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Mr. Howard rose—

Hon. Members: Give way!

Madam Deputy Speaker: Order. The House must come to order.

Mr. Brown: Before giving way, I want to set down our argument as a Government.

Mr. Howard: Will the Chancellor give way?

Mr. Brown: I have said that I shall give way during my speech, but I want to set down my argument.

First, we believe in a health service that is free at the point of need; the question that we must ask ourselves this evening is this: do the Opposition? Secondly, we believe in a health service that is principally funded from tax revenue—[Interruption.] Oh, indeed. The question is, do the Opposition? Thirdly, we believe in more investment in the health service, but the question is, do the Opposition? Fourthly, we believe in a continuing programme of reform in the health service, but do the Opposition still believe in the health service at all?

My hon. Friend the Member for Dumbarton (Mr. McFall), the Chairman of the Select Committee on the Treasury, asked the shadow Chancellor a very interesting question at the beginning of the debate. He asked whether the Opposition still believed in a comprehensive health service that was free at the point of use. At the general election, all Opposition Members had no doubt about the answer to that question. Individually, like us and the Liberals, they stood for election on a manifesto—I quote the Conservative one—that referred to

"a comprehensive health service free to all its users."

Why could not the shadow Chancellor repeat that commitment this evening?

I shall tell the House why the right hon. and learned Gentleman could not do so, as I have in front of me the memorandum written by the hon. Member for Arundel and South Downs (Mr. Flight) to the shadow Chancellor on 12 November. It is marked "Private and Confidential". I am sure that the Opposition now wish that it had been kept private and confidential. Let me refer to what the Flight memorandum, as we will now call it, said. [Interruption.] It answers the very big question about why

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the shadow Chancellor could not say that he supported a free health service at the point of need. I think that Opposition Members should listen, because this will feature in every constituency in the country.

Mr. Paul Goodman (Wycombe): Will the Chancellor give way?

Mr. Brown: I shall be very happy to give way after making this point. The memorandum said:

"we remain vulnerable to the irritating attack that we are the Party who will be cutting back on healthcare expenditure to reduce taxation.


We need to resolve and agree how we are going to break out of this, well ahead of the next General Election, or we will have the same problems of emasculation in this territory, that we had this summer. I believe most of our colleagues are looking to the Treasury Team to address this territory, but clearly the key is the fleshing out of the broad policy guidelines which IDS has set out in relation to healthcare."

What is that broad policy guideline? The memorandum continues:

"Quite logically, we will, therefore, be looking to lower the taxes on people at the same time, enabling them to have more of their own money to spend on better and more efficient healthcare . . . Put more simply, what Iain has already said in principle, with regard to healthcare, should have the corollary of reducing taxation to leave people with more of the income . . . to spend on the provision of improved healthcare."

[Interruption.] Conservative Members should listen. We have reached the main point because the memorandum also states:

"The reforms, which we will be proposing, will end the NHS monopoly and will entail those who can afford it making some payment for healthcare services."

That is not simply a suggestion or idea. The deputy Treasury spokesman wrote that. [Interruption.] Conservative Members will have to face up to that in every constituency. I repeat:

"The reforms which we will be proposing . . . will entail . . . some payment for healthcare services."

The memorandum also states that solving problems will require

"a degree of charging for healthcare service."

[Interruption.] The shadow Chancellor already regrets the debate. Should not we be told whether the charges are for visits to general practitioners or to hospitals? Are they for operations? Are they for medical drugs that are currently free? What proportion of people would be expected to pay the charges? What services would the rest obtain? Who would be exempted? What would happen to the terminally ill, cancer patients and old age pensioners?

If Conservative Members call for a debate in the House about the future funding of public services, they have a duty to tell us—[Hon. Members: "No."] Oh yes they do. Every Conservative Member stood on a manifesto—[Interruption.] They cannot get away from it. They stood on a manifesto that stated that there would be a comprehensive health service that was free to all at the

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point of need. Yet the deputy Treasury spokesman says not that there might be charges, but that there will be charges.

Several hon. Members rose—

Mr. Brown: I shall give way to the hon. Member for Wycombe (Mr. Goodman) if he tells me how he will justify a policy of charging to his constituents.

Mr. Goodman: Will the Chancellor confirm or deny that the Secretary of State for Health received only 24 hours notice of his plans last week? [Interruption.]

Mr. Brown: Madam Deputy Speaker—[Interruption.]

Madam Deputy Speaker: Order. The House must come to order. An intervention has been made and the Chancellor is responding to it.

Mr. Brown: The Secretary of State for Health received full notice of our decisions, but the hon. Member for Wycombe refused to say whether he supports charges.

Several hon. Members rose—

Mr. Brown: I shall give way in a minute. First, let us consider another piece of evidence. Nicky Campbell asked the Leader of the Opposition in an interview on Radio 5 on 22 June whether his health plans would involve people paying for treatment. The right hon. Gentleman replied: "Absolutely." Conservative Members cannot answer questions about their manifesto because they are planning charges for the health service.

Chris Grayling (Epsom and Ewell): Will the Chancellor confirm or deny plans to raise the upper earnings limit on national insurance contributions to pay for health care?

Mr. Brown: We gave our promises on taxation at the general election.

Matthew Taylor (Truro and St. Austell): Will the Chancellor clarify early in the debate whether the Prime Minister was right to say that the point of the Chancellor's statement last week was to ensure the fulfilment of the Prime Minister's commitment 18 months ago to raise spending on the health service to the EU average by 2005? Was the Prime Minister right?

Mr. Brown: Of course that is our policy. That is exactly what the Prime Minister said on Wednesday. The day before, I said that we wanted a substantially increased proportion of the national income to be used for health expenditure.

I shall explain what has happened in the past few years. As a proportion of national income, health expenditure increased from 6.9 per cent. That would not have happened under the Tories when the average was 6.2 per cent. Under us, it increased to 7.2 per cent. The Tories would not have done that. It will go up to 7.4 per cent., 7.6 per cent. and 7.8 per cent. Again, the Tories would not have done that. The Government are keeping their promises.

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I want to explain to Conservative Members why charging is wrong. The debate must focus on that central point.

Mr. Roger Gale (North Thanet) rose—

Mr. Brown: I shall give way in a minute. [Interruption.]

Madam Deputy Speaker: Order. If hon. Members want to make a contribution, that is no way to go about it.

Mr. Brown: The shadow Chancellor refuses to tell us whether he supports charges. However, I have a copy of his election literature. He issued a leaflet, in which one item is entitled "The Future of the NHS". What did he say in it? I shall give way so that he can tell us.

Mr. Howard: The Chancellor is right; we had no such proposals at the last election. However, he has overlooked the fact that his party won the election. The Labour party is responsible for funding the NHS for the next four years. When will he grow up, accept his responsibilities, do what he promised at the outset of his speech and answer the questions that I asked him?

Mr. Brown: I know why the shadow Chancellor is rattled. He cannot tell us whether he will support charges for the NHS in this Parliament. What did he say at the general election? The leaflet states:

"But there will be no charges".

It goes on:

"Do not believe the lies which are being spread by our opponents.


Conservatives will retain a free and comprehensive national health service".

He was right then and he is wrong now because a free NHS is the right policy for this country on the ground of equity. It means that everybody, irrespective of income, gets the health care that they need. It is right because comprehensive care means that people are not discouraged from using health care services through lack of income. It is right because it is an efficient system, which avoids the form filling and bureaucracy that a charging system would entail.

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