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Dr. Evan Harris (Oxford, West and Abingdon): Will the Secretary of State give way?

Mr. Dobson: Not at the moment.

Unlike our Tory predecessors, we are doing something about quality, and about our waiting list commitment. We admit that it will be hard to achieve. In the last year that the Tories were in power, the increase in treatment of people on the waiting list was just 1.2 per cent. To achieve what we want this year will require an increase

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of 10 per cent. It is a huge increase, but, on the basis of the statistics supplied to me, there are no 18-month waiters--I shall look into that. There are fewer 12-month waiters than in the past two years, and there has been the biggest fall in cancelled operations since figures were first collected.

All that depends on the people working in the health service, and on more money. We have found an extra £2 billion for the health service since we came to power--that is £2 billion more than the Tories intended to spend, and £1 billion more than the Liberal Democrats promised to spend. Last week, my right hon. Friend the Chancellor set out the Government's disciplined framework for public spending and investment. I am confident that, when the outcome of the comprehensive spending review is revealed, there will be more money available to the national health service.

The interesting question about the comprehensive spending review is not for us, but for the Tories. What will they say? They have been calling for more money for the national health service today, but last week the shadow Chancellor was attacking my right hon. Friend the Chancellor for squandering public money. We think that more money should go to the health service. Do the Tories agree? If so, do they have the agreement of the shadow Chancellor to say so?

We have no doubt that the national health service was under-resourced under the Tories, and needs more resources. Under this Labour Government, it will get more resources, not just to get waiting lists down, but to raise standards and give the hard-working staff the quality of buildings, plant, equipment and pharmaceutical products that match their excellence and commitment, putting them in a position to respond to the changing needs of the people of our country. With Labour--the party that founded it--the national health service will be renewed. It will be fit for the 21st century, and it will not be in the hands of the Tory party.

Mr. Faber: On a point of order, Mr. Deputy Speaker. I know that Madam Speaker values the rights of Back Benchers. I have heard her speak about the speed with which Ministers should reply to letters, and she has said that, whenever possible, Ministers should offer the courtesy of hosting delegations from Back-Bench Members of whatever party who want to discuss issues. This morning, I visited Warminster hospital in my constituency, where the mental health ward is due to be closed by the local health authority because of the Government's policies--

Mr. Deputy Speaker (Sir Alan Haselhurst): Order. I have heard enough to realise that that is not a point of order for the Chair.

Mr. Faber: Further to that point of order, Mr. Deputy Speaker.

Mr. Deputy Speaker: Order. I have ruled that there is no point of order, so the hon. Gentleman cannot raise anything further to it.

4.52 pm

Mrs. Marion Roe (Broxbourne): I am grateful to you for calling me early in the debate, Mr. Deputy Speaker. I am required to chair a Select Committee in 15 minutes.

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I apologise to you and to the House that my parliamentary duties will prevent me from remaining in the Chamber for the following speaker and for the winding-up speeches.

It is a great sadness that the 50th anniversary celebrations of the NHS are being marred by Labour's broken promises. At the general election, the public were misled into believing that NHS services would improve, not deteriorate. The reality is that acute hospitals and community hospitals are being closed, waiting lists are growing and waiting times are becoming ever longer. If the Labour party had matched the Conservative record on health service funding, the NHS would have £750 million more for next year than the Chancellor of the Exchequer has so far given it. I hope that the pressure from the Conservatives will persuade him to find additional funding.

In a recent Gallup poll on the two most urgent problems facing the country, 48 per cent. of respondents cited health, hospitals and medical services. No wonder the Prime Minister has been forced to postpone the publication of his first annual report on the Government's performance because of the growing criticism of Labour's failure to meet its key election pledges. The decision to postpone the launch of the report earlier this month has come as Ministers face embarrassment over a spate of official figures showing that the Government are encountering difficulty in achieving many of their five early pledges. The Secretary of State for Health has admitted to being embarrassed about waiting lists reaching 1.3 million--an increase of 133,300 since Labour came to power 14 months ago. He seems to be in a state of permanent blush.

Last February, I asked the Prime Minister whether he was aware that patients attending the Queen Elizabeth II hospital in Welwyn Garden City were waiting a maximum of 12 months for elective surgery in May 1997, but that nine months later they had to wait 18 months. The waiting lists have grown dramatically in every specialty. Needless to say, I did not receive a satisfactory reply from the Prime Minister.

