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Sandra Gidley (Romsey): Is the hon. Gentleman aware that owing to a closure of wards at Southampton general hospital people are being transferred to Haslar? Does he agree that is further evidence that Haslar should remain open?

Mr. Viggers: I am grateful to the hon. Lady for that important and effective argument. There are so many

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other arguments that one could make--for example, the links developed over the years between Haslar and Southampton and Portsmouth universities--that local people feel it is overwhelmingly important that the hospital should remain.

The alternative is to travel to Queen Alexandra hospital at Cosham, which is a journey of some 10 to 12 miles depending on which part of the constituency one lives in, along heavily congested roads. The A32 is the main road from Gosport to Fareham and is notoriously slow. There is deep concern that ambulances will not be able to get to Queen Alexandra hospital and that lives will be lost.

Admittedly, a minor accident treatment centre has been opened at Haslar, so to a certain extent the Haslar taskforce which I formed and chair has been successful in persuading the Government in all their manifestations to maintain an accident centre at Haslar. In addition, the Portsmouth and South-East Hampshire health authority has proposed that Haslar will remain open under NHS control, and that the main part of Haslar, which is called the crosslink block, will be transferred from the Ministry of Defence to the NHS and the local health authority will be able to run out-patient facilities there. That is good news. The number of out-patients will increase from the 55,000 currently treated to 60,000 in future.

That is not good enough. We in the Haslar taskforce are drawing up a paper which I have called, "Haslar hospital 2020--our vision for the future". We want to spell out what facilities can best be maintained at Haslar. Clearly, the world-leading MRI scanner and the world-leading hyperbaric unit should continue at Haslar. We also need beds. With the problems in Portsmouth hospitals that I have outlined, there is a dramatic shortage of beds which is not likely to improve.

There is a private finance initiative to expand Queen Alexandra hospital at Cosham and almost double it in size. During the time of its expansion, it will be a building site and top quality medical facilities cannot be run from there. Our proposal, therefore, will be that Haslar be given a surge capacity while Queen Alexandra hospital is being extended; and that having been increased in size to take the surge necessary to cope with the building work on a congested site, Haslar will stay "surged".

Nothing less than a continuation of the Haslar facilities will be satisfactory locally. My constituents feel strongly about that--as do a large number of people in the defence medical services and the armed forces. They believe that the Government have made a mistake and that it should be only a matter of time before the Government go back on their decision and keep Haslar open.

5.40 pm

Dr. Howard Stoate (Dartford): I am grateful for the opportunity to speak in this important debate. I am pleased that the Opposition have chosen the subject of priorities in the national health service.

I have been in the Chamber for almost all of the debate and have listened with care and interest to the contributions. However, I am disappointed. The debate was supposed to be on priorities in the NHS, so I hoped that the Opposition would lay out their stall for their policies to further and improve the service, but I have heard only a litany of complaints and moans and groans

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about the state of the NHS--how run down it has become; how low morale is and how patients are suffering. We have heard that time and again. We have not heard what the Opposition propose to do about it.

It took an intervention from me on my right hon. Friend the Secretary of State to find out the true Tory intentions for the NHS. I was grateful to my right hon. Friend because, by quoting the statements of Opposition spokespersons, he was able to tell me what they had in mind. Perhaps the Opposition are embarrassed; perhaps they do not feel happy about what they are trying to do.

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

Dr. Stoate: I shall not give way just yet--I will do so if there is time.

Perhaps the Opposition do not want to tell the public what they have in mind. I am a charitable person, so I do not like to run people down unnecessarily. I am even prepared to admit that the Opposition have honourable intentions in that they really want improvements in patient care. I think they do. However, there is a real difference in the way that we seem to want to achieve that.

I believe that the health service needs improvement and that the Opposition want better patient care, but there is a fundamental difference--clear blue water--between the parties. Today's debate offers us an opportunity to examine that distinction. Both parties agree that the NHS is underfunded and that there are not enough doctors, nurses, hospital beds or facilities. Patients wait too long--waiting times and waiting lists are too great. Both sides of the House agree. I have no problem about that.

The problem arises over what the two parties intend to do about the matter. Labour have made it clear that we are wholly committed to a publicly funded NHS, improving every year as resources become available. We aim to meet the European average on health as soon as practically possible given the available resources. I am pleased that the Government are making real improvements in health care every year.

