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Mr. Deputy Speaker: Order. There is far too much sedentary comment, and we cannot have a very coherent debate with that background noise.

Mr. Hughes: Thank you, Mr. Deputy Speaker.

I now want to deal with the announcement about beds which was remade today--"remade", because the announcement that there would be 2,000 more beds in the health service this year, and 1,000 beds saved that otherwise would have gone, was made a fortnight ago. It appeared in the Evening Standard, for example, on 2 June. I have the list of those beds here, and I already knew that Guy's and St. Thomas's, my local trust, would get 24 more beds. That is another example of one of the recycled announcements at which the Labour party in government is so good. I welcome the fact that more beds will be kept this year; of course I do. I welcome, and do not even doubt, the fact that there will be 2,000 of them--

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beds that would not have been kept or been reopened had it not been for waiting list money. I also welcome the fact that another 1,000 beds that would have been closed will be kept open.

However, I have not yet heard--I ask the Minister to tell us the answer in his winding-up speech--whether the money committed to doing that this year is guaranteed on a recurring basis for the three-year period that the Chancellor defined last Thursday. The Minister will understand that, if the money is not guaranteed, the beds may not be kept open after this year. There will then be a further crisis, and they will have to be reopened later using additional money. That is no way to run anything, let alone a health service.

My hon. Friends the Members for North Cornwall (Mr. Tyler), for Truro and St. Austell (Mr. Taylor) and for Oxford, West and Abingdon--in fact, probably all my English right hon. and hon. Friends--have told me that they know that the shortages in the health service, and the fact that we have so many people on waiting lists, are in part due to the fact that we do not have enough staff in the service. We have not had the money to recruit the 8,000-plus nurses that the health service is short of, or the 1,000-plus doctors, let alone the general practitioners.

Yesterday, I spoke to a recently retired very senior nurse manager who said that we were building up a huge crisis because staff did not want to come into the health service. I do not pretend that the Government do not understand that; I know that they are aware of the problem. It must be acknowledged, however, that we have to provide more than beds and operating theatres; we have to provide the staff.

I am not talking about existing staff working extra time--12 and 18-hour shifts--or about agency staff or staff on bank duty. I am talking about real permanent establishment staff who can supply all year the consistent teamwork to provide health care in the way that the NHS does best.

There have always been waiting lists. I suspect that doctors are keener on them than the rest of us, because they believe that lists are a good way of rationing. There has always been rationing, too, since the NHS was created--let us not delude ourselves about that. I rarely hear the fact admitted by either the Government or those on the official Opposition Front Bench.

I hope that, if not by the end of this Parliament--I see no sign of the present Government's delivering on the pledge--at least by the end of the next Parliament, we will have put enough money into the health service to reduce waiting times, and therefore waiting lists, to a reasonable level for everybody. In my book, "reasonable" means six months. I have worked out the figures and have explained them to colleagues in other places and at other times, and the Library has provided figures too. I cannot see why, with sufficient investment over five years, we cannot get waiting times down so that no one has to wait more than six months for any serious treatment.

People in many other countries do not have to wait longer than that. Longer lists are nonsense; they are evidence of the British queueing disease. When too many people are waiting for buses, once a few extra buses are provided to clear the backlog, one has to provide only enough to keep picking the people up from the bus stops.

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If we provided a decent injection of money into the health service over the next five years, we could clear the backlog.

Of course demand rises, and of course we may have to put in a higher proportion of gross domestic product, but we could get waiting lists and times down to a reasonable level. There is a realistic difference between somebody with, say, an ingrowing toenail, who could reasonably be expected to wait 12 months, and somebody with a serious condition. If someone has a cataract, the longer the operation is delayed the more likely that person is to go blind. The longer a hip operation is delayed, the longer somebody is likely to be out of work. Some conditions are serious and need treatment soon, and some are less serious.

More people are waiting now than ever before, whatever the arguments about the detailed statistics. There is a crisis. Demand may have risen; expectations may have risen--but that is the position we are in. We need to respond to that, and the public want us to spend more money on health, to deal with those problems, than on any other part of the public service.

Mr. Gareth R. Thomas: The hon. Gentleman says that we are not spending enough money on the health service, but would he speculate on what the state of the NHS would be if his party's spending plans had been implemented and £1 billion less had been spent on the NHS?

