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Mr. Christopher Chope (Christchurch): When are we going to have the debate on small businesses? Last week, in answer to my hon. Friend the Member for Tiverton and Honiton (Mrs. Browning), the Leader of the House said that many requests were received for annual debates and that it was not possible to comply with all of them. Is not this matter different, however? Does the Leader of the House remember that the Labour party made an explicit policy promise in its manifesto at the previous general election that there would be an annual debate on small businesses? Are not the Labour Government reneging on that promise?
Mrs. Beckett: We are not reneging on anything. I am simply unable to announce a date at the present time.
Mr. Richard Burden (Birmingham, Northfield): Will my right hon. Friend arrange an early debate on consumer protection? There are two principal reasons. The first is so that the Government can amplify the provisions of the White Paper "Modern Markets: Confident Consumers". Secondly, such a debate would give the Conservative party the opportunity to explain its consumer protection policies. For example, some Conservative Members supported the Outworking Bill and put their names to it; others opposed on principle providing legal protection from con artists wanting money up front; and those on the Conservative Front Bench, while saying that they agreed with the principles and participating in the debate, absented themselves from the vote, thereby effectively killing the Bill for this Session. Vulnerable people who could have been protected will now have to wait months, perhaps years, as a result of their actions.
Mrs. Beckett: I have great sympathy with the point that my hon. Friend makes. I know how disappointed he will be that he was unable to make further progress with his Outworking Bill. Sadly, as he will know, it is by no means the first time that Conservative Members have claimed to support legislation, or to be perfectly happy to facilitate its consideration, but the opposite has happened, and they claim it is all an unfortunate coincidence. He is therefore right to draw attention to that problem, and I share his regret that it is not possible to proceed with his Bill and do more to protect outworkers. I am confident that my hon. Friend, and those like him who genuinely
wish to help those who are being exploited, will look for other opportunities to raise the matter, but I fear that I cannot promise a debate on the issue in the near future.
Sir George Young (North-West Hampshire): The Government have made some very controversial changes to our procedures, with a view to injecting some certainty into the legislative programme. Against that background, will the right hon. Lady tell the House how optimistic she is that, by the end of March, the Tobacco Advertising and Promotion Bill, the Social Security Contributions (Share Options) Bill, the Health and Social Care Bill, the Homes Bill and the Hunting Bill will have completed their passage through Parliament?
Mrs. Beckett: I should have to check precisely where all those Bills are at present, but the right hon. Gentleman may be inviting me to anticipate some of the decisions of the other place. He is certainly right to say that we have embarked on some experimental changes in procedures, which are controversial, especially among Conservative Members, but have long been recommended by Members on both sides of the House. We believe that as the procedures settle down, they will give the House greater certainty and enable us to deal with legislation more effectively. I am confident that the Government's legislative programme is well on track.
Mr. Christopher Leslie (Shipley): Might my right hon. Friend find time for a debate on the administrative costs of social security--in particular, the new Conservative plan to scrap the automatic £200 winter allowance for pensioners, which would be expensive, complex and confusing--
Mr. Speaker: Order. I cannot hear the hon. Gentleman, with hon. Members shouting "order". Let me hear what he is saying. He might know that the Leader of the House is not responsible for Conservative party policy, but he can continue with the question; I want to hear what he has to say.
Mr. Leslie: I am grateful to you, Mr. Speaker. I wanted to ask my right hon. Friend whether the Government would find time to debate the administrative costs of social security, so that we could debate issues such as the effect of scrapping the automatic £200 winter allowance for pensioners--a plan that would be not only confusing and complex, but extremely costly. That blows a hole in the Conservative party's hollow aspirations to cut the costs of red tape, which are a complete and utter joke.
Mrs. Beckett: My hon. Friend is right to refer to the concern that any Government should feel about the possibility of a substantial increase in administrative costs for no gain. I understand his wish to debate the possible impact on costs of the policy that the Conservative party currently advocates. Such are the pressures of time,
however, that I fear I cannot find time to debate issues such as social security every time that the Conservative party changes its policy.
Mr. Quentin Davies (Grantham and Stamford): Does the Leader of the House have any intention of restoring to our timetable the debate on the Standards and Privileges Committee which, rather sinisterly, she pulled out of the timetable last week? Unfortunately, there is a danger of our whole system of self-regulation being irrevocably discredited. The Committee has overridden the Parliamentary Commissioner for Standards on three occasions, and it so happens that each time a member of the Government was involved: the Deputy Prime Minister, the right hon. Member for Hamilton, North and Bellshill (Dr. Reid), formerly the Secretary of State for Scotland, and the right hon. Member for Hartlepool (Mr. Mandelson), formerly the Secretary of State for Northern Ireland. The Chairman himself has been convicted by the commissioner of systematic non- disclosure.
