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Mr. Dobson: The right hon. Lady made one sensible point and one daft one. She is right to say that we need to review nurse education and training, not because we want to shift away from the improvements and achievements that have resulted from some aspects of Project 2000, but because its disadvantages are beginning to outweigh its advantages. I want a system that keeps the advantages and dispenses with the disadvantages. I want to discuss that with those responsible for nurse training and for representing nurses, and with the NHS as an employer, so that we get it right this time.
On local pay, the most popular thing that I ever said to the Royal College of Nursing was that we would get rid of the daft system of topping up the last bit of pay by local bargaining. It drove everyone mad and gave no one any worthwhile money.
Mr. Barry Jones (Alyn and Deeside):
May I say to my right hon. Friend, to his face and bluntly, that his stewardship has been very good and that he should not be fazed by attacks from Her Majesty's Opposition, who had 18 years to put right the many problems in our still great national health service? Will he give more detail of the new money that he and his ministerial colleagues have put into our health service since he took office? Will he and my right hon. Friend the Secretary of State for Wales visit my constituency and the Deeside community hospital, Dobshill hospital and Penyffordd hospital to see the wonderful contribution of nurses in my constituency?
Mr. Dobson:
I hope that my hon. Friend will not take offence, but I try my very best to get out of my office at least once a week to visit parts of the health service, and at the end of this week I am supposed to go to Swansea. I do not think that I will make two visits to Wales in one week, but I will bear it in mind, as I am sure will my right hon. Friend the Secretary of State for Wales. I share my hon. Friend's view that most people are reasonable folk and realise that all the things that were done wrong over 18 years cannot be put right in 18 months.
Mr. Julian Brazier (Canterbury):
The Secretary of State telephoned me two days before Christmas to tell me that the number of beds at Kent and Canterbury hospital was to be halved and the accident and emergency unit run down. The unit was so busy that last week it even had a bed in one of the bathrooms. I was grateful for his courtesy in telephoning me, but words cannot describe the dismay felt by my constituents and many beyond the boundaries of my constituency. Can the Secretary of State tell me whether the pledge that his right hon. Friend the Minister for Public Health gave me in her answer to my Adjournment debate still stands: that no bed will be removed until it is clear that provision exists to cope with the need that exists?
Secondly, can he tell me what steps he will take to ensure that the whole of east Kent, in particular Canterbury, Whitstable and the small villages, which suffer from the worst congestion problems anywhere in the British isles, will have a proper 24-hour accident and emergency service?
Mr. Dobson:
As I told the hon. Gentleman, who, to be fair, has campaigned vigorously for the Kent and Canterbury hospital, I have considered the services to be provided in that area, and have received advice from innumerable people and representations from even more. I think that I can at least claim credit for insisting on some substantial changes from the original proposals put forward by the people whom the Tory party appointed to run the health service in Kent. I have ensured special consultant back-up for the A and E service and that consultants are available for other specialist services in the area. I also gave the undertaking that I would keep a close eye on what was happening to bed numbers during the process of change to ensure that it did not go badly. If it looks as though things are going wrong, I am
Mr. Dennis Skinner (Bolsover):
Does my right hon. Friend agree that decisions on health service expenditure and where the money goes are much more important than other statements that we hear from time to time in the House? His ability to spend £1.7 million, set against the prospect of spending more than £20 billion, suggests that this humble, old-fashioned Labour stalwart may be able to do a much better job than those handcuff experts on the Tory Benches and the Liberal Democrats, who believe that we can solve all the problems of the NHS by raising an extra penny on tax. Does he understand that we will shortly reach the defining moment of what is to happen to that money? If he wants more nurses, will he give an assurance that he will pay them--and other NHS workers--a lot more money? He will be measured by that and prospects for a future Labour Government will be much rosier if he manages to resolve that problem, so that we have more, better-equipped and better-paid nurses, and if he ensures that, unlike last time, they are given all the money in one fell swoop.
Mr. Dobson:
My good and hon. Friend knows as well as I do that, compared with the £1.7 million that I mentioned, we will be finding more than £3 billion extra for the health service next year--an increase of 5.7 per cent., added to an increase for the health service in the country as a whole of £21 billion in the next three years. What is more, we have announced that as a three-year arrangement so that people in the NHS can do what they have always demanded, which is to plan for a longer period rather than living from hand to mouth from one year to another. I can assure my hon. Friend that I sincerely hope, as I have said on innumerable occasions, that the independent pay review body will bear in mind the evidence that we have given about affordability, the evidence that it has taken from the nurses and our evidence to suggest that it should pay particular attention to the pay of the lowest-paid nurses to make going into nursing more attractive, and will come up with an affordable settlement, which the Government will be able to implement in full.
Mr. Damian Green (Ashford):
The Secretary of State will be as alarmed as I am at news of the steady trickle of nurses in hospitals in east Kent who, over the past couple of weeks, in despair at his stewardship of the national health service, have resigned to become agency nurses. They will not be impressed by his attempt to lay the blame on anyone but himself, nor, I suspect, by the sneering tone that he adopted about the East Kent health authority in his reply to my hon. Friend the Member for Canterbury (Mr. Brazier), given that only two weeks ago he wrote to my hon. Friend congratulating him on the authority's work on hospital reorganisation.
We have heard the pious hopes of the Secretary of State. Will he tell us what he is doing now to staunch the flow of nurses resigning from the national health service? That flow is increasing and is likely to increase as long as he maintains his complacent attitude.
Mr. Dobson:
That question takes the biscuit, given the hon. Gentleman's party's record. There are 140,000
National health service staff constantly raise with me the matter of their being subjected to assaults and abuse. When I talked to a senior member of, admittedly in that case, the medical profession about the matter, he told me that they had given up talking to Tory Ministers about the problem, because they were told that nothing could be done about it and that that was the sort of society in which we now lived. The Government do not accept that; we are determined to change things. [Interruption.] That was what the man told me and I shall take his word for it.
We have taken a great deal of action and if Conservative Members do not believe me, let me point out that, not long ago, under the previous Government, someone in the east end was assaulted in a hospital--that person's place of work--and although the person who carried out the assault was successfully prosecuted, if the management had had their way and if there had not been a great row about the matter, they would have disciplined and sacked the person who was the subject of the assault for fighting back. That is the standard of concern that the Tories offered nurses when they were in power.
Ann Keen (Brentford and Isleworth):
I, too, welcome the statement from my right hon. Friend, as will all health workers. They are more than satisfied with his stewardship of the national health service. He is an extremely popular Secretary of State, who is not afraid to go into Marks and Spencer at any time of the day to do his shopping.
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