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6.29 pm

Mr. Charles Kennedy (Ross, Cromarty and Skye): We have had a useful set of exchanges, and we await the Minister's wind-up speech. At the outset, I associate my right hon. and hon. Friends with the condolences expressed to the Parliamentary Under-Secretary of State for Northern Ireland, the hon. Member for North-East Cambridgeshire (Mr. Moss), following his recent bereavement. Clearly, hon. Members on both sides of the House will want to extend their sincere condolences to him.

Secondly, I echo what was said by my hon. Friend the Member for Southwark and Bermondsey (Mr. Hughes) at the beginning of the debate--that it is perhaps regrettable that the Secretary of State cannot be with us today. Depending on the timing of the election, this could be one of the last opportunities for the House to examine the national health service, so it might have been appropriate for the right hon. Gentleman to be here.

Mr. Gallie rose--

Mr. Kennedy: No, I shall not give way to the hon. Gentleman. [Interruption.] I am sorry if he was frozen out of the debate, but the hon. Member for Southport (Mr. Banks), who is sitting close to him, spoke for nearly half an hour, and I am sure that he could have made his telling points in slightly less time.

Mr. Matthew Banks: Tell us where Paddy is.

Mr. Kennedy: I shall answer the hon. Gentleman in a minute.

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Some of the debate, especially the opening contribution by the Minister for Health, focused on statistics, but, as he began to deploy his case, one central feature of the restructured health service under the current Administration became clear. It was much in evidence in the way in which the Minister went about his business in the debate.

If there is any credit to be taken on health issues, it is claimed nationally, but if there is any blame or downside, the information is much too difficult to collect centrally, and the issue has to be dealt with locally. That is the political purchaser-provider split that Health Ministers want to establish. If there are problems, they do not have the information centrally, and we are referred elsewhere, but if there is a good song to sing, the statistics magically happen to be at hand. People outside the House who read the text of the debate will see through that.

Sir Roger Moate (Faversham): The hon. Gentleman talks a lot about statistics, but one important statistic is missing from the Liberal Democrats' presentation. How much money are they committed to spending? We have been listening carefully. They have invented a hypothecated tax on tobacco to pay for all the extra spending, but they did not put a figure on it. Can the hon. Gentleman give us a precise figure for exactly how much the Liberal party is pledging itself to raise in new taxation for health spending in the first year, and in the second year?

Mr. Kennedy: The hon. Gentleman has not been listening with sufficient care, or he would have heard both my hon. Friend the Member for Caithness and Sutherland and my hon. Friend the Member for Southwark and Bermondsey, when he opened the debate, setting out in crystal clear fashion specifically what the commitments are. The hon. Gentleman will find them in the columns of Hansard tomorrow.

My hon. Friend mentioned the proposal for extra revenue to be raised from tobacco. As my hon. Friend has said many times, including this afternoon, that will be specifically earmarked for the pledges or recommendations in respect of optical, dental and prescription charges that we have made in the debate. All that has been categorically set out, and it is nonsense for the hon. Gentleman to suggest that it has not.

Mr. Gallie: Will the hon. Gentleman give way?

Mr. Kennedy: If the hon. Gentleman will forgive me, I want to touch on some of the points made in the debate.

Mr. Simon Hughes: I do not want hon. Members who, for whatever reason, may not have been here for the whole debate to think that there is any doubt about the figures. My hon. Friend the Member for Caithness and Sutherland and I, together with our Treasury spokesman, my hon. Friend the Member for Gordon (Mr. Bruce), have made the figures very clear.

There is a £200 million commitment to be raised by putting 5p on 20 cigarettes, a £350 million per year commitment to be raised by closing the employers'

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national insurance loophole. There is also another commitment to do with keeping pace with national health service inflation. Those three commitments have been clearly costed, on the basis of Government answers given over the past 10 days.

Mr. Kennedy: I am grateful to my hon. Friend.

On the subject of statistics, the Minister for Health showed characteristic brass neck when he talked about the use of official statistics, in view of the fact that, in the past few days, we have seen the unprecedented withdrawal by the Office for National Statistics of the official Government health spending statistics, as a result of some apparent confusion over the application of the NHS deflator.

