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9.47 pm

The Minister of State, Department of Health (Mr. John Hutton): The hon. Member for Runnymede and Weybridge (Mr. Hammond) described the debate as predictable. I would prefer to describe it as fairly comprehensive. We have heard nine Back-Bench speeches, beginning with the speech by the former Secretary of State, the right hon. Member for South-West Surrey (Mrs. Bottomley). Much to the surprise of my right hon. and hon. Friends, she began with an apology. It was not, however, the one that many patients and the public

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would have liked her to make. We would have preferred her to apologise for her stewardship of the NHS. Sadly, she declined to do so.

Much to our surprise, the right hon. Lady dismissed NHS Direct as trivial and marginal. She should say that to the 500,000 people who have used the service, and she could learn about the contribution that the nurse-led service has made for many people.

Mrs. Virginia Bottomley: Does the Minister believe that the two children with head injuries who were not seen within one and a half hours at the local accident and emergency department and finally went home could have been helped by NHS Direct?

Mr. Hutton: Obviously, I do not have the details of that case. If the right hon. Lady refers it to me, I will look into it. However, lives have been saved as a result of NHS Direct, and it was sad and unfortunate that she and her right hon. and hon. Friends declined to acknowledge that.

My hon. Friend the Member for Wakefield (Mr. Hinchliffe) mentioned the importance of public health--rightly so--and the importance that we have placed on tackling health inequalities. He referred also to "The Common Sense Revolution"--a document recently published by the official Opposition. It is true to say that only in the modern Tory party could common sense ever be described as revolutionary.

The hon. Member for North Devon (Mr. Harvey) made a thoughtful speech, but he was weak on the arithmetic and in his appreciation of the £21 billion of additional resources going into the NHS over the next three years. Like many Opposition Members, he called for more money to be spent on the national health service, but when asked by the hon. Member for Runnymede and Weybridge, he declined to say how much more he wanted to spend.

At the election, the Liberal Democrats promised to spend an extra £540 million per year on the national health service. The hon. Member for North Devon might want to contradict that. We have done significantly better, exceeding that target within the first two and a half years of the Parliament, even without taking into account the additional resources available to the NHS under the comprehensive spending review.

Mr. Harvey: The hon. Gentleman refers to pledges at the election. They were on top of NHS inflation. The Government have tried to dupe the nation by bundling up NHS inflation and holding it back until the second half of the Parliament to make people think that the money was on top of what they should have been expecting. The fact is that by the end of this Parliament, the Government will not have increased health service spending as much as the Conservatives did when they were in office.

Mr. Hutton: I repeat, I do not think that arithmetic is the hon. Gentleman's strong point. He is wrong about the figures.

However, the hon. Gentleman coined a good soundbite about the new Tory policies on the national health service, saying that they would replace the postcode lottery that we inherited with a new tax code lottery. That would be the effect of Conservative policies. They will be rumbled and rejected by the people of this country.

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I welcome the support of my hon. Friend the Member for Wirral, West (Mr. Hesford) for the action that we have taken to improve mental health services, particularly his welcome for the national service framework that we published recently. It will help to drive up standards and improve the quality of care for millions of people who suffer from mental health problems and turn to the national health service for support. I am also grateful for his support for our initiative on health action zones.

The hon. Member for Spelthorne (Mr. Wilshire) complained about propaganda and then indulged in a serious dose of it. He has probably recently arrived in the Chamber with copies of the press release that I am sure he had written before he made his speech. We all look forward to reading that press release in his local papers.

Mr. Wilshire: That is yet another Labour lie. The Minister might care to know that I have with me a petition signed by 25,000 of my constituents and that his party in my constituency helped to organise it, because even the local Labour party thinks that he is wrong.

Mr. Hutton: I am sure that the hon. Gentleman will not mind if I do not take his word for that. I should like to point out some of the facts to which he conveniently failed to refer. The cash growth for West Surrey health authority this year is nearly £20 million, which is a 3 per cent. real terms increase. He and other Conservatives who referred to the situation in Surrey conveniently forgot to refer to the £9 million that is going into the new accident and emergency department at St. Peter's hospital, or the £4 million scheme that has now been approved to redevelop the Weybridge community hospital in the constituency of the hon. Member for Runnymede and Weybridge. It is unfortunate but predictable that the good news stories about the NHS always slip through the fingers of Conservative Members.

