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Mr. Hughes: I have great respect for the former Secretary of State. In many respects I think that he did an extremely good job as a Tory Secretary of State for Health. He was not responsible for the last review, and I acquit him of that. It is reasonable to assume that a new Government would not expect to revisit all the questions. It would not be credible for them to say that a review would take place but that the outcome would be identical. On that point I defend the new Secretary of State for Health.
I share the concern of the right hon. Member for Charnwood that it may be impractical to think that we can sort out all the problems in a short time, but people do not want to be kept in limbo for months and years. It is a difficult balance to strike. I represent staff at Guy's who want to know their future.
On this, as on other matters, I hope that we shall perform the task properly and that in this Parliament we do not have arguments over facts. I say that especially to new colleagues. Let us have arguments over funding and policy, but let us not argue over clear and incontrovertible facts. I hope that one of the signs of a new regime in government is that we do not get hundreds of answers on
health service questions--for example, how many hospitals have been closed and how many beds there are--all stating that the information is not held centrally. No colleague on either side of the House will be happy if we get a stone wall of silence about what is going on in the health service so that no one can find out what the score is locally, regionally or nationally.
I shall continue my resistance, should the Government not deliver on these matters adequately. I am still blocking a Bill, which got blocked before the end of the last Parliament, that would bring about a merger of the United Medical and Dental school and King's college London. I shall continue to do so unless we get satisfactory assurances about adequate numbers of beds at my local hospital.
I wish to make four points about the Queen's Speech. The first was made similarly yesterday by my right hon. Friend the Member for Yeovil (Mr. Ashdown), and my hon. Friend the Member for Bath (Mr. Foster) made it today in the context of education. I do not think that any objective analyst believes that there is sufficient money in the kitty to sustain the NHS as at present demanded by the citizens of the United Kingdom. I quote from the election briefing of the Institute for Fiscal Studies--not a party organisation--which stated:
If the Labour Government carry on the synchronised swimming--having the same budget for health as the Tories--they will be in trouble. I say that in the hope and expectation that the wisdom of government will descend on the new Chancellor of the Exchequer and the new Secretary of State for Health and that they will say, as Governments so rarely do, "We are sorry. We were wrong. We need more money, and it is better to tell you that than to pretend otherwise." We look forward to that process beginning in the Budget next month. If that does not take place, we shall vote against the relevant parts of the Budget and we shall table amendments to increase funding for the health service, as we have consistently argued over recent years.
Secondly, I welcome the Government's stated intention to end the two-tier health service. The great failing of the Tory reforms was that patients received different
treatment depending on which doctor they went to or where they lived. It is absolutely true that, as of today, the NHS is still a national health lottery. If we are to put that right and end the difference between fundholders and non-fundholders, we need to do so in a way that receives support from those in the profession and elsewhere. I welcome the fact that there will be consultation, and that it may not be necessary to legislate. If that is the case, we must have consultation about the proposed instructions, guidance and directions as though we were discussing legislation. Having got it so wrong last time, I do not want us--and patients do not want us--to get it wrong again.
Thirdly, I wish to refer to the private finance initiative. The hon. Member for Norwich, South welcomed the Bill--which I gather is to be published in another place tomorrow--to facilitate private finance coming into the NHS. That is not an uncontroversial matter. The only reason why we are going down that road is that the previous Government slashed capital spending in the NHS. There may be an argument for bringing private money into the capital budget of the health service, but last year the Treasury, the Treasury Select Committee, various financial advisers and certainly the Labour party were not persuaded by it. I do not think that, as of today, the public are persuaded either.
If we are to build a secure NHS--with the buildings, hospitals and facilities that we want--we must seek agreement about how to bring in private finance. I welcome the fact that, in theory, it is on the agenda. If the Government are seeking to push through a Bill to allow projects that have been in the pipeline for some time to be built--such as the example referred to in Norwich or such as Rochdale--some hard questions will be asked about whether that secures either the best investment of public finances or the best security for the NHS. Effectively leasing hospital buildings that one does not get back in 35 years may not be a good way of spending public money. A lot of people need to be persuaded about that proposal.
Finally, I wish to refer to public health. I welcome the appointment of a Minister for public health. The hon. Member for Preston is absolutely right in implying that the NHS is a national sickness service--and the more it is such a service, the poorer our public health will be. In most respects, we have not a national health service, but a national sickness service. We are rescuing people whom we have allowed to fall into the river rather than stopping them falling in in the first place.
The Government are right to single out smoking as one of the most pernicious routes to ill health. Smoking kills 100,000-plus people a year in this country--I am not sure of the arithmetic, but I believe that that works out at 300 people per day dying as a result of tobacco-related diseases. I ask the Government to be as tough as nails on this. There must be no backsliding or equivocation. There must be no tobacco advertising, except at the point of sale, and no tobacco sponsorship of sport--even if that means that sport has difficulties for a short period. The idea that a racing driver--or a snooker player or a darts player--gains success partly by being associated with smoking has to be hit on the head. Smoking kills you, and if it does not kill you, it debilitates you, puts you out of work and gives your family and friends a harder time. We have to be tough on smoking and tough on the causes of smoking. [Interruption.] I mean that. If this House does not deliver, we will betray our responsibility.
In addition, we must be tough on alcohol and tough on the causes of alcoholism--particularly among women, where there has been an increase. We must also be tough on drugs and tough on the causes. I do not mean illegal drugs only, but I mean drugs in the NHS which are often given with no proven benefit to the patient. There are far too many drugs given as a quick answer to a difficult question. Alternative remedies and alternative medicines are often a better way forward.
"The real growth in health spending planned over the next three years is well below average spending growth in health over any recent parliament, or indeed over any period of consecutive years . . .
the current spending plans--
The projected growth in health spending over the next three years is far lower than the average growth in health spending since the Conservatives took office in 1979, or at any time over the last thirty-five years. . .
Either they"--
"are unfeasible, and will be broken, or they will mean a much lower injection of new resources into the health service than hitherto experienced. At a time when the public's demand for health care is inevitably rising, this will have serious implications for how well the NHS will be able to continue its role as a comprehensive provider of free health care."
I say to Members on the Labour Benches that they were timid on health service spending before the election and during the election. It was only the moment before the election that they suddenly announced that they would spend as much as the Tories; previously, they said that they would spend less. That was because the right hon. Member for Charnwood and I had a go at them every Question Time until eventually they decided that it was so embarrassing to be third in the spending league table that they had better do something about it.
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