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Mrs. Laing: On a point of order, Mr. Deputy Speaker. I wonder whether you have had notice that the Secretary of State wishes to correct an error that he made earlier this afternoon, undoubtedly inadvertently, as I am sure that he would not wish to mislead the House deliberately.
Mr. Deputy Speaker: Order. I do not think that the hon. Lady is doing the House a service. She will know that this is a matter for debate and not a matter of order for the Chair.
6.48 pm
The Minister of State, Department of Health (Mr. John Denham): I apologise, in view of the time, that I, too, will not be able to refer to all the speeches made in the debate, including the many excellent speeches made by my right hon. and hon. Friends.
Unlike my hon. Friend the Member for Brentford and Isleworth (Ann Keen), I have no clinical training. Although I am quite sure that she is clinically able to diagnose a state of amnesia among Conservative Members, my observation that they are in a state of denial must be purely a layman's point of view.
Let us take, for example, the hon. Member for Wycombe (Sir R. Whitney). If I had been a junior Health Minister in 1985 and I came here in the year 2000 and said that we do not have enough doctors in the United Kingdom, I might have made some connection between that and the decisions that I took in 1985. For the record, I say here and now that, should I still be a Member of this House in the year 2015, and should I wander into the Chamber and make a speech saying that there are not enough doctors in England, I hope that someone will feel free to point out that I, along with my right hon. Friend the Secretary of State and our ministerial colleagues, were taking the decisions about how many doctors to train.
Sir Raymond Whitney: The Minister may recall that in my speech I predicted that what I said would be wilfully and grossly misrepresented. He has proved the accuracy of that prediction.
Mr. Denham: If the hon. Gentleman checks the record, he will find that he referred to the number of doctors in this country.
The right hon. Member for Hitchin and Harpenden (Mr. Lilley) spoke about the wonders of the reforms of the previous Government although, to be fair, he accepted that there had been some mistakes. However, the idea that the system of extra-contractual referrals allowed all patients to see whichever doctor they wanted is simply not true. For 15,000 GPs, if they wanted to refer to anyone outside their area they had to go through a set of bureaucrats in the health authority--bureaucrats imposed on those patients by the Conservative party. By getting rid of extra-contractual referrals we have restored to GPs the freedom to refer. Doctors collectively decide where their patients are treated and the health authority no longer has the veto power. That is a significant and important change.
Although I cannot develop the argument about neurological services today, those issues are important. However, a closer look will show that they are fundamentally to do not with the system of extra- contractual referrals, but with uncertainty about the clinical and cost-effectiveness of some of those treatments. It is an important issue and a number of hon. Members raised it. We need to resolve it as quickly as possible and I am determined that we should do so.
Finally, in a debate about responsibility, the right hon. Member for South-West Surrey (Mrs. Bottomley), knows as well as I do that while there has been a record of increases in funding for her health authority, her area has a major problem--the debts of £18 million that were run up under the stewardship of the previous Government. That problem has to be resolved, but there comes a point when those who were in government a few years ago have to take responsibility for the things that happened then.
I do not think that anyone here would describe Dr. Ian Bogle, the president of the British Medical Association, as a poodle of the Government. He has criticised Ministers and the Prime Minister. This week, however, when opening the BMA conference across the road from here he said:
- Following the Budget announcement in March, the Prime Minister offered to include us in the policy-making process . . .
- fundamental shift in government thinking that has given us the opportunity to help shape policy and have a say in how the significant extra investment in the NHS pledged in the Budget will be spent.
Tony Blair has challenged us to deliver change in return for extra investment. We are more than willing to meet that challenge.
Mr. Blair, your plan is eagerly awaited by every doctor in this conference hall and every doctor on the NHS frontline.
