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Mr. Nicholas Winterton (Macclesfield): The hon. Member for Wimbledon (Mr. Casale) made a constructive and well-informed speech. My only criticism is that, in parts, it was too flagrantly party political, as if only one party could serve the NHS. Since the establishment of the NHS, successive Governments from across the political spectrum--whatever some Opposition Members might say, or whatever some members of the public might think--have been united in their commitment to the NHS, a service providing treatment free at point of delivery. There may well be differences on how the funds and resources for the NHS can be found, but the hon. Gentleman will find, after he has been in the House a bit longer, that no one here is opposed to the NHS and its pre-eminent position in the provision of health care.

Mr. Casale: I share the hon. Gentleman's commitment to cross-party consensus, where possible, and I try to practise it in my constituency. However, one of the reasons why I joined the Labour party was that I believed that the NHS would not have a future were it not for a Labour Government. I have not been disappointed in that regard.

Hon. Members: Hear, hear.

Mr. Winterton: The hon. Gentleman has some support from his hon. Friends. I have been here a goodly number of years, and I had the privilege to serve for a time on the Select Committee on Social Services. When that Committee was divided between health and social security, I chaired the Select Committee on Health for two years. There was tremendous co-operation among all members of that Committee, who were totally convinced that our NHS was the best in the world.

The Committee wanted to improve the NHS, and we worked to produce reports that would provide a better service for the people of this country. I chaired that Committee as a Conservative and Unionist Member of Parliament. The hon. Member for Wimbledon may be aware that I was not always as warmly supported by my party colleagues as I might have been. Notwithstanding that, there are many hon. Members on both sides of the House who are committed to the concept and principle of the NHS.

Mr. Andrew Love (Edmonton): Does the hon. Gentleman accept--as the hon. Member for Ruislip-Northwood (Mr. Wilkinson) appeared to--that there was considerable concern in Greater London at the time of the general election about the thrust of the previous Government's policy towards health in the capital?

Mr. Winterton: The hon. Gentleman is right, and the country as a whole had a perception about what the then Government wished to do with the NHS. I think that that perception was wrong, and my hon. Friend the Member for Ruislip-Northwood (Mr. Wilkinson) was right to articulate that today.

At the risk of upsetting my right hon. Friend the Member for Bromley and Chislehurst (Mr. Forth), I can say that the Conservative party has sought in what it has said recently--despite being misunderstood by some sections of the media--to establish once and for all that

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we are committed to the NHS. We want to improve it and to get more money into London, where there are problems. Those problems have been articulated remarkably well in the debate.

Ten months ago, I had an unfortunate fall in Trafalgar square. I have nothing but praise for and appreciation of the speed and efficiency of the London ambulance service and the paramedics who crewed the ambulance. Likewise, I have every admiration, respect and regard for the service and attention that I got from the hospital just across the river--our hospital, St. Thomas's--when I was taken to the accident and emergency unit. The service was first class. I experienced virtually no delay, and I greatly appreciated the service. That experience was important, as it gave me an opportunity to appreciate what the NHS can do. I praise the NHS.

Members of my close family live in London, and five of my seven grandchildren were born at St. George's hospital in Tooting. Pressure on the maternity and labour facilities at the hospital cause concern, but the quality of service and attention that mums-to-be get at St. George's is high. We have much to be thankful for in terms of the hospital services in London.

As I said earlier, I served for many years on the Social Services Committee; initially under the redoubtable leadership of Mrs. Renee Short, whose commitment to the NHS was never doubted. We worked closely together. One thing that is of immense benefit to the House is the Select Committee system, in which members of all political parties sit on a Committee, undertake an inquiry and, at its end, produce a report that is based on the oral evidence given to them, the experience of visits and the written memorandums that have been submitted. My experience on the Social Services and Health Committees was that we were committed to the health service and to social services, and we wanted to produce reports that were based on the factual evidence given to us. Many of the reports had cross-party support in the House as well as in the Committee. I believe that the health service benefited, and continues to benefit, from the work of the Health Committee.

I had the privilege to have as advisers on health over the years such learned medics and clinicians as Professor Richard Beard of St. Mary's, Professor Osmond Reynolds of University College hospital, and Dr. Luke Zander, a GP who is about to retire and who was immensely helpful and brought great commitment and experience to our deliberations, helping us to produce reports that have aided the delivery of health care.

Concerns have often been raised, especially by those who happen to be in opposition, about the hours worked by junior doctors. I am well aware of the problems that face any Government seeking to reduce those hours, but many of us, including myself, remain somewhat concerned that, although the Government rightly intended to reduce the hours, they will not be reduced as quickly as we had hoped. I hope that the Minister will clarify the matter when she replies to the debate.

