Madam Speaker: I regret to have to report to the House the death of Mr. Clifford Forsythe, Member for South Antrim. I am sure that Members on both sides of the House will join me in mourning the loss of a colleague and extending our sympathy to the hon. Gentleman's family and friends.
The Secretary of State for Health (Mr. Alan Milburn): Average waiting times for operations are now lower than when we came to office. The waiting list figures for December and January reflect the fact that, as planned, the national health service gave priority to emergency cases. Waiting lists fell again in February and we remain on track to achieve our manifesto commitment to reduce waiting lists by 100,000 from the level that we inherited.
Mr. Paterson: In February, the Secretary of State said that he would eat his hat if priorities in Shropshirewere different from those in previous winters. Dr. Ian Rummens, secretary of the local medical committee, has written to me with numerous cases, some of which show that at times no beds at all were free in Shropshire this winter, even though there was less flu than usual. Even heart attack patients were turned away. Given this, will the Secretary of State please apologise, investigate these cases and go to a public place and eat his hat in penance?
Mr. Milburn: As I said to the hon. Gentleman at the time, I do not normally wear a hat--probably just as well. As for his allegation, he is simply wrong. He knows fine well that this year, just as in previous years, the NHS did the right thing. It put emergency cases first, and if that meant cancelling elective work that was the right thing to
Fiona Mactaggart (Slough): I was pleased to welcome the Secretary of State to Wexham Park hospital in my constituency this morning. Will my right hon. Friend use this opportunity publicly to congratulate the hospital on reducing by 1,700 the number of people waiting over the past two years, and on ensuring that three quarters of patients are treated within three months? Can he keep giving that hospital the resources that will enable it to modernise and to continue its good work?
Mr. Milburn: I am very pleased to join my hon. Friend in welcoming the excellent work that is undertaken at Wexham Park hospital. I had the pleasure of visiting the hospital this morning with her and my right hon. Friend the Prime Minister. I pay tribute to the work that my hon. Friend does with the hospital and, indeed, with the local trust and the broader local health community. The hospital is achieving results on the basis of a clear foundation of partnership between clinicians and managers and on the basis of the extra resources that we are investing in the national health service. I give my hon. Friend this undertaking: we will continue to invest those resources year on year to give patients the sort of modern, dependable health care that they deserve.
Mrs. Caroline Spelman (Meriden): What does the Secretary of State have to say to the widow of Bill Fox, who died, aged only 62, following a heart attack during the period referred to in this question? Sheffield health authority told him that there was no money to find the replacement for his outdated heart valve, but failed to warn him of the risk that such a delay might cause, or to give him the possibility of going privately, which might have saved his life.
Mr. Milburn: I say to the hon. Lady and to the gentleman's family that it is precisely because of those sort of cases that we place such priority on tackling coronary heart disease and improving access to heart surgery for patients when they need it. That is why we have already invested extra money to provide more heart operations--an extra 3,000 operations over the next few years. It is why, incidentally, we have provided Sheffield health authority with cash increases of more than 8.7 per cent. in this financial year alone.
Dr. Brian Iddon (Bolton, South-East): I am pleased to tell my right hon. Friend that the ophthalmology department at the Royal Bolton hospital has become a centre of excellence. It could get its waiting list down even further and take on extra cases if it could get the theatre time. Will my right hon. Friend therefore look favourably on the bid that the trust has made for a designated theatre for eye operations?
Mr. Milburn: How could I resist? I shall look very closely at the bid that my hon. Friend's trust has submitted. It is very important to use all the capacity that is available to the NHS so that we can reduce waiting times for patients. We are getting the waiting lists down and, as we know, reducing waiting lists reduces waiting times too. In particular, we are prioritising operations that
2. Mr. Desmond Swayne (New Forest, West): What estimate he has made of the number of patients who have left NHS waiting lists as a consequence of having paid for their treatment in the private health care sector since May 1997. 
15. Mr. John Bercow (Buckingham): What proportion of the decline in NHS waiting lists he estimates is attributable to patients having secured treatment from the private health care sector since May 1997. 
The Secretary of State for Health (Mr. Alan Milburn): The decision to seek treatment as a private patient, for whatever reason, is a matter for the individual. We have no data on the number of patients who have left NHS waiting lists and chosen to seek private treatment as an alternative.
Mr. Swayne: Let me give the Secretary of State some data. My constituent, Mr. Charles Scott, who lives in Hordle, suffered from atrial fibrillation for a number of years. In despair of the waiting list, and because his attacks were becoming more frequent and debilitating, Mr. Scott sank £12,000 of his savings into having a pacemaker fitted. Since then, he has received from Customs and Excise a demand for more than £1,000 in value added tax payable on his pacemaker. That cannot be right, or is it what is meant by Labour's double whammy?