The Labour party cannot claim naivety over the promises that it made at the general election. It must have been a calculated confidence trick on the British people. Those in the Labour leadership assessed how they could persuade electors to vote for them, produced the appropriate propaganda, inflicted it on the unsuspecting electors and are now pretending to us all that they really believed it.

Mrs. Louise Ellman (Liverpool, Riverside): Will the hon. Lady give way?

Mrs. Roe: I cannot give way, because I have to chair a meeting in 10 minutes. I apologise, but I am afraid that I am under pressure of time.

Anybody who knows anything about health realises that Labour's health policies were never going to reduce waiting lists by 100,000 in the early years of its term of office. The Secretary of State for Health is using crisis money in a desperate attempt to achieve a short-term solution instead of identifying the fundamental problems of demand and need. His strategy will reward poor performance by throwing money at trusts with longer waiting lists. It will distort practice, undermine the

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development of a co-ordinated strategy and bail out the inefficient practitioner who does not make best use of his facilities.

The Government have fallen into a trap. They are trying to reduce waiting lists by treating more patients through a short-term burst of activity. History shows that to be a fundamentally flawed strategy. Waiting lists have risen inexorably since 1948. Despite an increase of more than 800,000 in the number of patients treated annually, waiting lists lengthened by 100,000 between 1991 and 1995 because more than 1 million extra people were referred to the waiting lists.

Since the election of the Labour Government, on their spurious health pledges, the rate of increase has accelerated because they have failed to recognise the underlying pressures: increased chronic illness in all age groups; greater understanding of the options available; greater expectation of medicine; increasing demands on the service; new technology; and new therapy. Evidence shows that there is an equilibrium between waiting lists and activity. Increases in activity will be met by increases in referrals, which puts further pressure on the waiting lists. The Secretary of State's shallow attempts to bail out media pledges cannot succeed. Like King Canute, he will discover that the tide of demand will inundate him.

Of course, money for waiting lists will result in extra people being treated. They will benefit and their quality of life will improve, but that political measure will do nothing for genuine clinical need. Managers under pressure to deliver the Government's requirements will target the simple and quick procedures. Cataracts, varicose veins and bunions will be treated. People will be pleased and the statistics will improve for a while, but what about the chronically ill--those with multi-system pathologies, waiting for complex, time-consuming and expensive procedures? They will continue to wait and to suffer. The Government's facile financial approach makes fiddlers out of managers and victims out of patients.

The Secretary of State should have invested the money in meeting genuine clinical need, targeting those most in need of treatment. He should also remember social need. Consider the elderly lady with a sore hip. She may not have the highest clinical need, but what if she lives four storeys up in a block of flats with a lift that hardly ever works? Such desperate social need is not recognised. She is a number on a list that is ever delayed because the resources that she requires are expensive.

If the Secretary of State were genuinely keen to achieve change rather than short-term political kudos, he would understand the folly of his approach to those requiring hospitalisation. If he put lists in the hands of primary care GPs, he could build on the unique clinical intimacy between British GPs and their patients. Operations would be done not because they were quick, cheap and easy but because they delivered the best results.

It is no coincidence that waiting lists have improved dramatically since GPs became personally involved, with doctors controlling when and where to provide an intervention and having a cheque-book to back up fulfilling the need. It is incontrovertible that one GP practice providing clinical care and managing resources will achieve more than 10 that do not--or more than 50-plus reluctant participants in one of the new

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Government-imposed primary care groups. Such PCGs will undoubtedly mean that the initiative taken by GPs in the past on behalf of their patients will be lost, thus damaging the opportunity to provide more services at a doctor's surgery rather than in hospital, as well as damaging general improvements in hospital services.

If the Government want the best for patients, they must recognise the skills of GPs at practice level in identifying need. Such GPs support not just a list or a number but the individual who is damaged by disease or disability--the person who needs the help of the medical profession, irrespective of whether they are first or 101st on some list. That is what a visionary Government, unhampered by bigotry, should support. Of course, such practice already exists. The Conservative Government were operating such forward-thinking, innovative policy after the introduction of their reforms.

My constituents are not concerned directly that10, 100 or 100,000 other people are waiting for an admission or an operation. If they are distressed, in pain or incapacitated, they want treatment as soon as possible. The only way in which the Labour Government will truly benefit patients is to admit the magnitude of their folly and recognise that waiting lists are an irrelevance. They should focus on the true indicator of success: waiting times that meet the needs of the individual and not the statistician.

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