My hon. Friend the Member for Bethnal Green and Bow (Ms King) made a conciliatory speech, but she also skilfully shot the Tory fox, rumbling the real implications of their new policies on the national health service. We know what their intentions are and they have been made clear for everyone to see. Like my hon. Friend the Member for Wakefield, she was right to emphasise the importance of reducing health inequalities and the benefits of the health action zone in her constituency. We have not forgotten that the Conservatives were consistently unable to bring themselves to talk about the health inequalities that were the legacy of their policies. We are determined to tackle the problems.

The hon. Member for Southend, West (Mr. Amess), in a typical speech, covered a lot of ground very quickly. Intriguingly, he referred to a foreign affairs crisis in Southend. I am sure that we would all like to hear from him what he had in mind. He also kindly reminded the House of some of our election promises, and I can tell him, and all other hon. Members, that we are meeting those promises and will keep them.

My hon. Friend the Member for Dartford (Dr. Stoate), in a very good speech, referred to the improvements in the national health service in his county of Kent, putting some of the gloom and doom spread by the Conservative party into some sort of context. My hon. Friend asked how successful we had been at cutting red tape and transferring resources to front-line care, and I can tell him that nearly £200 million has already been transferred to front-line services.

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The hon. Member for Runnymede and Weybridge said that he wanted to add to health spending by encouraging more private health care, but his sums simply do not add up. When we were debating the Health Bill in Standing Committee, he said that health spending in the United Kingdom would have to increase by 2, 3 or 4 per cent. of GDP. Current spending on health care in the United Kingdom is about £48 billion--5.8 per cent. of GDP--and an extra 3 to 4 per cent. of GDP spent on health would require at least an extra £24 billion.

If we assume, as we should, that currently 3.2 million people spend £1.7 million on private health insurance, at an average annual payment of £531, the hon. Gentleman's policy could be delivered only if we increased the number of people covered by private health insurance from3.2 million to 45 million. That means almost every adult person in the United Kingdom.

The hon. Gentleman and his hon. Friends say that they do not intend their policies to result in compulsory private health insurance, but that does not add up. The only other way to meet the hon. Gentleman's promise to raise £24 billion would be to increase the average annual payment for private health insurance from £531 to £7,500.

Obviously, the Conservatives have lost some of the talents and skills necessary to run a country and be in government, but I suggest to the hon. Gentleman that, as a matter of urgency, he goes away, does his sums again and comes back with something slightly more credible. Throughout the debate we have heard nothing from the Conservative party that could be described as credible.

Mr. Hammond rose--

Mr. Hutton: No; I have given way three times to Conservative Members, and I do not believe that the hon. Gentleman gave way once.

The debate has highlighted some important differences between the Government and the Opposition concerning the future of the national health service. We want a service in which everyone can have confidence, which provides first class treatment and care to all who need it. The Conservatives want the NHS to be a second-line service for those who cannot afford to buy private health care. We want to modernise the NHS so that it can provide faster and better services where and when people want them. The Conservatives oppose all those changes.

The Tories opposed the new primary care walk-in centres. They oppose the appointment of a senior specialist to direct our fight against cancer. They do not want the number of people on waiting lists to be cut, and they oppose putting doctors and nurses in the driving seat through primary care groups, which are now up and running. They oppose the new public health strategy, and they described our commitment to spend an extra £21 billion on the NHS as reckless. Their position on all those issues is as dishonest as it is untenable. They claim to support the NHS, but they undermine it at every available turn.

The Conservatives say that the NHS cannot do everything, yet they oppose all attempts to improve the ability of the service to respond more quickly and

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effectively to patients' needs. We say that the NHS needs to be modernised so that it can provide the fast, convenient, high quality service that people want--


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