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Mr. Michael Fallon (Sevenoaks): It is a pleasure to be the first to congratulate the hon. Member for Tottenham (Mr. Lammy) on one of the finest maiden speeches that I have ever heard. He paid the most moving tribute to his late predecessor and followed that with the most eloquent advocacy of the need to invest in his constituents. He made a beautifully judged speech and described Bernie Grant as positioned between street heroism and Government office. I see that the hon. Gentleman has selected a place halfway between the very Back Bench and the Front Bench, so he is well poised between Back-Bench heroism and Front-Bench office. I am sure that it will not be long before he moves further forward and I hope that it will not be long before the House hears from him again.
The comprehensive spending review needs to be set in its context. The first CSR was only two years ago, but already we hear that the third is pencilled in for 2002. Instead of being a three-yearly review as originally promised, the CSR has already become two-yearly as the third year of each seems to be subsumed by the first year of the next. It is perhaps important for the House to recall that the first spending review did not even last two years. It was announced in 1998 and began in April 1999, but it collapsed that first Christmas as the flu crisis hit the national health service and the Prime Minister panicked on the David Frost show.
Within a year of the first CSR, the Government were rushing emergency funds to the health service and emergency cheques to our schools. When we assess the first CSR review, we look in our constituencies for signs of delivery. Three years into this Government, Kent has no additional police officers, longer health service waiting lists now and no new hospitals in west Kent. My hon. Friend the Member for Tunbridge Wells (Mr. Norman) and I have campaigned for the dualling of the A21, but that has still not been done. My constituents have paid all the extra taxes and heard all the promises but, three years on, the Government have still not delivered.
Perhaps one merit of the second CSR is that it has acknowledged the extent to which the first CSR was ill judged. We have now had sudden large increases in health, schools and transport spending. That in itself does not help planning by Departments. The evidence of the first spending review shows how much underspending there has been as a result of departmental expenditure limits. That kind of lurching--stop and go--has not allowed the long-term investment that everyone wants in the public services. That is especially true of schools and hospitals.
Conservative Members want better public spending. That means more public spending front line and public spending that gets through faster. Let me deal first with the public service agreements that were supposed to underpin the first CSR. Originally, there were 600 targets. Within a year, 400 of those had been scrapped and we were down to 200. I now see from the document presented on Tuesday that we are down to what are called "key" targets. Perhaps when he winds up the debate, the Minister can tell us just how many targets are still in operation--or have we gone from 600 to 200, to just one, in order to regain some popularity in time for the next general election?
If those public service targets are to be taken seriously, we need serious measures of outcome that are openly understood by our constituents and can be properly audited. It is one of the greatest weaknesses of the present targets that they are self-audited--that the Treasury alone says whether they have been met. The Government have got into trouble, through over-counting and over- promising with vague targets, because the electorate cannot understand what is being delivered, when and where. That disillusion is setting in.
Secondly, we must ensure that the money gets through faster. When the Chancellor announced in March the emergency package of sending some school money direct to schools, I cheered. That is what we were trying to do with grant-maintained schools. The CSR announced on Tuesday refers to direct grants. We applaud those. The amount of money is minuscule.
Mr. Fallon: I do not know what happened in the Chief Secretary's constituency, but in mine it took seven weeks to get those small cheques through to primary schools. Interestingly, those cheques were still routed through the LEA. We are still waiting for that money.
Otherwise, we are waiting. Our schools are waiting for the money that has been promised, but is still to get through to governors and head teachers. West Kent is still waiting for the transport expenditure. We have been paying extra motoring taxes and more for petrol, but our new trains have not arrived and our buses are no better.
NHS waiting times have gone up. For three years, we have been campaigning for a replacement for our two hospitals: the Kent and Sussex hospital in Tunbridge Wells and the Pembury hospital on the edge of Tunbridge Wells, both of which serve the Sevenoaks constituency. The case went not to the previous Government, but to this Government in the summer of 1997. It was turned down. It went to this Government again in 1999, but it was turned down. We are still waiting for the Government to get the extra health spending through to our constituents. Until they start to do that and to deliver on the ground, they will have no credibility.
At the date of this letter there is a waiting time of approximately 26 weeks for this examination.
