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Mr. Blizzard: Has my right hon. Friend noticed that, while Conservative Member after Conservative Member has risen to point out some deficiency in the NHS, all that the Conservative Front-Bench spokesman could offer has been privatisation, privatisation and privatisation? He could not offer the new public resources that the Government are investing because his Front-Bench colleagues described those resources as "reckless".

Mr. Milburn: As ever, my hon. Friend makes an extremely telling point. [Laughter.] Conservative Members are laughing now, but they will not be laughing in a moment or two because I am about to turn to that very matter.

We are making progress. The NHS is modernising and changing. There are new services, but there are also severe capacity problems. As my hon. Friend the Member for Dartford (Dr. Stoate) said in an earlier intervention, we need more doctors, more nurses and better services. Sadly, that takes time. It takes three or four years to train a nurse and double that to train a doctor, and it takes more money.

In the past 20 years NHS funding has grown by just 3 per cent. a year. That is the real legacy of the Conservative party. From last April, this Government have raised those levels of investment by a further 50 per cent. There is more money this year; there will be more money next year and more money the year after, but that is just the start. We know that we lag behind the rest of the European Union on health spending. We are determined to close the gap. As the Prime Minister said--

Mrs. Gillan rose--

Mr. Deputy Speaker (Sir Alan Haselhurst): Order. I am sorry to interrupt the Secretary of State. The right hon. Gentleman is clearly not giving way and the hon. Member for Chesham and Amersham (Mrs. Gillan) must resume her seat.

Mr. Milburn: As my right hon. Friend the Prime Minister said on Sunday, if we can get real-terms

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increases in funding of 5 per cent. a year, we shall get up to the European level. Our ambition is to have a health service that is doing more than coping. We want an NHS that is growing and modernising.

Mr. Mike Hancock (Portsmouth, South): If the Secretary of State genuinely believes what he has told the House this afternoon, why is it that the majority of people outside the House do not have the same confidence in the NHS and do not share his confidence in the Government's ability to protect it? I take the right hon. Gentleman back to his point about intensive or critical care beds. He said that there are 100 new beds, but he has been able to identify only eight of them. Where are the other 92?

Mr. Milburn: I shall deal with the hon. Gentleman's last point first. I shall publish the figures on intensive and high dependency beds in due course.

The hon. Gentleman talks about lack of public confidence. Of course there are problems with the NHS. Everybody understands that. The Government are addressing them, but there is a fundamental political debate taking place between the Government and the Opposition about the way in which health resources can grow in future. There are two very different futures on offer.

Everybody knows that we need to spend more money on the NHS, except the members of today's Conservative party. Only the Conservative party could argue that the Government have gone soft on public spending on class sizes and waiting lists. Only the Conservative party could impose on itself the straitjacket of the tax guarantee, which would mean less investment in public services such as the NHS and more investment in the Conservative party's priorities, including top-rate tax cuts for the privileged few.

It is no wonder that the former Prime Minister, the right hon. Member for Huntingdon (Mr. Major), said what he did about the tax guarantee. He said:

"To say that you are going to reduce the proportion of taxes to GDP in all circumstances is mad. You simply"--

[Interruption.] That is what the right hon. Gentleman said. I note that Conservative Members are not laughing now. Their former Prime Minister said that that was mad. He then said:

"You simply don't unless you make swingeing cuts in the Health Service."

Those were the words of the last Conservative Prime Minister.

The simple truth is that we are spending more on the Health Service and Conservatives want to spend less.

Mr. Christopher Gill (Ludlow) rose--

Mr. Deputy Speaker: Order.

Mr. Milburn: In the process, they want to force more people to go private.

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Dr. Fox: On a point of order, Mr. Deputy Speaker.

Mr. Milburn rose--

Mr. Deputy Speaker: Order. Did I hear the hon. Member for Woodspring (Dr. Fox) say, "On a point of order"?

