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Mr. Kennedy: My criticism of further reform at this stage is that many of the institutional and structural issues that the Government and, in particular, the Prime Minister will address are the result of insufficient funding during the lifetime of this Parliament. That is criticism No. 1. Criticism No. 2 is that, if we want to reform the delivery of health services at community level to make them more accountable and efficient--no hon. Member would be
against that principle--two things must be done. First, managers must be allowed to manage; the Government must not spend their time interfering politically. Secondly, managers must be set budgets that allow them to plan.Every year, the Government of the day suddenly announce--pre-Christmas or post-new year--extra cash to help solve whatever perceived problems arise during the winter months. We saw that in classic form with this year's flu epidemic. We all know that that happens; it is a feature of the weather and of demography. NHS managers tell us that the money is welcome and that, if only they had known that they would get it eight, 10 or 12 months ago, they could have deployed it far more efficiently and effectively. The Government need to deal with that, not with what one suspects is a high-profile, well news-managed health inquiry, chaired by the Prime Minister, which no doubt will be unveiled in glitzy fashion at No. 10 Downing street, but will not reach those whom it is intended to assist. That is the case that we are making. It is an issue of opportunity that is close to the hearts of Liberal Democrats.
Mr. Geraint Davies (Croydon, Central): Will the right hon. Gentleman give way?
Mr. Kennedy: I shall certainly do so, although I want to make progress.
Mr. Davies: I am grateful to the right hon. Gentleman for giving way a third time. He seems to suggest simply that more money is required, not modernisation or reform. Has he read the Public Accounts Committee report, which shows enormous variation in the unit cost of standard procedures such as hip operations, and in efficiency and performance? The Government are introducing benchmarking of costs and outputs to provide more cost-effective and consistent standards of health across the country, rather than simply throwing more and more money at what is often mismanagement and bad practice. Does the right hon. Gentleman welcome that?
Mr. Kennedy: Again, we have absolutely no objection to the most cost-effective delivery of health care in the country, which must be in everyone's interest. However--I am not in any way undermining the work of the Public Accounts Committee--it must be recognised that the delivery of health care in my part of the country bears hardly any relation to the delivery of health care in, say, the constituency of my hon. Friend the Member for Torbay (Mr. Sanders) in terms of, for instance, geography, demography and other demands.
I often feel that the indices and formulae that are used do not take adequate account of geographical disparities. That has an impact not just on health but on the delivery of education, and on many other things.
One group which, in terms of "Opportunity Britain", must feel that they are being the most denied under the present Government are pensioners. They are some of the poorest and most disadvantaged members of society. Let me quote to the Minister the last Labour manifesto, in which Labour pledged that pensioners would
- share in the increasing prosperity of the nation.
Insult has been added to injury by the increase of 75p in the basic state pension. Lifetime savings of just £8,000 bar 600,000 pensioners from entitlement to income support, although their income is lower than £75 a week. Up to 700,000 pensioners who are entitled to claim income support fail to do so.
In 1998-99, there were 50,000 "excess winter deaths"--a chilling phrase--most among elderly people. That is the highest figure for many years, and is substantially higher than the figures in any comparable western country.
As a people, we should be ashamed of such statistics. There must be a substantial increase in the amount given to pensioners, and the comprehensive spending review will provide a big opportunity. Any increase should be loaded in favour of the oldest and poorest pensioners, who all too often form the same group.
I could mention many other issues, but there is not enough time for me to do so. Let me say a word about one of the most dispiriting aspects of national political dialogue. I refer to the increasing sense that there is a difference between urban Britain and rural Britain. There is no such difference. A lack of opportunity in rural Britain may take a different form from a lack of opportunity in urban Britain, but a lack of opportunity in either should be something that a Parliament is not prepared to tolerate. We are seeing too much of it.
In rural Britain in particular, the extent of deprivation and social exclusion is all too often disguised. That applies as much to the fate of the local post office as to the lack of access to decent transport. It impacts on the single mother as much it impacts on the pensioner. The Government are not doing enough, and we want more to be done. We also want aspirations and anxieties to be met in the context of the incidence of crime, and the perception and fear of crime. Before the election, it was a case of "Vote for us; more bobbies on the beat". Three years after the election--in which enough people voted for the Government--there are thousands fewer police to be deployed in our rural and urban communities. Those are the facts, and they need to be exposed.
