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Mr. Bercow: My hon. Friend's natural generosity of spirit should not be allowed to get the better of him. I understand why he makes some favourable reference to the late Aneurin Bevan. However, will he put it on the record that in 1952 the late Iain Macleod famously denounced the Bevan approach and attacked him
specifically for the crude, vulgar and intemperate speech to which the House of Commons had listened? Does my hon. Friend recall that, along with another great parliamentarian and Minister, the late Enoch Powell, Macleod went on to pen a magnificent pamphlet with a radical view of the development of the health service and social services entitled "Social Services: Needs and Means"?
Sir Raymond Whitney: I must not allow my hon. Friend to lead me down the road of militant partisanship. I am strongly of the view that this is a national issue, although it has never been treated as one. Given the probable imminence of the general election and the fact that I shall not stand again, this is my last--I shall not say "despairing"--chance to get the matter looked at calmly, so I shall resist, up to a point, the temptation offered by my hon. Friend.
However, if my hon. Friend studies the pamphlet written by the late Enoch Powell--whose great qualities we all admire--he will find a brilliant analysis of the ills of the NHS in the mid 1960s, but no solution. Why not? Because in the first paragraph of the last chapter, Mr. Powell said, in effect, that the political situation in Britain was too difficult, so rationality had to go out of the window. That is the measure of the problem that we are dealing with. I am grateful to my hon. Friend for giving me the opportunity to make that point.
I was referring to the Jones committee, which reported in April 1970 and recommended an insurance-based system--such as those used with considerable success in several countries. However, by that time, the wind in the BMA had changed; caution was back in and Dr. Jones and his crew were out. People of equal eminence to Dr. Jones received CBEs and knighthoods--he received nothing. The issue went quiet again--it was put back in its box.
Both parties staggered on with the old system until 1982, when the Central Policy Review Staff took the papers down and looked at the problem again; 12 years on, it was much greater than in 1970. The CPRS, too, produced the idea that there should be an insurance-based system that people should chip into. Again, there was horror. By that time, there was a Conservative Government. My right hon. Friend the Member for Sutton Coldfield (Sir N. Fowler) refers to the idea with horror in his book; that dreadful cat was nearly out of the bag, but he cheerfully reports how it was safely put back into the bag. The next year the CPRS was obliterated--it was suspended. I suspect that I, too, shall be suspended soon, because the subject is dangerous.
That is where we have arrived. Is there an answer? There must be one; we have to look at what other countries do. As my right hon. Friend the Member for Bromley and Chislehurst (Mr. Forth) suggested, not only in France but in all the industrialised countries people make a contribution. That is understandable. What is more important to any of us than our health and that of our families? According to our circumstances--I shall discuss the very poor in a moment--we are very ready to chip in with £100 or £200 to bolster health care, whereas we all know that a rise in our taxes, by stealth, income tax or whatever, goes into a great pot and nothing seems to come out.
That could not have happened in 1946 because the personal disposable income of the average Briton was extremely low. If it was grossed up to today's money,
it would be only about $5,000 a year at most--equivalent to the current national income per capita in Namibia or Gabon. In real terms, we are four or five times richer. By whatever statistical tricks one might play, we are manifestly much richer. Today's society is not the one for which the NHS was created.We must thus ensure that the public understand what is happening. Very, very gradually, the penny is beginning to drop. In these days of speedy communication, when we all think that we know everything that happens in the world the day before yesterday--in Sierra Leone, Zimbabwe and so on--it is extraordinary that, somehow, we have kept what is going on in health care across the channel from the British people. I hope that my right hon. and hon. Friends will not engage in our other familiar debates--
Mr. David Davis (Haltemprice and Howden): Don't tempt us!
Sir Raymond Whitney: The idea that, because of disparity in expenditure, people should wait seven months, or even 18 months, for treatment is simply not comprehended in those countries. I accept that NHS spending is not necessarily inefficient. Inevitably, in private health care there are duplications.
We have 1.64 doctors per thousand; the Germans have 3.19. We have 4.5 nurses per thousand; the Germans have nine. On life expectancy at 60, the UK ranks 19th in the world--level with Turkey. There is nothing wrong with Turkey, but we might have assumed that our health service would have given us better provision. We are 14th in the Economist Intelligence Unit health rating system for European countries. That is a measure of how far we are behind. It is difficult to understand why politicians will not recognise that.
