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Mrs. Laing: I add my support to HEAL and all the work of Neville Davidson and his team; they do a lot of good in my constituency, too.

Ms Perham: I thank the hon. Lady for her support. Several hon. Members in our local area are involved with that charity; it has a particular resonance because of Helen's great fight against her disease, and I am pleased at the support it has gained locally.

I have also been involved in campaigns to raise awareness of human papillomavirus testing for cervical cancer and have added a personal contribution to the fight against ovarian cancer, which kills 4,000 women a year, by participating in the ovarian cancer screening programme at Bart's hospital. Therefore, I welcome the answer that the Under-Secretary of State for Health, my hon. Friend the Member for Pontefract and Castleford (Yvette Cooper), gave in February of this year showing that the Government spent £1 million in 1998-99 on directly commissioned research relating to ovarian cancer and another £1 million on supporting research councils and charities. She also promised the setting up of a major ovarian cancer screening study.

I am pleased that, as part of their overall commitment to modernising--if I can use that word--the NHS, the Government are prioritising patient care to ensure fast and convenient access and increased patient empowerment, which will give patients a greater say in their treatment.

I have been honoured, as a member of the all-party group on cancer, to be asked to chair one of the groups working on five pledges to develop a comprehensive cancer strategy. Those are to improve the prevention of cancer; to ensure equal access to higher standards of care; to provide patient-centred care through the NHS--the group with which I am involved is working on that--to increase Government spending on a national agenda for cancer research; and to develop better treatments and to implement them quickly. At a time when the world is coming to terms with the staggering potential of the human genome breakthrough, we cannot afford to wait for miracle cures while one in four people in the United Kingdom is dying of cancer now.

I have focused on the treatment of cancer because of my attempts to press for improvements in the fight against that killer disease, but I am equally determined, as are the

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Labour Government, to confront the challenges of providing health care to all our people in the new century, and vigorously to oppose the Tory party's agenda of privatisation and selection for certain services by the ability to pay. I want to protect, to support and to expand our NHS. That is what the British people want and that is what we are delivering.

4.1 pm

Sir Geoffrey Johnson Smith (Wealden): First, may I say that I think that the hon. Member for Ilford, North (Ms Perham) has shown a great deal of courage? That demonstrates not just her keen personal interest, but her wider political and social interest in health. I hope that all goes well with her family.

There are one or two irritating factors in the debate. One is the view that the NHS was created by just one party. It was not. It came out of a coalition that was developed during the war and it was finally put into practice with the support of Governments of both parties--[Interruption.] I do not want to argue about that because it is a fact.

Secondly, the question of expenditure is very important. When the NHS started, it had a budget of about £170 million. After two or three months, it increased to £250 million. Then it went to £374 million. The structure of everything being free at the point of demand was demolished when Mr. Bevan accepted--reluctantly--that there would have to be prescription charges. In 1951, he had to resign because he could not stomach the Government's view that there should be charges for spectacles and dentures.

Many advances are being made in the medical profession and in modern technology. Some are life saving; others we could deal with ourselves. Of course, we could embrace every illness and ailment--any pill that we want we can have--but that is not the reality of modern medicine, or of the problems that Governments have to face.

There may be occasions when a Chancellor of the Exchequer comes to the Dispatch Box and does not give the NHS the extra money that we all think it should have, because he thinks that there is a greater demand for housing, that there is some problem to do with defence, or that the economy is not quite as robust as it was the previous year and the forecast is not so good either. If we demand that the health service should always be financed to meet every demand, we refuse to face up to the reality of modern medicine, modern needs and social responsibility; we fail to recognise financial prudence.

Those are points that I would have thought could unite the House. Having come into the House in 1959, I have sat through a great many debates. I am astonished that we go on year after year having the sort of fights that we have. It is not true to say that--

Mr. Stephen Hesford (Wirral, West): Will the right hon. Gentleman give way?

Sir Geoffrey Johnson Smith: Let me finish the sentence and then I will give way to the hon. Gentleman. It is not true to say that the Opposition want to rely on the private sector totally and to demolish the health service; that is such rubbish. After all, when we came into office the NHS had a budget of £9 billion. We ended up with a budget of just over £40 billion.

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Now we are told that there will be another increase of about £20 billion from the present Government. Why is it that we automatically assume that, having poured that money in, we will have solved the problem of increasing expenditure on health? Of course we will not. We all know that there are many reasons why the burdens on health--the demands that are put on us--are increasingly greater and cannot always be solved with taxation. Some people say that they should be, but as I have said, there will be other priorities; there always are.

