| Previous Section | Index | Home Page |
Mr. Dobson: I am not sure that I can deliver on my hon. Friend's last words. It is in the nature of things that some of the health trusts will feel aggrieved--it is almost part of their job to feel aggrieved. However, we will make sure that every penny of that money gets out and is used for patient care, not squandered on bureaucracy as so much has been in the past.
We are also keeping our election promise to conduct a comprehensive review to assess how to use resources better and root out waste and inefficiency. The previous Government planned to--
Mr. Ian Bruce:
How many bureaucrats will lose their job?
Mr. Dobson:
The hon. Member for South Dorset (Mr. Bruce), who was so warmly endorsed by his electorate that he only managed to beat Labour by 77 votes, is apparently the only person in the Chamber who does not think that there is too much bureaucracy in the national health service. We can see why he won by only 77 votes.
Mr. Bruce:
It may well be that those 77 people are about to be sacked by the national health service. The right hon. Gentleman refuses to tell us how many people will have to be sacked. In Dorset, the health service will have to find £1 million to pay for the reductions in bureaucracy. How can he respond to the question asked by his hon. Friend the Member for Workington (Mr. Campbell-Savours) by introducing more bureaucracy to gather more figures when he also says that he is going to cut bureaucracy?
Mr. Dobson:
If the hon. Gentleman is saying that it will cost £1 million to save on bureaucracy, that is a further reason for his electorate to have reduced his majority in South Dorset to just 77.
The previous Government planned to increase spending on the NHS in England next year by £775 million. That would have meant a reduction in real terms. Labour promised at the general election that NHS spending would grow in real terms year on year. We are keeping that promise. Next year's total increase of £1,775 million amounts to real-terms growth of 2.35 per cent.--more than the real-terms growth in the last two Tory years put together.
Nevertheless, next year's settlement is very tough. It will, however, be augmented by the savings that we intend to make by reducing bureaucracy, waste and fraud. I look forward to working with NHS staff to do that and to improve patient care at the same time. That is what NHS staff and patients want. It is what the taxpayer wants and it is the Government's job to help to achieve it.
Part of the Government's contribution is to ensure that NHS staff have decent, well-equipped hospitals in which to work. The previous Government decided that new
hospitals should be built using private sector money under their private finance initiative which was first announced in 1992. Under the Tories, all hospital building schemes had to be PFI tested. Little or no advice was issued to trusts, which were allowed to go their own way. Advisers and consultants were recruited as and when the trusts felt like it. No effort was made to establish whether the legal status of the trusts met the needs of private sector partners.
Tory Ministers trumpeted the success of the PFI. Hospital building schemes were announced, re-announced and announced yet again. The Tories talked a lot and they spent a lot--30 million quid on consultants. But even now--five years after the PFI was launched--not a single PFI-financed hospital has been started. Not a brick has been laid.
When we took over in May, we were pledged to sort out the mess. That is another election promise which we have kept. The Tories talked about building hospitals; we will actually get them built.
I asked the Minister of State, Department of Health, my hon. Friend the Member for Darlington, to sort out the mess and he has done so. After a great deal of hard work by my hon. Friend personally and by officials in the Department of Health, the NHS Executive, the regions and the trusts, some order has been established. Priorities have been thrashed out and decisions have been taken. As a result, we were able to announce last Thursday a £1.3 billion hospital building programme--the biggest ever programme of new hospital building.
The programme includes the following 14 hospital projects: Norfolk and Norwich, Dartford and Gravesham, North Durham, South Buckinghamshire, Calderdale, Carlisle, Hereford, Wellhouse, Worcester, Bishop Auckland, South Manchester, South Tees, Swindon and Bromley. We expect building on all 14 new hospitals to begin within the next 18 months. Some will commence as soon as the National Health Service (Private Finance) Bill is enacted.
Progress will be strictly monitored to ensure that the schemes are delivered to price and on time. I realise that those involved in schemes that lost out in this round will be disappointed, but, as things stood, everyone was losing out. The whole system was in shambles. There were no national priorities and no national criteria. No decisions were taken.
We have selected the schemes that contribute most to the health needs of their locality and can be expected most rapidly to provide affordable, value-for-money new hospitals. Schemes that have not been given priority in the review will now be considered as part of a national capital investment programme involving public and PFI-funded projects. Some may be given the go ahead by next spring. The PFI will augment the Treasury's capital allocation for the NHS of £1.35 billion in 1998-99 and £1.39 billion for 1999-2000.
