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Dr. Fox: I shall give way shortly. Yesterday, in what was billed as a great boost and a propaganda coup for the Government, the pay awards for NHS staff were brought forward in a panic measure after the Prime Minister's speech at the weekend. However, the Government failed to understand that NHS staff would spot immediately that the awards were unfunded. This morning, The Guardian said that NHS services would be squeezed and The Mirror said, graphically:

"Brilliant! But how will nurses be paid?"

The pay award issue goes to the heart of how the Government run our health care. Lord Winston said:

"I think we've been quite deceitful about it. We haven't told the truth and I'm afraid there will come a time when it will be impossible to disguise the inequality of the health service from the general population."

Those are damning words from one of our leading health experts who is also a notable ally of the Prime Minister.

Of all the factors that prevent us from having a meaningful debate on health care, one of the most obstructive is the Government's dogmatic approach to the independent sector. The private sector tells us that, if there had been earlier consultation before the winter flu outbreak, it would have been able to make more beds available for the NHS when it was overstretched. It is the Labour party's dogmatic hatred of the independent sector that makes the Government incapable of any meaningful negotiation with it in the interests of patients.

Jean Corston: Will the hon. Gentleman give way?

Dr. Fox: The hon. Lady must not jump up and down like a demented meerkat. I shall give way in a moment.

The Prime Minister's press secretary, who now doubles as prime ministerial stand-in and as a Treasury spokesman, intervened in the debate today. The Press Association reported:

"Blair rules out tax breaks for private health insurance".

However, it was his press secretary who said:

"We don't have an ideological hatred of the private sector, it's just that we don't see it as a solution to the problems of the NHS."

Dr. Stephen Ladyman (South Thanet): The hon. Gentleman mentioned the pay awards and I can tell him

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that the nurses will get their pay rise from the biggest boost in spending on the NHS in its history, which this Government have delivered. However, the Conservatives' guarantee to cut taxes, even in a recession, means that if they were in power they would have guaranteed to cut spending on the health service and hand it over entirely to the private sector.

Dr. Fox: That is a bizarre intervention. The hon. Gentleman suggests that health expenditure cannot be increased at the same time as taxes are cut. He does so just two months before the Government cut taxes by 1p to compensate for the stealth taxes that they have already imposed. That is a ridiculous argument.

No one begrudges the nurses' and junior doctors' pay rise, which they thoroughly deserve. However, allocations to health authorities and spending plans were already complete before those fully accepted--but not fully funded--pay rises were announced. So some cuts will have to be made in the allocations for the patient programmes already planned by health trusts and health authorities. The hon. Member for South Thanet (Dr. Ladyman) is grinning, but it is not funny for the people whose services will be squeezed and cut.

Jean Corston: Will the hon. Gentleman give way?

Dr. Fox: Very well, if only so that I can get some peace.

Jean Corston: I am very grateful to the hon. Gentleman for giving way, however reluctantly. The Avon health authority provides hospital services for people in my constituency and the hon. Gentleman's. It said today that, despite an average daily increase of 14 per cent. in emergency admissions during the flu epidemic, no health trust had had to refuse emergency admissions. It also said that, although some routine surgery had had to be cancelled, plans were in hand to cut waiting times. Does not that show that the health service for our constituents has responded magnificently to a once-in-a-decade epidemic? Does it not also throw into stark relief the hon. Gentleman's assertion to the Tory party conference that the NHS could only ever provide a second-rate service?

Dr. Fox: The hon. Lady was doing quite well for the first four or five minutes of her intervention. I was going to welcome what she was saying, and I am grateful that her constituents and mine live in the area of a health authority that has coped reasonably well.

However, the hon. Lady said that this epidemic has been the worst in a decade. In reality, it is probably only the fourth worst outbreak in 10 years, and it is not so different from other outbreaks. In any case, why should routine surgery have to be cancelled? Outbreaks of flu in our health care system happen in most years, so why should we be grateful that emergency admissions have not been stopped? The hon. Lady's remarks reveal an almost incredible complacency.

The Secretary of State is second to none in his dislike of independent health care. I have a letter from the former chairman of the St. Helier health trust, describing what happened on Thursday 26 March 1998 at the Department of Health building at Elephant and Castle. He and his

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colleagues were to be lectured on their obligations by the then Secretary of State for Health, the right hon. Member for Holborn and St. Pancras (Mr. Dobson). However, because the right hon. Gentleman was late, the present Secretary of State gave the lecture. The letter states that the Secretary of State admonished the audience to deliver the Government's promise on waiting lists. The letter adds:

"During questions, someone (I think, but cannot be sure, that it was Dr. Tudor Thomas, the Chief Executive of Epsom Healthcare NHS Trust) referred to a satisfactory arrangement his Trust had with a local private hospital."

The present Secretary of State was described as "furious". The letter states that he

"told us all that he would 'come down like a ton of bricks' on anyone who had anything to do with the private sector."

The letter went on:

"I was sitting next to Sir William Rous (sadly deceased) chairman of Kingston Hospital NHS Trust, and he was as incensed as I was at the dogmatic and nonsensical attitude."

That dogmatic and nonsensical attitude persists to this day at the heart of the Department of Health.

The real reason for today's debate is that matters need not be as they are. Up and down the country, doctors, nurses, other health care professionals and voters do not want the NHS to be used as a political football in future. [Interruption.] The mechanism for delivering health care in this country need be no more controversial than it is in other developed countries. That is entirely possible.

Today, my right hon. Friend the Leader of the Opposition and I made an offer to the Government and to the Liberal Democrat party. Three things can be done to remove the national health service from this febrile political atmosphere. First, we offer the NHS a guarantee. It needs long-term stable financing and less political interference. We believe that there should be increased NHS funding year on year in real terms. We believe that there should be improved NHS management, allowing hospitals to get on with the job of treating patients, and no privatisation--instead, as now, there should be a continued commitment to publicly funded health care, free at the point of delivery.

Secondly, the NHS should give patients a guarantee. [Interruption.] This is a serious debate; it requires something more than the primary school outing that is being held on the Government Back Benches.

Patients should have a guaranteed waiting time, determined by the clinical priorities of doctors, not the political priorities of spin doctors. There should be an agreement that if the NHS cannot meet the guarantee, independent health care resources should be used. What matters is when patients are treated, not where they are treated or what sector they are treated by.

Overall, our health service requires more resources. We need to increase our expenditure in the NHS--the state-funded sector--and in the private sector. There should be no ideological block to partnership with independent health care providers. I mentioned how the crisis in the health service could have been averted had we used the independent sector better. However, there should be no punishment through the taxation system for those who take out independent health care provision, and we should review the tax treatment of health care costs

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on companies and individuals. We should create the opportunity to expand total health spending in both the public and personal sectors to reach more quickly the level spent on health by our major European partners.

We believe that a mixed provision in health care will enable us to reach the health outcomes of our European partners, but far more quickly than the target set by the Prime Minister. The dogma of the Labour party, however, prevents us from doing so.

Dr. Howard Stoate (Dartford): I am grateful to the hon. Gentleman for giving way. He is right to say that the NHS is under great stress. He is also right that the health service does not have enough beds, doctors or nurses. Could he therefore tell the House why his Government cut the number of beds by 40,000 and the number of nurse training places by 2,000 a year, which is what got us into this mess in the first place?

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