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Mr. Robert Key (Salisbury): My constituents, too, are grateful for our splendid new hospital, but they know that their hospital was built under a Conservative Government. Does the hon. Gentleman suggest that his wonderful new hospital did not even see the drawing board until after the general election?

Dr. Stoate: Although the Conservative Government thought up the idea, it took a Labour Government to change the law to allow it to happen. That is the difference. The Conservatives can come up with the ideas, but it takes a caring Labour Government to deliver on those ideas and turn them into reality. I am proud to be the Member of Parliament for the constituency that will have the first PFI hospital in the land.

19 May 1999 : Column 1164

9.35 pm

Mr. David Amess (Southend, West): I did not believe one word uttered by the hon. Member for Dartford (Dr. Stoate) and I did not recognise the health service described by the Secretary of State. The health service is in crisis. Morale has never been so low. I blame three people: the leader of the Labour party, the leader of the Liberal party and the Secretary of State for Health.

The leader of the Labour party gave an inept performance at the Dispatch Box today. He could have been Harry Enfield delivering the sermon of platitudes. Conservative Members are entitled to be angry. For 18 years, the Labour party tried every trick in the book to undermine the national health service. Labour Members built up people's expectations, saying that if they voted Labour on 1 May 1997, the new Government would save the national health service.

I have received grubby little letters that have been sent to Conservative party members exhorting them to give money to the Labour party. They say:

That rubbish has been torn up and thrown in the bin by every Conservative activist. It is a disgrace. The Labour party is peddling a lie about the £21 billion.

The Liberals have about six useless pledges. I am sick of Liberals--

Dr. Harris: Liberal Democrats.

Mr. Amess: Okay. I am sick of the Liberal Democrats and their crocodile tears. They have made a grubby little deal to join up with the Scottish Labour party. They are sharing power in Scotland and in Southend. They also bear the blood of the national health service on their hands.

The Secretary of State is primarily responsible for the lowest morale in the NHS in my life time. The so-called health service reforms are a shambles. All my hon. Friends in the Standing Committee considering the Health Bill on Tuesdays and Thursdays can see that the Government are making a mess. They cannot deal with the amendments that we are ably tabling. They are not accepting any of our arguments. The General Practitioner has said that "Chaos" reigns on the eve of reforms. The Government do not accept that there is rationing or that they fiddle the waiting list when they should be addressing waiting times.

I have evidence of the chronic shortage of consultant radiologists. A letter from the clinical director of a local trust says:

Everyone understands how serious that it.

This dreadful Government have misled the nurses, the doctors and everyone who works in the health service. I salute the women and men who work in Southend

19 May 1999 : Column 1165

general hospital. They do a magnificent job in spite of this rotten Government, who have done everything that they can to undermine them. A few weeks ago I was walking round the hospital talking to a range of people employed there. Every one of them was dissatisfied with the Government. The Government led people to believe that voting Labour on 1 May 1997 would transform their lives and give them a better deal. In fact, hundreds, thousands, even millions of people have realised that the rotten Labour Government have broken promise after promise, letting the British people down when it comes to the health service.

9.40 pm

Mr. Philip Hammond (Runnymede and Weybridge): We have heard some excellent speeches from the Conservative Benches and some complacent speeches from Labour. Our national health service is a vast organisation. The 1 million people who work in it are its very essence. The way they are treated and the state of their morale are crucial to the quality that the NHS can deliver. That is why we tabled our motion.

The sad fact is that, two years into a Labour Government, we have had two years of frustrated expectations, interference with clinical judgments, meddling from central Government and selective abuse by the Secretary of State. Morale in the health service is at an all-time low. The chairman of the British Medical Association's junior doctors committee has described relations between the medical profession and the Department of Health as being in a state of cold war. He went on to say that things are definitely getting worse.

It is a fundamental principle of good personnel management that one does not raise expectations that one cannot meet. Labour's spin doctors did a great job on NHS staff before the general election, promising the earth. The not-so-subliminal message was "Vote Labour, and all your problems will be solved." Two years on, the day of reckoning has arrived. When the movie comes to be made of the first two years of the Labour Government, the title will be "Mind the Gap". There is a gap between what they promised in Opposition and what they are delivering in office, between what they say they are doing and what is really happening in our health service and elsewhere.

Staff in the health service must live not only with their own disillusion. They are at the sharp end and have to deal with the general public from day to day, and they must live with the frustration and disillusion of their patients, people who heard the Government's rhetoric about huge and fictitious sums of money allegedly being pumped into the health service. Patients see the Secretary of State on television congratulating himself on his so-called achievements on waiting lists, and they struggle to reconcile that with the reality that they find--a struggling health service of endless delays, even for an out-patient consultation. Increasingly, they find explicit rationing of drugs and services.

My right hon. Friend the Member for Maidstone and The Weald (Miss Widdecombe) said that many people in the health service believed Labour's pre-election rhetoric. It is probably fair to say that the Government inherited a substantial fund of good will among NHS staff two years ago. That fund has been dissipated by the stresses placed

19 May 1999 : Column 1166

on staff and the system by Labour's transparently political waiting list initiative, and by the persistent distortion of clinical priorities and interference with clinical judgments. Morale has been sapped by understaffing, reorganisation of the primary sector and the pressures of underfunding and winter crises.

General practitioners, the linchpin of our primary care-led system, have had to fight the Government tooth and nail to secure their place in the new primary care groups. They had to ensure that they were properly remunerated for the time that they put into setting up and managing the groups. They had to protect their infrastructure budgets and to safeguard their status as independent contractors. Morale among GPs has never been lower. The 50-odd per cent. who were fundholders find themselves forced to withdraw services that they had previously been able to offer to their patients. They can no longer offer their patients the freedom and choice that they had become used to. No wonder there is a continuing recruitment crisis in general practice.

In our hospitals, the situation is, if anything, worse. Junior doctors are incensed by what they see as the Government's treachery in seeking to renege on the new deal. Since its introduction by the previous Government in 1990, the new deal has seen a progressive reduction in junior doctors' working hours. In 1991, 58 per cent. of junior doctors were contracted to work more than 83 hours per week. By 1998, only 16 per cent. were contracted for more than 56 hours per week. That is not good enough, but it is a dramatic improvement.

The discovery that the Government were secretly attempting to persuade Brussels to extend for another 15 years the derogation for junior doctors and to increase to 65 the number of hours per week that they can be forced to work has outraged the junior doctors and sent morale plummeting. The BMA has condemned the Government's negotiations with the EU as a

The BMA has expressed its outrage at the development and described it as "the height of hypocrisy." It has called the Government's actions

    "a sign of the utmost bad faith"

which has led to "anger and disillusionment" among doctors.

No one believes the Secretary of State's explanation because no one whose intentions are genuine argues for a 65-hour week when the current week is 56.

Many junior hospital doctors already find themselves working inhumanely long hours for a master who appears intent on making them work longer hours still. Many people will have been outraged to learn that junior doctors are paid for their overtime work at 50 per cent. of their normal rate. That means that a junior doctor dealing with casualties and emergencies in the dead of night or at the weekend earns £4.02 per hour.

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