Dr. Fox: I made the position extremely clear when I spoke. I do not wish the Secretary of State unintentionally to mislead the House. I made it clear to the right hon. Gentleman that our policy--

Mr. Deputy Speaker: Order. The hon. Gentleman has been here long enough to know that that is a point of debate and not a point of order.

Mr. Milburn: I know that it is a narrow judgment call, but if the question is whether I trust most the hon. Gentleman or the former Prime Minister, the right hon. Member for Huntingdon, I will go with the former Prime Minister.

The Conservatives want to force more people to go private. The hon. Member for Woodspring calls his patients' guarantee a Trojan Horse. I think that that was the phrase he used. We are beginning to see what lies within that horse.

The hon. Gentleman could not have been more explicit in his interview with The Sunday Times only two days ago. He boasted:

"Philosophically, we have moved on".

That is, moved on from the NHS. He added:

"Insurance companies could cover conditions that are not high-tech or expensive, like hip and knee replacements and hernia and cataract operations."

Now we know the first set of treatments that the Tories' patients' guarantee would surgically remove from the NHS. Every year--

Dr. Fox: Will the Secretary of State give way?

Mr. Milburn: Oh no. I shall give way at the end.

Every year a third of a million people have hip, knee, hernia and cataract operations on the NHS. Under the patients guarantee, those 300,000 people would be denied NHS care because the hon. Gentleman thinks that their condition is too trivial. Instead, they will have to pay privately for treatment that they now receive free.

The average cost to the NHS of a hip replacement operation is £3,755. In the case of a knee replacement, the bill rises to £5,157. However, the cost of the operation is only half the picture. If those operations are beyond the pale of the NHS, who pays the bill for the initial consultant referral? The patient pays. Who pays the bill for the pre-operative out-patient assessment? The patient pays. Who pays the bill for community physiotherapy? The patient pays. Who pays the bill for the district nurse visit to remove sutures? The patient pays.

Who pays the bill for the follow-up at six weeks? The patient pays. Who pays at six months? The patient pays. Who pays at 12 months? The patient pays. Time and again, the Conservative guarantee is that the patient pays.

Dr. Fox: Sadly for the Secretary of State, I write the Conservative health policy, not him. He can make up as

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much of it as he fancies in his little fantasy world. We intend that patients will get a maximum guaranteed waiting time. Many of the procedures that he mentions are carried out at present through many different independent schemes, including through trade union schemes.

Mr. Milburn: Is the article right?

Dr. Fox: No, it is not right.

Every single time any of those procedures are carried out in the independent sector, it reduces the waiting list in the national health service. The problem is that the Secretary of State is so blinded by his own dogma that he wants to put politics before patients.

Mr. Milburn: I look forward to the retraction in The Sunday Times. I presume that even now there is a letter winging its way. Is that right or is it wrong?

Dr. Fox: The Secretary of State is trying to create yet another smokescreen with yet another example of what the Labour party does best--half-truth, misinformation and disinformation. We have made it clear in this debate that we believe in increasing spending on the NHS year on year in real terms. We believe in encouraging as many people as possible to take up independent provision, because that increases the total capacity of health care in this country. It is a shame that the Secretary of State is so intellectually sterile that he cannot accept the argument, as can other socialists in Europe and every commentator in the United Kingdom.

Mr. Milburn: I look forward to reading the letter. The hon. Gentleman did not convince his own side, let alone the House.

Let us have a debate about the merits of private health insurance. I am happy to engage in such a debate. The patients who would be forced to pay private health insurance under the patient guarantee and the tax guarantee are precisely those who could least afford to do so.

Two thirds of patients in hospital are elderly people. Together, the very young and the very old are the biggest consumers of health care in our country, but they are the very people who would be priced out of the health insurance market. The very people who need most care, and the very ones who are most at health risk, are they very people who would be least able to get it.

The second reason why private health insurance is the wrong answer is that it would divert hundreds of millions of pounds that should be spent on the NHS into a huge cash handout in tax reliefs and subsidies.

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