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Madam Deputy Speaker (Sylvia Heal):
We now come to the funding of public services. I must announce that the Speaker has selected the manuscript amendment, which is available to Members in the Vote Office.
Mr. Michael Howard (Folkestone and Hythe):
I beg to move,
That this House notes that the Chancellor of the Exchequer's statement to the House of 27th November has been contradicted in whole or in part by the Secretary of State for Health, the Chairman of the Labour Party and Mr. Derek Wanless; further notes that the Chancellor of the Exchequer refused to endorse the statement made to the House by the Prime Minister on 28th November; and condemns the total confusion over funding the public services which these contradictions have caused among users and providers of these services.
Last Tuesday was a black day for Britain's public services and was especially black for health care in Britain. The Chancellor of the Exchequer, in one breath, called for a debate on health care funding, then announced the result of that debate. It is no wonder that on Friday The Guardian
reported one Minister as saying:
"Gordon's idea of a debate is Gordon and a mirror".
The conclusion of that one-man debate is that
"a publicly funded national health service is best for Britain".
The Chancellor arrived at that conclusion not because of any evidence but in the teeth of all the evidence, and did so despite the fact that the Prime Minister said less than two months ago that the barriers between public and private are coming down all over the world. The Chancellor arrived at his conclusion despite the fact that all the countries that provide their people with better health care than we do do not have such a system and despite the fact that the Organisation for Economic Co-operation and Development said only last week in its economic survey of the United Kingdom:
"Overall, the current plans to provide services privately in sectors such as health and education are limited. Such services are provided on a much larger scale privately in many OECD countries and greater ambition in this respect would raise competition and performance in these sectors."
The way in which the Chancellor reached his conclusions speaks volumes; it was the most bare-faced exercise in deception since he was deceived by the Prime Minister over sun-dried tomatoes in Granita all those years ago.
The Chancellor relied on the Wanless report. He said:
"So having examined whether a publicly funded national health service is sustainable . . . Mr. Wanless's view is that the principle of an NHS publicly funded through taxation . . . remains both the fairest and most efficient system for this country."[Official Report, 27 November 2001; Vol. 375, c. 838-39.]
At all times last Tuesday the Chancellor gave the impression that Mr. Wanless had carried out an objective and authoritative inquiry into the best way to fund health care in this country. Of course, that was a million miles from the truth. First, the Chancellor fixed the terms of reference that he set Mr. Wanless so that Mr. Wanless could consider only a publicly funded health care model.
The terms of reference asked Mr. Wanless to
"identify the key factors which will determine the financial and other resources required to ensure that the NHS can provide a publicly funded service."
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Far from asking Mr. Wanless to look at different methods, the Chancellor told him not to do that; he asked a Labour question and he got a Labour answer.
Phil Hope (Corby):
I have a simple question for the right hon. and learned Gentleman. Will the Opposition match Labour's commitment to spending on the NHS and do they support an NHS based on clinical need, not on the ability to payhis policy, which was leaked to the press?
The hon. Gentleman has asked an interesting question[Interruption.] Yes, I will answer it. The hon. Gentleman asked whether I would match Labour's spending commitment on the NHS. We do not know what that commitment is[Interruption.] I am coming directly to the hon. Gentleman's question, which I shall answer in detail; he just needs to be patient for a moment and he will have a comprehensive answer.
The references in the Wanless report to different systems of financing health care are all expressed in terms of their effect on the economy, itself a reflection on those terms of reference. They state that the report should allow the Chancellor
"to consider the possible implications of this analysis for the Government's wider fiscal and economic strategies in the medium term and to inform decisions in the next public spending review in 2002."
Most telling of all, the Chancellor's cover was blown within hours by Mr. Wanless himself. On Thursday, Mr. Wanless said:
"I've not sought to bury anything for good. It would be quite presumptuous and premature for anybody to think they could do that. When the figures are available about what resources are likely to be required that's the time at which people will be looking at the financial options . . . Issues about precisely how they should be financed are . . . not for decision now."