Mr. Hughes: If that had been a less predictable question, it might have caught me unawares. [Hon. Members: "Answer it."] Of course I shall answer it--unlike other hon. Members, I answer every question asked in the House. The reason why the hon. Gentleman makes that point is that he misunderstands that the Liberal Democrats argued for spending additional to inflation, not inclusive of inflation, as the Labour party's figures were. The debate between Labour and the Liberal Democrats has always been on that point.

Mr. Thomas indicated dissent.

Mr. Hughes: The hon. Gentleman might not like the argument, but that is the difference. Before I sit down, I shall get rid of the history, because debates about what we said we would spend before the election are debates about history. I like history and am happy to debate historical points, but that is not what people outside think matters the most; they are concerned about what is to be spent now.

Mr. Andy King (Rugby and Kenilworth): The hon. Gentleman should be supporting us.

Mr. Hughes: Of course I support money going into the NHS, but I want more, the nation wants more and there is more available to spend. Let me tell the House how.

In the document produced by the Chancellor last week accompanying the first stage of the announcements of the outcome of the comprehensive spending review, "Stability and Investment for the Long Term", a revealing section on page 41 shows that the Government have more in reserves this year than they had expected at the time of the Budget. In the Budget, it was announced that there was estimated to be a £1.5 billion undershoot in public spending--spare money in reserve for this year; the Chancellor announced

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last week that public spending last year undershot by £3 billion; therefore, there is in reserve an additional £1.5 billion.

Mr. King: No.

Mr. Hughes: It is no good the hon. Gentleman saying no--that is what the Chancellor said last week.

Mr. King: It is what is done with it that counts.

Mr. Deputy Speaker: Order. I have already asked hon. Members to cut out the sedentary comments--they are not helping the debate.

Mr. Hughes: I apologise, Mr. Deputy Speaker. I agree that it is what one does with the money that matters.

There is £1.5 billion extra in the reserves--£3 billion in all, sitting unallocated, waiting. Whereas the Government have so far announced £500 million extra--this picks up on the intervention from the hon. Member for Harrow, West (Mr. Thomas)--we say that they should have allocated the health service £1.25 billion this year, to be spent on staff recruitment, the reduction of waiting lists and improvements to community care and social care, which help to prevent hospital bed blocking.

The 50th anniversary of the NHS is about to be celebrated. None of us is naive, so we do not doubt that there will be a bit of a song and dance and an announcement of more money for the health service. We are all ready for that and we shall welcome it, but the sum to be announced will have to be far greater if it is not to be misrepresented as largesse, when it is not very large at all. The reality is that there is £3 billion sitting in the reserves this year. The health service this year could easily have spent the money on funding the staff pay review all at once, instead of its having to be phased. That would have greatly helped morale and recruitment, but the Government have not done that; nor have they since increased pay for NHS staff, which hardly anyone in the House would resist.

The announcement that the Prime Minister should make is, at least, that real growth--not cash growth--this year should be 5 per cent. over that of last year and that, for the rest of this Parliament, it should be 4 per cent. a year. That is about another £1 billion this year coming out of the reserves and probably an additional £2 billion--real growth--each year for the remaining three years of this Parliament. We shall judge the Government by whether there is a real, significant and substantial increase in money for the health service, not by recycled announcements of a bit more money that will not go halfway toward meeting the shortfall accrued under the previous Government.

I leave the House with this reflection: despite the Chancellor's announcement last week and the fact that what should first be measured is quality, not quantity--the Secretary of State was right to say that what matters most is how good the health service is, not how much we put into it--there is not a single informed person in the country who does not believe that, unless we ratchet up considerably the relatively small amount that we put into the health service, our 6.5p in the pound, we shall not be able to sustain the health service at the level the public expect and need. The reason why the Labour

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Government's rating in terms of public confidence in their handling of the health service has slipped so badly from last year to this is that the public do not see the money being forthcoming. Our challenge to the Government for the 50th anniversary of the NHS is to announce money that will keep the beds open next year and the year after, money that will keep the health service growing at a decent rate throughout the lifetime of this Parliament and money that will catch up with the consistent underfunding of the past 18 years.

The pledge on waiting lists was an early pledge which, sadly, will be delivered late, if at all. It was a modest pledge that will hardly affect most of the people waiting for treatment. It was the wrong pledge. The Government now need to change their priorities. If they do that and come up with the money, the NHS and its patients will be grateful; but, if they do not, they will surely and justifiably be held to account by the electorate.

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