My hon. Friends the Members for Uxbridge (Mr. Randall) and for Ruislip-Northwood asked, very constructively, about current facilities and specialties at hospitals in their constituencies. I raise those matters not because they have asked me to do so, but because other people continue to write to me on the subject because of

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my known commitment to and interest in our national health service. I hope that the Minister will respond appropriately.

I appreciated the way in which the hon. Member for Upminster (Mr. Darvill) delivered his speech, which was both considered and constructive. It is important for hon. Members to present their knowledge and views to the House in a way that can be accepted across the party divide, even if people disagree. The health service is too important to be a party political football.

I am concerned about the long-term care of the elderly in London. I continue to be approached personally and to receive correspondence on the issue, even though I represent a constituency about 175 miles from London. There is widespread recognition, across the political spectrum, that the current arrangements for funding long-term care of the elderly are both unsatisfactory and unfair.

My party made proposals before the general election to begin to address the current unfairness, but it did so far too late and, sadly, the incoming Labour Government rejected those ideas and chose instead--I can understand the reasons--to set up a royal commission to consider the question of long-term care for the elderly. Having recognised the problem as urgent in opposition, the Government deferred any decision on what I readily accept is a difficult issue by establishing the royal commission.

I know that the royal commission has sought evidence from a wide range of sources, and it has produced a report that, although it may not tell us anything new, comprehensively and accurately lists the issues, options and views that were presented to it. Clearly, the Government will shortly make a positive response. The current arrangements are unfair and the matter needs urgent attention.

The proposals made by my party when in government would have met the immediate needs of today's elderly population, and especially those in London, and would have eliminated much of the unfairness in the system of funding long-term care. It could have formed an important element of a long-term solution to the problem for future generations.

As the Minister knows, the proposal was based on the concept of asset insurance, which would have allowed people to protect the assets that they had accumulated through thrift and hard work. Members on both sides of the House want to recognise thrift and hard work, and to encourage them for the future. That would have been achieved in a partnership insurance scheme with the state. Again, I am sure that that would appeal to both sides of the House. I am not trying to put everything into the private sector, or the private basket, as some people say.

That is the best, simplest and most affordable proposal that has yet been made. It is unfortunate that the Government's comprehensive rejection of the plan when they were in opposition--they ruled out the asset protection partnership scheme in advance--has left them with little room for manoeuvre. As so many people in London will be affected, I hope that the Minister will be able to make some response, even if it is only a holding response, to what I have said on the subject.

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Two years into the Government's period in office, many people will feel that we have scarcely moved forward on the issue. Behind the "Whitehall-speak" about further consultation and extensive debate, there lurks the suspicion that the Government--this could be said of a Government of any party--having used the device of a royal commission to delay things for nearly two years, have no intention of accepting its proposals, yet have no alternative of their own to offer. Sadly, they appear to have kicked the question of long-term care into the long grass.

The subject was of tremendous interest to me throughout the 18 years that I was involved with health and social services. The problem remains with us today. Any durable solution to the challenge of funding long-term care for the elderly must address as a matter of urgency the sense of injustice felt by many older people who have worked and saved all their lives, only to be forced to sell their assets to pay for their care.

The system put in place must be sustainable and based on a partnership between the state and the individual. Surely that is what the House wants--to provide for the care needs of generations of older people. So far, there is no sign that the Government have recognised the true urgency of the twin imperatives that I have outlined.

Finally, I apologise to the House for having had to nip in and out of the debate so frequently before I was called to speak. As I explained to you, Mr. Deputy Speaker, there are few Members here today, apart from those who represent parts of London. At one time the House looked like a sitting of the Standing Committee on the Greater London Authority Bill, which I had the honour and privilege of chairing. Except for the fact that you, Mr. Deputy Speaker, or one of your colleagues has been in the Chair, and the fact that there were "strangers" on both the Government and the Opposition Front Benches, those who have spoken today overwhelmingly make up the membership of what I have described as the extremely well-informed and entertaining Greater London Authority Bill Committee.

I apologise to the House for my erratic attendance, but I had duties with the Commonwealth Parliamentary Association, which was holding a lunch here today. Many people from the Commonwealth were here, and there were too few of us to accompany them.

I have found the debate informative and useful, and I hope that Members on both sides of the House have found my contribution both constructive and positive. I strongly support our health service, and I want to see it continue to provide an improved service for the people in London and throughout the country.

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