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6.44 pm
The Secretary of State for Health (Mr. Alan Milburn): This has been an extremely constructive and positive debate about the future of public services.
First and most importantly of all, let me pay tribute to the two hon. Members who made their maiden speeches today, not just for the quality of their contributions but for their bravery in making them so early in their parliamentary careers. The hon. Member for Mid-Dorset and North Poole (Annette Brooke) paid an extremely handsome and fulsome tribute to her predecessor. Perhaps her only omission was her refusal to mention the one person whom many people regard as being responsible for getting her elected: a certain Mr. Billy Bragg.
My hon. Friend the Member for Edinburgh, North and Leith (Mr. Lazarowicz) also made an important contribution. He has had a long and successful career in local government and I have no doubt whatever that he will make a long and successful contribution to the proceedings of the House. In highlighting Labour's
achievements in its first term, he reminded us of how far we have to go in both reforming and investing in our key public services.This debate has been overwhelmingly about health and education--necessarily. However, as my hon. Friend the Member for Barnsley, West and Penistone (Mr. Clapham) said in a rather philosophical speech--I shall read the details of it later and hopefully understand it more than I did the first time round--the priority for the Government in this second term is to reform all our key public services, not just health and education but transport, the police and welfare services.
As my hon. Friends the Members for Liverpool, Walton (Mr. Kilfoyle), for Sheffield, Attercliffe (Mr. Betts) and for Hyndburn (Mr. Pope) rightly said, strong public services are the foundation for a strong society, in which there are opportunities not just for some people but for all our citizens and all our communities.
I suspect that, for many of my hon. Friends, it is a delicious irony that the official Opposition chose for this first full day's debate on the Queen's Speech the very subject that they spent virtually the whole of the general election campaign ignoring, namely health and education. That point was made by the right hon. Member for Fylde (Mr. Jack). I can only conclude that, during the election campaign, their minds were more concentrated on the forthcoming election campaign than on the outcome of the general election.
At one point, I became worried about the hon. Member for Woodspring (Dr. Fox) because he seemed to have disappeared from view. He disappeared from the television studios and I searched up and down the country for him. Indeed, I went to his constituency and took with me a 10 ft wooden trojan horse as a reminder of his policy on health: private health insurance rather than investment in the national health service. However, I could not find him there either.
The hon. Gentleman brags that his majority went up, but the majority in the country went one way. We know that we have a job of work to do, but he should know--I hope that he draws this important lesson from the general election campaign--that the Conservatives were not trusted in 1997 on public services and they were not trusted in 2001 either. I hope that he survives the trials and tribulations of the forthcoming leadership election campaign. That would be good news for him; it would be rather better news for us because he and his hon. Friends on the Opposition Front Bench--and, I suspect from some of the contributions that we heard today, on the Opposition Back Benches too--are responsible for the parlous state in which today's Conservative party finds itself. That is because of the paucity of their policies on public services.
The issue of public services is what concerns people the most. The hon. Member for Runnymede and Weybridge (Mr. Hammond) talks about delivery. I agree that people are concerned about delivery and we know that we have a job of work to do. However, what was interesting about this afternoon's debate is that we heard so much, including from the hon. Member for Woodspring, about problems in the national health service and so little about how to make progress in the NHS.
The right hon. Member for Fylde made a good speech. He talked down the number of doctors and of nursing posts that we shall create over the next few years. There
will be 10,000 more doctors and 20,000 more nurses, as well as lots more teachers and police officers. I hope that he has had the opportunity to read his manifesto and to draw some conclusions from it. Whereas our manifesto promises extra doctors and nurses, his promises not a single extra nurse or doctor. As I understand it, it did not promise a single extra police officer or teacher either. That is because the Conservatives made a different choice. We chose to put the public's priorities first--to put investment in, and reform of, the national health service, the education system, transport and the police service first. As he fairly concluded in his speech, the Conservatives put something else first: they put unaffordable tax cuts first, and they got the result that they deserved.