The inquiry into the affairs of the Minister of State, Foreign and Commonwealth Office, the hon. Member for Leicester, East (Mr. Vaz), has dragged on for more than a year and will drag on for even longer because the Committee is hearing witnesses, something which the same Chairman refused to do in the inquiry into the Hamilton affair at the beginning of this Parliament. In fact, he cut off the Committee proceedings when I was about to question Mr. Hamilton, and he prevented us from calling Fayed or any of the other witnesses.
We need to know what is going on. Will the Leader of the House restore that debate to the timetable so that we have an opportunity to express our concerns? I hope that there will also be an opportunity for those concerns to be satisfactorily addressed.
Mrs. Beckett: Although I am somewhat disappointed by what the hon. Gentleman has said and the tone in which he said it, I am in some ways quite pleased that he said it on the Floor of the House, because it enables me to tell him how disgraceful I thought his contribution was on the BBC last week, when he made exactly the same points. He was, as he pointed out, a member of the previous Standards and Privileges Committee, and in consequence I should have thought that he knew better than to try to undermine the work of the present Committee in the way that he has done previously and again today.
I must say two other things to the hon. Gentleman. First, despite his remarks, the Committee's decisions--which it is free to make on behalf of the House, as is right and proper--were unanimous. The Committee makes the decisions that it believes are in the interests of the House. Secondly, my right hon. Friend the Member for Ashton-under-Lyne (Mr. Sheldon), who chairs the Committee, is held in high esteem and respect in the House, which is more than can be said for the hon. Gentleman at present or will be said if he carries on like this.
NHS Hospital Building
1.11 pm
The Secretary of State for Health (Mr. Alan Milburn): With permission, Mr. Speaker, I wish to make a statement on the NHS hospital building programme.
The national health service is in the most prolonged period of expansion in its history. The NHS plan that we published last July set out a major reform programme to accompany the investment that we are making. Extra cash is now beginning to bring on line the extra capacity that the NHS needs to make care better and faster for patients.
This morning, my Department published new figures showing continued growth in qualified staff within the health service. The figures show that in September 2000, compared with September 1999, there were 2,500 more doctors, 3,500 more scientists, therapists and technicians and more than 6,300 more nurses working in the NHS. That means that since 1997, the number of doctors has risen by 6,700, the number of scientists and therapists by 9,600 and the number of nurses by 17,100. Of course, problems do remain with shortages of doctors, nurses and other trained staff, but progress in the health service is now being made.
The NHS plan set ambitious targets for addressing the shortage of trained staff that has bedevilled the NHS for many decades. From April, NHS budgets for training doctors, nurses and other qualified staff will rise by over 11 per cent. Together with the other action that we are taking to recruit and retain more staff, that increase in training budgets will sustain growth in staff numbers not just until 2004, as the NHS plan promised, but until 2010. The record increases in funding which the Government are now making mean that the NHS today is the fastest growing health service of any major country in Europe.
There is a huge amount of catching up to do. Nowhere is that clearer than in the state of NHS buildings. This afternoon, I am publishing a report on the progress that we need to make as a nation in improving the NHS estate and, in particular, in modernising its hospitals. One million patients a week use NHS hospitals. One third of those hospitals were built before the NHS was created, and one tenth date back to Victorian times. We cannot deliver 21st century care in 19th century buildings.
For too long, investment in NHS infrastructure has been a low priority when it should have been a high priority. Capital investment in the NHS was lower at the end of the previous Parliament than it was at the beginning. The consequences are plain for all to see: shoddy buildings, unreliable equipment and out-of-date hospitals. In too many places, the environment in which staff work and patients receive care is simply unacceptable.
We have made a start in putting that right. The biggest new hospital building programme in the history of the NHS is already under way. Since 1997, 38 major capital schemes, worth almost £4 billion, have been given the go-ahead. New hospitals are already open in Carlisle, Dartford, south Buckinghamshire, Rochdale and Sheffield. A further five new hospitals are due to open later this year.
The NHS plan set out proposals for a total of 100 new hospital developments in England during the course of this decade. Many parts of the country need those new hospitals--some local communities have been waiting
decades for them. In 1997, we established a team of experts--the capital prioritisation advisory group--to advise the Government on which new hospitals should move ahead first. The criteria that the group uses includes an assessment of where health need is greatest and facilities are poorest.The group has met during the past few months to advise on the next round of new hospital developments. I am grateful to it for the difficult work that it has had to do. The NHS plan indicated that nine new hospital developments would be given the go-ahead in 2001, with a further nine to follow in 2002. The group considered 29 bids for those 18 new hospital developments. The advice that I have received is that there is a strong case for investment in all 29 proposed schemes. I have accepted that advice. Instead of approving 18 schemes, I am giving the go-ahead to all 29.
