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Dr. Liam Fox (Woodspring): I thank the Secretary of State for his statement, and for his courtesy in making a copy available to the Opposition in advance.
Given the huge potential importance of the NHS plan, I am sorry that the House has not yet held a debate on the full plan in Government time, but as the Leader of the House is sitting on the Treasury Bench, I hope that she might take note of that point and make time available so that the House can discuss the plan in the detail it deserves.
The Secretary of State did not say much that was new; in many cases, he made a series of re-announcements, but we have got used to that. However, we very much welcome parts of the statement. As we have said previously, we welcome the increased funding that the Government are making available. Again, we pledge to match that increase in NHS funding.
I also welcome the right hon. Gentleman's attempts to tackle inequalities in health care. That is most important. But it must be done in such a way as not to rob Peter to pay Paul, and by levelling up services rather than levelling them down.
I welcome the extra resources for staff in high-cost areas; I notice that the Secretary of State has kindly--as might have been expected--included my own. I welcome the fact that cancer and cardiac care are to be made a priority; as I have often pointed out to the House, that would also be the priority under the next Conservative Government. I particularly welcome the specific mention of acute leukaemia. I undertook my junior doctor training in a leukaemia unit in the Glasgow Royal infirmary; that disease should be one of the priorities.
I also welcome three-year budget setting, although there is no use in doing that if there is constant interference from the centre and a constant re-setting of priorities once budgets have been set locally.
The Secretary of State says that the NHS is growing again. This year, however, the Government's figures show that since last winter there has been a reduction in the number of intensive care beds, acute beds and residential care beds. We now have the concept of the funded bed blocker--whereby people who already have a social services funding package block acute beds because there is nowhere to put them. What does the Secretary of State intend to do about that?
Will the Secretary of State give the House answers to the following specific questions? He says that, over the next year, there will be an expansion in the number of beds. Where will they be? How many extra beds does he expect to be provided in the NHS? In which sectors will they be? Will they be in the hospital sector? What is his estimate of the impact on bed numbers of the private finance initiative?
The Secretary of State refers to the allocations to health authorities--funding of a further £450 million to help to tackle cardiac and cancer care. Is that ring-fenced money? Will he clarify that point so as to avoid misinterpretation of his statement?
There is to be more help for those people who want to give up smoking. The Government's cancer tsar says that their anti-smoking strategy is "misdirected" and poorly managed. What is the position on Zyban? In April, the Department of Health promised GPs guidance on who should receive the drug and in what circumstances. That guidance never materialised, and there is now piecemeal provision. Will the Secretary of State clear up that matter?
The Secretary of State tells us that by March 2002, three in four eligible patients will receive thrombolysis treatment, but that means that one in four will not. What conceivable reason could there be for not making that treatment available?
The right hon. Gentleman talks about reducing inequalities, but as he is aware, one of the big problems is not only the provision of services but their uptake. For example, he will know of the problems of uptake in the inner cities for programmes such as those for cervical smears. What specific measures will he introduce to make sure that uptake matches any increased provision?
The Secretary of State talks about redefining the formula for allocating funding. Can he give the House an indication of how he expects that to work, although I do not expect him to provide the details now?
The Secretary of State talks about the lottery in patient care coming to an end. We have all read the spin today about extra money being made available for cancer drugs. Can he tell us the position on that? As the National Institute for Clinical Excellence has been given the criterion of affordability by the Government, what impact will his statement and the funding that he makes available have on affordability of cancer drugs? What does he expect to happen? It is pointless saying that cancer will become a priority and it is pointless even providing more specialists if there is not then access to diagnostics and the treatment is not made available to patients. That is the most important issue of all.
I welcome the recent concordat that the Secretary of State has signed with the private sector. It could allow for the type of public-private partnership that is enjoyed
in most European countries. If the Government have genuinely moved ideologically, we welcome that. However, will he confirm that the concordat is not just about NHS doctors treating NHS patients in private facilities, but that it will allow primary care trusts to buy services for patients in the private sector using only NHS funding? That is our understanding from reading it.The Secretary of State's statement promises much, but he has promised before. The improvements that he claims exist are not borne out by the experience of the public. Only yesterday we heard that the waiting time to get on the waiting list had gone up. Where the Government make improvements, we will welcome them. However, they are now setting targets for hospital waits for 2008--a far cry from the early pledges and "24 hours to save the NHS". The Prime Minister recently said that he did not understand the scale of the problem that he faced in the NHS. Nothing that the Secretary of State has said today reassures us that he does, either.
Mr. Milburn: I thank the hon. Gentleman for his grateful acceptance of the cash. Perhaps that is not surprising. I remind him that, in the last year of the previous Government, his health authority received an increase of about 3 per cent. This year, it is receiving an increase of just under 9 per cent.
I am also grateful to the hon. Gentleman for his latter-day conversion to the idea of tackling inequality. In 1992, he was the hon. Member who said:
- poverty, poverty, poverty--la, la, la, . . . It is just boring for Conservative Members.--[Official Report, 22 October 1992; Vol. 212, c. 636.]
The hon. Gentleman raised the issue of cancer drugs, and I can confirm that 13 up-to-date cancer drugs have been referred to the National Institute for Clinical Excellence. It is due to report in the summer of 2001, and we have made provision in the health authority allocations. However, that provision will depend on what NICE comes up with. It is true that, when we have previously referred cancer drugs to NICE--most notably, the taxanes, which we referred last year and this year--the result has been a dramatic uptake in the number of patients receiving high-quality cancer drugs. I think that one in four patients with ovarian cancer and three in four patients with breast cancer did not receive taxanes before the NICE recommendation. However, every patient who needs taxanes now receives them, thanks to the decisions of NICE, a body that we established and the Conservatives opposed. We are investing extra money in the health service. The Conservatives opposed that. Those are the results of the choices that we have made.
On intensive care beds, the hon. Member for Woodspring (Dr. Fox) will find that this winter there are more intensive care beds than there were last winter. We allocated a further £150 million, and I expect there to be substantially more than 300 extra critical care beds.
On bed blocking, the rate of delayed discharges is falling, certainly from the level that we inherited from the previous Government. As for the number of beds, the hon. Gentleman is aware that yesterday I announced the third wave of major hospital redevelopments. Many of those will be built as part of the private finance initiative. I have also stipulated that in the third wave, the 18 major new hospitals should help to increase the number of hospital beds, thereby helping to reverse a 30 or 40-year trend of decline.
The hon. Gentleman knows that the point that he made about Professor Mike Richards, the cancer tsar, is wrong.
On waiting times, the report published yesterday is factually inaccurate. The same company produced a report last summer. It was factually inaccurate then; it is factually inaccurate now.
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