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Mr. Chris Smith: In that case, can the Secretary of State tell us why 56 per cent. of GPs polled by Doctor say that they will vote Labour?
Mr. Dorrell: If the hon. Gentleman ever holds my responsibilities, he will have to address how to secure the support of the majority of GPs who have chosen fundholding because they believe that it is in the interests of their patients. Doctors have chosen the option of fundholding because they believe that it allows them to do their jobs better. The hon. Gentleman has tabled a set of proposals that 71 per cent. of those doctors have rejected outright.
As Mr. Pollard concludes in his article:
Dame Jill Knight (Birmingham, Edgbaston):
Should we not consider another point when looking at fundholding? Does my right hon. Friend recall that, in many health debates and perhaps Question Times too, Labour Members have complained that patients of fundholding doctors get better service than those who do not have fundholding doctors? Are we not back to the old Labour belief that, instead of trying to lift them to the level of those receiving some good, we should get rid of the whole lot?
Mr. Dorrell:
I could not agree more with my hon. Friend. Such a reaction to a model that has been chosen by the majority of GPs, and, as has been demonstrated, delivers improvements in patient care, is extraordinary. Indeed, the hon. Member for Islington, South and Finsbury argues against fundholding precisely on the ground that it has delivered improvements to patient care. To remove the system that has delivered such improvements in order to rely on the one that has not seems to be a contortion of logic which I find impossible to understand.
Mr. Heppell:
Will the Secretary of State give way?
Mr. Dorrell:
No, I shall conclude.
The truth is that, when Labour deals with health, it carries absolutely no conviction. It makes silly, superficial points on waiting lists, has nothing whatever to say about the private finance initiative and promises a huge new upheaval on the purchaser side of the health service. Most fundamentally, the hon. Member for Islington, South and Finsbury is prevented by the leader of the Labour party and the shadow Chancellor from saying anything at all about resources.
In every year since 1979, the Government have expanded the resources available to the NHS--in sharp distinction to our predecessors. I remind the House that health spending was lower in 1979 than in 1976. We have grown the health service year after year through 18 years in office. My right hon. Friend the Prime Minister has made it clear that, during the five years of the next Parliament, the next Conservative Government will deliver growth in real-terms spending on the NHS year on year on year. That is the commitment that the Conservative party gives. As The Guardian said clearly, for the Labour party:
Mr. Tom Clarke (Monklands, West):
Will the Secretary of State give way?
Mr. Deputy Speaker (Mr. Michael Morris):
Order.
Mr. Clarke:
On a point of order, Mr. Deputy Speaker.
Mr. Deputy Speaker:
I hope that it is a point of order.
Mr. Clarke:
Was it in order for the Secretary of State to make a speech that failed to relate to the motion and not say one word--
Mr. Deputy Speaker:
Order. Had I thought at any time that the Secretary of State was not relating his speech to the motion, I would have intervened immediately.
Mr. Alfred Morris (Manchester, Wythenshawe):
The Secretary of State's long and, at times, repetitive speech reminded me of a celebrated apology by George Bernard Shaw.
Sir Donald Thompson (Calder Valley):
Will the right hon. Gentleman give way?
The Conservatives contested its founding principles when the NHS was created and still seek to undermine them today. As the Prime Minister was beside himself to remind me at an hour-long meeting that I had with him about the Government's obstruction of a private Member's Bill that I was then promoting--my Civil Rights (Disabled Persons) Bill--in the third year of his premiership:
The Government are no less in fundamental conflict with the principles of the national health service when it was founded, and the sooner the NHS is under the direction of people who genuinely believe in them, the more likely it is that their purpose will be fully achieved, not least that, as my hon. Friend the Member for Islington, South and Finsbury said, of restoring equity to the service and fairness between its patients.
The opening speech of my hon. Friend the Member for Islington, South and Finsbury was one of high distinction. It was that of a man both determined and well equipped to tackle existing wrongs and to achieve improving quality of care. I am naturally delighted also that my hon. Friend the Member for Monklands, West (Mr. Clarke) shares the Front Bench with him in this debate. As the House knows, the role of my hon. Friend the Member for Monklands, West is one of special significance to me. What he has already achieved for long-term sick and disabled people alone entitles him to the highest regard in all parts of this House.
