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HOUSE OF COMMONS

The President of the Council was asked--

Modernisation Committee

48. Helen Jackson (Sheffield, Hillsborough): What response the Government have made to proposals of the Select Committee on Modernisation of the House of Commons to improve the efficient working of the House. [136373]

The President of the Council and Leader of the House of Commons (Mrs. Margaret Beckett): The Modernisation Committee was set up to propose changes to improve the efficient working of the House of Commons, which has already accepted Government motions to implement the programming of legislation and to defer voting. I anticipate that the House will shortly be invited to approve the continuation of the experiment with Thursday sittings and sittings in Westminster Hall.

Helen Jackson: I am grateful to my right hon. Friend for the amount of work that she has done, through the Modernisation Committee, to improve the efficiency of the House and its workings. Does she agree that there is room for further improvement, as the years go by in this century, to see how best the new availability of information technology and communications systems can be brought into all our working practices, even in Committees?

Mrs. Beckett: I, in turn, am grateful to my hon. Friend, not least for her work on the Modernisation Committee, as well as for her remarks. She is right that the issue has been raised across the House, and I believe that the House will need to consider it. We cannot and should not turn our backs on the opportunities opened up by new technology, but should consider how it can most effectively supplement and make more efficient the work that Members carry out.

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NHS

3.31 pm

The Secretary of State for Health (Mr. Alan Milburn): With permission, Mr. Speaker, I wish to make a statement about the resources being made available to local health services in all parts of England, and the priorities for reform in the NHS.

In the past three years the NHS has treated 2.3 million more patients. It now employs 10,000 more nurses and more than 5,000 more doctors. Waiting lists for in-patient treatment have fallen by 126,000. For the first time since records began, last year saw the number of patients waiting for out-patient appointments and in-patient treatments falling simultaneously. Every accident and emergency department that needs it, and 1,000 general practitioners' surgeries, are being modernised. The biggest hospital-building programme in the history of the NHS is under way.

After decades of neglect, the NHS is now expanding its services to patients. For two decades or more, the NHS budget rose by an average of just 3 per cent. a year. In the previous Parliament it rose by rather less than that--by just 2.6 per cent. In this Government's first two years in office, spending on the NHS did not rise as quickly as many had hoped. However, the tough choices that we took then are paying off for the NHS now. Interest rates and inflation are at historic lows. Unemployment is down, employment is up. The public finances are back in balance. A strong and growing economy is providing the foundation for strong and growing public services.

Over the five years from 1999, the NHS budget will grow by one half in cash terms and by one third in real terms. This year, and for the next three years, the real-terms annual increase in NHS funding will be 6.3 per cent--twice the trend growth of the past few decades.

Today I can inform the House of the funding allocations for each health authority in England. The cash is for revenue purposes. I will be making announcements in due course about capital resources. Details of today's allocations for the local health authorities in right hon. and hon. Members' constituencies are available in the Vote Office. I have also written today to all right hon. and hon. Members with details.

For the first time in the history of the NHS, I am making outline revenue allocations for the next three years rather than just for a single year ahead. This will allow every local health service to plan with confidence for the medium term rather than just for the short term. As right hon. and hon. Members are aware, there has been too much boom and bust in NHS funding in the past. Today we bring that to an end. [Interruption.] I knew that would excite them, Mr. Speaker. From April next year, health authorities will receive an average cash increase of 8.5 per cent. No health authority will receive less than 7.8 per cent. The average rise in cash terms for a health authority next year will be £29 million.

I can also announce today that every health authority will benefit from a further rise of at least 6 per cent. in 2002-03 and a further increase of at least 6 per cent. in 2003-04. Those increases are the minimum that all health authorities can expect to receive, with final allocations to be made in the autumn of next year and the year after. I know that the House will want to compare the increase

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in investment for next year and the following years with allocations in previous years. For the benefit of right hon. and hon Members on both sides of the House, let me explain that in the last year of the last Parliament the NHS budget actually fell in real terms. I am pleased to tell the House that, after years of under-investment, the NHS is now growing again.

Of course, different parts of the country have different health needs. The Government are currently reviewing the formula according to which we distribute NHS cash to ensure that it is better focused on addressing those needs properly and fairly. In the meantime, I will make a number of important changes for next year. First, I am more than doubling, to £130 million, the resources available within health authority allocations to help address some of the appalling health inequalities that scar our nation. Life expectancy for a baby boy born in Manchester is six and a half years less than that for a baby born in east Surrey. The existing funding formula does not take full account of the excess morbidity and mortality from cancer, coronary heart disease and other causes in those areas, as expressed through rates of years of lost life. The extra funding will help places in the north and midlands such as Bury, Rochdale, Calderdale, Kirklees, Dudley, Leeds, Leicestershire, Manchester, Newcastle, north-west Lancashire, Nottingham, Sandwell, Tees and Wakefield. It will also help areas in the south such as Bedfordshire, Brent, Cornwall, east Kent, Herefordshire, Lambeth and south and west Devon. Those extra resources will help to narrow the health gap between the better-off and the worst-off.