There has been an extraordinary political no-go zone for so long. However, I hope that, especially given the dangerous high-wire act that the Chancellor seems so ready to perform over the next couple of years, it will become clear that the situation cannot continue. To achieve the expenditure of continental countries--leaving aside that of the United States--would require an unbelievable and unsustainable burden of Treasury spending, even if we called it Treasury investment. We must, therefore, calmly say that although the NHS was a great idea in 1944 when the White Paper produced it, and that for more than 50 years, we have tried hard to make it work, Aneurin Bevan was right when he said that it would mean constantly expanding pressure on the Exchequer. We must have some new thinking. I do not think that is too much to ask.
6.18 pm
Mr. Ken Purchase (Wolverhampton, North-East): I add my congratulations to those offered to my right hon. Friend the Chancellor on an extraordinarily clear and well put Budget speech. If we are to believe the newspapers, this may be the final Budget before the general election is called, so it is important to judge my right hon. Friend's speech in the context of his chancellorship in the longer term.
By any post-war reckoning, my right hon. Friend's chancellorship has been exceptional, although one would not expect the Opposition to reach that conclusion.
That is to be expected in the cut and thrust of politics. However, after the speech of the hon. Member for Wycombe (Sir R. Whitney), who expresses himself so moderately, it is especially appropriate to point out that the people of this country will have seen that, over the past four years, successive Budgets have benefited, by and large, not just some people--not just a few of them; not just most of them--but the whole country. The whole country has benefited from the Chancellor's stewardship of our taxes and revenues.Budgets always take time to be fully and properly understood and to mature in their widest effects, and we shall have to suck this one and see, as we do on every occasion, but in the fulness of time, we shall find that the nation has prospered, that its taxation revenue has been spent wisely and that people have benefited from a range of services under the Budgets of my right hon. Friend's chancellorship. One of his themes today was investment in public services. People will see that services are improving, and I shall refer later to the national health service. I accept that that is vexatious, but it is not beyond our wit to improve it.
I regret that the hon. Member for West Worcestershire (Sir M. Spicer) has left the Chamber. He always makes an interesting contribution, if sometimes one that is rather eccentric and extremely right wing. He would certainly have qualified for a job as Hoover's right-hand man in the CIA and would have sorted out the liberal wets on the Conservative Benches; he would not have bothered getting round to us. The hon. Gentleman made his usual extraordinary contribution to our debate.
I must confess in the hon. Gentleman's absence that we share one thing in common--a love of the countryside around West Worcestershire. The Malvern hills are a beautiful part of the country. I sometimes think that if the hon. Gentleman admired the countryside around him as much as I do, he would spend a little less time worrying about the international monetary scene and a little more on developing his soul, which would benefit us all enormously. None the less, his was an interesting contribution. I am disappointed that the hon. Gentleman has gone because I want to deal with the savings ratio and I know that he would have interrupted me at least three or four times.
Mr. Purchase: I thank the hon. Gentleman.
To rehearse the point about the savings ratio, it is a matter of agreement that savings tend to rise more steeply when people are concerned about their future prospects. That is a natural and normal response to a worsening economic scenario, when people decide that they need to put money away for a rainy day. If that goes too far, the savings ratio rises steeply as a consequence and there is a fall-off in demand, so the thought that we must save for a rainy day becomes a self-fulfilling prophecy. It is, of course, vital that people save for a rainy day, because misfortunes that do not affect the population in general may fall on any family: it is always a wise precaution to try to make savings from our disposable incomes.
It is interesting that the savings ratio is now not such an important indicator as it used to be, in so far as people now have greater wealth in goods, houses and so on than
has ever before been known in the history of the United Kingdom. For the past 20 years or so, people have recognised that they have the opportunity to reward themselves with a plethora of consumables and white goods that make our lives so much easier, so they are investing in their lives now.In those circumstances, the ratio of savings to expenditure clearly falls, but let me reassure hon. Members that the important point is that the money available for investment in productive industries and services has in no way fallen. Money is, in fact, available through many different sources, especially the merchant banks, to provide opportunities to borrow and invest. That is an important facet of the whole equation.
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