The Secretary of State has important duties for the well-being of Britain's 6.9 million disabled people: for example, that of ensuring full and ready access to the services to which they are entitled under section 2 of my Chronically Sick and Disabled Persons Act 1970. The right hon. Gentleman must be aware how much the organisations of and for disabled people have wanted him--and want him now--to exercise that duty with the same sense of responsibility and commitment as his ministerial predecessor, Sir Hugh Rossi.
Sir Hugh, one of my Conservative successors as Minister for disabled people, made their mandatory duties under section 2 of the Act strikingly clear to all local authorities when he told the city of Liverpool and the London borough of Wandsworth that they were acting unlawfully in keeping disabled people on waiting lists for services for which they had been assessed under the section. He instructed the two local authorities to clear their waiting lists forthwith by providing the many hundreds of disabled people involved with the help to which they were entitled by law. If the Secretary of State is prepared to listen to no one else in this important matter, I hope that he and his ministerial colleagues will at least concede that what their predecessor said and did is worthy not only of careful study but urgent emulation.
I spoke the other day to a severely disabled woman about ministerial attitudes to the Chronically Sick and Disabled Persons Act 1970 in anticipation of this debate. She said, "They are dragging their feet." Looking down, she added, "And tell them they're lucky to have feet to drag." She is not alone in her anxiety about the Government's growing failure to give meaningful effect to legislation that is so deeply important to their independence and well-being.
The Secretary of State and his colleagues often get themselves into a muddle in trying to decide whether to say that the last Labour Government did too little or too much for long-term sick and disabled people. They try to square the circle by saying both. For example, while boasting that they have given them more help than we did, they repeal hugely important legislative advances that we made for disabled people. That can be documented at length, but I ask the House to consider just one instance.
During my time as Minister with responsibility for the disabled, in 1975, the Labour Government legislated to link disability benefits with growth in prices or average
earnings, whichever was the more beneficial to disabled people. The ending of that link, after the change of Government in 1979, had cost recipients of invalidity or incapacity benefit alone £8.57 billion by the end of the year 1994-95. Given the rate of progression of the Government's savings in the final three years for which figures are available, that figure must now be in excess of £12 billion.
Recipients of the attendance allowance had been denied £5.85 billion by the end of 1994-95, which must now have risen to more than £8 billion. Other cash benefits for disabled people have been cut just as drastically below the levels for which I legislated under the last Labour Government. There was even a saving to the Exchequer, by the end of 1994-95, of £420 million on our pioneering invalid care allowance, which today must have increased to more than £600 million.
Ministers would need more polished oratorical powers than Demosthenes to argue away factual information of that eloquence. The figures that I have given are not mine: they are quoted from parliamentary replies that I had from the present Minister for Social Security and Disabled People as recently as 10 February. I am grateful to him for correcting his earlier replies. I urge all right hon. and hon. Members to read the figures he gave me.
The central truth about our achievements and those of our successors is that, by common consent, Britain led the world in the 1970s in legislating to make life better for disabled people and their carers. That is why I was asked by the United Nations in February 1979 to open the discussion in New York that paved the way for the International Year of Disabled Persons in 1981 and why I was invited by Rehabilitation International to chair the world planning group that drafted the "Charter for the 1980s" for disabled people worldwide. Britain was then unquestionably a world leader in this policy area. As everyone knows, we are anything but a world leader today. In the north, south, east and west of the world, there are today countries that used to follow our example but that we now lag woefully behind.
I must make one more point about disability legislation in this debate. In government, we, for our part, went far beyond our manifesto commitments of 1974. There was no commitment then to legislate for the mobility allowance, for the non-contributory invalidity pension, for the invalid care allowance or for the disabled housewife's allowance. Those were advances made over and above our manifesto commitments, and I am totally sanguine that my hon. Friend the Member for Monklands, West will again make action speak louder than words as the Minister.
Far too few resources are spent today on research into tackling even the major scourges that still destroy the health and wreck the lives of their victims. Consider the reply that I had on 18 February to my parliamentary question on the progress of research funded by the Government into Alzheimer's disease. Anyone who reads the reply will be left wondering why voluntary organisations should have to spend so much of their time and meagre resources in funding research, the benefits of which are manifestly important to us all.
