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Mr. Swayne: Will the hon. Gentleman give way?
Mr. Swayne: Surely the hon. Gentleman recognises that the easiest way to achieve a proportion of GDP as a
target would be to engineer an economic downturn. That would secure it quicker than any other method. Does the hon. Gentleman recognise that at the current growth rate of 5 per cent. per year, as claimed, it will take us 19 years to reach the level of funding enjoyed by France, and 25 years to reach that enjoyed by Germany?
Mr. Hesford: I wish that I had not given way, but I am generous to a fault.
The other matter that the Tories would not discuss today was their approach to health insurance. It seems surprising in a debate on financial provision that they should say nothing about that. I call it their "one club" approach, and I suspect that they have begun to realise that they have been beating themselves over the head with it. Whether they have abandoned the club, I do not know. If they finally put away the nonsense about privatisation and health insurance, I would be the first to welcome their conversion. I suspect, however, that that is not the case. They privately harbour that wish, but have not had the courtesy or decency to mention it in the debate.
I listened to the hon. Member for Woodspring (Dr. Fox) address a conference of general practitioners in Bristol. He was asked how far we could push the burden, and who would pay for the expansion of private health insurance. He said two strange things, which may explain why he will not talk now about this aspect. He was asked whether, if he were Secretary of State and he thought that people should take out private health insurance, he would he give all members of public sector services private health insurance. He burst out laughing and said no, he would not. Why would he not give that commitment if it is such a sensible way forward? The answer is cost.
More telling was the hon. Gentleman's remark that the burden should be put on to private business. That answer went against his own logic. Pressed on how far that could be taken, he said, "But not too much." He recognised the flaw in the argument--that lumping private health insurance on to private business would burden it with a cost that it does not now face. The Tories are seeking to impose burdens on the private sector business community. The hon. Gentleman had to say, in a lighthearted way, that the burden should not be put on too many companies. What does that mean? Who will pick up that bill? It is a chaotic approach.
Bearing in mind that the hon. Gentleman was addressing an audience of GPs, it is not surprising that he was asked from the floor, "If you want to bring private sector money into the health service, where does that leave us?" The hon. Gentleman said something like, "It's not for you; it would be too much trouble to introduce those arrangements for GPs." So GPs, who make up 90 per cent. or so of the health service in terms of seeing patients, would not be included in those insurance provisions.
When the right hon. Member for Maidstone and The Weald (Miss Widdecombe) spoke for the Opposition on health, she said:
Dr. Fox:
I will put the hon. Gentleman out of his misery for a moment while he gathers his thoughts. It is
Mr. Hesford:
I am amazed by that intervention, which brings me to my next point.
Rather curiously, the hon. Gentleman also said at that meeting--and I have seen it reported elsewhere on a number of occasions--that the insurance sector, on his own estimation, is not up to the job. It is diabolical at the moment; it does not serve the public. When will it start serving the public? When will this be a credible policy? As the Prime Minister has said in Question Time, it is a Trojan horse. It is, as my hon. Friend the Member for Wakefield said, privatisation by any other name.
To paraphrase a former Member of this House, I say this to members of the public who take note of these debates, "Under the hon. Gentleman's regime, don't become elderly, don't need a hip operation, don't need a knee operation, don't need a hernia operation, don't need a cataract operation. If you do, they will make you pay for it, and if you can't afford it, you won't get it."
I want to discuss what is happening in my constituency. I cannot believe that Wirral is unique in this regard. It was interesting that in his opening remarks, the hon. Gentleman refused to go into detail or give any examples--I wonder why, considering that this is an Opposition debate. It may have been because of a lack of clear examples. I contacted the chief executives of my community trust, the health authority and the acute trust. I read them the title of the debate and asked them to comment on it in the light of their experience in Wirral.
The chief executive of the community trust said that he is satisfied with the current year's financial position. He went on to say that the trust has benefited considerably from the modernisation agenda, and gave the example of NHS Direct. I welcome the introduction of that in the Wirral.
The chief executive of the health authority said that there are sufficient resources to address the current programme and there is no evidence on the Wirral of a skewing of clinical priorities. He knows of no local consultants who are saying that such a distortion is happening. On the Wirral, local consultants with waiting lists and other priorities to take into account have been able to show sensitivity and flexibility and deal with each priority to the satisfaction of all concerned. The chief executive described that to me as a clinically sound case mix. Skewing clinical priorities is not an inherent part of the waiting list initiative, as is claimed by Conservative Members.
The chief executive of the acute trust, who is, perhaps, put on the spot more than anybody by the waiting list initiative, said that he has not been under any financial pressure at all in the current financial year, and in terms of capital investment this is the best year that the trust has had since its inception in 1991.
Mr. Hayes:
As the hon. Gentleman is fond of quoting health professionals and their confidence in the Government's ability to deliver, will he reflect on the British Medical Association's view? It has written to the
Mr. Hesford:
If I may, I will leave that to the parties concerned.
I endorse the Secretary of State's remark in a recent speech in Birmingham:
Mr. Deputy Speaker:
I call the hon. Gentleman.
Mr. Desmond Swayne (New Forest, West):
The greatest potential distortion of clinical priorities--[Interruption.]
Mr. Deputy Speaker:
Order. Perhaps I might just say to hon. Members that it is as well to pay attention to the debate. If no one had risen on the Opposition Benches, an hon. Member on the Government Benches could have been called. I hope that hon. Members will concentrate and not spend too much time gossiping.
Mr. Swayne:
I hope that your stricture was not aimed at me, Mr. Deputy Speaker, for I am bereft of anyone with whom to gossip.
It strikes me that the greatest potential for distortion of clinical priorities lies with the very mechanism that the Secretary of State has set up to do away with those distortions: the National Institute for Clinical Excellence. When the Health Act 1999 went through the House, we were assured that the institute's terms of reference would be merely clinical efficiency and effectiveness and cost-effectiveness. In Committee Room 16 last July, the Minister introduced a change to those terms of reference, under which the institute had to consider also the overall affordability to the health service of any decision that it made. In other words, the Secretary of State would be able to hide behind the implications of any decision by NICE.
I welcomed the Secretary of State's answer to my hon. Friend the Member for Woodspring (Dr. Fox), when he said, "No, I will make decisions on funding and on whether to make provision for certain treatments." The exchange was about beta interferon, which is appropriate given the lobby today. I am glad to hear that the Secretary of State will make those decisions, but it strikes me as rather odd that he introduced the change last July.
It is, of course, appropriate that the question of whether a treatment should be available is one of overall funding to the health service. We have flogged the question of funding this evening, but it is only the Government who are to blame for the general lack of confidence in their figures. The fact that they claim to have provided an additional £21 billion for the health service in this Parliament was interestingly questioned by Mr. Kellner's article in the Evening Standard on 14 January. He said
that there had been a process of triple accounting, and the actual figure was nearer £5 billion. The fact that the Government's figures should be questioned in that way is a consequence of their own systematic spinning.
I think if someone wants to pay to see their GP, they should be encouraged to do so . . . The problem with the NHS is that we do not charge for much of what we do."
Which is it? Do the Tories really have no intention of funding visits to the GP by imposing charges?
There is no funding system or health care system that is fairer or more efficient than the NHS.
Mr. Deputy Speaker:
I call the hon. Lady--
6.22 pm
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