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Sir Raymond Whitney (Wycombe): As we are comparing letters from doctors, will the right hon. Gentleman comment on the letter, dated 15 January, from five consultants at Wycombe hospital that asks him formally to take responsibility for the rundown state of intensive care in this country?

Mr. Milburn: It is undoubtedly true that there has been particular pressure on intensive care beds, despite the fact that we provided extra beds this winter. It is not true, as the hon. Member for Woodspring alleges, that those critical care beds do not exist. They do exist; throughout the country, there are extra intensive care beds and extra high-dependency beds.

Mr. Brazier: What does the Secretary of State say to people in east Kent who face the loss of the accident and emergency unit at the Kent and Canterbury hospital, and a 16 per cent. fall in total bed numbers over the next three or four years?

Mr. Milburn: I shall come to bed numbers in the next sentence or two. However, I point out to the hon. Gentleman and to his Front-Bench colleagues that, every time today's Tories talk about health care, there is an epidemic--an epidemic of hypocrisy and an outbreak of selective amnesia. Nowhere is that more evident than on bed numbers. We shall take no lectures on beds from the hon. Member for Canterbury (Mr. Brazier), from his Front-Bench colleagues or from the Conservative party.

The Conservatives cut 40,000 beds from our hospitals during their last 10 years in office. That is why we set up the national beds inquiry--

Mr. Philip Hammond (Runnymede and Weybridge): What about the beds inquiry?

Mr. Milburn: I will give the hon. Gentleman the answer, if he will remain patient for a moment or two. I shall publish the results of that national inquiry within the next few weeks. It will make the case for an increase in bed numbers. It will end two decades of orthodoxy and ideology that declared that beds were bad. Modernising the health service means expanding health services.

Dr. Fox rose--

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

Dr. Fox: I am extremely grateful to the Secretary of State. As I referred to his letter of 6 January, and as it would be extremely unfortunately to have the Secretary of State or his Department's officials accused of either misinformation or disinformation when the Prime Minister said that there would be 30 extra intensive care

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beds and the Secretary of State said that there would be 100, will the Secretary of State assure the House that he will publish where those 100 beds are?

Mr. Milburn: I can give the hon. Gentleman some of the details today if that is helpful. There are extra beds at St. Mary's in London; extra beds in Norfolk and Norwich hospital; extra beds in Leicester general; extra beds in Warrington hospital and extra beds in the Royal Victoria infirmary in Newcastle. They are all extra intensive care beds. [Hon. Members: "How many?"] Conservative Members ask "How many?" There will be two at St. Mary's; two at Norfolk and Norwich; one at Leicester general; two at the Royal Victoria infirmary and one extra intensive care bed at Warrington hospital. The hon. Member for Woodspring asked for a full list. He will get a full list when we publish it.

Mr. John Bercow (Buckingham) rose--

Mr. Milburn: I will give way to the hon. Gentleman in a moment or two, because I always like giving way to him. For the moment, however, I ask him to calm down.

It is the same story when it comes to nurse training: the same amnesia and the same hypocrisy from the Conservative party. The Conservatives say that we have left the NHS short of nurses, but it was the Conservative Government who cut the number of nurse training places by almost 4,000. It is this Government who are increasing the number of nurses, and of nurses in training, with 5,000 more nurses returning to the NHS; 4,500 more training places; and 14,000 more applicants for courses. Just today, the first 140 nurse-consultant posts have been established in all parts of the country.

Mrs. Cheryl Gillan (Chesham and Amersham): Will the Secretary of State give way?

Mr. Milburn: No, I will not. I have given way several times. I might give way in a moment or two if the hon. Lady will just calm down.

Let us not forget, either, the two largest real-terms increases in pay that nurses have received in almost a decade and a half. They have been paid in full--and unlike under the Conservative party--without any staging. They are fair pay rises so that we get more doctors and more nurses into the health service and make it more worth their while to stay in it too. Expanding the staff of the health service is the way that we will expand services to patients.

That is one of the differences that the Labour Government are making to the state of the national health service, and I shall tell--

Several hon. Members rose--

Madam Speaker: Order. The Secretary of State is not giving way for the moment. Members should know better than to continue to try to intervene.

Mr. Milburn: The hon. Member for Woodspring, and the Conservative party generally, are very keen to talk

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about mismanagement. Let us talk about it, then. Mismanagement is when one wastes £30 million on legal and consultancy fees for private finance initiative--

Mrs. Gillan rose--

Madam Speaker: Order. Let me just get this straight. Is the Secretary of State giving way to the hon. Lady?

Mr. Milburn: No.

Madam Speaker: Thank you. The hon. Lady must resume her seat.

Mr. Milburn: I have given way several times to Conservative Members and I deeply regret the fact that I have. If the hon. Member for Chesham and Amersham (Mrs. Gillan) is patient, I might give way to her at the end of my speech.

Mismanagement is wasting £30 million on legal and consultancy fees for private finance initiative hospital schemes that one could not even get off the ground. Good management is building 16 new hospitals worth £1.3 billion as part of the biggest hospital building programme that the health service has ever seen. That is the difference between this Government's management of the health service and the Conservative Government's mismanagement of it.

The Opposition motion deplores mismanagement. I deplore it too. That is precisely why we have abolished the internal market that the Conservatives created--an insane competition between hospitals that fragmented services and wasted millions. That is why we have ended two-tier care and that is why we are well on the way to moving £1 billion out of NHS bureaucracy and into front-line patient care.

Mismanagement is when a Government, in the name of free-market ideology, turn a blind eye to poor hospital standards and second-rate performance. Good management is when a Government have the courage to establish for the first time an independent inspectorate and a systematic dismantling of the lottery of care. Mismanagement is when in-patient waiting lists rise by 400,000. Good management is when they fall by 87,000. Mismanagement is when a Government leave office with investment in new NHS building, plant and equipment at a 10-year low. Good management is when that investment is at an all-time high. There is more investment in cancer and in GP surgeries, and 150 casualty departments are already being modernised.

Mismanagement is when cancer and cardiac services--the services that deal with our country's biggest killers--are left neglected and under-invested for decades. Good management is when more money is being invested, more doctors are being trained and more operations are being performed. That is the difference that the Labour Government have started to make. More hospitals are being built; more nurses are being recruited; more doctors are being trained and more patients are being treated.

Mr. Bercow: In the light of what the Secretary of State has said, what does he have to say to my constituent, Colonel Bruce Owen from Marsh Gibbon in Buckingham--[Laughter.] It is not a laughing matter for him. He suffered a heart attack on 7 July last year,

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eventually saw a consultant surgeon at Harefield hospital in the middle of November and was told that he would have to wait at least 12 months for the triple bypass surgery that he requires. Will the right hon. Gentleman tell my constituent and the House why that individual, who has saved and who has contributed to this society throughout the 60 years of his life, should have to spend £13,000 of his hard-earned savings on the treatment of which the inadequate health service is currently depriving him?

Mr. Milburn: The hon. Gentleman raises an important constituency case. I say to him that of course we always regret circumstances in which patients do not get the care that they deserve from the national health service. Let me say to him, however, that it is fatuous to pretend that problems in cardiac services began on 1 May 1997. It is fatuous to pretend that problems in cancer services began on that date. The truth is that for decades the previous Government failed adequately to invest in cancer and cardiac services. They left those services under-invested, under-doctored and under-nursed. That is why we have made those services our top priority for modernisation.


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