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Dr. Fox: The number of doctors in the health service was higher at the end of our term of office than at the beginning--as was the number of nurses. I should have thought that that was record enough. As for nurse training places, I know that the hon. Gentleman knows that the number of nurse training places had already increased for the two years before the Conservatives left office, a trend that is happily being followed by the current Government.

Before we can entertain a proper, mature health debate, we have to accept three basic facts. First, the NHS cannot do everything at a time when medical science is expanding faster than our ability to fund it. Secondly, we no longer have the best health care system in the world--we used to, but we have fallen behind. Thirdly, the NHS has failed as a welfare model, because the poorest in our society have not only the poorest access to health care but the worst health outcomes. That must be addressed.

The Labour party is in a panic over the one issue that it arrogantly and complacently believed was its own. The Secretary of State was undermined by the Prime Minister over the number of intensive care beds. He was in the dark about the Prime Minister's announcement about funding on the David Frost programme. The Secretary of State is no doubt being lined up as the fall guy by the propaganda machine for when the trust ratings fall further.

Before No. 10 starts briefing that the Secretary of State is going to run as mayor of Darlington, and before he plumbs new depths of unpopularity, he has one chance to safeguard and protect his future and that of the NHS. He should drop the dogma, the soundbites and the deception, and should join us in creating a health care system fit for Britain in the 21st century.

4.10 pm

The Secretary of State for Health (Mr. Alan Milburn): I beg to move, To leave out from "House" to the end of the Question, and to add instead thereof:

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    the vital role in meeting these pressures played by the unprecedented level of planning for the winter, covering health and social services and the extension of NHS Direct to two-thirds of England; welcomes the measures already taken by this Government to increase the capacity of the National Health Service, including increased provision of critical care beds, the modernisation of Accident and Emergency departments, the biggest ever National Health Service hospital building programme, the employment of additional doctors and the recruitment of more nurses, the cuts in in-patient waiting lists, the extra investment to modernise cancer, coronary and mental health services and the commitment to increased investment in and modernisation of the National Health Service; and rejects the Opposition's proposals to privatise the National Health Service."

May I say first that we already have a good mayor in Darlington?

Today's debate is not only about the state of the national health service. As the hon. Member for Woodspring (Dr. Fox) said, it is about the future of health care itself. There are no closed minds in the Government when it comes to radical reform of the NHS. That is precisely what we have been doing for the past two and a half years. The Labour Government made the private finance initiative work in the NHS, and will continue to do so. [Interruption.] The Conservative Whip may scoff, but as a consequence of the PFI, 16 new hospitals are being built, some in parts of the country that had been waiting for decades.

Several hon. Members rose--

Mr. Milburn: I shall give way to the hon. Member for Rutland and Melton (Mr. Duncan), because he, too, is a radical.

Mr. Alan Duncan (Rutland and Melton): The Secretary of State says that there are no closed minds on the Labour Benches. Will he therefore dissociate himself from the comments made by the hon. Member for Wakefield (Mr. Hinchliffe), the Chairman of the Select Committee on Health, who said:

Mr. Milburn: The hon. Gentleman and the hon. Member for Woodspring have raised the matter of private medicine several times, and are starting to be--

Mr. Michael Portillo (Kensington and Chelsea): Answer the question.

Mr. Milburn: The right hon. Gentleman seems to have a hearing problem. I know that he returned to the House only recently, but if he bears with me, he will hear the answer. The Conservative party is beginning to act as if it were the political wing of the private health insurance movement. Let me make it absolutely clear that no matter how serious the challenges facing the NHS--I readily admit that there are many--a private alternative is not the right remedy for Britain.

Modernisation and the investment that goes with it are the only means by which our health care system can serve the whole nation. No one pretends that there are no problems in the NHS, or that all patients are receiving the care that we all wish them to have. If we thought that nothing was wrong, we would not be working hard to put matters right.

Miss Anne McIntosh (Vale of York): Does the Secretary of State regret the Government's early decision

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to abolish tax deductibility on private health care insurance for the over-60s? Will he move rapidly to reinstate it?

Mr. Milburn: No, I do not regret that decision. Anyone who reads Lord Lawson's memoirs will gain an interesting insight into the debate that took place between him, when he was Chancellor of the Exchequer, and the then Prime Minister, Lady Thatcher, about private health care insurance. In fact, tax relief on private health insurance meant that the number of elderly people who took it out barely moved for seven years. When we abolished it, we put £140 million to much better effect by cutting value added tax on fuel.

Dr. Fox: Why, when all other socialist Governments in Europe see private medical insurance as a supplement augmenting state spending, do our Government, isolated among commentators in the United Kingdom and Europe, believe that it must be an alternative?

Mr. Milburn: It would be an interesting development in the Conservative party if the hon. Gentleman was advocating foisting on the British people the German or French models. The Government do not support that development for reasons to which I shall come shortly. [Interruption.] It is not about dogma or ideology but about what works best for Britain.

Nobody pretends that there are no problems in the national health service. The difference between the Labour Government and the previous Conservative Government is that we recognise the problems, and--what is more--we are taking action to tackle them. As I made absolutely clear in my statement to the House eight days ago, the NHS has been under severe pressure this winter. The doctors, nurses and other staff of the health service have done a brilliant job during the past few weeks--the hon. Member for Woodspring is quite right about that. However, to listen to the hon. Gentleman and some of his hon. Friends--and, indeed, some of the more hysterical parts of the media--one would think that the health service had simply ground to a halt. It has not. During the past four weeks alone, there have been more than 350,000 999 calls; almost 820,000 attendances at casualty departments and more than 250,000 emergency admissions to hospitals.

The Conservatives accuse us of mismanaging the NHS this winter. That is not what health service managers are saying. The NHS Confederation describes health service planning for this winter as "excellent" and "unprecedented". Doctors' leaders agree. Dr. Ian Bogle, the chairman of the British Medical Association, said that

The hon. Member for Woodspring has been quoting doctors. Let me quote from a letter that I received today from 20 senior clinicians throughout the country--a letter, incidentally, that The Times refused to publish. [Interruption.] All of a sudden, Conservative Members are keen to listen to doctors' leaders--let them listen to what those doctors have to say. The letter stated:

    "To suggest as some commentators have done that the NHS is offering 'third world care' or that the health service failed to prepare adequately for the pressures of winter is incorrect . . . the Government's policy is moving the NHS in the right direction. The NHS represents the fairest and most effective way of delivering

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    health care. The British people are right to press for it to be properly funded and modernised. To dismantle it would be a disaster we would live to regret."

The letter was from clinicians in London, Birmingham, Cheltenham, north Tyneside and other parts of the country.

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