Mr. Milburn: I remind the hon. Gentleman that it is not my party's policy to force patients to leave the NHS and pay for private treatment. That is, in fact, his party's policy. If he has a concern, he should take it up with the hon. Member for Woodspring (Dr. Fox), who told his party conference last October:
Mr. Bercow: Given that Austria, Finland, France, Germany, Greece, Italy, the Netherlands, Portugal, Spain and Sweden all spend proportionately more on health than we do, and given that a larger share of their expenditure derives from the private sector--often, indeed almost
Mr. Milburn: I welcome the hon. Gentleman back from his break, which has obviously done him a power of good. There is a world of difference between the NHS paying the private sector to provide patients with care for free and the policy suggested by his party, which is that patients should be forced out of the NHS and should pay for their own care. That is precisely what the Tories advocate. The hon. Member for Woodspring advocates it, and so does the hon. Member for Buckingham(Mr. Bercow). However, he and his constituents should be aware that the operations that the Conservative Front-Bench team would take out of the NHS altogether are precisely those that involve old age--hips, knees, cataracts. Conservative policy amounts to a new tax on old age, and pensioners will reject it.
Angela Smith (Basildon): Is the Secretary of State not astounded by the Conservative party's hypocrisy on the NHS? The Conservatives claim that they want the NHS to deal with serious, life-threatening illnesses, but they would force my constituents to have private operations. It may not mean much to Conservatives if they have to pay £5,500 for a hip operation, but that is far too much for my constituents to pay.
Mr. Milburn: My hon. Friend is absolutely right. The elderly are the very people who most need health care and can least afford private health insurance, yet it is their operations that the Conservatives want to force out of the NHS. Judge the Conservatives not only on their record--cuts in bed numbers, cuts in nurse numbers, cuts in NHS funding--but on what they promise for the future. They want treatment not according to clinical need, but according to ability to pay. The Conservatives offer patients only one guarantee for the NHS--an NHS that is not modernising, but privatising.
Mr. Barry Jones (Alyn and Deeside): Can my right hon. Friend say what the Government have done so far to hurry along surgery for knee and hip operations? Can ordinary people afford large sums for private surgery on their joints? What does he hope to do to help older people who cannot afford private surgery?
Mr. Milburn: We are trying to get waiting times down for precisely that sort of operation. Indeed, as we get the lists down, so waiting times go down too. It is obviously important that people do not have to wait, sometimes in pain and discomfort, for a long period before they receive treatment.
It is self-evident that people cannot afford to pay for such operations. The average cost of a hip replacement is between £5,000 and £7,800; the average cost of a knee replacement is between £5,700 and £8,400. If the Conservatives had their way, too many people--especially pensioners--would simply be priced out of care and treatment altogether.
Mr. Milburn: It is precisely so that patients avoid the invidious choices that they are sometimes forced to make that we are trying to get down waiting times and waiting lists. We are doing that by investing more cash in the national health service and modernising the way that it works. I wish that the hon. Gentleman and his party would have the courage of their convictions. Before the Easter recess, the Opposition had the opportunity to back their apparent commitment to match our spending on the national health service by supporting our proposal to increase tobacco taxation and to earmark the proceeds for the NHS. At the very first test, they failed. They failed to put their money where their mouth is, because their commitment to the NHS is, I am afraid, not what it was in the past.
Dr. Phyllis Starkey (Milton Keynes, South-West): Last week, when I was canvassing, I met a constituent--an elderly woman--who had been forced into paying £7,000 for a hip replacement operation. However, my constituent was clear about who was most to blame for that--the Conservatives, for their previous underfunding of the NHS. Will my right hon. Friend confirm that the £800,000 allocated to Milton Keynes general hospital as its share of the extra money announced in the Budget to deal with waiting lists is a much more effective way of ensuring that no more of my constituents feel forced to go private than the Opposition's proposals?
Mr. Milburn: My hon. Friend is right. The extra resources that we have already committed to the NHS are allowing services to be modernised. They are a once- in-a-lifetime opportunity to speed up treatment and care for all patients in the NHS--not just some patients, but every patient. Nobody pretends that that is easy or that it can happen overnight; of course, it cannot--not least because we have to recruit the extra staff and build the extra capacity that the NHS needs. However, we have the opportunity to do that because the Government have put their money where their mouth is: we have backed our commitment with real cash. We have done that because we believe in the NHS. We believe that the NHS can work--it can be sustainable; it can modernise and can offer patients the fast and convenient services that they want in the 21st century.
We shall continue to invest resources in the NHS precisely because we believe in its ability to deliver the goods. What we have invested is the biggest increase in resources that the NHS has ever seen. I remind my hon. Friend that, over the past 20 or 30 years, the NHS saw real-terms increases in funding of about 3 per cent. on average. That is the record of the Tories in office. Over the next four or five years, we shall be doubling that