| Previous Section | Index | Home Page |
Mr. George Stevenson (Stoke-on-Trent, South): I am delighted to hear what my right hon. Friend has said, but, while he is dealing with this particularly important point, may I raise two issues with him?
The first issue is social services departments' ability to deliver their part of the multi-agency package to which my right hon. Friend rightly referred. That has been affected by a lack of resources. The second issue is the growing problem of disagreement between health authorities and social services departments about who should pay for care, support and treatment. Increasingly, people who need such treatment are falling through the net.
Mr. Dobson:
My hon. Friend is right to make those points. Those are two reasons why we are so concerned, and so determined to do something. We are considering concepts such as pooled budgets, but it would be silly of me to pretend that there are easy, simple, quick solutions to the problem. If there were, it would have been solved a long time ago. We are determined to sort it out, however, because it is at the interface between the two providers that many of the most vulnerable people are to be found, and we owe it to them to do better than we have done up to now.
Mr. Dorrell:
I agree with the right hon. Gentleman that the interface between health and social services is one of the most sensitive issues and one of the most critical to the successful management of the national health service. What decisions have the Government made in regard to increasing the standard spending assessment for social services departments as a consequence of the spending decisions that the Chancellor announced last week? Am I right in believing that the education SSA for next year has been increased, but the social services SSA has not been increased over and above the figure that the Government inherited?
Mr. Dobson:
There was a touch of "All Our Yesterdays" in the former Secretary of State's intervention. I can certainly confirm that, last year, the Government gave the impression that they had found more money for local education authorities, but, while they may have increased the SSA, they did not increase the funds. Consequently, money was moved out of social services into education, following pressure from local people who were under the impression that the Government had given their local council extra money.
We emphasise that--as my hon. Friend the Member for Stoke-on-Trent, South (Mr. Stevenson) pointed out--all our aims depend on more co-operation. We want to promote co-operation at all levels and in every part of the national health service. The internal market introduced by the previous Government set different parts of the health service at one another's throats. A health service manager in my area described it to me a few years ago as "dog eat dog". That must stop: stupid, petty and ridiculous competition must end. Co-operation must be the order of the day from now on, with different units helping each other out, because patients suffer when they do not.
That is happening already, in that many common-sense people in the health service have been trying to work together, but they have been obstructed by the system and the messages from Tory Ministers. Here is a good example. Last year in Birmingham, the various parts of the NHS got together with the council to make contingency plans to cope with the winter pressures. As a result, they coped well last winter. That approach must be applied right across the NHS.
At the general election, we promised that we would make sure that the boards of health authorities and trusts would be more representative of the local communities that they serve. Some 900 appointments to trusts are due in November and December this year. The appointments process was set in train before the general election, but I am nevertheless trying to live up to our manifesto commitments, even in the limited time available. The sort of people whom I want to appoint are the sort of people whom I would like to stick up for me and my family and for local services on my local health authority and my local trusts.
I have opened up the appointments exercise. I have invited local councils to put names forward and invited every Member of Parliament in England with a local trust board vacancy--regardless of party--to do the same. I emphasise, however, that no one will receive special treatment: all the appointments will be made on merit and will be subject to Nolan procedures. I have also made it clear that I expect trust boards to meet in public in future and I propose to change the law to require them to do so.
Those measures are not window dressing; they are a serious contribution to improving the services that the health service provides. They will increase public involvement, public knowledge and public commitment--and commitment counts for a lot when it comes to providing local services and improving cost-effectiveness.
Most of the debate on the Budget has been about money. That is only natural, but money is not the only thing that counts in the NHS. The health service certainly needs money. Its staff need decent pay and conditions, and access to modern medicines and up-to-date equipment. They need good data systems and top-quality management. All that is, at least in part, to do with money, but something else that the staff want is not connected with money. Above all else, the staff need to feel that they are treated with the respect that they deserve--respect for their commitment, respect for their professional skills and experience, respect for their dedication. With this Government, they will get the respect that they deserve.
The changes that we make will be carefully thought out and carefully discussed in advance with the people involved, and they will be tested. Unlike the previous Government, who thought that they knew it all and forced repeated changes on the NHS against the advice of the people who have to do the work, this Government will involve the staff, listen to their ideas and respond to their concerns. We will not always agree with any particular group, but we will listen, because we recognise that the future of the NHS depends on the people who work in it.
We want to see a genuine national health service, providing top-quality services close to home--top-quality services ranging from the health visitor, local pharmacist, local GP or district nurse to community hospitals, district hospitals and centres providing specialist care, but all part of the same national health service and accessible to all.
We want them to work together, helping each other to help the patients. That is what we promised in our election manifesto. We also promised, "If you are ill or injured, there will be an NHS there to help. Access to it will be based on need and need alone, not on your ability to pay, who your GP happens to be or where you live." We will keep that promise to safeguard the basic principles of the health service.
Unlike the Conservative party, we take our election promises seriously. We do not make promises that we cannot keep; we do keep the promises that we make. We promised to raise NHS funding in real terms year on year, and we have. We promised to cut bureaucracy and shift more funds to patient care, and we have. We promised to overcome the problems that plagued the private finance initiative, and we have. We promised to replace the wasteful competition of the internal market, and we have. We promised to give priority to the NHS, and we have.
That is because we treasure the NHS, which was founded by the Labour party. It has served the people well for 49 years, and it is the most popular institution in our country. That is partly because it works well in practice and partly because it is based on the principle that the best health services should be available to all--the best for all: quality and equality.
Mr. Stephen Dorrell (Charnwood):
It is always a pleasure to be able to take up the remarks of the Secretary of State. I have had the pleasure of speaking opposite him, or shadowing him, for a month or two. He has made a familiar speech this afternoon--it is a good campaigning speech--and I shall respond as I have always responded by saying that commitment to the principle of the national health service and health care on the basis of need rather than the ability to pay is not, as the right hon. Gentleman likes to present it, one that divides the House. In reality, it is a principle that unites every party in the House. The right hon. Gentleman's attempts to portray it as a principle that divides one party from the other sound rather stale in the immediate post-election period.
It is an especial pleasure this afternoon to hear the Secretary of State announcing the list of front-runner private finance initiative projects. I think that I could have recited the list of 14 such projects almost from memory. It is an extremely familiar list. I am pleased that the Government are following the policy through. The Secretary of State is right to say that it represents the best way of delivering modernised capital stock for the health service.
The Secretary of State did not explain, however, why he feels that it is necessary in the context of the PFI to reintroduce the capital rationing process that the PFI was designed to abolish.
The right hon. Gentleman did not succeed in his effort to explain to the House how the Government's commitment to deliver their election pledges can be
squared with the fact that the Prime Minister and the Chancellor of the Exchequer went round the country in advance of the general election saying clearly:
"We have no plans to increase tax at all."
Those are the words of the Prime Minister, yet we are debating a Budget the effect of which is to increase taxes on pensioners and business and to introduce major disincentives to the process of investment and wealth creation.
| Next Section
| Index | Home Page |