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The Prime Minister: I shall certainly do that. One of the important parts of this exercise will be to make sure that we have the right level of care within the system: the right primary, intermediate and acute care. Part of the changes that are necessary will be to ensure that patients are treated at the appropriate level of care, in contrast with what often happens at the moment.

Rev. Martin Smyth (Belfast, South): I noticed that in his statement, the Prime Minister made no mention of mental health services, although that might be a Freudian slip. Nor did he mention the national health service in Northern Ireland. I assure the right hon. Gentleman that we welcome the increased financial provision; on the other hand, we have to face harsh realities. In respect of private care and clinical priorities, why should a person with a heart condition be told that if he paid £100 he could see the surgeon sooner, then pay that £100 and still be waiting more than nine months later for the urgent treatment that he requires? It is time that we stopped bluffing ourselves that clinical care is a priority.

The Prime Minister: I do not know about the individual case to which the hon. Gentleman refers, but precisely such issues need to be investigated. Change and reform as well as additional resources for the health service in Northern Ireland will be major part of our work.

Mr. David Taylor (North-West Leicestershire): Following the completely crass and deeply damaging

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decision by Leicestershire health authority, the status of the most modern, best-located acute hospital in Leicestershire, with the highest reputation, is due to be downgraded. Can my right hon. Friend confirm that before the extra £30 million is allocated to Leicestershire and its health authority, there will be a requirement that such decisions and plans about acute hospital provision will have to include a logical and sane approach to the allocation of resources.

The Prime Minister: Again, I am in difficulty in commenting on individual cases, the circumstances of which I do not know. Of course there will be additional money for the health authorities, but they will then have to look at their own priorities and judge them accordingly. It is important that we do not try to micro-manage every decision that is taken by health authorities around the country, but obviously additional resources will help to make their decision making more open.

Mr. Graham Brady (Altrincham and Sale, West): In a damning report published this morning, Dame Rennie Fritchie spoke of a disconnection between the purpose of the board of an NHS trust or health authority and the ability of the people serving on it under Labour's policy of systematic politicisation of the appointments process. Given that she has pointed to examples of people appointed to NHS trusts and health authorities other than on merit, will the Prime Minister now identify those who have been appointed ahead of more able candidates and ensure that more able people are put in their places so that there can be progress in the NHS instead of the failure that has occurred under the present Government?

The Prime Minister: I shall simply refer to the following sentence of the Fritchie report:

Mr. Dale Campbell-Savours (Workington): May I express the hope that the very rigid criteria that are used in allocating money for in vitro fertilisation--criteria that vary across the United Kingdom--can now be relaxed as I have a particularly difficult case in my constituency?

The Prime Minister: I think the best thing is that I look into my hon. Friend's point and write to him.

Dr. Evan Harris (Oxford, West and Abingdon): Does the Prime Minister accept that after 18 years of dreadful NHS Tory rule, he inherited in Oxfordshire operation waiting times that were too high and have got higher; out-patient waiting times that were too high and have got higher; and a mental health trust deficit that has got worse? He also inherited Oseney Court elderly persons' home, which has now closed under new Labour and Cutteslowe Court old people's home which has been closed for financial reasons. Eighteen beds at Abingdon community hospital have now been closed under Labour. Will any of those closure be reversed? Will he apologise to the people of Oxfordshire for the delay in bringing funding to the health service? What does he have to say to Dr. Bob Hoyle, formally a Labour councillor in the heartland ward of Temple Cowley in the constituency of the Chief Secretary to the Treasury, who joined the

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Liberal Democrats today in protest at Labour's decision to put pre-election tax bribes ahead of health service funding.

The Prime Minister: We have made the largest-ever investment in the health service, and it is being introduced now. This is the right time for that investment, because the Government had to cure the financial deficit that we inherited when we took office. We have done that, and we have gone through two tough and prudent years, as we promised at the last election. We did not break an election promise when we kept to very tight spending plans, we fulfilled one. We knew that we could not inherit a £28-billion borrowing requirement and do nothing about it.

The hon. Member for Oxford, West and Abingdon (Dr. Harris) did not give the full facts about what has happened in Oxfordshire. In fact, more money has been put in than the Liberal Democrats ever asked for, and in-patient waiting lists are down. It is correct to say that out-patient lists are longer, but that is why we must make sure that we put in the necessary investment, which must go along with change and modernisation. In that way, we shall get both in-patient and out-patient waiting lists down. It is also why we must make the extra investment to pay for nurses, doctors and specialists in the service.

However, the process is not helped when Liberal Democrat Members pretend that all the problems of all those public services can be solved overnight, and that there is a limitless amount of money that can be spent. That contention is not true, and it is not responsible. The Government have been determined to avoid boom and bust in the economy, and in the investment in public services. We have been able to put in sustainable investment only because we took the right decisions on the economy. In the end, that is better for the health service and for patients.

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Points of Order

4.21 pm

Mr. Graham Brady (Altrincham and Sale, West): On a point of order, Madam Speaker. My point of order concerns a matter of which I gave you notice. The independent commissioner's report on NHS appointments was released at 10 o'clock this morning, but it was not made available in the Library of the House and in the Vote Office until 3 o'clock this afternoon, after most hon. Members had entered the Chamber for Prime Minister's questions. Was it not essential that hon. Members of all parties should have had access to the report and been able to read it so that they understood what it contained before the statement on the NHS? If the Prime Minister had had a chance to read it, he would not have given the misleading response that he gave to me.

Madam Speaker: I think that it was a discourtesy to the House that the report was not available, but I am sure that the hon. Gentleman appreciates that distribution of the report was not the responsibility of the Government, as the commission is an independent tribunal. While I have been in the Chair, I have received a letter from Dame Rennie Fritchie, in which she states:

I think that that clears the matter up.

Mr. Michael Jabez Foster (Hastings and Rye): On a point of order, Madam Speaker. My constituency of Hastings and Rye has been popular with visitors since 1066. Indeed you, Madam Speaker, came to my constituency a week or so ago. You were courteous enough to tell me about that visit, which did us all a great honour. Over the past few months, four Conservative Front-Bench spokespersons have visited my constituency, but none has given me any prior warning. One of the hon. Members involved told me about the visit after it had happened, and two others apologised when I brought the problem to their attention. I shall not mention their names, but last Wednesday, yet another Conservative Front- Bench spokesman, the hon. Member for North-East Cambridgeshire (Mr. Moss)--

Madam Speaker: Order. I think that I have got the hon. Gentleman's point. These are matters that must be resolved between the hon. Members involved. I always take the opportunity to write to hon. Members when I visit their constituencies. Rye is a wonderful place, and I hope to return to it. In the letter that I sent to the hon. Gentleman, I also said that he should not raise matters such as these on the Floor of the House, but should deal directly with those hon. Members who visited his constituency without letting him know.

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