Dr. Fox: I am grateful to the Secretary of State for giving way, as time is limited. He referred to extra doctors, teachers and nurses. What is his definition of the word "extra"? Does it mean more than trend or more than previously planned? Will they be full-time? Will it be a net increase?
Mr. Milburn: Extra means on top of the position in 2000. We have not done the count for 2001 yet--we carry out an annual census in September, and we shall publish the results of that. I am extremely confident that we shall continue to make progress in recruiting and retaining extra doctors and extra nurses.
Mr. Milburn: There will a net increase of 10,000 doctors and 20,000 nurses. Conservative Front-Bench Members have no right to complain about the lack of ambition--as the right hon. Member for Fylde called it--of our targets in our manifesto, given that they promised not a single extra doctor or a single extra nurse.
Mr. Jack: Does the Secretary of State agree that he is now responsible for delivering those extra public servants? Does he also agree with me that if the numbers of extra staff are spread out across the nation, there will be few per health unit, per police station or per school? He will have to make any progress that he makes very clear if the public are to believe the rhetoric. As my hon. Friend the Member for Woodspring (Dr. Fox) said, there is a gulf between the Secretary of State's rhetoric and what we believe will be the reality.
Mr. Milburn: The public will see further expansion in staff numbers. There must be an increase in the number of staff working at the front line in the national health service. We need more doctors and nurses, clinical scientists and physiotherapists, and we need more backroom staff, who provide essential services in order that front-line staff can do their job and improve services for patients. We can do that only if we make the right choices as a country and as political parties. The choice that we made was to provide investment. The choice that the Conservative party made was completely different. I was pleased to see the hon. Member for West Dorset (Mr. Letwin) present earlier. He will be a constant reminder of the Conservative party's real agenda on public services, which is not extra investment, but cuts.
I know how far we have to go. I am a great supporter of the right hon. Member for Haltemprice and Howden (David Davis). I do not know whether that is a help or a
hindrance to him--it is another lost vote. He made important points about the progress that we need to make on clinical negligence, infections in hospitals and expansion in services. Importantly, he made a crucial point about what we need to do about the culture of the NHS and other public services. They must be attuned to the needs of the public. The only vested interest that should count in the national health service is that of the patient. The only vested interest that should count in schools is that of the pupil and the parent. That is where we need to get to.There is a long way to go. I have acknowledged on many occasions that there are problems in the health service and that NHS staff are working under real pressure, but it paints a false picture always to allow the problems to obscure the progress that has been made during the past four years. We now have 17,000 more nurses and 6,500 more doctors. We have a hospital building programme that is delivering hospitals rather than just extra cash for accountants and lawyers. We have put more investment into primary care and community services. My hon. Friend the Member for Doncaster, North (Mr. Hughes) asked about the expansion in GP numbers, as did the hon. Member for Belfast, South (Rev. Martin Smyth). During the next few years, we expect to have at least 2,000 extra GPs working in surgeries up and down the country. By 2005, we will have increased the number of medical students by 57 per cent., which is the biggest rise on record and a guarantee of expansion in doctor numbers not just for a few years but for a decade or more. All that is underpinned by the extra resources demanded by the right hon. Member for North-West Hampshire (Sir G. Young), not just for health but for social services.
As my hon. Friend the Member for Barnsley, Central (Mr. Illsley) reminded us, there is much progress still to be made, especially in the poorer parts of the country, where we know that health needs are greatest and resources have not always matched those needs. It is because of that knowledge that I can tell him and, indeed, Members on both sides of the House who have made the point about distribution of resources that we will conduct an urgent review to ensure that resources are better for, and more fairly distributed to, the parts of the country that need them most. I trust that that will be helpful, at least at this stage. I do not know whether the outcome of the review will be helpful, following its publication, but it will at least be helpful in assessing where health needs are greatest and trying to direct resources in that direction.
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