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Mrs. Anne Campbell (Cambridge): As he is speaking of interviews, does the right hon. and learned Gentleman stand by his remarks in the Financial Times last week, that the NHS is a Stalinist creation?

Mr. Howard: The NHS is indeed a Stalinist creation. [Interruption.] Yes, it is. That is the age in which it was born, and it does much more to hinder and hamper the efforts of those who work in it—who work heroically despite it—than it does to help them.

Let us see how the evolving saga develops. After 18 years in opposition to consider these matters and after four years in government, what do the Government do? They set up a new committee. Once the Prime Minister got to know the terms of reference of the Wanless committee—he clearly did not know about them until they were produced in the House last Tuesday—he thought that he had better remind people of his own committee, the Adair Turner committee. So important was the Turner committee that the Prime Minister appeared to have forgotten all about it. The Chancellor certainly made no mention of it in his statement last Tuesday, yet on Friday night he was hurriedly dispatched to give an interview to "News at 10", giving the impression that it was an entirely new committee.

It is worth reminding people of the Turner committee. It was set up in October. [Interruption.] Labour Members should be listening to what their Prime Minister's committee—

Madam Deputy Speaker: Order.

Mr. Keith Simpson (Mid-Norfolk): Mr. McNulty!

Madam Deputy Speaker: Order. The word "Order" applies to both sides of the House.

Mr. Howard: I am interested that the hon. Member for Harrow, East (Mr. McNulty), from his usual sedentary position, says that it is not worth reminding people of the Turner committee, but it is his Prime Minister's committee, not mine. The Prime Minister set it up. It was set up in October and asked to do what was described as "blue sky" thinking, looking

"not less than five years and probably 10 to 15 years out".

However, we were told that its conclusions would never be made public. The outcome, Downing street said, would be "private, for private thinking".

My second challenge to the Chancellor is this: is that still the position, or have the Government changed their mind on that as well? Will we ever be told the conclusions of the Turner committee? If so, when? The Wanless committee is supposed to study the amount of money

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needed for health care. The Turner committee is supposed to examine the way in which health care is managed. It does not seem to have occurred to the Prime Minister and the Chancellor that there may be some connection between the two—between the way in which health care is financed and the way in which it is provided.

What health care in this country needs is not more committees; it needs radical reform so that the dedicated doctors and nurses working in it can be helped, and not hampered by the structure in which they work. It needs action to ensure that the money wasted on the NHS—between £7 billion and £10 billion, according to reports this weekend—is no longer wasted. It needs to be able to put an end to the state of affairs in which people die in our country from illnesses that they would survive in other countries. It needs extra resources, in addition to those that can be provided out of general taxation.

That is what happens in every other country with health care better than ours. It is what the OECD recommends, and what would offer the best prospect of bringing better health care to Britain. That is why today my right hon. Friend the Leader of the Opposition and the shadow Health Secretary are in Stockholm, as part of a series of visits to learn from other health care systems in Europe and beyond. Our party has put health care reform at the very top of our agenda.

Let no one be in any doubt about how badly we need better health care. Even the Prime Minister was unable last week to dispute the claims of his party chairman that far from improving, the national health service has gone backwards since 1997. Even Mr. Wanless says in his report:

"Across a range of health outcome indicators, the picture which emerges is one of generally poor outcomes in the UK relative to comparator countries, with significant gaps between the UK and the best performers for key outcome measures."

Even Sir Stephen Robson, a recent permanent secretary in the Treasury and someone who has worked very closely with the Chancellor, says:

"Don't have breast cancer or lung cancer, don't want to go to accident and emergency, don't want to have a non-urgent operation in the UK—you'd be better off in continental Europe."

This Government have made promise after promise on the health service. They have broken their promises, they are beginning to be rumbled, they have no idea what to do about it and the result is blind panic.

