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Mr. Martlew indicated assent.

Mr. Barron: My hon. Friend agrees. He and I were involved in many debates on the NHS.

At a fringe meeting at the Conservative party conference, the hon. Member for Woodspring said:

When the Labour Government came to office in 1997, they had to put right many wrongs; for example, the case of my constituents who had been robbed by going into private pension schemes. The Government had to set up schemes so that people could get back the money that had been taken off them by private pension plans. After the Conservatives were defeated in 1997, I thought that they would have learned something, but they have learned nothing from the way they ran the Government--getting citizens into a mess.

In relation to the announcement that was made just before Christmas, my own health authority--the Rotherham health authority--received an increase of 7.28 per cent. That is a real-terms increase of 4.6 per cent. It is the best increase for many years--since long before May 1997. That real increase will do something about the real problems in our area.

During the past few weeks, we have seen vested interests at play in the NHS and in politics. We know that the Opposition have a vested interest; in theory, it is to oppose. They claim that the NHS is not just in acute crisis, but that it has been brought to its knees. I do not believe that, nor does anyone working in the NHS.

Since 1997, the Government have been changing the way money is spent in the NHS. They have built up public health services and supported primary care groups. They have spent money on services that were formerly poor relations in the NHS. They have deliberately done all that to try to improve public health so that we can hope that, in 10, 20 or 30 years' time, there is not the need for an acute sector of the size it is today.

Our debates on the national health service always concentrate on hospitals and repairing people who have been damaged or who have become the victims of circumstances, but they are not sensible debates about promoting public health. The Government have rightly targeted the biggest killers, such as cancer and

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heart disease. They have spent money on those diseases, but they have been criticised for doing so. I think that such criticism is wrong.

The Government have reduced waiting lists. I do not care what anyone says about that. Waiting lists peaked in April 1998 and they have fallen by 18 per cent. since then. Hon. Members can come to the Chamber to say how long X and Y have waited, but they should talk to the people who are waiting for less time now than they were in April 1998. They will say that the Government are doing the right thing.

Mr. Graham Brady (Altrincham and Sale, West): Will the hon. Gentleman give way?

Mr. Barron: I might give way in a minute.

The Government are improving joint action between local health authorities and local authorities to improve care for people in the community with disabilities and to improve mental health care. We have waited years for such an agenda and for joint co-operation. Money has gone into that as well as into the modernisation of the national health service.

Since 1948, the health service has been riven by an internal debate between hospitals and general practitioners and between the acute sector and primary care. The Government are taking those issues on. Such action is perceived to hurt some people and especially those who work in the acute sector. They do not like what is happening. Their empires are being realigned, but the Government are absolutely right to realign them and I will defend them when they do. When we hear from the vested interests and organisations involved in hospital care, we must always remember that the Government's aim is to improve public health and the health of the nation.

The Government are modernising the national health service. None of the new money--as much as it is--that is going into health authorities such as my own is being given to them so that they can continue to spend in the way they did in the past. Packages tell them that they must spend differently. The Government are also making the health service more modern by improving information technology and using such wonderful technology for the general good.

The Government are improving clinical practice. They are not just putting money into the national health service, but are making sure that it is spent properly. Let us forget about the cost of the private sector; let us instead examine the reference costs on which the Government reported a few weeks ago. They considered the actual costs of certain procedures in the health service and clinical outcomes, so that, after 50 years of its existence, we can begin to have an idea of what goes on in the NHS.

A press release in the Library provides three examples of reference costs. It shows how we should be able to ensure better care and get the most effective use of resources. I have suffered from lower back pain over the years, and the press release shows that one course of treatment for that can cost £638 in some hospitals, but that the costs rise elsewhere to £1,578. We ought to know why.