The Opposition, on the other hand, want to do something different. I do not accuse them of wanting to privatise the health service--I do not believe that is what they want to do. That is not on their agenda. However, they do want to increase resources by increasing the private element in the health service. They want to increase health resources, using private sector money, by encouraging people to take out private insurance. Even the Opposition probably agree that that is what they are trying to do.

Labour, however, want the health service to be almost completely publicly funded.

Mr. Hammond: I am grateful to the hon. Gentleman for his comments. Does he acknowledge that, in trying to reach average European health spending as a percentage of gross domestic product, there is a problem? In the European countries to which he refers, spending on privately financed health care is much higher than in the UK; on average, it is nearly double.

Dr. Stoate: I accept that we have a different philosophy from our European partners, but our philosophy is correct, as I shall explain. Let us consider the consequences of the Opposition's proposals to increase the number of people

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who take out private insurance to fund their so-called non-life-threatening, so-called non-urgent operations, such as hip or knee replacements, or treatment for cataracts or hernias.

The hon. Member for West Chelmsford (Mr. Burns) suggested tax relief on private health insurance; he said that he had voted for that under the Thatcher Government. What would happen if that were implemented? I quote the Baroness Thatcher. In her book, "The Downing Street Years", she stated:

Tax relief will not increase the number of people who take out private health insurance.

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

Dr. Stoate: I cannot give way at the moment; I have already given way once and there is not much time.

What other consequences would flow from the Opposition policy? Many people--indeed the majority--who need hip and knee replacements do not pay tax because they are pensioners. The Government have taken the majority of pensioners out of the tax system. What advantage is there to giving tax relief to people who do not pay tax? None, so that will not help pensioners very much.

If tax is removed from private health insurance, premiums go up. Lord Lawson says:

Those are not my words, but Lord Lawson's. Therefore, giving tax relief on private health insurance would not increase the number of people taking out insurance, but it would push up prices. I do not see the value of providing a huge public subsidy to the private sector if it does not even increase the number of people using private health insurance. There is no point in that.

Let us suppose that the policy worked and we managed to increase the number of people using the private sector. That would result in a scarcity of private facilities and resources. Where would the doctors, nurses and other staff in the private sector come from if not from the health service? The annual representatives meeting of the British Medical Association pointed out how overworked and overstretched doctors are. I know, having been closely involved in medicine, that doctors and nurses are overworked and overstretched. However, if those same doctors and nurses also work in the private sector, they will be even more overstretched and overtired. I do not understand how that will improve patient care. The only alternative is for doctors, nurses and others to leave the health service and work only in the private sector. Again, that would be to the detriment of the NHS and patient care.

So far, I have heard nothing in the Opposition's proposals that could conceivably improve patient care, improve the uptake of private insurance or improve the supply of medical care. The proposals would not work at all.

Pooled risk presents another problem. Private insurance companies do not want to take on high-risk patients. The principle behind the NHS is that it pools risk. Those with

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low risk effectively subsidise those with high risk and we have accepted that for 50 years. If insurance companies were to pool risk, people would rightly become upset by that. We would all be upset if we pooled risk on car insurance. If I paid the same premium as an 18-year-old driving a sports car, I would be fairly upset. I consider myself to be a lower-risk driver, so I do not want to cover the risk of someone who drives extremely badly and who is a very high risk. I do not believe that people would be prepared to pay enormously enhanced premiums for private health care to subsidise those at risk.

I can provide chapter and verse on what happens to medical care in the private sector. A friend of mine who is a consultant diabetologist had a patient who took out private health insurance in good faith. The patient developed diabetes and--fair enough--the private sector paid for his treatment. He then developed the common complication of eye problems; he needed laser surgery on his eyes. The private sector paid for his laser treatment, but he needed more laser treatment and--fair enough--the private sector paid for that. He returned a third time and the company paid again. However, when he returned the fourth time for treatment, the insurance company wrote to him to say, "We are sorry. Four episodes of treatment mean that you have a chronic condition by definition. Chronic conditions are not covered under your policy. We ain't paying no more." That is precisely what happened.

That patient took out private health insurance in good faith, but found that the treatment was ruled out of order because he had the bad luck and the temerity to develop a chronic condition. I do not see how such insurance benefits anyone.

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