it odd, too--that the hon. Gentleman and his party have chosen three immediate priorities. The first is a national commission--a sort of fairness commission on statistics. Commissions to gather figures always fascinate the Liberal Democrat party. We are always told that these proposed commissions will be independent. They are surrounded with worthy words, which the Liberal Democrat party hopes will play well with the public, although they will perhaps not do very much at all--[Interruption.] As I hear an Opposition Member say from a sedentary position, a commission such as that being proposed will certainly not do what the Audit Commission does, which is to provide a real insight into how the health service works.

As a second immediate priority, the hon. Gentleman wants to reduce the money spent on patient care by reinstating free eyesight tests and dental checks. I shall deal with that matter in some detail later, but the rather interesting cross-talk on the Labour Benches made it clear that that was what the hon. Gentleman was proposing.

The hon. Gentleman's third priority was to end local pay awards in the NHS. He was long on saying how important it is to accept the review body's recommendations, but I must point out that one of its consistent recommendations has been the introduction of local pay in the NHS. The hon. Gentleman and his party quote selectively when it suits them and depart from a consistent line of argument when it gets too difficult.

I thought that the hon. Gentleman might have had a few other immediate priorities for the health service--probably boring old ideas such as treating more patients,

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improving the quality of care and the effectiveness of treatment and underpinning the research programme that keeps the NHS at the cutting edge when compared with any health service in the world.

The hon. Gentleman mentioned waiting times. He said that he wants to reduce them, but he failed to acknowledge that, for the first time in the history of the NHS, this Government have focused on waiting times. We have made great progress in identifying the length of time that people wait and then in reducing it according to patients charter standards.

I also thought that the hon. Gentleman would make it an immediate priority to underpin the reform of primary care, which is currently in another place and which will come to the House in the not too distant future. Perhaps the hon. Gentleman will say what he thinks about that. Such ideas may be boring to the Liberal Democrat party, but they are the essence of our health service and they are top of the agenda for patients and the professionals who work in the service.

Mr. Simon Hughes: None of those things is boring or unimportant. The Minister knows that I share his view in that respect. Does he accept that, according to the evidence that he is receiving, waiting times are increasing again?

Mr. Malone: Since we began to examine waiting times and since we bore down on them with the patients charter standard and the setting of benchmarks, remarkable progress has been made. The vast majority of patients are now treated within three months of an operation being diagnosed as necessary. The hon. Gentleman may shake his head, but he fails to recognise that, during the winter months, when there is pressure on the health service, elective surgery will take second place to emergency care. That is perfectly obvious--it is how the NHS has always operated. The important point is whether we are continuing to build on the standards that we have brought into the health service. I confirm that that will be the priority of this Government and of the next Conservative Government.

Mrs. Alice Mahon (Halifax): Will the Minister answer the question asked by the hon. Member for Southwark and Bermondsey (Mr. Hughes)? Will he confirm that waiting lists in every constituency are getting longer?

Mr. Malone: I told the hon. Gentleman that when the service is under great pressure, of course elective surgery will take second place for a while. Progress on reducing waiting times and securing better standards, if we can, has to be maintained. The hon. Lady is making a non-existent point.

The speech of the hon. Member for Southwark and Bermondsey was rather thin gruel compared with the announcements of my right hon. Friend the Secretary of State in the document, "A Service with Ambitions", which set out clearly not just the immediate priorities, but the long-term priorities for the health service. I shall set out those priorities again to the House.

Mr. Matthew Banks: Before my hon. Friend moves from the subject of waiting lists, will he confirm that the

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additional £25 million that the Department has put into areas of pressure has been directed to the causes that the hon. Member for Halifax (Mrs. Mahon) is concerned about--blocking and mental health services?

Mr. Malone: That is absolutely right. The history of reducing waiting times--as my hon. Friend understands, but the hon. Member for Southwark and Bermondsey clearly does not--shows that, to maintain progress, it is important to invest in that progress. The Government have consistently done that by setting targets and standards and by the actions that we took to cope with the emergency pressures that we foresaw during the winter.

Mr. Gordon Prentice (Pendle): Will the Minister give way?

Mr. Malone: No. I want to move on to my next point. I have given way a lot so far.

In "A Service with Ambitions", recently published by my right hon. Friend the Secretary of State, we set out our ambitious alternative for the immediate and long-term future of the national health service. It is an ambition for a quality integrated service that is responsive to patients. Those working in the NHS share that ambition. It can be brought about by having a well-informed public and a seamless service working across boundaries, so that patients understand that they are being treated by an integrated service. It should become more a knowledge-based, decision-making service and should have a highly trained and skilled work force. It should be a responsive service, sensitive to differing needs.

"A Service with Ambitions" sets out the Government's policy of underpinning our national health service, based on the principles on which it was founded, into the foreseeable future. The Government are also committed to real-terms increases in funding, because we believe that the NHS is affordable in its current form and needs continuing investment.

The document gives a detailed commitment to the development of the NHS as a public service. It outlines an exciting vision of an integrated service, sensitive to the needs and wishes of patients. It is very useful to the NHS and has been widely welcomed, setting out strategic objectives to help set future direction nationally and locally. It commits the Government to the future of the service, much criticised by Opposition Members at every opportunity. We will build a service of quality for the future.

The debate introduced by the hon. Member for Southwark and Bermondsey is based on a false premise--the idea that we can somehow remove health from politics. Raising the issue and then claiming to want to remove it from politics is a frequent Liberal Democrat party tactic. The Liberal Democrats go up and down the country, from constituency to constituency--all my hon. Friends are aware of this--making health a political issue in a way that is a disgrace to any party that says that it supports the national health service, and the hon. Gentleman knows it.

The Liberal Democrats have made an industry of saying piously that everything controversial should be removed from politics and then doing exactly the opposite. They want to remove the economy and education from politics. They actually want to remove

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Government from politics, as it is part of their policy pretty well to abolish Westminster and to set up regional assemblies across the country. Now we hear that they want to abolish health as a political issue.

I find it extraordinary that the hon. Gentleman should make the absurd suggestion about central Government clearly not being very important at local level, but for some bizarre reason he and his party are not in favour of local pay.

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