Day care for rheumatoid arthritis can cost £183 in some hospitals but £370 in others. The national health service should provide that service, but there should not be such a difference in costs. The costs of bronchial pneumonia

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emergency admissions range from the lowest figure of £828 up to the highest, £1,617. Wherever it comes from, that is taxpayers' money that is spent on health care, but there are great cost discrepancies in the national health service. The Government are absolutely right to look into such matters, which concern people who work in the health service because such examination requires them to consider their costs, their use of resources and their clinical effectiveness. Numerous measures are being taken to improve clinical effectiveness.

I know from my experience in this House that any Member can go to the Library and read reports from the National Audit Office and the Public Accounts Commission about expenditure in our health service and many other areas of public life. Those reports reveal extraordinary divergences of cost and expenditure.

I remember a report about procurement in the NHS, which was published about four years ago. I have it in my office. It told how a hospital, which was not identified, bought a syringe drive for £800 from a manufacturer in October of the year concerned. The following March--in the same financial year--another department in the same hospital bought a syringe drive from the same supplier for £1,036. That department was trying to get rid of its annual budget by the end of March because in April it was to get another departmental budget. The report showed that procurement practices in the NHS are costing us tens of millions of pounds per annum.

I am all in favour of the Government putting new money into the NHS, and I am pleased that my health authority has received a big increase of 4.66 per cent. in real terms for the next financial year. However, I am also concerned to ensure that the health service is spending money properly in the most cost-effective and clinically effective way. I am unconvinced that it is doing so.

I turn now to a vested interest. The Secretary of State quoted a letter that was sent to The Times but which was not published today. In that letter, clinicians were saying that the situation was not as bad as it was being painted in the media. I do not think that the situation is that bad; nor do most people who know the national health service.

A front page article in The Times today contains a quote that I assume is connected with the increase that nurses have received this year. As the hon. Member for North Devon (Mr. Harvey) said, nurses received a big increase this year and last year, which is aimed to sustain nurses and to get more of them back into the NHS. We should all be pleased about that increase. The quote in The Times is from Dr. Ian Bogle, the chairman of the British Medical Association, who said:

When I read that, it took me back to the years before I came to this House--the '70s--when the then Labour Government were giving flat-rate increases to people who were poorly off because they wanted to try to make work pay for them. At that time others asked, "What about our differentials?" I hope that I have not misquoted Dr. Bogle or the BMA, but if that is their line, we have returned to the argument about differentials.

We should all--doctors and nurses included--be concerned about having a health service that provides for this nation. We should forget about vested interests in society, and some of the vested interests in the NHS ought to be removed. We ought to be improving clinical effectiveness and spending resources better.

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Conservative Members sit there smiling because they have been in government and they refused to start the modernisation that this Government have introduced. This Government certainly have my support.

5.48 pm

Mr. Kenneth Clarke (Rushcliffe): This is the third time in less than 12 months that I have taken part in a health service debate. I therefore hope to make it my shortest speech because I want to hear the remarks of many of the other hon. Members who wish to take part in this short debate.

Looking back on what I said before, I find that I warned about the impending sense of crisis in the national health service. I said that unless the Government shook themselves out of their complacency, they would take us into a series of winter crises like those that we have seen before. It gives me no pleasure to say that that is exactly what has happened because the response on previous occasions has been a combination of complacency and slogans--until the Secretary of State now finds himself in a serious position.

It is certainly true, as the hon. Member for Wakefield (Mr. Hinchliffe) said, that we have experienced winter crises before. That is all the more reason for predicting them when we realise that things are going wrong. It was no remarkable insight on my part or that of the other hon. Members who spoke in those earlier debates to talk of an impending crisis. Any Member of Parliament who kept in touch with the NHS would have received repeated warnings about the mounting problems, mainly financial, in health authority after health authority.

Long before this winter began, every Member of Parliament was receiving an increased burden of correspondence from people complaining about the steadily deteriorating service that they were receiving. The Government's response was a party political debate. There was almost a complete absence of constructive long-term policy to address the problem. I am not sure that they are accepting even now that they have had a bad winter, after a predictable increase in flu cases hit a vulnerable system. Having listened to them, I think that they have returned with more complacency and slogans for the future.

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