The Government have done much that is good, and the Liberal Democrats have said that. As the Minister knows, we are frequently criticised by others--members of the Conservative party and the media--when we do so, but if we think that the Government are trying to do the right thing, why should we not say so? That is an example of sane, rational, constructive politics. What is most disappointing, however, is that although they have a benign economic scenario, a thumping House of Commons majority, a so-called official Opposition who have shown no signs of getting their act together over the first three years of the Parliament--
Miss Julie Kirkbride (Bromsgrove): Dream on.
Mr. Kennedy: The few of them who are here are dignified and distinguished representatives of a dwindling band.
Despite having all that in their favour, the Government have a poverty of ambition. What could, and should, they have done on the social justice agenda? What could, and should, they have done to make life better for pensioners?
What could, and should, they have done to improve our national health service? What could, and should, they have done to improve the lot of those in education in general and the tertiary system in particular?I want us to be ambitious about our politics. The Liberal Democrats are ambitious, and we will make the case for greater opportunity--a case that finds no resonant echo in the Conservative party, still less the Government of the country.
4.1 pm
The Parliamentary Under-Secretary of State for Education and Employment (Mr. Malcolm Wicks): I beg to move, To leave out from "House" to the end of the Question, and to add instead thereof:
- 'believes that true opportunity for all requires that access to higher education should be based on merit not background; welcomes the measures the Government has implemented to widen access as part of the record increase in education spending of 8 per cent. in real terms in this year alone; and welcomes the many initiatives taken to help those in society whose needs are greatest, including an extra £950 a year for older pensioners on low incomes and a record increase in NHS spending of an extra £2 billion this year, plus 6.1 per cent. average growth year on year until 2004.'.
Mr. Charles Kennedy: They are for the second motion.
Mr. Wicks: Indeed. One of my colleagues said that the motion had all the hallmarks of being written on the back of an envelope; I thought that the back of a serviette was more likely. Despite that remark, I shall treat the subject of the debate seriously.
Despite the right hon. Gentleman's criticisms of the Government, some, though not all, of which I can address, I acknowledge that my party and his have in many respects shared in the radical tradition and ambition of the past century. Long before new Labour--indeed, 100 years or so before--there came the new Liberals, following the great schism at the end of the 19th century between the welfare Liberals and the market Liberals.
In spite of the many differences between us--I shall not be wholly conciliatory--there is a sense in which we have all been concerned about how to attack injustice and pursue a just society. That has led us to discuss issues concerning the right balance between economic prosperity and fairness and between the values of equality and liberty. It was a great liberal--Hobhouse--who reminded us in 1911:
- Liberty without equality is a name of noble sound and squalid result.
We have been concerned about citizenship and the balance to be struck between rights and duties. The unjust society--the motion is about justice--has been described in many ways across epochs. It varies from era to era in terms of its determinant causes and characteristics, but I always think--I say this not just to be conciliatory--that the best portrayal of injustice is still that from Sir William
Beveridge, a great Liberal, in his report of 1942. Sir William talked about the challenge facing our country after the second world war. In a wartime speech, he said:
- Reconstruction has many sides, international and domestic. On the domestic side, one can define its aims best by naming five giant evils to be destroyed: want, disease, ignorance, squalor and idleness.
Much has changed in the 50 to 60 years since then. Many substantial improvements have been made in the life chances of our people, not least in their life expectancy. There is much to applaud, but, when the Government came to power in 1997, the socio-economic context was depressingly familiar in terms of rampant inequality.
There was a real sense in which Beveridge's five giants, well known in the 1940s and before the war, still stalked the land. There was want--one in three babies were born into poverty. Disease, sickness and mortality correlated with social and economic circumstance. There was ignorance--one in four or five of our adults were lacking basic numeracy and literacy skills. There was squalor--neighbourhoods were grim and desolate. There was also idleness, which is, of course, the experience of mass unemployment, with one in five households having no adult in work. We were familiar with that when we came to power, and we are seeking to deal with that agenda.
All five of those Beveridge giants are significant. All of them are interconnected. One cannot be overcome on its own--we need to overcome all of them. The connections include the fact that one third of adults without skills are on benefits. By contrast, those who have good GCSEs are able to increase their earnings by 40 per cent., compared with those who lack any qualifications. That is why, in addressing these issues, we need comprehensive strategies.
We need joined-up government. We also need the important work of the social exclusion unit, and projects such as sure start that bring together health, education and other services to help families with children in the early years. We need the Connexions service, for 13 to 19-year-olds, which involves the modern development of careers and the youth service, cutting across Departments and involving a range of professionals.
I shall focus on three of the giants that I mentioned: idleness, want and ignorance. I shall not cover all the points raised by the right hon. Member for Ross, Skye and Inverness, West, but I want to examine some of the aspects that he mentioned--employment, social security and education. [Interruption.]
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