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Mr. Heppell: The quotations are very interesting, but the Secretary of State might find it difficult to go to his Cabinet colleagues and say that he thinks that we ought to adopt the better European standards of health care. The climate in the Conservative party might not be right for him to say that.
The examples given by the right hon. Member for Wealden (Sir G. Johnson Smith) are interesting, as were the Secretary of State's statistics, but many Opposition
Members see the reality. Tory Members are telling me that things are getting better and better, and that I am either bitching or raising a political point. But in my constituency, no elective surgery will be carried out at all on the patients of non-fundholding general practitioners--including at the Nottingham City hospital and the Queen's Medical Centre--until April. That will be a total of seven months with no operations.
Mr. Deputy Speaker:
Order. The hon. Gentleman should have raised that point earlier in his intervention.
Sir Geoffrey Johnson Smith:
The hon. Gentleman was obviously too busy talking to his hon. Friend the Member for Morley and Leeds, South (Mr. Gunnell) to fully understand what I said. I should make it clear that all those countries are facing rising costs and, without exception, are looking at how they can make more efficient use of resources. As part of that philosophy, they are using the private sector to help them on their way. That is important, and it is happening in socialist countries as well. But Opposition Members will not look at the matter in that way.
Mr. Nick Ainger (Pembroke):
Does the hon. Gentleman accept that every country that he has mentioned with a private-public mix spends a far higher proportion of gross domestic product on health than this country does? Our system--which is basically public with a fringe element of private provision--is the most cost-effective health service in the world. To start moving down the road of greater private sector involvement will only increase costs without benefiting patients.
Sir Geoffrey Johnson Smith:
If they thought that, why are those countries which have to some extent depended on the private sector moving down that road? They are not so daft that they will move to a situation that would lead to the conclusion that the hon. Gentleman advocates. [Interruption.] I have the reports here. Those countries are not moving down the road to more expensive health provision. They believe that by reforms which parallel our own--the purchaser-provider split and things of that order--they are more likely to gain the efficiency and the additional resources that are necessary if they are to fund the higher cost. That was the purpose of the article written in Fabian Review--making better use. That is what we are doing.
Had the hon. Member for Pembroke (Mr. Ainger) been listening, he would have heard me say that much of the increase in the percentage of gross domestic product that other countries can boast for their health services is due to the use made of the private sector and I quoted some figures. That is what brings the percentage in, and it is important.
Sir Geoffrey Johnson Smith:
The figures are there. If the hon. Gentleman reads my speech, he will realise that those figures support my argument. Those countries are going further down that road. Unless they were blind, daft or batty, they would be unlikely to go down that road if they did not feel that better use of private resources and better management would lead to better delivery of the services, which they all find are under strain. There is
Mr. Simon Hughes (Southwark and Bermondsey):
I have great sympathy with the general proposition put forward by the right hon. Member for Wealden(Sir G. Johnson Smith). I have argued from this Bench before that much of our debates on the health service is pointless. It is simply an exchange of statistics and arguing about matters that could be objectively verified, which leaves people out there thinking that they should not trust any politician because they are not tackling the main issues.
I looked up the right hon. Member for Wealden in "Dod's Parliamentary Companion". He was married in the year that I was born, so he has been around a little longer than I and perhaps remembers the pre-NHS health service a little. But we share a commitment to the NHS, which has been a great success. He is right in his analysis that there is a similar challenge in health care the world over. In advanced democracies such as ours, the issues are the same--people are living longer, demanding more, putting on more pressure and costing more.
There is a longer-term debate to be had and I regret that we spend far too much time on these short-term debates. When the election is out of the way, I hope that more politicians will be honest enough to own up to the fact that unless we tackle those issues, we will be serving the people of this country badly. The way we are going on, there will need to be some radical rethinking of how we fund the health service. The right hon. Member for Wealden may have a view about the private sector and more private money coming in. I probably have a different view, as I think that the NHS should remain substantially funded by the taxpayer, but as the NHS is a key part of the welfare state, this issue ought to be addressed and the sooner we get away from short-term exchanges of contradictory information that illuminate nothing the better.
None the less, this is an extraordinary debate. The Labour party has chosen the subject for its sixth Supply day and has entitled the debate "National Health Service"--nothing more specific than that. It is as if the Opposition then suddenly thought that they had better include some other things, so they mixed into the debate about the health service, debates about disability and community care.
Mr. Hughes:
The hon. Gentleman says yes, but disabled people do not like the idea that health and
Mr. Clarke:
Will the hon. Gentleman give way?
Mr. Hughes:
Not for a second. Unlike the Labour health spokesman, who would not give way because he knew that I would ask him a question that he could not answer adequately, I will give way to the hon. Gentleman, whom I respect, but first I must quote something written by some of my party's advisers on disability in 1993. They said:
Mr. Clarke:
I reciprocate the respect that the hon. Gentleman says that he has for me. Disabled people expect a debate on the health service to be relevant to them and I have had several letters and telephone calls since the Labour party announced that it would use the time to have this extremely important debate. I shall clarify some of the hon. Gentleman's points in my reply, if he is able to stay for the end of the debate.
Mr. Hughes:
I do not want to be distracted by this dispute, but the Labour party had an Opposition day on health recently and it could have had a full day's debate today on disabled people's issues, but it chose not to do so. The Labour Opposition have added this issue into a debate on the national health service and disability is not even mentioned in the title.
Mr. Barron:
Why does the hon. Gentleman's party not have one?
Mr. Hughes:
We get two days a year and the Labour party gets 17--that is one of the reasons. We have had such debates in the past. We, too, receive representations. There is a range of disability issues that we could raise, but they should not be put into a debate on the national health service. If we are to debate them, I hope that before the election the Labour party will go further than its present commitment, as it is not yet sufficiently committed to the equality of treatment for disabled people that they and their representatives want.
"It is a sad fact that debate on disability issues is often assumed to be simply about health, social security or community care. It is also very surprising that this should be so because the disability debate is fundamentally about human rights".
It is about equal treatment, equal citizenship and access. Although there is a movement in the right direction in Labour policy, it falls short of what disabled people want because it does not commit the Labour party to the introduction of a Bill of Rights that would automatically give people equality of treatment. Until the Labour party goes that far--I stand to be corrected--it will not serve the interests of disabled people adequately.
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