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Dr. Fox rose--

Mr. Milburn: I will give way to the hon. Gentleman, for the last time.

Dr. Fox: I am grateful to the Secretary of State.

As a matter of historical fact, can the Secretary of State tell us what proportion of this record capital spend on the NHS is due to PFI projects? Can he also tell us what was his party's attitude before the election?

Mr. Milburn: Let me tell the hon. Gentleman what my party promised in its manifesto at the last general election. We promised that we would rejuvenate the private finance initiative and make it work. The hon. Gentleman raises the issue of the private finance initiative in health at his peril, because the Conservatives had not done a single hospital deal by the time we came to office.

The hon. Gentleman talks of management consultants. The Conservatives spent £30 million on consultants' salaries and lawyers' salaries, and not a single hospital was built. We have the hospital building programme under way, through both the PFI and the public route. Communities throughout the country which have waited for decades are now seeing the building of new hospitals.

It is this Government, too, who have invested an extra £21 billion in the national health service. The hon. Gentleman skated over that today, which did not surprise me. After all, it was his party that described the extra spending as reckless, madness and irresponsible. Try as

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the hon. Gentleman might to rewrite history once again, his right hon. Friend the shadow Chancellor of the Exchequer gave the game away when he accused my right hon. Friend the Chancellor of being goaded on class sizes and waiting lists, and to have gone soft on spending. We are spending more; the Conservatives want us to spend less. We will take no lessons from them on the inadequacy of support for the health service.

Nor will we take any lessons on waiting lists. When we came to office, waiting lists were at a record level, and rising fast. Today, they are falling. They are already down by 69,000, and we will keep them going down. By the end of the current Parliament, they will be 100,000 lower than the level that we inherited. The hon. Gentleman says that I should abandon the promises that we made at the last election. That is the cavalier Conservative way with election promises. When we make promises, we keep them. Indeed, it is because of our success in getting waiting lists down that we are now able to move into the next phase of our modernisation programme.

Cutting waiting lists was always just the start. I want all aspects of NHS care to be modernised. We start with services dealing with our country's biggest killers, cancer and coronary heart disease. Those are my priorities for modernisation. In the last fortnight, I have been able to put more money into paying for extra heart operations, so that patients can gain quicker access to the surgery that they need.

The hon. Gentleman says that I did not announce the provision of 400 extra consultants. Let me tell him that I did. He should know that there is a difference between doctors in training and doctors in post. The Opposition are in training, while we are in post--and the same applies to my announcement.

Yesterday, I also announced more money for cancer services. The hon. Gentleman dismissed that as a gimmick, but it is £80 million of new, extra money, enabling cancer patients to obtain faster, fairer access to care. Let us hear no more from Conservative Members about the distortion of clinical priorities. The question for the hon. Gentleman is simple: does he support our efforts to modernise services dealing with the most severe clinical conditions, or does he not? The public support them; staff support them; patients with suspected cancer support them. They want faster, fairer care, and they know that it will be delivered by this Labour Government.

Miss Anne McIntosh (Vale of York): Will the Secretary of State give way?

Mr. Milburn: I will give way one last time.

Miss McIntosh: Last week, the Secretary of State was kind enough to suggest, in reply to a question, that Shaun Johnstone should have had a brain tumour scan within two weeks. He was not given a scan within two months. The health service clearly failed him. Indeed, the photographer on the local newspaper in his home constituency--

Mr. Deputy Speaker: Order. Interventions should be brief; they should not be seen as opportunities to raise constituency matters at length.

Mr. Milburn: Let me repeat what I said to the hon. Lady last week at Question Time. I understand the

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circumstances surrounding the tragic case of Shaun Johnstone. I know that it has been looked into by the health authority, and I know that Shaun Johnstone's parents have been advised that they should go to the health service commissioner, which is the right thing for them to do. Nevertheless, I repeat my promise to examine the case, and when I have had an opportunity to do so, I shall return to the hon. Lady.

Mr. Simon Burns (West Chelmsford): Will the right hon. Gentleman give way?

Mr. Milburn: No, I will not.

It will take time, effort and investment to turn the national health service around, but, notwithstanding the allegation in the motion, the national health service is not getting worse; it is getting better. More patients are being treated, more doctors are being trained, more nurses are being recruited, more hospitals are being built and more services are being modernised. It will go on getting better each and every year that this Government are in office. No doubt, every step of the way, it will go on being talked down by the Conservative party. The Conservatives are determined to brand the NHS a failure.