We can argue that the health budget is not always the one that will create a healthier society--I mean in a physical sense. Better education and looking after oneself can help, as can a better sense of individual responsibility. It is not always the doctor to whom one must go. We might consult our own consciences about whether we can provide for some of our own health needs. That is why the debate is at times disappointing.

Has any other country followed us? Not one has done so. The socialist Governments of Europe studied our methods, but not one of them has copied us. I have heard no contradiction on that point from any Minister, either. I have been to see them; I have talked with them; I have seen them struggle with their problems. My heart bleeds for them at times, because there is a recognition that, somehow or other, we can meet those demands, as the hon. Member for Wakefield (Mr. Hinchliffe) said. I have heard him say it before and do not doubt his sincerity. I ask him to get out of the mould of his experience and try to broaden it a bit.

In 1959, I fully supported the health service. Members of my own family have been involved in it. I was the Member for Holborn and St. Pancras, South, and I knew all that went on there. I have enormous respect for those in the health service; I know that many of them have to put up with tremendously long working hours--that is not something of which we should be proud--but they do so with enormous good will. Why, then, should I tolerate the existing situation, when Minister after Minister says, "Let us spend more."? Then there is always someone who says, "You should have spent more and you should have done it the year before."

In Germany, the Netherlands and other countries--we have all the statistics--they have more doctors, more specialists, more nurses and far fewer waiting lists. I am treasurer of a NATO parliamentary assembly. I must ensure that the assembly pays sufficient money to help our employees to meet their bills because they have to pay so much to the Belgian Government. They can get many other things very cheaply and, as I say, they have a better service. Not one of those people, some of whom are British, goes across the sea and gets it all for free in Britain. They would not touch it. They know that they have a better deal. Why do not we accept that? We have a lot to be proud of, but we will not be proud of it if we always have a spat year in year out.

I do not see any reason why we should resent the private sector having some part in the health service. The Secretary of State for Culture, Media and Sport said in The Times on 8 May 1996:

There are others. The Secretary of State for Northern Ireland and Mr. Roger Liddell claimed the same in their book "The Blair Revolution." I will not quote it, but

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anyone can see what it says. They also talked about the need for diversity and innovation in the provision of public services, so what are we arguing about today? Where is the consistency? Then there is that venerable figure Mr. Steven Pollard, former director of the Fabian Society, who in a document entitled "Towards a More Cooperative Society" said on the role of independent health care:

He is right.

That brings us to the formidable problems that we have to face: rising demand for primary and secondary care, the rising number of elderly people, advances in medicine--one could go on and on. Ministers know about the shortage of consultants, but also that some who have been trained cannot find posts. In addition, as the BMA points out, it will take years for doctors currently attending medical school to emerge into general practice or senior hospital positions. Announcements that another 1,000 people are to be trained fill people with hope, as though the doctors will be turned out the next day, like rookies entering the Army, but that is not how medical training works. That is why we get disillusioned with Ministers--we know darned well that they cannot deliver just like that, but they give the impression that they can.

If we are to be true to ourselves, we have to recognise the facts, one of which is that private provision, in its place, has a role. It does not diminish the health service--after all, consultants and GPs work in both the NHS and the private sector. I know people who work under contract with the NHS and give of their time to the private sector, and why should they not? In my constituency, we have people who work in a charity-supported private hospital that takes NHS patients. Such skilled people are the strength of our health service. I see no reason why we should not examine the extent to which we can broaden that base, as those on the continent have done, with better results than we have achieved.

I welcome the comments of the right hon. Member for Birkenhead (Mr. Field) who, in a recent edition of our favourite House Magazine, advocated two longer-term reforms that might help:

That would certainly give buoyancy to NHS revenue. People do not mind paying insurance and, as Lord Beveridge pointed out, if a service has been paid for in advance--that is one way of seeing insurance--people are more likely to respect that service. They are also more likely to take more personal responsibility. When I see the many people in this country who eat far too much, become bloated and suffer from a heart attack or some other condition while they are relatively young, I wonder to what extent the problem was the result of natural causes, or whether it was self-inflicted. We know that we are not a healthy nation and that we do not take sufficient personal responsibility for our health.

I hope that the House will take note of the views that I have expressed, which are not mine alone. They are the views of those who are progressive--workers at all stages

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of the national health service who are dedicated to improving it. They recognise that team spirit in the NHS and the private sector, and among those with specialties and knowledge, is the answer. If we acknowledge that, we might have a better debate and, more important, we would, for the first time, be able to give the British people hope that they have a service that is manageable and meets their needs.

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