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Mr. Bernard Jenkin (North Essex) indicated dissent.

Mr. Milburn: There seems to be some dispute on the Opposition Front Bench. The hon. Member for Woodspring was urging me to reinstate private health insurance subsidies. The hon. Member for North Essex (Mr. Jenkin) indicates that that is wrong. Which is it? Is the hon. Member for Woodspring right? I presume he is.

Dr. Fox: I was urging the Secretary of State not to extend national insurance contributions to employers to punish them for giving private health care to their

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employees, which is enjoyed by a large number of employees in the United Kingdom, many of whom are trade unionists.

Mr. Milburn: The hon. Gentleman should keep digging because he is doing a good job for us. Today's Conservative party, like that of the 1990s, wants to give a huge cash handout in tax reliefs and subsidies for private medical insurance. Much of that would go to people who already have private medical insurance. The hon. Gentleman quoted the Daily Mail, which reported today that the costs of subsidising employers would be £368 million. That is before a single extra person signs up to an extra health insurance policy. That £368 million from the national health service budget is the equivalent of 1,050 intensive care beds or 16,000 nurses. Yet Conservative Members have the gall to claim that their policy is about expanding access to health care. It would be money down the drain.

It is fatuous to pretend, as the hon. Member for Woodspring does, that more private health care would lift the burden from the health service. It would impose an extra burden.

Mr. Edward Leigh (Gainsborough): Will the Secretary of State give way?

Mr. Milburn: No. There is no reserve army of unemployed oncologists or cardiac surgeons waiting for a private call to arms.

Mr. Leigh: Will the Secretary of State give way?

Mr. Milburn: No. An expanded private sector would mean a contraction of the public sector, which would face higher costs with fewer staff. It would mean a brain drain from the NHS. The Conservatives' proposals on private health insurance are wrong. They affect the wrong people at the wrong cost and have the wrong effect.

Private health insurance, the knee-jerk reaction of the Conservative party, could not provide an efficient or fair health care system. It would take the United Kingdom back to an era when access to health care depended not on clinical need, but on ability to pay. That is not the future for health care in our country. The Government reject the idea that the NHS should be a residual safety net service for the poor, which will inevitably become a poorer service. We reject that not on ideological grounds but because it simply would not work.

Dr. Stoate: How would the private insurance sector respond to people who have chronic conditions such as diabetes or rheumatoid arthritis, or those who have chronic health problems, most of which are excluded from the majority of health insurance programmes?

Mr. Milburn: My hon. Friend, who is a general practitioner, makes a good, telling point. He knows that the private insurance sector would be incapable of insuring the people whose health is most at risk. That is why Conservative arguments are so fatuous. We do not oppose them on ideological grounds [Hon. Members: "Oh!"] We do not. We oppose them because they would not work. There are two possible futures for health care in our country: privatisation with the Conservatives and

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modernisation with Labour. We have the courage of our convictions. We believe in a comprehensive, modernised and well-resourced NHS, which provides care that is based on need, not ability to pay. We believe in a truly national health service, which is worthy of the name. The people of our country expect that. Tax relief for private health care is not an answer to the challenges of the health service. The answer is a rising level of resources for the NHS, funded through general taxation, in a way that the people can understand and in which they can have confidence. That is the way forward for the modern, 21st-century health service that our nation needs.

The NHS is one of the greatest achievements of the 20th century; it must now undergo one of the greatest modernisations of the 21st century. No matter how much Conservative Members rant and rave, we will not yield one inch to the privatisers of our nation's health. We stand firm for the NHS--not as it is, but as the modern health service that it could be. The nation now knows the choice that it faces--between those who want to privatise the NHS and those who want to modernise it. The nation should know that we will deliver a modern NHS--a new NHS fit to face the challenges of the new millennium.