There will be a limit to people's patience, as the Chief Secretary can see from Labour's falling position in the opinion polls. In the end, the people of west Kent and Sevenoaks will be waiting not just for more money for schools and the NHS; they will be waiting for the return of a common-sense Conservative Government.
Mr. Stephen Hepburn (Jarrow): I should like to touch on two specific areas of public expenditure that are of great importance to my constituents. First, I want to raise the issue of health spending, because recent figures show alarming discrepancies between my constituency and those in other parts of the country. Secondly, I shall talk about defence spending and its role in the key industries in my constituency, and its effect on the major issue of job creation, which leads on from that.
The Chancellor's statement was first class. There is no doubt that it was good news for the area that I represent, and for the north as a whole. The increase in Government spending will be welcomed by my constituents, but I should like to draw the House's attention to some other figures that were not given such a high profile as the Chancellor's statement--the annual performance figures for the NHS that were announced last week.
It is five decades since the Labour Government established the NHS, yet there has never been sufficient accountability for the quality of treatment that the health service provides to the public. The statistics were an illuminating source of information. We must be careful when using statistics, as it has been said that they are often
The shocking fact about the performance indicators for my constituency is that on most indices we are near the bottom, or bottom, of the league table. We are the third worst for the number of doctors per head of population. Obviously, if we do not have enough doctors, people's health will be worse. We are the third worst for the number of people dying from cancer, and we have one of the highest death rates in the country. Those figures are not a reflection on the staff of my local health authority, because the same performance indices show that they are among the best performers in the country. They have been swimming against a historic tide of staff shortages, lack of resources and a local population whose health has traditionally been among the worst in the country because of the concentration of heavy industry and the prevalence of deprivation.
I am sure that we all agree that health inequalities are immoral and unacceptable. I am pleased that the Government have announced that the abolition of those anomalies for ever is a priority. They cannot be abolished quickly enough, because my constituents are twice as likely to die as a person in a constituency in the south of England.
The Government have adopted a two-tier approach to abolishing inequalities--first, by giving greater resources to health authorities in more deprived areas to allow them to narrow the inequalities between them and other authorities. The investment announced this week will pay for the extra doctors and nurses that are needed, and to improve the equipment that, sadly, has been neglected for 20 years.
The second tier is tackling deprivation, which is one of the major of causes ill health, and that means tackling unemployment head on. The new deal has certainly had an impact in Jarrow. Already, youth unemployment is down by 78 per cent., and long-term unemployment is down by 62 per cent. On top of that, raising incomes in the constituency through the minimum wage, the working families tax credit and child benefit brings people out of the terrible spiral of deprivation that they have faced for so long.
I shall now refer to defence expenditure. The mainstay of the local economy in Jarrow is shipbuilding--it has been in the past, is now and I hope will be in the future. The shocking fact is that the average age of the skilled worker on the Tyne is now 50. Urgent investment in skills is required if we are to retain a shipbuilding presence on the Tyne.
We are currently awaiting an announcement from the Ministry of Defence about where the roll on/roll off ferries will be built. I appeal to Ministers to make an early announcement, and end the misery of the workers who want to know whether they will have a job or not. I also appeal to Ministers to give preference to the first-class Maersk bid, which unselfishly--I stress the word "unselfishly"--splits the work between the work force of Cammell Laird in Liverpool and the rest of Merseyside, and the work force in Tyneside. They have come up with a solution involving workers from across the country with similar problems who are not currently using their skills.
I do not underestimate the importance of that order for my constituency. It involves significant defence expenditure. A positive announcement would provide employment for about 1,500 new workers in my constituency and up and down the Tyne. It would provide new apprenticeships to replenish depleted skills. The wages alone would inject about £650,000 into the local economy, not to mention the knock-on effect of a further 1,500 jobs or more in the local economy through support for local businesses.
I shall end on that note. I hope that Ministers take on board the issues that I have raised about health inequalities and the lack of shipbuilding orders on the Tyne. The Chancellor is taking positive action by providing increased expenditure, and the Secretary of State for Health is taking positive action on health. In my area and in Tyneside as a whole, we also need positive action to ensure that our industrial base--and shipbuilding in particular--has a future.