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Mr. William Hague (Richmond, Yorks): The media informed us throughout the day that we would hear the Prime Minister's plan for the reform and modernisation of the health service. There was obviously some mistake in their briefing. If all the cliches and waffle that one could express about the health service had been swept into a heap, the result would be remarkably similar to the Prime Minister's statement.
The statement included such concepts as, "We must now all work together"--brilliant idea! The Prime Minister said that we must all match the standard of the best--what a very innovative thought! He suggested that together, we need to find the answers--absolutely inspirational! There will be a new Cabinet committee chaired by the Prime Minister. Wow! A new Cabinet committee! By July, there will even be a timetable for delivery. We believed that 1999 would be the year of delivery, but there will be a timetable for delivery by the middle of 2000. Today, the Prime Minister produced a timetable for a timetable.
To avoid further distortion by the Prime Minister, I make it clear from the outset that we welcome the additional funding for the national health service. We have always provided additional funding for the health service. However, the fact that the Prime Minister has made his first statement in three years about a matter of domestic policy is a clear demonstration of the Government's abject failure. The need to relaunch their policies on the health service clearly shows that they have failed so far.
After three years of mismanaging the health service, the Prime Minister has the nerve to make a statement about professional failures. What about ministerial failures in running the health service in the past three years? Through his statement, the Prime Minister has taken personal responsibility for the health service, from the Secretary of State for Health. We shall now hold him personally responsible.
Does the Prime Minister now accept that the problems of the NHS have become worse since the Government took office? Is it not the case that the out-patient waiting
list has doubled, with 250,000 more people waiting to get on the waiting list? Has the right hon. Gentleman forgotten that his promise to take 100,000 people off the waiting list was an early pledge? When he said that, people thought that he meant early in the Parliament, not early in the next millennium.
Now the Prime Minister is launching yet another new initiative, setting out on yet another crusade to save the health service. People remember the Chancellor's £21 billion announcement of two years ago, which turned out to be £3 billion a year, and that the promised improvements did not take place. The right hon. Gentleman may have fiddled the figures before, but now people have figured the fiddles: they know what the Government are up to and they know that the Government have let people down. Will he accept that one reason for the letdown, which must be seriously considered in all those discussions that he is to have, is the way that clinical priorities have been distorted? Will he recognise that that has happened?
The chairman of the British Medical Association consultants committee, Dr. Peter Hawker, says that the Government have tested
Is it not the Government's failure that whether people have money has become more important to their health care under Labour's management of the health system than ever before in the history of the health service? Is that not the classic story of what happens when the system is run by ill-informed and interfering busybodies whose only interest is in newspaper headlines and who produce the exact opposite effect of that which they intend? Can we have a guarantee in the Prime Minister's new, relaunched plan for the NHS to end the distortion of clinical priorities and a guarantee based on waiting times and clinical need? Why does he not set aside all the pride of the past few years and support a guarantee on that along the lines of the patients guarantee put forward by my hon. Friend the Member for Woodspring (Dr. Fox)? Can he not see that there is no point announcing money--[Interruption.] Well, the right hon. Gentleman will find that these points come up from the health professionals, so he had better start listening to them.
Can the Prime Minister not see that there is no point announcing money for the NHS unless we make sure that it gets to the patient being treated? This time, will he get the money into the hands of people who know what to do? The Government's record has not been encouraging; it has been a story of centralisation, with decisions taken further and further away from patients. What is more, have not the people whom he has trusted to take decisions
been appointed not on the basis of what they know about the NHS, but on how much crawling and toadying they have done to the Labour party leadership?
Has the Prime Minister read the report of the Commissioner for Public Appointments, who says:
Is not that culture also one of the distortion of numbers? Does the Prime Minister realise that no one any longer believes the figures that he presents about the health service? When people hear about the £2 billion, they know that there are already £1 billion-worth of deficits in the health authorities and £200 million of underfunded pay awards. People wonder what will happen with the £2 billion. Unless the Prime Minister can give positive answers to my hon. Friends' questions about health facilities that are closing now, and whether that will change under his plan, the figures that he is reciting will not be believed in the country at large.
