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Mr. Tom King (Bridgwater): Presumably the speed with which we were able to make improvements through the 1980s was not helped by the cancellation of the hospital building contracts towards the end of the Labour Government. The whole health programme was put seriously behind when their economic policy ended in such chaos.
Mr. Dorrell: My right hon. Friend is right, and I shall speak later about the importance of a proper capital investment programme in the health service, an issue that
the hon. Member for Islington, South and Finsbury did not touch on in his speech, which was supposed to be about health policy.
Mr. Dorrell: I should like to make some more progress and then I shall give way.
If Labour cannot say anything intelligent about waiting lists, let us move to another fundamental issue which my right hon. Friend the Member for Bridgwater (Mr. King) raised in his intervention. Health care is highly capital intensive. The facilities by which hospital care is delivered are expensive, and furthermore the shape of health care is changing quickly. That means that the NHS appetite for capital investment is considerable. Although there was a huge increase in the capital investment programme through the 1980s, reversing the 28 per cent. cut in capital that the Labour Government imposed in the 1970s, too many hospitals are still caught trying to deliver 21st-century health care in 19th-century buildings.
The issue confronting the health service, which the hon. Member for Islington, South and Finsbury refuses ever to confront, is how to ensure a sufficient capital flow to keep the capital stock up to date so that we can deliver the best high-quality and efficient health care to our patients. That is why the Government have introduced the private finance initiative.
Mr. Dorrell:
I shall shortly give way to the hon. Gentleman.
The PFI was introduced to allow the health service to escape from the capital trap. Since we started it, we have approved 71 schemes to a total value of £626 million. We have signed contracts for 44 of those 71 schemes to a total value of £432 million. There remain 22 schemes which have been approved in principle and for which approved bidders have been selected. The total value of those schemes is £1.7 billion.
I have not yet given way to the hon. Member for Islington, South and Finsbury, but when I do, I hope that he will take advantage of his intervention to set out Labour's policy for the people of Bishop Auckland, Calderdale, Carlisle, Gloucester, Greenwich, Hereford, north Durham, Bexley, Rochdale and Coventry and other places who are on the list and have preferred bidders under the PFI and the realistic opportunity of seeing the needs of their local health service for capital investment met. Labour's position on the PFI is one of the great unsolved riddles of the hon. Gentleman's speeches. Is he in favour of delivering modern hospital care to those communities? I give way to the hon. Gentleman to give him an opportunity to answer.
Mr. Smith:
The short answer to the right hon. Gentleman's final question is yes. Will he answer two questions? First, will he confirm that, within the overall national health service budget, he has cut the capital budget for this year and next year by one third? Secondly, will he also confirm that the new Norfolk and Norwich hospital was first announced by his predecessor in 1990, but not a single brick has yet been laid?
Mr. Dorrell:
I have already made it clear that the PFI was introduced to increase and improve the quality of capital investment available for the national health service.
The hon. Gentleman has taken to writing letters to some of my hon. Friends and to Labour parliamentary candidates, copies of which I have seen. In those letters, he says:
I give way to the hon. Gentleman once more, so that he can come to the Dispatch Box and set out one proposal that will speed up the PFI. I ask for one proposal. If he cannot do that, those letters to my hon. Friends, like the one he wrote to the Labour parliamentary candidate in Worcester, are a sham. What programme does the hon. Gentleman offer under the PFI to speed up hospital projects in the communities to which I referred? Will he come to the Dispatch Box and tell us? I give way to him. What is his idea? He writes letters to Labour candidates, to my hon. Friends and to anyone who will listen promising that Labour will speed up the PFI. I give way to him. I look forward to hearing about those ideas.
Mr. Smith:
I ask the Secretary of State to answer the two questions which I posed to him, and to which he has not yet replied. He should stop trying to blame the Opposition for the shambles on the PFI that the Government have created. The Government have promised hospital after hospital up and down the country, but have not delivered on their promises.