Mr. Michael Jack (Fylde):
I have two simple questions for the Secretary of State. First, can he give the House an assurance that he will publish the details of the health needs criteria that he used in selecting the 14 projects that are to go ahead? Secondly, for the sake of clarity of language, will he confirm that it is not a hospital building
Mr. Dobson:
So far as I know, the details that the right hon. Gentleman requested are already in the Library and people in areas affected have been sent those details. If, by some freak of fate, they are not in the Library, they will be placed there. There is nothing secret about them. Secrecy is the last thing we want on this issue.
The right hon. Gentleman said that we cannot guarantee that all the hospitals will be built. He is right, but I am willing to bet that some of them will be built--
Mr. Stephen Dorrell (Charnwood):
Some of them.
Mr. Dobson:
Yes, some of them will be built. We will not have a period of five years in which none of them will be built. The former Secretary of State is yawping, "Some of them," from the Opposition Front Bench, but he and his predecessor did not get a single hospital built, so it would be more appropriate for him to keep quiet.
Mr. Andrew Lansley (South Cambridgeshire):
The Secretary of State talks about some projects going ahead, but does he realise that his decisions have been deeply disappointing to those in my constituency who are associated with Papworth hospital? He talks about health service need in the context of local need. Papworth provides not only for local need, but for regional and national need. It is internationally renowned for heart and lung treatment, and the decisions made by the Secretary of State and his hon. Friends have brought to nothing a great deal of work that was put into the preparation of that PFI project.
Mr. Dobson:
Unless my memory is playing tricks on me, one of the main reasons why Papworth was not included in the first round was that the scheme had not made sufficient progress. I cannot recall how many points it was awarded for meeting health service needs, but it scored fairly high. The scheme was held back by the lack of progress that had been made.
The £2.5 billion programme to start modernising the NHS is not the Budget's only contribution to improving the health of the nation. Nor is that task confined to the NHS. It is a task for the Government and for everyone else. Some factors, such as air pollution and crime, damage everyone's health. Others, such as poor housing, unemployment and low wages, damage the health of people who are worst off. The new Labour Government are determined to tackle the sources of ill health.
My right hon. Friend the Deputy Prime Minister has in hand proposals to reduce air pollution resulting from motor vehicles. That will benefit the health of all of us, as will the commitment of my right hon. Friend the Home Secretary to reduce crime and disorder.
My right hon. Friend the Deputy Prime Minister is also in charge of our programme to build more homes for people who have nowhere decent to live. It will be financed by the release of funds from the sale of council houses. That will improve people's health. A recent survey in east London showed that improved homes reduced by one third the number of general practitioner
visits and hospital referrals for the people concerned. In other words, better homes improved health and saved the NHS money. So investing in housing is money well spent.
My right hon. Friend the Chancellor of the Exchequer spelt out our scheme for finding work for young people and the long-term unemployed. It will be financed by the windfall tax on the utilities. That will improve the health of people who get jobs, because being out of work makes people physically and mentally ill.
Being out of work increases the likelihood of death and injury from accidents, suicide and cancer. The chances of a middle-aged man dying in the next five years are doubled if he loses his job. Low pay makes people ill. It usually goes with long and unsocial hours. It often leads to a poor diet, stress, and mental, physical and family breakdown. So our manifesto commitment to a national minimum wage will improve the health of the people who will get higher wages. It will improve the health of their families. Therefore, it will be a health measure.
All those measures will help improve the health of the nation. They will reduce the dreadful inequalities in health that mar our society and blight the lives of millions of families. When we took over, we discovered that the words "inequalities in health" were not used in the Department of Health and the NHS. They had been branded politically incorrect by the last but one Tory Secretary of State--the right hon. Member for South-West Surrey (Mrs. Bottomley). The politically correct phrase under the Tory Government was "variations in health".
Inequalities in health are back on the agenda and the first-ever Minister for Public Health, my hon. Friend the Member for Dulwich and West Norwood (Ms Jowell), has been given the job of reducing those inequalities. It is not just her job, however. I have made it clear to all concerned that identifying--and then reducing--inequalities in health is one of the core functions of the Department of Health and the national health service. It is not an optional extra; it is at the heart of what this Government are about.
The reason why tackling inequalities in health is at the heart of what we are doing is that inequalities in health are the most profound and far-reaching inequalities of all. Poor people are ill more often and die sooner, and you cannot get more unequal than that. We must tackle those inequalities. I have been warned that that is an ambitious policy, but people have all sorts of political ambitions, and this is mine: I want to be able to say "Vote Labour and live longer". I want to be able to make that promise and make it a truthful promise.
| Next Section
| Index | Home Page |