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Laura Moffatt (Crawley): I thank my right hon. Friend for his welcome news for trusts, particularly in my area. They will heave a great sigh of relief at now being able to recruit in the way that they wish. My right hon. Friend knows that modernisation, not just investment, is the key to our NHS moving forward. With regard to improving treatment for cardiac patients, has my right hon. Friend given any thought to allowing paramedic ambulance crews to give the so-called clot-busting drugs? As my right hon. Friend said, it is so important for those to be given as quickly as possible. Has my right hon. Friend made any movement on that?

Mr. Milburn: Yes, I can confirm that. During the next few months and in the next financial year, we shall start to do precisely that, ensuring that, in future, more and more paramedics are appropriately trained to give those life-saving drugs to people who have had a heart attack. It is far more sensible to do that immediately the ambulance arrives at someone's home rather than having to transport the heart attack victim from home to hospital, with all the delays that can accrue.

Mr. Simon Burns (West Chelmsford): When the Secretary of State talks about real-term increases in funding, he rightly bases that on the retail prices index. But as the right hon. Gentleman will be more than aware, NHS inflation and wage inflation are significantly higher than the RPI. Has he calculated what impact NHS inflation will have on his spending plans during the next three years and how it will affect NHS spending?

Mr. Milburn: Yes, we have done that. I can confirm that, while the cash rise is, on average, 8.5 per cent., the real-terms rise is about 5.9 per cent. The hon. Gentleman

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will be aware that, as when the right hon. and learned Member for Rushcliffe (Mr. Clarke) held office, it is well in excess of the amount of money made available to the NHS when he, I think, was a Health Minister.

Helen Jones (Warrington, North): I welcome what my right hon. Friend has said, particularly with regard to the performance fund, some of which I hope will come to Warrington hospital in due course. Will my right hon. Friend ensure that, in his review of funding, the needs of areas such as north Cheshire, which has large pockets of health inequalities among areas of affluence, particularly in my constituency and that of my hon. Friend the Member for Halton (Mr. Twigg), are met, so that they can tackle the health inequalities that exist outside big cities?

Mr. Milburn: Yes; I do not know whether it was made clear to my hon. Friend in the letter that she received from me today, but I can confirm that, in the allocation to North Cheshire health authority, there is a health inequalities adjustment of an extra £1.1 million, precisely recognising the real health problems of her area and others.

Sandra Gidley (Romsey): It would be churlish not to welcome extra money, and I particularly welcome the cost of living allowance for health professionals, but I represent a Hampshire constituency and I did not hear Hampshire mentioned in the list. Will the Secretary of State please confirm the situation with regard to Hampshire?

Mr. Milburn: The following health authorities, which--helpfully--are not ranked in alphabetical order, gain from the cost of living allowance: Southampton and South West Hampshire, Portsmouth and South East Hampshire and North and Mid Hampshire. It is good to make someone happy.

Dr. Ian Gibson (Norwich, North): I thank my right hon. Friend for granting resources for Norfolk, but I especially welcome the fact that the resources are to be spread throughout the country. That is an important political point. I have known my right hon. Friend for many years through our days in the Association of Scientific, Technical and Managerial Staff. I never imagined that he would become the man with the team that cracked the postcode lottery. Today's announcement means that he has done that. Thank goodness the right party won the election in 1997; it is a shame that we did not win in 1992. Some of us might have enjoyed our jobs in cancer research in the intervening five years much more than we did.

Will my right hon. Friend confirm that the money is separate from the money for radiotherapy machines and buildings that has always existed? Today is a heyday in the fight against cancer and for the medical world in general.

Mr. Milburn: I am grateful to my hon. Friend, and for all his work for cancer research and in the battle against cancer. I can confirm that the extra money will be for revenue purposes. I shall make announcements in due course about extra capital. Without letting too many cats out of the bag, we expect further improvements and

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investment in the modernisation of cancer equipment. That is long overdue; it is desperately needed and, as my hon. Friend rightly said, it should have started many years ago.

Mr. Andrew Rowe (Faversham and Mid-Kent): As the Secretary of State knows, I am especially glad that cancer is beginning to get the sort of priority that it deserves. However, he knows that some nursing agencies on which the NHS depends have been recruiting staff in sub-Saharan Africa. Does he believe that robbing the poorest countries in the world to improve our health service constitutes proper use of the money that has been put into the NHS?

Mr. Milburn: No, I do not. Sadly, I do not run the nursing agencies that are responsible for such conduct. However, as the hon. Gentleman knows from the NHS plan commitments, we will recruit some staff from overseas, for example, nurses from Spain. We shall also attempt to recruit some doctors from other parts of Europe. However, we do not believe that we should rob developing nations of the medical and clinical staff that they desperately need.

Mr. Tony Lloyd (Manchester, Central): My right hon. Friend's remarks, especially about Manchester, gave a clear signal of the Government's commitment. One of the biggest blots on the NHS in recent years has been the relationship between poverty and ill health.

Earlier, my right hon. Friend mentioned "la, la", sitting opposite. There were no kindly Tory Teletubbies in previous Governments; instead, there was indifference to and cynicism about health inequality. Every Manchester Labour Member beat a path to successive Tory Health Ministers and were told that inequality did not matter. Today's announcement means that my constituents can look forward to the same quality of health care as those of Conservative Members. That is a genuine sign of proper commitment to a fair and universal national health service.

Mr. Milburn: I am extremely grateful to my hon. Friend. I agree with the thrust of his remarks. We all know from our constituencies, regardless of whether we represent a so-called poor area or a so-called rich area, that there is a clear correlation between poverty, deprivation, poor housing, lack of employment opportunities and ill health. Frankly, the position is worse than my hon. Friend suggested. Not only did that lot refuse to recognise inequality: they banned the word in the Department of Health.

Mr. Julian Brazier (Canterbury): At a time when there have been patients, some with serious conditions, on trolleys and in offices in all three acute hospitals in east Kent, and when many of our roads and our rail system have been disrupted by flooding, is the Secretary of State aware of the dismay with which people continue to face the proposed reorganisation in east Kent? It includes closing the accident and emergency unit in the heart of east Kent, stripping the Kent and Canterbury hospital, to whose coronary and cancer units the Secretary of State is committed, of many of its supporting services, and funding the process by a cut in beds in that overstretched hospital.

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Mr. Milburn: I am not particularly surprised by the hon. Gentleman's comments, although I am somewhat disappointed. He should welcome the 8.44 per cent. increase in funding for the health service in his area, because it will help to deal with some of those difficulties. Just because we are putting record levels of investment into the national health service, it does not mean that the health service at a local level will not change. Medical advances, changing technologies and changes in demography are all driving change in the national health service. It has changed over the past 52 years, and it will continue to change over the next 52. Rather than stand in the face of change, the hon. Gentleman should get on side and support the changes to ensure that his constituents get better care than they have received in the past.

Mr. Eric Illsley (Barnsley, Central): My right hon. Friend's announcement will be most welcome in the Barnsley health authority area, especially in view of the inequalities in health care in that authority in the past. As my right hon. Friend knows, historically Barnsley is one of the lowest-funded health authorities in the country, yet it has some of the greatest needs in the treatment of cancer, strokes and heart disease. Will my right hon. Friend give me some reassurance that the needs of our health authority will be met by closing the funding gap and bringing us closer to our target funding in future years?

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