Whether or not those people support the Government as voters, they all believe that this Government are right on two key issues. The NHS needs more money, and they
know and believe that this Government are doing what the Conservative party never did, never wanted to do, never dreamed of or believed was right, which is to deliver more money to the NHS at unprecedented levels. Those people also agree with us that money alone is not enough. We have to change the way the NHS operates, the way we organise our services around the needs of patients, the way we train and use our staff, and the way we manage the NHS.A huge national debate is taking place on the future of the NHS and all that debate is shaping the national plan, which we are drawing up. What gets up the nose of the Conservative party is that it has chosen to be outside that debate--because of its past record, its opportunistic attacks and its obsession with private medical insurance, and because Conservatives are more interested in drumming up business for Abbey National than in facing up to the challenges of delivering a better national health service.
Not everyone who is taking part in that debate supports the Government. The hon. Member for North Devon (Mr. Harvey), who made an excellent speech, is not a supporter of the Government, but he made it clear that he wants to be part of the national debate and his views should be listened to. We have listened to patients, we are listening to staff. Many Opposition Members have attacked us for waste in doing so. They say that listening to patients' views is not a good idea. If they want to talk about waste, let us talk about waste. One of our first actions when we came to power was to abolish the internal market--the bureaucratic, inefficient, unfair, internal market. By doing so, we will save £1 billion; £1,000 million will be saved over the lifetime of the full Parliament and spent on patients because we abolished the ideological, wrong-headed waste created by the previous Government. So let us not have any debates about waste and inefficiency in the NHS.
The hon. Member for Woodspring (Dr. Fox) is a pleasant gentleman. I understand that by repute he has an excellent bedside manner. He is, of course, a doctor. But when I look at him he strikes me not so much as a 21st century doctor as a 19th century quack, touring country fairs on the back of a wagon and looking for gullible people.
Mr. Owen Paterson (North Shropshire): Will the Minister give way?
Mr. Denham: No, I will not give way to somebody who has just wandered in off the street.
I say that the Opposition spokesman is like a 19th century quack, because whatever symptoms and problems the NHS patient faces, the prescription is always the same: a strong dose of Doctor Fox's patent private medical insurance. [Laughter.] A bad knee? Better buy some insurance. Bad hips? Better buy some insurance. Trouble with the eyes? Better buy some more insurance.
This evening the hon. Member for Runnymede and Weybridge (Mr. Hammond) tried to put all this behind the Tories and say that what he had said on Sky television or what the hon. Member for Woodspring had said in The Sunday Times was all in the past. I have sat here, as have several of my colleagues, and listened to speech after speech from Opposition Members, every one of whom has said that the only answer to the problem is more private
medical insurance. It is no use the hon. Gentleman saying that that is not their strategy. Clearly, back in January he convinced all his colleagues that it was, and they are continuing to say that it is. I believe them rather more than I give credence to the hon. Member for Runnymede and Weybridge.One of the flaws in what we have heard this evening is the Tories' claim that they will match our spending plans. The final judgment about whether they are telling us the truth should rest with the voters, who are a good deal less stupid than the Opposition hope. Before the Budget, when my right hon. Friend the Chancellor of the Exchequer announced record increases in NHS spending, not once had there been a single indication that any Tory Member thought that an increase in spending at the level that we are proposing was either possible or desirable.
In the middle of the winter flu epidemic, did we hear calls for more money? In our debate in early January, did hon. Gentlemen call for money for the NHS? No, they called for more private medical insurance. What did we hear on the eve of the Budget from the shadow Chancellor on "The Money Programme"? Did he say, "If I were the Chancellor, I would put a bucketload of money in the NHS"? Did he say, "The NHS needs more money. That must be the Chancellor's top priority"? Did he say, "Give them the money, Gordon"? No, he said:
- He--the Chancellor--can either reduce taxes or he can increase public spending. What I would recommend is that he use the money to reduce taxes.
The Tories have made a claim born, as always, of opportunism and expediency. Voters will know that that type of promise has less value than commitments that are made from conviction and determination. It is worse than that, because the promise has a gaping hole in it: this afternoon, £500 million for private medical insurance, and a year-on-year tax guarantee that means cuts in health expenditure to pay for tax breaks for the rich--
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