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Mr. Giles Radice (North Durham): You did the same when you were in office.
Dr. Fox: As I have already shown, the previous survey carried out in 1995-96 demonstrated that that was not true. There is a culture of rottenness, corruptness and cronyism that pervades this Administration, which has never pervaded any previous British Administration. They attempt to manipulate and control at every level of public life, whether it be the law, the media, through Parliament or the quangos. The Government are obsessed with control and getting their people in place, irrespective of whether they are the best people or not.
Mr. Radice: Will the hon. Gentleman give way?
Dr. Fox: No, indeed not. The right hon. Gentleman made as good an intervention as he will, from a sedentary position.
The Prime Minister's statement this afternoon was trailed as very important. I have never heard a Prime Minister address the House with such a bunch of meaningless waffle as I heard this afternoon. It was a platitude from start to finish. He spoke of a partnership challenge, meaning why do not we all just work together? That is truly remarkable. He mentioned a performance challenge, suggesting that we should all do our best--as though those who work in the NHS would do anything else.
The Prime Minister spoke of a challenge for the professions, and called on staff to be flexible. What does he think they are being, in the face of the Government's hostility? He proposed a challenge on prevention and suggested that people should have a healthy life style--what a revolutionary thought. My right hon. Friend the Member for South-West Surrey (Mrs. Bottomley) espoused that some years ago, when we published "The Health of the Nation".
It was sheer gall for the Prime Minister to tell the House about a patient care challenge to treat the sickest patients quickly, when for three years the Government have presided over a waiting list initiative which every health care professional in the country says has distorted clinical priorities, to the extent that some of the sickest patients are waiting far longer than they need because health managers are being penalised financially if they do not meet their waiting list targets.
That was brass neck, even for the Prime Minister. What a cheek, when we hear that cardiology patients in Bristol have died on the waiting list. The Paymaster General, who used to make so much noise in opposition, was silent when patients in Bristol were dying, and when patients have been paying to get more treatment.
A gentleman who came to my constituency surgery last week had been clinically advised that if he did not have a coronary bypass operation within six weeks, his condition would become life-threatening, but he could not have the operation done in the NHS within a year. At the same time, we are still undertaking more minor procedures, resulting in a distortion of clinical priorities. What the Prime Minister said today is diametrically opposed to the effects of his own policy of the waiting list initiative, which needs to be ditched. If it were not for the Prime Minister's arrogance and his point-blank refusal to believe that he could ever be wrong, even in the face of advice from every part of the medical and nursing professions, people would not have died unnecessarily.
Mr. Nigel Beard (Bexleyheath and Crayford):
Does not the hon. Gentleman recognise that at the heart of the Prime Minister's statement was the concept of medical audit, which is an attempt to overcome the gross disparities in treatment and cost in different regions, which have grown up over many years? Why, over so many years, did the previous Administration, whom the hon. Gentleman supported, tolerate such gross disparities?
Dr. Fox:
The figures showing what was happening within the NHS were not always available. It was only the development of the internal market that showed up exactly what was happening, yet the Prime Minister now wants to abolish the source of the information about which he spoke today. The problem with the Prime Minister's statement, as with so many of his statements, is that his words are not the same as his or the Government's deeds. In this case, they are diametrically opposed. The British people will rightly judge the Prime Minister, who has now put himself at the centre of the Government's health policy, not by the words that he uses in the Chamber but by his actions and the effects that they have on patient care. He will be judged not by what he says at Prime Minister's Question Time, nor by his photo-opportunities or by his soundbites, but on whether
Mr. Ivan Lewis:
Will the hon. Gentleman give way?
Dr. Fox:
No, I have already given way quite a lot.
There are several matters which any party in government has to bear in mind when considering budget allocation for the NHS, the most immediate of which are cost pressures, historic deficits and demand pressures. Let me outline for the Secretary of State one of the cost pressures.
The Government said that they wanted to attract another 10,000 nurses. What economic model has been used to decide what level of pay would be required to bring 10,000 extra nurses back into the system, and what would be the resulting additional cost for the nurses that we already employ? That cost pressure would be inevitable, given what the Chancellor said yesterday.
The NHS has large and growing historic deficits, so whenever new money is allocated, the first call on that is for the deficit that health authorities have built up, which may be as much as £1 billion. I notice that the Prime Minister did not deny that figure when it was put to him by my right hon. Friend the Leader of the Opposition.
In addition, there are the demand pressures of new pharmaceuticals and new treatments. We are moving towards gene therapy and stem cell transfer--new technologies in medicine which will be extremely expensive. We shall have demand pressures to an extent that we have never known before. All that needs to be considered when planning ahead. I hope that the Secretary of State will say something about that because it is a matter of real concern to health professionals.
It was disappointing to hear nothing in the Budget about long-term care and its funding. We have now been waiting 14 months for an adequate response to the royal commission. I imagine that the excuse is that there cannot be an announcement because we are waiting for the results of the comprehensive spending review, yet the Chancellor did not feel compelled to stick to that when announcing the spending totals for the NHS. As with anything else, if it suits the Government, they will break the rules, but if it does not, they will keep quiet. Each year, under this Government, 40,000 people lose their homes, yet when the Government took office they promised a quick solution to the problem of long-term care. The phrase "quick solution" is used in much the same way as the phrase "dealing with the early pledge", which means roughly the same in their language as "more" or "extra" in relation to the truth. I hope that we might hear something about that when the Secretary of State replies.
The Secretary of State for Health (Mr. Alan Milburn):
Yesterday, my right hon. Friend the Chancellor of the Exchequer delivered a Budget for a stronger and fairer Britain; a Budget that continues to build steady economic growth, that will modernise our schools, transform our hospitals and support families and communities throughout the country. He announced the right measures at the right time to do what is right for Britain.
The Budget has been widely welcomed in the country. It was welcomed by the Institute of Directors as
confirmation of the Government's belief in creating an enterprise economy.
It was welcomed by the Trades Union Congress as
a generous and much needed boost,
and by the British Medical Association as a
major step in putting the health service on a firm, long term basis.
I have seen probably eight or nine Budgets in my time in this House; other hon. Friends will have witnessed many more. However, I have never before seen Opposition Members looking so mute and so glum during a Chancellor's statement. Nothing expresses more clearly the distance between today's Conservative party and the public than their respective reactions to the Budget. While nurses and teachers were described as being over the moon, the Leader of the Opposition--with his new, trendy, David Beckham haircut--looked as sick as a parrot. As well he might.
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