Now that the right hon. Gentleman has finally recognised that he is presiding over a permanent crisis in the health service, is it not time to put in place a proper programme of reform? Is it not time that we had health care based on clinical need? It is not time that we had money going as close as possible to the patient? Is it not time that the Prime Minister co-operated with all parts of the health care sector--the NHS and the private sector--in increasing the total resources available for health care? Is it not time that he got rid of his ideological blinkers, his crony appointments and his failed approach based on political priorities?
Is it not true that this statement, which contained so many cliches and so little in actual announcements, is the ultimate demonstration of all mouth and no delivery? Is it not time that the right hon. Gentleman started to deliver?
The Prime Minister:
If anyone wants to know why the Tories should not be trusted with the national health service, they need only listen to that contribution from the right hon. Member for Richmond, Yorks (Mr. Hague). The Tories opposed the formation of the health service, and now they oppose the plan to modernise and reform it. It is unbelievable. [Hon. Members: "What plan?] What we have set out has been welcomed by every group in the national health service, but it is opposed by the Conservative party. As for the health record, we are putting in a 6 per cent. real-terms increase, which is double what the Conservative party put in. The right hon. Gentleman's priorities, which include tax cuts for a few, would mean that the Tories could not possibly afford that sum of money.
We know already that the right hon. Gentleman is opposed to the tobacco duty increase. [Hon. Members: "Oh."] That is right. [Interruption.] So that would be
£300 million out of the £2 billion straight away. [Interruption.] Well, the right hon. Gentleman attacked the increase in tobacco duty yesterday, presumably not because he supported it. Let me state the position that we inherited. The number of beds had been cut by 40,000; the number of nurses in training had been cut; the hospital building programme had stalled; waiting lists for in and out-patients were at record levels, and there was a £500 million deficit.
If hon. Members want to know how good the right hon. Gentleman would be at managing the health service, let me point out his record when he was in charge of the Welsh national health service. When he was in charge of the health service in Wales, it lost doctors; it lost 1,200 hospital beds; waiting lists rose by 6,000; 300 nurses, midwives and health visitors were cut; and health spending increases were just a little over 1 per cent. So we know what would happen if the Tories were put back in charge.
The right hon. Gentleman goes on about private health care. We are perfectly happy to co-operate with the private sector, but we oppose forcing people to take out private health insurance. In case the right hon. Gentleman should deny that that is his party's policy--as Tories try to do occasionally--I shall quote his health spokesman. When he explained Conservative party policy, he said that
the tolerance of patients who are waiting even longer for treatment, and the goodwill of Health Service staff by persisting with an initiative that distorts clinical priorities and denies care to people in more acute medical need.
That is what the BMA consultants think, so if the Prime Minister is to go around listening to people, that is the sort of thing that he will hear. He had better start thinking about it now. His Secretary of State claims that there is no distortion. Why does he not tell the Secretary of State to wake up, get into the real world and acknowledge that there is distortion? He has to deal with that soon, because is it not the result of such distortion that 160,000 people felt compelled in the past year to pay for their own operations rather than rely on the NHS? That is the situation--the situation that the right hon. Gentleman has created.
It is clear that there have been instances where a person's political association has been a decisive factor in the consideration of their . . . appointments . . .
There is evidence to indicate that candidates who declare political activity on behalf of the Labour party have a better chance of being appointed than other candidates. That is the evidence to which the right hon. Gentleman did not respond at Question Time. Can he not see that there is no point in his wringing his hands and gnashing his teeth about people in the health service when he has produced a system of appointments debased, corrupted and contorted by the crony culture that he has built all around him?
Less successful candidates have been brought forward to replace those . . . identified on merit . . . ?
people would look to the NHS to provide them with service when they had serious life-threatening conditions, and would look to their private insurance to help them with those things where the NHS had to ask them to wait.
That is why the right hon. Gentleman's health spokesman called the policy a "Trojan horse". It is a Trojan horse.
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