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Mr. Deputy Speaker (Mr. Michael J. Martin): Order. The Deputy Speaker is not laughing.

Mr. Burns: Thank you, Mr. Deputy Speaker. I thank my right hon. Friend for her intervention. My constituents and many others in Essex were extremely grateful to her

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when she was the Secretary of State for Health. When the resource allocation working party was ended, she gave a commitment to the now Lord Newton of Braintree, my hon. Friend the Member for Maldon and East Chelmsford (Mr. Whittingdale) and me that she would start using a per capita basis for funding. For five years, we started to catch up, after the problems that had arisen from our finances being drained into the east end of London. Sadly, one of the first acts of the present Secretary of State as Minister of State when he took office in 1997 was to fine-tune what my right hon. Friend had done. That means that my health area gets £1 million less a year than it would have got without that fine-tuning.

In conclusion, I hope that hon. Members will stop the party political denigration of our position on the health service by misrepresenting it as privatisation. It is not privatisation. Many of us passionately disagree with the idea of a privatised health service and could never support it. I also hope that more is done to ensure, especially in mid-Essex, that waiting lists come down, and that a reduction in waiting times is the next step, so that my constituents can benefit.

4.44 pm

Mr. Kevin Barron (Rother Valley): I must say to the hon. Member for West Chelmsford (Mr. Burns) that the history of the national health service over the past two decades and the debate about privatisation shows the Conservative party hoist by its own petard.

Everything that the Conservatives did when they were in office suggested that they would go down the road of privatisation. The introduction of the internal market and of fundholding made it clear what the line was at the time. Many speeches made from the Opposition Front Bench since May 1997, with talk of Trojan horses and assisting private health care, give every indication that if they could go down that road, they would.

The right hon. Member for Wealden (Sir G. Johnson Smith) said that the Conservative party had always been in favour of the NHS. He was rewriting history slightly. When the vote was taken in the House of Commons in 1948, the Conservatives voted against the NHS coming into being, but I give credit to all Opposition Members for the fact that for decades after 1948, there was a consensus in the country that the NHS should remain and continue to give the wonderful service that it has given to generations of people in Britain--until the 1980s and the Thatcher Government.

It was then that the consensus broke up, not just in the public sector and in relation to health, but in many other parts of the public sector. If that causes Opposition Members embarrassment, it serves them jolly well right for what they did to the public sector during all the years that they were in office.

Sir Geoffrey Johnson Smith: I do not want to peddle history, but I do not want it thought that I did not report it correctly. Yes, there was that vote, but it was not a matter of principle. The proposal was agreed by the coalition Government and agreed right up to the legislation. We had no real opposition to it. If we look back at the records, we will find how events happened as they did. As for the business of moving towards privatisation, I have tried to convince many in the Labour

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party to accept that there is a role for the private sector. That is shown by the social insurance polices that operate successfully in Europe.

Mr. Barron: I do not want to go down that road. The right hon. Gentleman said how wonderful the NHS was, then he listed six or seven countries where, I assume, he was arguing that the situation was better. On the question of social insurance, who uses our national health service? Elderly people and young children. How can the majority of people who use the NHS benefit from tax breaks--even if there are tax incentives, as there were in the past, which the Government rightly argued impacted badly on the NHS by taking resources away from where they were needed? That does not square, and it is time that the Opposition admitted it.

At the beginning of the debate, we heard from the Opposition Dispatch Box that the Government claimed to have dismantled the internal market, yet that Lord Winston said that it still exists. One or two of us shouted, "And what do you think?", but there was no reply.

Mr. Lilley: What do you think?

Mr. Barron: I think that the internal market has been dismantled, and a jolly good thing too. It was about time, because it was the vehicle whereby Baroness Thatcher's Government would have privatised the NHS, and it is about time that Conservative Members admitted it.

Mrs. Laing: Will the hon. Gentleman give way?

Mr. Barron: I will not give way; I must make progress. I have enjoyed listening to the debate, especially the opening speech of the hon. Member for Woodspring (Dr. Fox). It is a pity that he is not present. I thought that the first 10 minutes of his speech were quite good. It was like watching "What the Papers Say", with one quote after another. However, he then advanced the fantastic and incredible argument that the Labour Government send people round the NHS looking for good news stories so that they can get them out into the media.

That comes from someone who supported the previous Government. For the last 10 years of their term of office, not one new hospital was built in the NHS. Presumably, the hon. Gentleman will now say that the announcement last week of the opening of the new hospital in Carlisle, or the announcement that another 36 hospitals are to be built by the Labour Government--

Mrs. Virginia Bottomley: Will the hon. Gentleman give way?

Mr. Barron: No, let me finish my point. There is one of the culprits. I will give way to her in a moment.