The Chancellor's own carefully picked appointee has given him the lie and directly contradicted him. When Mr. Wanless says that it would be premature and presumptuous of anybody to think that they could bury anything for good, who does the Chancellor think he had in mind? Who could he possibly be referring to but the Chancellor himself? The Chancellor's elaborate attempt to fix that exercise has collapsed about his ears.
It was not just the Secretary of State for Transport, Local Government and the Regions who "contaminated" the pre-Budget report last week; the Chancellor did so himself. His attempt to hoodwink everyonethe House, the nation, even the Prime Ministerhas spectacularly imploded. It is not surprising that the Downing street spin machine swung into action.
Mr. John McFall (Dumbarton):
Will the right hon. and learned Gentleman give way?
In a moment.
The spin machine claimed that "everything's up for grabs"; that the Government were prepared to "think the unthinkable"; that Downing street is "less protective" than the Treasury; and that there are "no holds barred", but it was too late. On Tuesday the Chancellor had indeed barred the holds. He had boxed everyone in and slammed
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the door on the debate for which he himself had called. He has robbed our country of the opportunity for the better health care that we so desperately need.
I give way to the Chairman of the Select Committee on the Treasury.
The right hon. and learned Gentleman uses the word "hoodwink" freely. So that we can get it straight and so that he does not hoodwink anyone, will he reflect on his party's manifesto, which stated that the Conservatives would provide a fully comprehensive NHS, free at the point of use? Does he intend to hoodwink people and deny that now?
We certainly will provide an NHS that is fully comprehensive, and we will spell out our detailed proposals long before the next general election.
Kali Mountford (Colne Valley):
Is it still the policy of the right hon. and learned Gentleman's party to charge for some GP services? If so, which services does he intend to charge for?
The hon. Lady will have to wait some time before she gets an answer to that question, but she will get it long before the next general election, when the British people will see exactly what we propose.
On a point of order, Madam Deputy Speaker. I asked the shadow Chancellor a question, and I am dismayed that he did not answer the second part, about whether the health service would be free at the point of use. Can you come to my aid and ensure that he answers it?
Madam Deputy Speaker:
That is a point of debate, rather than a point of order.
I want the Chancellor to answer some questions when he replies to the debate. I want him to confirm whether, as has been widely reported, the Health Secretary was told of the Chancellor's intentions only on Monday last week, 24 hours before his statement. The Health Secretary is reported to be "furious". [Hon. Members: "Where is he?"] Surely my hon. Friends would not expect the Health Secretary to come and support the Chancellor. We are told, for good measure, that the Prime Minister is also angry, on behalf of the Health Secretary.
One of the most astonishing things about last week was that the Chancellor was disappointed by the coverage that his announcement received in the press on Wednesday. So what did he do? He cleared his diary and rushed down to Wapping to see The Sun. He told The Sun:
"I am going to insist any additional resources must be matched by reforms so that we get the best value for money. There is not to be one penny more until we get the changes".
That must have caused the Secretary of State for Health some alarm. After all, only 48 hours earlier he had been promised an extra £1 billion next year. No mention was made of any conditions. On Tuesday the Chancellor promises £1 billion, and on Thursday he says that the NHS must reform first. This is my first challenge to the Chancellor tonight: what exactly does he have in mind? When does he expect those reforms to be in place? What criteria will he use to decide whether to release the money? When will he make that decision, and when will he announce it?
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I can tell the Secretary of State for Health that he need not worry too much. The Chancellor has told The Sun exactly the same thing before. He wrote an article for The Sun on 15 July 1998, in which he stated:
"We are determined you get value for every penny we spend to give you the public services you want. . . Unless standards and targets are met, they will lose money. It's payment by results."
Nothing happened, however. Nothing happened in 1998, in 1999, last year or this year. The money has continued to pour in and, as the Government admit, much of it has been wasted.