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NHS Services (Charging)
Mr. Deputy Speaker (Mr. Michael J. Martin): I inform hon. Members that Madam Speaker has selected the amendment standing in the name of the Prime Minister.
7.16 pm
Mr. John Maples (Stratford-on-Avon): I beg to move,
- That this House expresses deep concern that the Government, in implementing its review of the National Health Service, has refused to rule out extending charging for NHS services, particularly the possible imposition of prescription charges for pensioners, charges for hospital hotel services and charges for visits to general practitioners.
Whereas Lewisham was four square miles, Stratford-on-Avon is 400 square miles--of fields as opposed to tarmac--comprising lovely villages and towns. In the middle is Stratford itself, which is perhaps one of England's most beautiful and historic towns. In future, I intend to speak often in the House about the rural economy, agriculture and development. It is a wonderful place to represent and to live.
I thought that I should say something courteous about my constituency and my predecessor. I am in an unusual position, as my predecessor is still a Member of Parliament--although he is on the wrong side of the House. When I was selected to represent the Conservative party, I promised my supporters that on television on election night they would see five words that they never expected to see: "Stratford-on-Avon: Conservative gain". My constituency had the largest Labour to Conservative swing of the night, and I understand why my predecessor did not hang around. As his defection created this opportunity for me, I remain grateful to him.
I turn now to the motion. It must amaze everyone that the Government have managed to get into such a mess on this issue so quickly, and that we should be in the position of choosing--on the first Opposition Supply day of this Parliament--to debate charges in the national health service under a Labour Government. We are debating the allegation that the Government are considering introducing charges for pensioners' prescriptions, the hotel costs of stays in hospitals and visits to general practitioners.
During the election, we showed repeatedly that Labour's sums did not add up, but few people, including even me--I am about as cynical about Labour's tax promises as one can get--could have imagined that Labour would have thought of squaring the circle by imposing new taxes on sick people.
We could shorten the debate a great deal. The Secretary of State could now--if he wants to do so, I shall give way to him--categorically deny all this. If he will now say that none of that to which I have referred is even being considered and that he rules out such charges completely, categorically and for all time, perhaps we can go home
early. Does the right hon. Gentleman wish to intervene? My right hon. Friend the Member for Fylde (Mr. Jack) and I will even put in a good word at the Treasury for him. We have a few friends there and we know that we are dealing with a Treasury-driven exercise. It seems, however, that that is not enough. We might even put in a good word for the Minister without Portfolio, the hon. Member for Hartlepool (Mr. Mandelson), because I think that he has something to do with the exercise. I think that the response was to be expected. At least I shall get to make the rest of the speech that I have prepared.
The story first appeared in the Financial Times on Monday 9 June in an article written by, I think, one of our most respected health commentators among journalists. The article read:
Senior insiders were quoted as saying that
Both stories clearly originated from an official civil service briefing. The journalists involved did not invent the stories, and they say as much in them.
The very next day, pulling the pieces of the puzzle together--they need to be put together because the Secretary of State has certainly not made it clear what is going on--the Chief Secretary to the Treasury announced to the House what appeared to be a run-of-the-mill public spending review. There was no indication from him or the Secretary of State for Health how far-reaching it was intended to be. That did not emerge until the next day, when the Secretary of State was apparently rather indiscreet with journalists after speaking to the Institute of Health Service Managers at Cardiff.
The right hon. Gentleman did not come clean in his speech at Cardiff. Indeed, he deliberately confused the issue. The day before, his Minister of State announced a review to the House. Perhaps we were intended to confuse that announcement with the review that I am discussing. A much narrower review was announced with a named team that would examine ways in which more money might be directed to patient care.
After the Cardiff events, the cat was pretty well out of the bag. That Friday, a rescue exercise was attempted by means of a press release quoting the chief executive of the NHS and the Secretary of State as saying that the health service would remain free. But neither of them used that opportunity or has used any opportunity before or since to deny our fundamental allegation that the review would include possible charges for patients.
As if to confirm our suspicions, the Secretary of State was quoted in The Times on 14 June as saying:
The Secretary of State may, however, have taken some comfort from the fact that the story was given fresh life and credibility by the Prime Minister during Prime Minister's Question Time on the Wednesday. We are all rather grateful to the Prime Minister for dropping into the House occasionally, taking intervals in his world lecture tour. We now understand clearly why he wanted to have only one session of Prime Minister's Question Time each week. He was planning to be in the country for only about one day a week.
We know that it must be much more agreeable cuddling up to Lionel, Helmut and Bill than to come to the House to clear up the mess left by the Secretary of State. Instead of lecturing European Heads of State on flexible labour markets--a concept that was entirely alien to the right hon. Gentleman until a few month ago--or lecturing the Americans on their environment, perhaps he should spend more time here getting right the line on the NHS.
During Prime Minister's Question Time on 18 June, my right hon. Friend the Member for Huntingdon (Mr. Major) asked the Prime Minister five times to confirm or deny the story. The Prime Minister, even by his own standards, was pretty loquacious in his answers. The first answer took 144 words but the right hon. Gentleman failed to answer the question. The second time he got down to 124 words. The third time--he must have been getting a bit rattled--he got back up to 157 words. Answers four and five consisted of 127 and 143 words respectively. On none of the five occasions, however, did the right hon. Gentleman answer the question. It was a pretty straightforward question but he took 695 words to say nothing.
We know that precis is not part of the lawyer's art, but civil servants are rather good at it. I suggest that the Prime Minister let them draft his answer next time. I suspect that it will be very short. I suspect that on 18 June the answer would have been yes.
The Prime Minister may have prevaricated, but by not denying the story he has, of course, confirmed it. There is a Treasury-led review of NHS spending that will include consideration of charging patients for services in areas where there are currently no charges.
Both my right hon. Friends on the Opposition Front Bench, the Members for Fylde and for Charnwood (Mr. Dorrell) know something about the Treasury. We all
had our postgraduate educations there. I can only say to the Secretary of State that if the Treasury is in control of the exercise, it will fight its case to the wire and will win. For a start, Treasury officials were much cleverer than anyone else in the civil service.
"The Department of Health's review is expected . . . to examine charges for NHS 'hotel' costs and GP visits . . . But a review of the structure of prescription charges could see the better off elderly being asked to pay."
The story was then taken up the next day by the Daily Mail, which made it clear that the exercise was Treasury- driven. The article stated:
"Two million pensioners may have to pay prescription charges as Labour cracks down on the NHS budget . . . The Chancellor . . . is determined"--
this is interesting--
"to slow the ballooning growth of the NHS budget".
That is not a story that we often hear from Labour Health Ministers.
"the entire structure of the charges is being reviewed and non-pensioners could also face paying more. A senior Whitehall source confirmed last night that a cutback on free prescriptions was being considered . . . There may also be 'hotel-style' charges"
for stays in hospital.
"We are going to look at charges."
How could the Secretary of State have got himself into such a mess with what is supposed to be a simple review of health service spending and public expenditure? According to the next day's edition of the Daily Mail, the Prime Minister had the same reaction. The article stated:
"Tony Blair is furious with Frank Dobson's 'incompetent' handling of the row over charging patients for health services. The Premier is angry that his Health Secretary confirmed the Government is considering making people pay for GP visits, staying in hospital, and forcing pensioners to pay . . . for prescriptions."
That is rather restrained language. I imagine that if that message was delivered to the Secretary of State by either the press secretary or the Minister without Portfolio, it was in rather more robust language than that used by the Daily Mail.
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