Mr. Dorrell:
The hon. Gentleman grossly misunderstands me. I do not want to hold him responsible for the Government's record; I want to hold him responsible for Labour's policy. He promised to speed up the PFI. How does he intend to do that? That is a simple question. He made that promise to his own supporters and to Conservative Members. How will he deliver that pledge? The House will draw its own conclusion from the fact that the hon. Gentleman has set out no proposals. It is empty rhetoric: he has not the beginnings of a shred of an idea of how he will deliver his pledge.
Mr. Hartley Booth (Finchley):
I am the recipient of one of the letters from the hon. Member for Islington, South and Finsbury (Mr. Smith) to which my right hon. Friend referred. The hon. Gentleman refers to his anger at the delays in the rebuilding of Barnet hospital caused by the Government's approach to PFI. Is my right hon. Friend aware that Barnet hospital was built in 1939, and it was to be rebuilt at the end of the last world war? The Labour party was in office in the 1940s, 1960s and 1970s, but it never rebuilt that hospital.
Mr. Dorrell:
I am aware of that. I am also aware that, under this Government, phase 1A of the rebuilding of Barnet hospital is currently taking place, and will improve hospital care for the people of that part of London. I am further aware that the Government introduced the PFI, which is the basis on which phase 1B will go ahead. The predecessor of the hon. Member for Islington, South and Finsbury used to describe the PFI not as the private finance initiative but as the privatisation initiative. I notice
Mr. Jim Cunningham (Coventry, South-East):
The Secretary of State mentioned Coventry when he gave his catalogue of PFIs. What will happen to the Coventry and Warwickshire hospital, because there has been an element of doubt, about which I have written to the Secretary of State? What is the state of the PFI for the Walsgrave hospital?
Mr. Dorrell:
I shall write to the hon. Gentleman about the Coventry and Warwickshire hospital. Walsgrave hospital is one of the projects for which we have a preferred bidder. We are seeking to put in place a plan to replace the existing hospital. It is quite a modern hospital, but it does not provide an efficient use of resources. The private finance option for Walsgrave hospital shows the merits of the private finance approach. Instead of carping from the sidelines, the hon. Member for Islington, South and Finsbury would do well to learn from that approach.
Mr. Toby Jessel (Twickenham):
My constituents and those of my hon. Friend the Member for Brentford and Isleworth (Mr. Deva) are extremely keen for the excellent PFI scheme to reconstruct the West Middlesex university hospital to go ahead without delay. My right hon. Friend and his colleagues have been giving us all the help that they can. However, our constituents will be extremely unimpressed when we tell them that the hon. Member for Islington, South and Finsbury, having boasted that he would speed up PFI schemes, was completely unable to say what he would do to achieve that when he was challenged to do so by my right hon. Friend.
Mr. Dorrell:
My hon. Friend is absolutely right. His constituents will feel the same as those of many other right hon. and hon. Friends around the country. It will be within the memory of those who regularly attend these debates that, on the last occasion we discussed the health service, I referred to the people of Worcester, which is my home town. They are in the same position as my hon. Friend's constituents. The hon. Member for Dulwich (Ms Jowell) came to Worcester after an earlier visit by the right hon. Member for Livingston (Mr. Cook), who said that, if the deal for the hospital there had not been signed by election day, it would be put on ice. The hon. Member for Islington, South and Finsbury had to send his hon. Friend the Member for Dulwich--he has apparently forgotten about it--to dig the right hon. Member for Livingston out of the hole into which he had dug himself. The right hon. Gentleman was able to sit on proposals to privatise the Tote, but the citizens of Worcester will be relieved to know that he failed to sit on their plans for a new hospital.
"Where a contract has not been signed by the time we come into office"--
I hope that that never happens--
"we will be seeking urgent ways of speeding up the process."
Labour has had 18 years: is it not time it produced just one proposal?
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