So, is it any wonder that the Chancellor and the Prime Minister are at sixes and sevens? Last Wednesday, the Prime Minister could not have been clearer. When asked whether it was still Government policy to raise health spending to the EU average by 2005, he replied, "Of course it is." The following day, the Leader of the House announced that he wanted to clarify that statement. We were told that when the Prime Minister had said 2005, he meant to say 2006. Conveniently, that means that he will have to be held to account after, rather than before, the likely date of the next general election.

Then the Chancellor got in on the act. In his interview with The Sun, he refused to explain what the Prime Minister actually meant. He refused to say whether the promise applied to EU spending at the time mentioned in

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the Prime Minister's original promise or in 2005, so the Prime Minister's official spokesman was brought in. When he was asked to shed light on this appalling mess, he said:

"the Prime Minister's words at PMQs this afternoon spoke for themselves".

Unfortunately for him, the Prime Minister took a different view. Yesterday, he decided to downgrade what had been a firm commitment to the status of a mere aspiration "in broad terms"—the Chancellor smiles about that, as he has had his way—and the Secretary of State for Health yesterday described it as an aim.

My third challenge for the Chancellor is this: will he now clarify matters? [Interruption.] Is it a firm commitment or a vague aspiration? Does it relate to European health spending in 2000, 2001, 2005 or 2006? Does it relate to averages including or excluding Britain? Are those averages weighted for population differences, or is Germany being given the same weight as Luxembourg? [Interruption.] And when will it be achieved: 2005, 2006, some time or never? [Interruption.]

Madam Deputy Speaker: Order. It is clear that the right hon. and learned Gentleman is not prepared to give way at this point.

Mr. Howard: This is not some arcane, theoretical dispute, but a matter that is vital for the lives of every person in this country. The Chancellor must make the Government's position clear once and for all.

The confusion does not end there. The Secretary of State for Health and the chairman of the Labour party are reported to have called for a hypothecated health tax. They are said to have the support of the Home Secretary and the Secretary of State for Trade and Industry. The right hon. Member for Hartlepool (Mr. Mandelson) has asked the Government to consider compulsory social insurance or a ring-fenced health tax. He said:

"These systems must all be properly examined."

So, my fourth challenge to the Chancellor is this: does he agree with his Cabinet colleagues and the right hon. Member for Hartlepool, or with the Treasury aide who described the idea of a hypothecated health tax as foolish? The Chancellor has called for a consensus, but he cannot achieve it even in his own Cabinet.

If the Government, blinded by their prejudices against the private sector, refuse to put patients first, the Opposition will do so. We genuinely recognise that, in the words of the Prime Minister,

"round the world, the barriers between public and private are coming down".

Our overriding objective is to improve the quality of health care in Britain. We are not so arrogant as to believe that we can achieve better health care for the British people without learning from countries that have already achieved better health care for their people. We are not so dogmatic as to arrive at our opinions before embarking on our review and we are not so blinkered as to set the terms of reference, as the Chancellor did, so as to make the conclusions inevitable.

The Government have demonstrated in the past few days that we will never get the health care that we need so long as they remain in power. We must show that we will do better, and that is exactly what we intend to do.

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7.45 pm

The Chancellor of the Exchequer (Mr. Gordon Brown): I beg to move, as a manuscript amendment, in line 1, leave out from "House" to end and add

"welcomes the Pre-Budget Report with its emphasis on delivering high quality public services accessible to all in society as part of the Government's wider agenda to match resources with modernisation to progress reform; particularly welcomes Mr Derek Wanless's interim report "Securing our Future Health: Taking a Long-Term View", the first comprehensive look at the long term funding needs of the Health Service; notes Mr Wanless's conclusion that there is no evidence that any alternative financing method to the UK's would deliver a given quality of healthcare more equitably and at a lower cost to the economy; and reaffirms its support as stated by the Prime Minister and the Chancellor for future increases in public funding and NHS reform to ensure a comprehensive high quality service available on the basis of clinical need and not ability to pay."

I shall answer all the detailed points that have been made and take interventions from the Opposition during my speech.

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