Again, why cannot the Government find even a moment of parliamentary time to enact the Disabled Persons and Carers (Short-Term Breaks) Bill, so ably piloted through the House of Lords by Lord Rix? Not to
allow it to achieve its admirable purpose of strengthening the ability of carers to cope with their problems will inevitably lead to further dependence and higher spending by the national health service; so it is self-defeating as well as inhumane. Ministers will know that there is another opportunity this Friday for them to stop obstructing the Bill, and I implore them to let this much-needed measure go forward then without further delay.
I turn now to the Secretary of State's responsibility in relation to the compellingly urgent claims of people with haemophilia who were infected by contaminated blood products in the course of NHS treatment. There is a deep sense of injustice among them. The tragic fate of three brothers explains why.
Two of the brothers were infected with HIV by NHS treatment and died of Aids-related illnesses. The third was infected with hepatitis C and died of liver failure. The two who died of HIV infection had financial help from the Government and were able to make provision for their families. The third brother went to his grave having been refused any help at all. He could make no provision for the future well-being of his family.
All three brothers died from the same cause: contaminated NHS blood products; but the third brother was deprived of the help given to the other two by a Government who provided £70 million for people infected with HIV and set up the Macfarlane trust to give them continuing support. The Government accepted their moral responsibility in the case of HIV infection. They have the same responsibility now in hepatitis C cases.
The Government argue that compensating those infected with hepatitis C would take money away from patient care in the NHS. To say that is to bark not just up the wrong tree but in the wrong forest. The payments made in the HIV cases came from contingency moneys, which is what the Haemophilia Society is asking for now for the hepatitis C victims. The society simply wants the terms of reference of the Macfarlane trust to be extended to include them.
Measured against the pain and suffering endured, the claim is extremely modest. Hepatitis C attacks the liver and is life threatening. Current medical opinion is that up to 80 per cent. of those infected will develop chronic liver disease, of whom about 20 per cent. will develop severe liver problems, such as cirrhosis or liver cancer. Scores of those infected have already died, and the death rate is accelerating.
In recognition of the scale of the problems, an all-party early-day motion was tabled in my name and now has 273 signatories: a majority of all Members of Parliament who are free to sign such motions. As the list of hon. Members shows, the issue is treated in the motion not as one of right and left, but of right and wrong.
"That this act of vandalism should be contemplated by Labour is doubly ironic. The NHS is Labour's proudest boast, and it was Bevan who saw the GP as the gatekeeper and patient's best friend. Fundholding is no more than a logical development of Bevan's vision."
That is the argument that the hon. Member for Islington, South and Finsbury will have to answer. It is presented not in a Tory newspaper but in the New Statesman in the words of a former director of research for the Fabian Society.
"Honouring next year's settlement is meaningless. Labour can hardly take away money already promised. What it must do is match the Tory five-year promise: real increases year on year on year."
That is a commitment that the hon. Member for Islington, South and Finsbury simply cannot give. It represents the ultimate choice that the electorate and the
people who work in the health service will have to make. Until the hon. Gentleman can pledge a growing NHS under a Labour Government, all his rhetoric is so much spit and wind. He likes to think that he can bask in the glow of the memory of Aneurin Bevan. That may be good in Labour committee rooms, but it will not cut ice on the hustings or in the NHS. The hon. Gentleman holds an important key responsibility; he has not begun to measure up to it. I look forward to more and more opportunities to expose his hollowness to the House and the country.
5.4 pm
"I'm sorry",
he said,
"for writing at such length. There wasn't time to write more briefly."
The right hon. Gentleman spoke at greater length than my hon. Friend the Member for Islington, South and Finsbury (Mr. Smith), but not to more effect. Anyone who believes, as the right hon. Gentleman pretends, that the founding principles of the national health service are in safe keeping with the Conservative party will have no difficulty in believing that pigs, even Lord Emsworth's beloved Empress of Blandings, might fly.
"This is a non-interventionist and deregulating government",
and thus, he said, in fundamental conflict with crucially important provisions of my Bill.
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