That does not fill the rest of us with confidence that the ministerial touch on the tiller in the production of the statistics is as firm and sure as all that. The whole thing becomes all the more suspicious when one notes that the original version showed that real-terms spending on the health service did not match Government rhetoric, yet, lo and behold, when the error spotted by our sharp-eyed Ministers was amended, the graph was slightly more in accord with the Government's case.

That shows that the general point that we have argued in the debate is valid. We should have independent statistical advice, free of the Department of Health, which would do a lot not simply to boost public confidence in the information made available to us but to enable debates on health--debates about the kind of priorities that my hon. Friend the Member for Southwark and Bermondsey described--to be conducted in a more rational and better informed way.

When my hon. Friend opened the debate, as well as calling for that form of independent assessment, he stressed the need for investment--the hon. Member for Faversham (Sir R. Moate) will be able to read about that tomorrow, too--for planning and for accountability. I do not want to go back over those issues, but I shall refer to one or two of the points that came up in the debate.

First, I shall reply to the hon. Member for Southport, who paid advance tribute to our friend and former parliamentary colleague Ronnie Fearn, by wishing him many happy returns for his birthday tomorrow. I do not want to be churlish, but the hon. Gentleman will appreciate the fact that, in the electoral sense, I cannot wish him many happy returns. I hope that Councillor Fearn will be back among us after the election.

The hon. Member for Southport asked about my right hon. Friend the Member for Yeovil (Mr. Ashdown), the leader of my party, who was in the Chamber for a brief part of the debate--[Interruption.] If the hon. Gentleman wishes to listen, he will hear that my right hon. Friend has spent the afternoon visiting Bart's. When political parties are debating the national health service, it is entirely sensible, fitting and appropriate for a party leader to be visiting such a centre of excellence and listening to the people there at first hand.

I shall reply to a couple of other points that the hon. Gentleman touched upon. He said that he chooses, as is his legitimate right, to have private medical insurance.

Mr. Banks: I have never used it.

Mr. Kennedy: The hon. Gentleman happens not to have used his insurance, and I certainly hope that he does

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not need to. However, the philosophical point that we want to make about our party's stance is that no Liberal Democrat opposes the right of any individual to make private provision out of his or her own disposable income. But we object to the fact that the rest of the tax-paying public should give such a person an additional tax incentive.

Mr. Banks: What about choice?

Mr. Kennedy: Choice is entirely open to the individual in the marketplace, but that choice should not be bankrolled by the state via the tax system. It was the former Prime Minister who insisted on allowing that, although, as was well reported at the time, it went rather against the instincts of her then Secretary of State for Health, the right hon. and learned Member for Rushcliffe (Mr. Clarke), who is now Chancellor of the Exchequer.

I note in passing that the right hon. and learned Gentleman has not used his present office to reverse that policy, although as Secretary of State for Health he made little secret of the fact that he did not agree with it at first.

The hon. Member for Southport sees the private finance initiative as central to the future delivery of the fabric or infrastructure of health. The jury is still very much out on the PFI in terms of the longer-term accrual of debt that it loads on to future generations, but I should point out to him that, if he thinks that the PFI is the answer to all the problems, he should note that this debate will be answered by the Minister of State, Scottish Office. He is something of a world expert on the subject, having delivered the Skye bridge by means of the PFI. His reputation in Scotland has never, and will never, recover from his involvement in that fiasco.

I was disappointed--although not surprised--by the timid nature of the Labour party's stance on these matters, but I was even more surprised and disappointed by the general tone of the rhetoric of the hon. Member for Dulwich (Ms Jowell). Had one come into the Gallery without being aware of the party politics at work here, one might have thought from listening to the hon. Lady that she was an up-and-coming young Conservative health Minister, speaking in a rather patronising way about proposals to reform and improve the health service, while doing a rather good job of defending the establishment line.

We should note for the record that the only specific commitment that the Labour party feels able to give in terms of the wording of our motion this evening, which refers to

relates to bed closures in London only. There is no commitment whatever from Labour on service withdrawals and bed closures across the whole of the UK.

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