4.45 pm

Mr. Nick Harvey (North Devon): As we have this debate, the Government have been under fire over the national health service, in the media and politically, for getting on for three weeks. It is hard to think of any occasion since 1 May 1997 on which their spin doctors have so lost control of the agenda that they have found themselves under fire on a domestic policy issue for three weeks solid, but this is largely a mess of their own making. Listening to the hon. Member for Woodspring (Dr. Fox), who introduced the debate on behalf of the Conservative party, one could have been forgiven for thinking that all those problems had miraculously started on 1 May 1997. Nothing, of course, could be further from the truth.

The 18 years of Conservative misrule led to a great many of the problems. It is not the present Government's fault that they inherited a mess, but it is their fault that in three years they have not made more progress in putting some of that mess right. They played the health issue up strongly at the general election, saying that they alone could save the NHS, but what they have done since--certainly in terms of investment in the NHS--has not even kept up with the year-on-year funding increases made by the Conservatives. The changes that they have made, which the Secretary of State described as radical modernisation, have been over-hyped, although some have started down useful tracks. The recent flu crisis, outbreak or wave--whatever hon. Members care to call it; regrettably, I have sampled it from a patient's perspective--validated the warnings given by health managers, doctors, nurses and others about the pressure that the NHS was under. It took the recent outbreak to show the situation in its true light.

Mr. Bercow: Does the hon. Gentleman support the hon. Member for Wakefield (Mr. Hinchliffe) who denounced all who work in the independent health care sector, using a word that begins with "b" and ends with "s", or does he agree that that outrageous attribution in

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The Health Service Journal was a profound insult, both to people working in the independent sector and, indeed, to children born out of wedlock?

Mr. Harvey: The hon. Member for Wakefield (Mr. Hinchliffe) must speak for himself, but we regard the private sector and the private health insurance industry as perfectly legitimate parts of the health service. If it is possible for them to grow and play a bigger part we are perfectly happy for them to do so, but we cannot conceive of any circumstances in which taxpayer funds should be used to enable that to happen.

The hon. Member for Woodspring introduced the debate in an entertaining knockabout style and with his usual good humour, but I was rather puzzled that, halfway through, he suddenly launched an initiative to stop the NHS being a political football and called for all-party talks on the issue. We have not had an encouraging start, as his speech made precisely that of the NHS. However, if it is possible to get some all-party dialogue going on health, if we are to break certain taboos and accept, for example, that rationing exists, and if we are to debate what the health service can or cannot do and how it is to be funded, we are ready to take part.

I shall look back to the proposals by which the Government invited the nation to measure their performance at the general election. They pledged that they would bring down waiting lists by 100,000 and maintain that they are making progress towards that figure. They have made progress in bringing down in-patient waiting lists, but unfortunately that has been more than outweighed by an increase in out-patient waiting lists from 295,000 at the time of the general election to 513,000 now. The number of people, and the time for which they are waiting, have grown.

The folly of all this is demonstrated by the fact that, according to any health service professional to whom one speaks, the waiting list pledge itself was completely misguided, has caused a distortion of clinical priorities in the vast majority of hospitals, and is not the best measure of the progress that the Government are making in the health service.

Mr. Leigh: The hon. Gentleman mentioned cross-party consensus, and then talked about waiting lists. Will he at least accept--so that we can secure as big a majority as possible for this view--that the NHS is helped, and in no way harmed, if people relieve pressure on it by taking out private health insurance?

Mr. Harvey: I hope that I made it clear that that was my view in my response to the hon. Member for Buckingham (Mr. Bercow). There is certainly no harm done--indeed, it is welcome--if the private sector can play a part in relieving pressure on the NHS. If people choose to take out private insurance, that is entirely a matter for them and a positive development.

We believe that the private sector could have a growing role in undertaking work commissioned by the NHS, and there is no reason why the reverse should not happen from time to time. The private sector occasionally needs to fall back on the services of the NHS--[Hon. Members:

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"Frequently."] Yes, frequently--not least in the case of intensive care, which is one of the aspects on which people have focused over the past couple of weeks.

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