The idea that the £3 billion to fund the 37 new hospitals is part of a Machiavellian plot by the Labour Government to try to pull the wool over people's eyes is nonsense, especially when we consider the previous Government's shameful record on hospital building. We ought to sing from the roof tops the Government's actions in improving the health service, and especially in building new hospitals.

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Mrs. Bottomley: I invite the hon. Gentleman to come on a tour with me of the various plaques that I have opened.

Mr. Peter Luff (Mid-Worcestershire): Hospitals.

Mrs. Bottomley: Yes, I meant hospitals.

Mr. Barron: A plaque is not a hospital. The right hon. Lady well knows that new hospitals were not built under the previous Administration--[Interruption.]

Mr. Deputy Speaker: Order. Again, I appeal for calm. The points are matters of debate--[Hon. Members: "Fiction."] Order. They are not fiction, but matters of debate. Opposition Members will be called to rebut the hon. Gentleman's case. We must have calm.

Dr. Brand rose--

Mr. Barron: I shall give way to the hon. Gentleman.

Dr. Brand: The right hon. Member for South-West Surrey (Mrs. Bottomley) reminds me that the previous Government opened a hospital on the Isle of Wight. Unfortunately, it needed repairs worth £15 million because it was built so appallingly by the right hon. Lady's cronies in the region.

Mr. Barron: We are time limited, so I shall move on.

I fundamentally disagree with the motion's suggestion of political interference in the day-to-day management of the NHS. It is not true. Ministers are probably examining the NHS in greater detail than they have done in the past. There are good reasons for that.

I have sat on the General Medical Council since the middle of last year. This morning, the British Medical Association conference passed a resolution that was hitting the headlines as I came to the House. It relates to the Government's actions. The BMA has passed a motion of no confidence in the GMC. Given that many members of the GMC are also members of the medical profession, and that it is a statutory, self-regulating body, members of the BMA have virtually passed a motion of no confidence in themselves, especially when we consider the way in which people are elected to the GMC.

I agree with some of the comments about the need for structural changes in the GMC. An internal paper is circulating about its governance, and we are considering the matter. I understand that the BMA wants delays in disciplinary procedures to be tackled. Next week, the House will consider a regulation, which the Government are introducing, which will assist with that. More lay members will be elected on to the GMC. That will mean that we can speed up the disciplinary process and reduce waiting times. The BMA is also worried about more regular testing and revalidation.

Today's headlines suggest a conflict: the BMA versus the GMC. That does a disservice to the issues. The real issue is doctors and patients' confidence in them. Revalidation is led by the GMC, but it complements the work of the Committee on Health Improvement, and other plans that the Government have put in train since May 1997. I compliment the Government on their proposals

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for clinical governance and improvement. Improvements have to be made to help all our constituents to get better treatment from the NHS.

Revalidation was hotly debated in the GMC. A minority of people opposed it, but they were heavily defeated. I understand that a tiny minority opposed it at the BMA, but they, too, were defeated. My hon. Friend the Minister can take heart from that. We recognise the need for change. We also acknowledge that the Government's clinical governance and clinical appraisal proposals, and the GMC's changes, will ensure that patients have more confidence in doctors. In the majority of cases, such confidence is high; the proposals and changes will ensure that it is maintained.

Medical regulation must modernise to fulfil the public's changing requirements. The GMC, the Government, the BMA, the royal colleges and health service managers have a role to play in that. The public will not accept unnecessary delays by any of the parties. Modernisation is moving at a quick pace.

In view of media reports in the past few weeks, especially about one specific case, it is important to progress quickly. In years gone by--I do not place any party political blame on anyone--people in clinical practice have not been appraised. Sometimes they have run single-handed practices, and there has been no peer pressure to ensure that they keep up to date and provide a good service, as the majority of doctors do. Sadly, any shortcomings that come before the GMC are blazoned in the press, and people could be forgiven for believing that no control existed. The Government and the GMC are trying to put better systems in place for effective annual revalidation or reappraisal.

I hope that I have two minutes to mention not only the changes that have taken place in the past two years, but those that are imminent in primary care. My constituency has a primary care group; it is one of three in the borough of Rotherham. We are in a position to apply to become a primary care trust. A debate about that has taken place. It seems to most people that having one primary care trust is sensible. I do not know whether there are any guidelines about that.

I wonder whether there are guidelines about another issue that is up for heated debate in Rotherham: mental health services. Do the Government or the regional office of the NHS have any guidance about whether those services should remain in a primary care trust or whether they could be floated off into a bigger trust? There is a worry in our area that if we become a primary care trust, and mental health services are not part of it, they will go to a neighbouring trust somewhere in South Yorkshire and we shall lose our local influence on mental health services.

Earlier, the hon. Member for Broxbourne (Mrs. Roe) described mental health services as Cinderella services. That might have been true in the past, but such services are vital in our health service and our local communities. Will my hon. Friend the Minister tell us whether there is any guidance about including mental health services in primary care trusts?


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