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Mr. David Taylor: That £2 billion represents about £3 million per average parliamentary constituency, and represents about £10,000 per day. It is not as if the money must be spent on the first day, the first week or the first month. The hon. Gentleman is exaggerating the difficulties that any health authority or trust will have in dealing with the money.
Mr. Burstow: Try telling that to the 512,000 people who are currently on waiting lists to see a consultant
before they even get treated. Try telling that to the people who have had their operations cancelled in the last year. Try telling that to my health authority, which has been told that, on the current allocation, it will be £4 million short if it honours the Government's commitment--made on its behalf--to fully fund the nursing and doctors' pay awards. That is why a system where the Chancellor announces at the Dispatch Box ten days before a financial year begins that, suddenly, there is an extra £2 billion to be made available is not a sensible way of spending public money.
Mr. Philip Hammond (Runnymede and Weybridge): Does the hon. Gentleman agree that the real test of the usefulness of this additional money will be whether it is to be passported through to health authorities and trusts, so that people at the sharp end can spend that money to deliver better health care, or whether it will be held back by the Government to use for its pet projects?
Mr. Burstow: We await with bated breath what the Prime Minister has to say to the House tomorrow. There must be a real fear that there may be a similar approach in education, where the standards fund is used as a way of following Ministers' pet projects, rather than meeting local priorities. We will judge on what the Government say and what they then do in practice.
Mr. Alan W. Williams: I find the hon. Gentleman's comments on pensions and health extraordinarily grudging. We are talking about £2 billion on a budget of £40 billion. There is an extra 4 per cent., when the Budget this year is 5 per cent. up in real terms on last year. Cannot the hon. Gentleman find it in the bottom of his heart to give the Labour Government credit for doing something right?
Mr. Burstow: If I sound grudging--Labour Members think that I do--it is because many of my constituents feel grudging. They have suffered over the last two years from an underfunded NHS and a Government who over-hyped and over-promised in opposition and have subsequently failed to deliver. The announcement today is about trying to put right the fact that the promises were unfunded. To the extent that the announcement puts in place the necessary funding to deliver these proposals, of course I welcome it. However, that is as far as I go in welcoming this sum today.
The crucial question--as the hon. Member for Runnymede and Weybridge (Mr. Hammond) said--is how the money will be spent. It must be invested in building up the capacity of the NHS. That means, as the Government have rightly acknowledged, more nurses and doctors. We must make it worth while for some of the 70,000 nurses who are currently outside the health service to come back into it, to start to fill some of the 15,000 nursing vacancies.
There is a need to invest in physiotherapy and occupational therapists. If all the money goes to the acute sector, it will not meet people's real needs. We need investment in recuperative and rehabilitation services so that we will have easier discharging from hospitals and reduced emergency re-admissions to hospitals, which all too often is one of the biggest problems. We need to look at ways to ensure that we help older people to continue
living in their own homes, rather than being prematurely consigned to care homes, as is all too often a byproduct of our current health care arrangements.
On the funding of long-term care, the Government's silence--which continued today--is deafening. A royal commission was established in December 1997 and it reported, as it was requested to do, in just over a year, in February 1999. We then waited week after week, month after month, for the Government to say what it was going to do in response to its recommendations. We were told in December that we would have a debate in which the Secretary of State would outline the Government's proposals. However, we were then told in December that the Government were going to review the matter still further and that we would have a White Paper in June this year.
All this means that there will have been no legislation in this Parliament to change the legal framework under which long-term care is financed and operated. So much for the Government who promised before the general election that they would do something to prevent hundreds of thousands of people from being forced to sell their homes to pay for their care. Under this Government, 100,000 more people have been forced to sell their homes to pay for their care, because the Government have done nothing to implement the royal commission's proposals.
It is hardly surprising that we have constituents coming to our surgeries who have been confronted by local authority accountants proffering a bill to them to pay for their care. That has happened to families such my constituent's, Mr. Albert Philo. His family cannot believe that after decades of hard work and diligent taxpaying, they have to pay for nursing care. Mr. Philo has a medical condition--dementia--and his family thought that the NHS was free at the point of use on the basis of need. However, Mr. Philo's wife is being pursued for payment for his care, pushing her into debt and causing great anxiety. The Budget does nothing to sort out the chaos that is long-term care finance.
The Government have made much of their support for carers. We have had a national carers strategy, and that was welcome because it codified much good practice around the country. However, we heard nothing today about carers, and the Government have allocated a mere 15p extra a week for carers. The vast majority of carers are older people, caring for a husband, wife, parent or adult child. Because those carers are pensioners, they are not entitled to the invalid care allowance. If the Government valued older carers, they would extend ICA to all pensioner carers.
In the Budget today, the Chancellor offered pensioners an inflation increase in the basic state pension of £2--in April next year. Wow! He also offered them an extra £1 a week in their pocket through the winter allowance, and a consultation on the income tapers on the minimum income guarantee. But what does the Budget do now to make a difference to pensioners? It puts 75p in the pockets of pensioners, with possibly a little bit more through the winter allowance in due course. When pensioners come to examine the rabbit that the Chancellor has pulled out of his hat for them this year, they will find that it was not just emaciated but well and truly dead before he even drew it out of his hat.
8.42 pm
Mr. David Chaytor (Bury, North):
I am pleased to congratulate my right hon. Friend the Chancellor on his Budget speech. By contrast with the hon. Member for Sutton and Cheam (Mr. Burstow), I shall try to bring a note of enthusiasm and gratitude into the debate and not repeat the Liberal Democrat approach of occasional helpful suggestions spoiled by opportunism and grudging acceptance of what are major improvements to the public services and quality of life of people in this country.
The Budget will be warmly welcomed by my constituents in Bury, North. Whether they are pensioners, parents bringing up children, patients, doctors, nurses or ancillary staff in our hospitals or teachers in our schools, they will be pleased that the Chancellor has listened in the past few months and responded to many of their pleas. I also welcome the fact that the Budget moves our party forward in its historic commitment not just to achieving full employability but to achieving full employment.
In my constituency, the most recent recorded figure for unemployment was 2.7 per cent. Not everyone will need reminding that that figure is below the 3 per cent. recommended by Beveridge in his definition of full employment in 1945. That 2.7 per cent. represents a dramatic fall in unemployment in the past two years, including, most notably, a 70 per cent. reduction in youth unemployment.
I was astonished by the line of attack on the Budget from the official Opposition. Since I was elected a Member of Parliament three years ago, thousands of people have written to me and come to my surgery and I have had thousands of discussions in the street, at social events and on constituency visits, and no one has ever said to me, "I am really worried about the tax burden and the percentage of GDP being taken by tax."
The Conservative party has failed to move on from the election campaign that it fought in 1987, which was dominated by its obsession with tax cuts. It does not understand that people are now calling for more investment in public services, and fails to grasp that they understand that there is a price to be paid for that. My constituents tell me--I have no reason to think that they are different from people in any other part of the country--that their priority is more investment in jobs, education, the national health service, better public transport, an improved environment and a lower level of crime. The Conservative party's obsession with the tax burden does not address those issues.
In most western European democracies, tax as a proportion of gross domestic product varies only slightly. Perhaps there is a limit below which it should not fall, and that may be 35 per cent. Equally, there is a limit beyond which it should not increase, and that could be 40 per cent. Within that band, and allowing for the circumstances of different countries and different stages in the economic cycle, the tax burden as a proportion of GDP is not the main issue in the debate about tax, public services and the economy.
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