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Dr. Liam Fox (Woodspring): I am grateful to the Secretary of State for his statement and for giving us a

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copy in advance. It is long on complacency and short on detail and substance. Many people will have voted new Labour because of the Prime Minister's promises about the health services. How hollow those promises sound now. Those voters must feel betrayed.

I am happy to join the Secretary of State in praising health service staff. I have been one of the health service staff who had to deal with flu outbreaks in the past. However, first-class staff work in an increasingly second-class service, thanks to second-class Ministers.

We may have a flu epidemic--it is hard to get decent information from the Government about what constitutes an epidemic. When considering statistics, there is no truth or untruth with this Government: simply convenience and inconvenience. People in this country are asking how, in the world's fifth biggest economy at the beginning of the 21st century, an illness as predictable, cyclical and common as flu can cause the system to break apart at the seams.

The Secretary of State admits that no elective work has been done in the past week. If the health service had been doing its normal work, it would have fallen apart completely. What faith can we have, in view of the Secretary of State's attitude? When we see sick patients left to die in waiting rooms, waiting in car parks to be seen or stored in converted operating theatres, and when the Secretary of State can say something as complacent as, "The NHS is coping tremendously well," we wonder whether the only isolation unit in this country that is operating is the one that he keeps himself in so that he cannot see the complete picture. NHS staff are coping tremendously well, but they are being badly let down by those who run the service.

The Secretary of State has to answer several points today. Too many beds, especially non-acute and respite care beds, have been lost. How many beds have been lost in the health service since Labour came to power? How many extra beds does he estimate will be needed in the coming months if there is a proper flu epidemic? There are too few intensive care beds. I was warned by a consultant six weeks ago that that represented an impending crisis. Ministers presumably got the same information. What did they do? What plans have been made in the past two months for extra intensive care beds; and what measures were they putting in place, knowing that this was coming? It is also true that the Government's obsession with their waiting list initiative has left the service overstretched and with too little spare capacity to deal with any crisis, including this one.

The Government's dogmatic hatred of the private sector instinctively leads them away from co-operation. Only last week, the Secretary of State was saying that NHS patients would not be treated in the private sector. Now he tells us that they will. Their dogma is put ahead of patients' interests. Will he tell us clearly now whether he will guarantee that no trust will be penalised this month for failing to meet its waiting list targets because of action that it may take to deal with the flu epidemic?

More importantly, in the longer term, will the Government look at a better immunisation programme--[Interruption.] The Secretary of State seems to think that funny. Will they look at a better immunisation programme for the over-75s to make sure that the sort of deadly morbidity of this year is not repeated? What specific measures will the Government take? If they suggest a good immunisation programme, we shall support them.

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Will the Secretary of State also please review the decision not to make Relenza available on prescription? That false economy, with the huge cost to British industry--an estimated £6 billion to £8 billion, compared with the £100 million for Relenza--shows what a shabby mechanism the National Institute for Clinical Excellence could be: people can improve their chance of survival by buying Relenza if they can afford it, but cannot get it if they are old or needy. That is the reality of Labour's health policy.

There are three truths that we have to accept: we no longer have the best health care system in the world, the health service cannot do everything--we must not pretend that it can--and the NHS on its own, as currently funded, cannot provide the health care that we need and deserve in this country at the beginning of the 21st century. We need a Government who take a full assessment of the failings of the NHS, who are willing to recognise the reality of the situation that we are in, who will avoid the complacency that we have heard today, and who will increase the total resources across the board for health care in this country.

The Government are failing patients, but worse, they are betraying the trust that the people of this country put in them.

Mr. Milburn: I welcome the hon. Member for Woodspring (Dr. Fox) back from his holidays. Indeed, I welcome him back to the country, which, in his absence, has seen the staff of the national health service coping with a very serious flu outbreak.

Let me deal with the issues that the hon. Gentleman raised one by one. As far as cuts in the number of beds are concerned, if I were he, I would be extremely wary of getting into that territory. Let us not forget that the Conservative Government, during their last 10 years in office alone, managed to cut 40,000 hospital beds--but the Conservatives now have the temerity to complain that there are not enough hospital beds in the NHS.

The hon. Gentleman asked about intensive care. If he had listened to the statement--indeed, if he had read it, as I made it available to him in advance--he would know that we listened carefully to what intensive care doctors and nurses were saying to us. They said that, on the evidence of last year, we needed additional intensive care and high dependency beds. We have provided them: an extra 100 critical care beds were made available to the NHS last year and I am pleased that we did that, given this serious outbreak of flu.

As for the use of private sector beds, I have never said that the national health service would not co-operate with the private sector when it is appropriate to do so. There is nothing to prevent local NHS hospitals from using capacity in the independent sector locally. Some have done so, especially in hard-pressed areas such as London.

Making ideological points cannot mask the facts. It is overwhelmingly the case that the national health service has better intensive care facilities than the private sector, for the simple reason that NHS hospitals are able to provide 24-hour medical cover. Private sector hospitals are not usually able to do that. That is why, this winter, the national health service has taken requests from private sector hospitals to admit private sector patients to NHS critical care facilities. We shall of course continue to do that when it is appropriate. Some estimates show that up

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to 1,000 patients a year are shifted by private hospitals into NHS intensive care units precisely because the private sector has not been able to cope with the complications that have arisen.

On the issue of Relenza, I do not know where the hon. Member for Woodspring takes his advice from--presumably from the marketing departments of pharmaceutical companies. We take our advice from expert clinicians. The National Institute for Clinical Excellence, which is staffed by a dozen professors of medicine, gave us clear advice that Relenza was not right on clinical effectiveness grounds. However, NICE is working with the drugs company to see whether Relenza could be made available in the future. [Hon. Members: "Ah!"] There is nothing new in that. I know that the sheep are baaing early this year, but that was made clear when we made the announcement on Relenza.

What is depressing about the hon. Gentleman's response to my statement is that it is so predictable. I know that it suits Conservative Members to talk down the incidence of flu in order to talk up the problems in the national health service, but the truth is that the Conservative party is out of kilter with the British people on this issue. The public--each and every family in the land--know that the national health service is dealing and coping with a serious outbreak of flu. While the staff of the national health service are busy coping, the best that the Conservatives can do is to carry on carping.

Mr. Kevin Barron (Rother Valley): Does my right hon. Friend agree that the attack on the National Institute for Clinical Excellence is an attack on some of the most eminent clinicians in the health service? The ideology coming from the Opposition Front-Bench spokesman shows that he should take some sound advice.

How many people were immunised against flu last year to try to prevent their being affected? If expenditure had remained as it was under the previous Government, how many, if any, of the extra 100 critical beds would have been available in the national health service to cope with this problem?

Mr. Milburn: I am grateful to my hon. Friend. As he rightly says, Conservative Members are always urging the Government to take difficult decisions to prioritise health services but, when we take those difficult decisions, they criticise them.

As I explained, we have increased the doses of vaccination available through GPs' surgeries. We do not yet have the figures on uptake rates, but we shall review them when we get them. We know that we probably need to do more to encourage uptake, and I have asked the chief medical officer to report to me on the best way of doing that in the future.

My hon. Friend is on to a very good point about the funding of the national health service. The Conservatives claim that there are not enough hospital beds and there is insufficient funding for the NHS. The Conservative party is the very party that, when we announced our record cash injection into the national health service, described the extra funding as reckless, mad and irresponsible.

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