I can announce that, during this year, work will begin to procure 12 new hospital developments in Birmingham and Bradford, for Bristol's mental health services, in Central Middlesex, East Kent, Leicester, Lewisham, Peterborough, Salford, Tunbridge Wells, Wakefield and Whipps Cross. Next year, work will begin to procure a further 13 new hospital developments in Brighton, for Bristol's acute services, in Central Nottinghamshire, Chase Farm, Chelmsford, Colchester, Hull, North Middlesex, North Staffordshire, Plymouth, St Helens, Walsall and Wolverhampton. The following year, work will begin to procure a further four new hospital developments in Oxford, Southampton, South Devon and Tameside.
The total projected value of the new hospital developments is £3.1 billion. Each will need to be subject to the normal approvals process and, of course, each will need to confirm viability, affordability and value for money before it is finally signed off. The first of the new hospitals will be open by 2006. That is an unprecedented expansion in new hospital developments in the NHS. For millions of patients and thousands of staff, it will provide modern state-of-the-art hospital treatment and care.
Many of the new hospital developments will be delivered through the private finance initiative, if that represents best value for the taxpayer and the NHS. I can confirm that, at the end of the PFI contract, the option will be open for each hospital to become the property of the local health service.
I am also making a further major reform of the PFI process. For too long, hospital developments have been considered in isolation from other changes to local health services. A hospital can only work successfully--for example, avoiding bed blocking and long waiting times--if it works in partnership with local primary, community, intermediate and social services. In each of the PFI deals, consideration will need to be given to building alongside a new hospital new primary and intermediate care facilities in the local community to help to ensure more seamless care for local patients. In some cases, that has already happened, spreading the benefits of private finance to other parts of the NHS, where investment is sorely needed.
However, we need to go further still if we are to deliver the shorter waiting times that patients need and good health demands. NHS hospitals deal with almost 4 million emergency admissions a year. They have grown by more than one quarter in the past 10 years. In the NHS,
emergencies always come first. That is as it should be, but every year increased emergency admissions displace planned elective admissions. That sometimes means that planned operations are cancelled at the last minute, causing distress for patients and frustration for staff.The NHS plan announced a new generation of diagnostic and treatment centres to overcome that problem by separating emergency from elective work. Today, my right hon. Friend the Prime Minister is visiting one such pioneering centre at the Central Middlesex hospital. As its experience shows, insulating routine hospital operations from often more complex emergency treatment can make a real impact on the time that patients wait for treatment.
Within the hospital developments that I have announced, 16 such new centres will be developed. In addition, similar projects have been agreed at City Birmingham hospital, Dudley, Hinchingbrooke, Kidderminster, Liverpool, Milton Keynes, Ormskirk, Southport, Sutton Coldfield and West Middlesex. In total, we shall invest around £250 million in this new generation of fast-track surgery centres.
The centres will each have distinctive features according to the needs of the local health service, but they will all bring faster care to patients. Patients will be able to book their admissions at their convenience rather than simply being given an appointment time. Some centres will operate at weekends. There will be more day surgery and more same-day test and diagnosis. They will all help to get waiting times down for patients. Crucially, they will mean greater reliability for patients by helping to end the misery of last-minute cancelled operations.
Investment in new hospitals must produce reform in the way in which hospitals deliver care. The problems that patients and staff experience today in the NHS are a product of previous failures not only to invest, but to reform. The resources that we are making available will help to lever in long-overdue changes.
The new hospital developments that I have announced will provide new standards of care for patients and a better working environment for staff. There will be workplace nurseries for staff. There will be no mixed-sex wards, but more single rooms. Patients will have access to a bedside telephone and television, and will have the latest scanning and diagnostic equipment. There will be same-day test and diagnosis facilities to make services faster and more convenient for patients.
There will also be more beds in the new hospitals. For four decades, the number of hospital beds has been falling--157,000 were cut between 1980 and 1997 alone. More than 60,000 of those were general and acute beds. In the year to December 2000, the number of general and acute beds in hospitals started to rise again. I am determined that that trend should now continue.
Overall, these new hospital developments will provide almost 3,000 extra beds on the number currently provided. Indeed, in every single one of the new developments more, not fewer, beds are planned. Moreover, I am issuing to the NHS today new guidance, following the national beds inquiry, which requires each region to expand, not to contract, the number of beds available for patients. The prevailing culture in the NHS has been one of bed closures and cutbacks. That is no longer sustainable. What the NHS needs is more, not fewer, beds.
This major programme of investment will bring more staff, more beds and more new hospitals. It will also bring reforms to the way in which health care is delivered. Patients will be treated in modern, high quality facilities with the latest equipment and the best trained staff. Reliability will be improved and waiting times will be cut. Of course it will take time to deliver, but after decades of neglect, the NHS is now set for a decade of sustained growth alongside far-reaching reform.
The choices that we as a Government have made for Britain--economic stability and investment in our key public services--are paying off for the NHS, the staff who work in it and, most important of all, the patients who use it.
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