Yesterday, we saw the clearest contrast between Conservative priorities for the NHS and Labour priorities. Yesterday, both the hon. Member for Woodspring and I visited NHS hospitals. I went to visit patients and staff in the cancer care unit at St. Thomas's hospital, which is opposite this place. He visited an NHS hospital in Burton-upon-Trent. I outlined plans for modernising England's cancer services. He outlined plans to get more people to buy private health insurance.

I talked about more money for the NHS. The hon. Member for Woodspring talked about pricing policy in private health care. I talked about national standards to end the lottery in health care. He talked about product standards in private medicine. What better contrast could there be--Labour creating a faster, fairer health service, available to all; the Tories encouraging a private, pay-as-you-go health system that is available only to a few.

The differences between Labour and the Conservatives on health have never before been clearer. They believe that improvements in health care can come only through an enhanced role for the private sector. We believe that improvements in health care have to come through the NHS. Only the NHS is capable of offering care on the basis of need, and need alone, not of ability to pay.

We now know what the next Conservative manifesto will mean for the national health service; the hon. Member for Woodspring has been explicit about that at least. He calls his approach the "silent revolution", although, as he told a conference fringe meeting just a few weeks ago:

I can tell him. We have picked up on exactly what it means. I am determined that his secret revolution gets all the publicity that it deserves in communities throughout the land. He believes that

    "the biggest problem we have in the NHS is that it is not a proper market".

That will come as a bit of a surprise to NHS staff, who could not wait to get rid of the last market that the Conservatives introduced to the NHS.

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The hon. Member for Woodspring says that the secret revolution could

no doubt with the same impact. The Conservatives' secret revolution can be summed up in a simple phrase: not modernisation, but privatisation. It is a measure of how far today's Conservatives have moved from the political mainstream. They are prisoners of their own extremism.

Today's Conservatives have no ambition for the NHS. They do not feel comfortable with the NHS's values. They want market forces in a service that is founded on co-operative principles. Fifty years after they opposed the creation of the national health service, they oppose its modernisation. They deserve to be rejected now, just as they were rejected then. I invite my hon. Friends to do just that in the Division Lobby later.

Several hon. Members rose--

Mr. Deputy Speaker: I remind the House that Madam Speaker has ruled that there will be a 10-minute limit on Back-Bench speeches.

8.3 pm

Mrs. Virginia Bottomley (South-West Surrey): I congratulate the right hon. Member for Darlington (Mr. Milburn) on his appointment as Secretary of State for Health. For all the demands and pressures, I think that it is one of the most exciting and rewarding roles in government, but there is a profound difference between the way in which he sees the health service and the way in which many Conservative Members see it.

Behind the rhetoric, the Secretary of State knows the position. He consults the Organisation for Economic Co-operation and Development, the World Health Organisation and other international bodies, which believe that others are copying our changes in the health service over the past decade, the essence of which his party has endorsed. They include a focus on primary care, the introduction of a preventive strategy and greater efficiency: what is called corporatisation of hospitals. Those are all developments that, for all the rebranding and rebadging, his party has, with a lot of noise, endorsed. Evidence-based medicine was the labour of love, if we like, of my term of office. I am delighted to see it move forward with the service frameworks and the development of NICE.

Where the Secretary of State and Conservative Members differ is that he really believes that the service is getting better. It is a serious criticism of his party that, in office, he and his colleagues rarely visit constituencies of Members who do not belong to their party.

I spent many days in Darlington, Newcastle, Manchester and Leeds. I saw the investment in hospitals and primary care. I recognise the variations in health and the need for economic and social policies to address the problems, but I ask the Secretary of State and his colleagues to spend the same amount of time in South-West Surrey and other comparable constituencies. The degree of pessimism in the health service in my area and in those of many of my right hon. and hon. Friends is appalling.

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I would have liked to have asked the hon. Member for Shipley (Mr. Leslie), who has now left the Chamber, an ethical question about private health services. If your child went to an accident and emergency department with a teacher or nurse--both have come to me in the past fortnight--was not seen after an hour and a half, and it was suggested that you took the child home, would you think that that was a good enough service? If mental health provision were so inadequate that a young man with developed schizophrenia burned his parents' house to the ground, even though they warned the services of his deteriorating condition, would you think that the service was good enough? If you spoke to a consultant, as I did today, who said that the situation has never been worse--

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