Secondly, I am making available a further £65 million to pay a new cost of living supplement for 100,000 qualified nurses, midwives, health visitors and those in professions allied to medicine, such as physiotherapists and radiographers, who work in the highest-cost parts of England. From next April, there will be a minimum of £600 extra for every one of these staff working in London, over and above current London weighting, and up to £1,000 for ward sisters and senior nurses in the capital. Staff in those groups who are working in the highest-cost areas outside London such as Avon, Berkshire, Buckinghamshire, Cambridgeshire, Hertfordshire, Oxfordshire, Surrey, Sussex and Wiltshire will receive between £400 and £600 each. Those extra resources will help in our efforts to recruit an extra 20,000 nurses and 6,500 therapists to the NHS over the next four years.

There is a one further change that I am making to the way the local health service is funded. In the past, there have been too few means to drive up performance and tackle unacceptable variations between local health services. If the NHS is to make progress, it must move from a position in which it bails out failure to one in which it rewards success. The best NHS organisations should have more freedom and more resources to expand their services to more patients, and the worst should have more help to enable them to improve. For next year, I am making available a new £100 million performance fund to provide a clear financial incentive to all parts of the NHS to improve local services. The fund will rise to £500 million by 2003-04. The best local services will be free to spend their share of the fund on equipment, facilities or cash bonuses for staff. The worst will still get a fair share of the fund, but it will be held by the new modernisation agency to use for targeted external assistance to help turn round performance. We will no

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longer tolerate second-rate services in any part of the NHS. The lottery in patient care must now come to an end.

The extra investment that we are making will bring about the major reforms that the NHS needs. At present, services are too slow, standards too variable and staff too often run off their feet. In July, the Government published the NHS plan, which describes the radical reforms necessary to redesign the service around the needs of its patients. The money that I am allocating today will raise the pace of implementation. Next month, I will publish a detailed NHS plan implementation programme for the health service and for social services. It will detail the investment and the progress that will have to be made over the next year--for example, in improvements in hospital standards, and in services for elderly people, children in care and patients with mental illness.

The next year will see a major expansion in beds, staff and services. Improved co-operation between health and social services, for example, will deliver more packages of intermediate care support to benefit 60,000 elderly people, so that in every council area in every part of the country more older people can live independently at home. The result will be lower rates of delayed discharges from hospitals in all parts of the country. It is crucial that the resources now available to the health service should allow a proper focus on how we can bring about improvements in health, not just an increase in the scale of investment in health services.

The allocations to health authorities will fund a further £450 million to help tackle our country's biggest killers--cancer and coronary heart disease. Our rates of both diseases are too high, and both are largely preventable. The extra resources will mean more drugs to combat cancer and heart disease, more help for people to give up smoking--a major cause of cancer and heart disease--and more operations provided more quickly for more people with cancer and heart disease. By December next year, for example, there will be a new maximum one-month wait from urgent general practitioner referral to treatment in hospital for men with testicular cancer, for children with cancer and for patients of all ages with acute leukaemia. Similarly, by March 2002, three in four eligible heart attack victims will receive life-saving, clot-busting drugs--thrombolysis--within 30 minutes of arrival at hospital. At present, many people wait twice as long.

Waiting is the public's number one concern about the health service. That is why the Government have placed such strong emphasis on winning the war on waiting in the NHS. The NHS plan set out how waiting times will reduce by 2005. The waiting time for seeing a GP will fall to 48 hours, for being seen in accident and emergency departments to an average of 75 minutes, for out-patient appointments to a maximum of three months, and for in-patient treatment to a maximum of six months. By 2008, there will be waits for hospital treatment of weeks rather than months.

The investment that we will make over the next year will deliver real progress towards those shorter waiting times. At present, 126,000 patients wait more than 26 weeks for an out-patient appointment. By March 2002, no one should wait that long, and the number of people waiting for 13 weeks will also have been reduced.

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Similarly, the maximum waiting time for in-patient treatment is currently 18 months--a target set, but never achieved by the previous Government. We estimate that about 50,000 people wait between 12 and 18 months for a hospital operation. By spring 2002, the NHS will have reduced the numbers waiting more than 12 months, and the maximum waiting time will have been reduced from 18 to 15 months for all patients.

I recognise that these new maximum waiting times are still too long, but they represent the first instalment on real progress towards the NHS plan objectives. The NHS is in a position to deliver substantial improvements for patients because of the commitments that the Government have made to it. While some in this House say that they have philosophically moved on from the NHS, the Government remain committed to the NHS and its survival and modernisation. We have made our choice. Our choice is an NHS providing care according to need, not ability to pay. Our choice is a tax-funded health service, available to all, and not a privatised system of care available to only a few. Our choice is long-term investment in our key public services, not cuts in those services. Our choice is record levels of investment, alongside a radical programme of reform.

The step change in the resources that we have made available to the NHS must now produce a step change in results. None of what follows will be easy. Much of it will take time. However, the NHS now has the best opportunity that it has ever had to bring about the radical changes needed to give patients better and faster services. The resources that I have committed today will bring about improvements in health and health care in all parts of the country. I commend them to the House.


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