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Mr. Simon Hughes: Is it the fault of the statisticians or of the Government that, when a parliamentary colleague asks how many hospitals have been closed since 1979, the answer comes back from the Minister that those figures are not held centrally?

Mr. Malone: The hon. Gentleman totally fails to understand the point. We collect statistics across the

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national health service because they may be relevant to its operation. Often, parliamentary questions are asked that are relevant to the operation of the NHS, while other questions are not. The suggestion that we should collect a whole range of statistics of which we could make absolutely no practical use is foolish, and would add to the burdens on the NHS that we are effectively trying to reduce.

The example raised by the hon. Gentleman was a good one, because I should like to hear his definition of what constitutes a hospital, for which statistics might be gathered. Would a hospital be a super-surgery, with a small number of in-patient beds serviced by a general practitioner? If we added such surgeries to the statistics, the hon. Gentleman would say that we were fiddling the figures by adding things that were not hospitals at all. Should we include community hospitals, or hospitals that have a certain range of services? Would a hospital with a minor accident treatment facility be counted in the same way as a hospital with a major accident and emergency unit? If the hon. Gentleman wants to collect statistics which he may find interesting but which are of no practical use to the health service, he will be frequently disappointed when they are not available centrally.

Mr. Charles Kennedy (Ross, Cromarty and Skye): I wish to ask a follow-up question on the rather intriguing theory now being advanced by the Minister. Clearly, there will be differences in the definition of different facilities within the health service, and I quite accept that. But is the hon. Gentleman trying to tell the House of Commons that, as the Minister for Health, he does not have at his disposal relevant information as to the rate of closure of hospital facilities throughout England and Wales? Surely that information is central to the conduct of his duties.

Mr. Malone: The hon. Gentleman completely fails to understand what is important to the NHS. It is fundamental that decisions should be taken at a local or health authority level on the future of services. That is what is meant by devolved NHS. I understand that it is the ambition of the Liberal Democrats to hand control of the NHS to local councils, and that makes a double absurdity of the suggestion that we should accumulate non-operational statistics of that kind.

Mrs. Mahon: Will the Minister give way?

Mr. Malone: No, I have given way a lot. I intend to move to another point, which is openness in the NHS.

Mrs. Mahon: I wish to ask about openness.

Mr. Malone: Let me develop my point, and I might give way to the hon. Lady in due course. Recently, we have made the NHS a far more open organisation, and it is now more accountable to both Parliament and the public. The code of practice on openness was published in April 1995 and came into effect on 1 June, when the NHS executive published detailed guidance on its implementation. The code supports the Government's commitment in the White Paper "Open Government" of 1993, to increase public access to information about the NHS.

That complements the code on access to information, which applies to the Department of Health, including the NHS executive, and helps the public to know what

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information is available and where they can get it. All NHS organisations are required to have a named individual responsible for the operation of the code, which sets out the basic principles underlying public access to information about the NHS. I totally reject the implication of the hon. Member for Southwark and Bermondsey that the NHS is not open and accountable. It is, and in a way that it never was before.

Mr. Gordon Prentice: Why was the Minister prepared to tell me the location of the dental practices of the highest-paid orthodontists who practise in Norfolk and Essex, but when I asked him the same question concerning dentists doing primarily non-orthodontic work, who receive £350,000 from the NHS, he told me that the disclosure of that information would be in breach of the code of practice on open government?

Mr. Malone: I can answer that simply. In some cases, it would be possible to identify the individual dentist. That would be in breach of any proper code. If the hon. Gentleman wants a system by which one can gain an insight into people's private affairs without any let or hindrance, it is up to him to explain that to his constituents or to the country as a whole. Of course, any sensible code of operation should protect people's privacy.

The hon. Member for Southwark and Bermondsey mentioned sight tests and dental examinations. In 1994-95, spending on sight tests alone was in excess of £90 million. We assess that £120 million would have to be taken from expenditure on other forms of health care if free sight tests were to be restored. The hon. Gentleman never even touched on whether, if that were done, the quality of health would improve.

There is an on-going debate in the national health service among professionals and politicians about the priorities and direction of targeted resources and where they can be effective. The hon. Gentleman might be interested to know that the number of sight tests has increased since the fee was introduced. Other things are happening as well. For example, domiciliary visits, which are paid for by health authorities and provide sight tests for the housebound--often the elderly, to whom the hon. Gentleman referred--have increased by 105 per cent. in the five years to 1995-96, from 109,000 to 222,500.

I point that out simply to illustrate the fact that, rather than introduce some universal benefit, which the hon. Gentleman might think would play well to the audience, he would be far better advised to ensure that expenditure was targeted, as we are doing in the NHS, for example with domiciliary visits and the targeting of those at risk, such as the relatives of people suffering from glaucoma. That should be his priority instead.

The suggestion on dental examinations would be a fruitless exercise. The hon. Gentleman failed to point out that the number of individual treatments carried out within NHS dentistry has risen from 17 million in 1978 to 24.8 million in 1995-96, which shows that there are even more opportunities for the general examinations that must surely precede such treatments. More facilities are available for examinations now. Again, it is a matter of properly targeting the resource--of targeting those who are at risk. That is why we reformed the child capitation system and why we are ensuring that, in funding NHS dentistry in the future, we shall use purchaser-provider

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agreements driven by health authorities, which have an insight into the local health needs of their population. Thus we shall target the resource effectively at those who need it, rather than spreading it across the population, as the hon. Gentleman suggests.

Mr. Charles Kennedy rose--

Mr. Malone: I shall give way for the last time.

Mr. Kennedy: I am grateful to the Minister, as he has been generous about interventions. On dental charges, surely the Minister, like every other hon. Member, will have anecdotal evidence--through his family, for example--and any dentist could tell him the same story. Dentists can give comprehensive and proper preventive and restorative attention to only two categories of patient--those who are fully funded by the benefits system because of their income status and those who can afford to pay. A great swathe of middle-class families do not qualify for support and are having to take short cuts, or are not undergoing the full treatment that the dental surgeon prescribes.

Mr. Malone: The hon. Gentleman should have a care. People can always promise to do more. Within NHS dentistry, anything that is clinically required is available for patients. Of course, there is a system of charges that raises a substantial amount that can be spent elsewhere in the NHS or targeted at at-risk groups in dentistry. The hon. Member for Southwark and Bermondsey completely failed to recognise that properly targeting need in the NHS is far more important than simply spreading the resource thinly across a population: that cannot bring results.

There are immediate priorities for the health service. The Government have pledged funding on a secure basis for the years to come and the Prime Minister pledged to increase spending on the health service in real terms, year on year on year. That is the foundation stone on which the service will rest in the years to come.

We are developing a primary care-led NHS, which is vital for patients and for the profession, especially those in the primary health care team who can now develop their professional roles, and we are continuing to make more effective use of taxpayers' money, so that more and more patients can be treated. That is the Government's record and that is what we intend to continue. We shall continue to build the quality of the whole NHS team--doctors, nurses and other medical professionals--which has greater horizons than ever before.

Our long-term priorities are to build a service in which the public can have confidence, which expands the professional skills of all who work in it, and which invests in work that keeps us at the clinical cutting edge of medical research and development: a service that can take pride in its achievements over the past 50 years, and has ambitions for the next 50 years. That is what the Government have delivered and will sustain after the general election.

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