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Mr. Cook: The hon. Gentleman characteristically provides a new angle on the search for a successor to Mrs.

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Filkin, and the House of Commons Commission will take his proposal on board. It seems to me, however, that the logical next step in the process is for Mrs. Filkin to reply to the letter sent to her by Mr. Speaker inviting her to explain the allegations that she has chosen to put in the public domain. When that has been done, Mr. Speaker and the Commission must consider what is the next appropriate step; but I look forward to the reply.

Mr. Graham Brady (Altrincham and Sale, West): The Leader of the House will be aware that on Tuesday I presented the Health (Patients' Rights) Bill. The gist of it was that patients who had been waiting too long for treatment in the NHS should have a right to treatment overseas, or in the private sector.

I was delighted to see the Secretary of State for Health on the airwaves this morning, apparently adopting my proposal as Government policy. I am always happy to be as helpful as possible to the Secretary of State. Could the Leader of the House bring forward my Bill's Second Reading, scheduled for 18 January, to next week? We could then have a debate in Government time, and the Secretary of State, instead of merely saying that he wants to offer patients that right, would be able to give them a statutory right to treatment within a maximum period.

Mr. Cook: I would not wish to withdraw from the hon. Gentleman the satisfaction he evidently feels about the fact that what he proposed one day became Government policy the next. I know, however, that my right hon. Friend the Secretary of State for Health has been working on the matter for some time. His announcement was one of a series made by the Department of Health about the need for us to ensure that patients have a right to operations and, when those operations are cancelled, a right for them to be replaced within 28 days. We will continue to work on that within the targets of the national plan, and I am sure that the hon. Gentleman will wish to support and encourage us as we proceed towards our joint goals.

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Health Authority Resource Allocations

1.18 pm

The Secretary of State for Health (Mr. Alan Milburn): With permission, Mr. Speaker, I wish to make a statement about the resources that will be available to local health services in all parts of England next year. Today I am allocating revenue resources to local health authorities for the financial year beginning April 2002. I have written to all Members today, giving information about the health authorities in their constituencies.

The national health service is currently the fastest growing health care system in any major European country. Under this Labour Government, it is growing twice as fast as it grew under the last Conservative Government. With the additional resources announced by my right hon. Friend the Chancellor of the Exchequer last week, it will grow by a further 6.8 per cent. in real terms next year.

As the House knows, however, that follows decades of underfunding. No one should believe that a few years of extra investment, even on this scale, can put right decades of underinvestment. The NHS plan that we published last year is, rightly, a 10-year programme of investment and reform.

Major problems remain in the health service, of course, but there is progress too. Last year there were almost 5,000 extra heart operations, and waiting times for treatment are falling. Because prevention is as important as treatment, the number of cholesterol-lowering drugs being prescribed has risen by a third in just one year. Nine out of 10 cancer patients are now being seen within two weeks; many used to have to wait for months. The maximum waiting time for any hospital operation is already down from 18 to 15 months in three quarters of NHS trusts, and all trusts will be in that position by next spring.

This is the first year in 30 in which the number of general and acute beds in our hospitals is rising rather than falling. Ten new hospitals are already open, as part of the biggest hospital-building programme that the NHS has ever seen. Most important of all, the NHS today has 17,000 more nurses and 7,000 more doctors than it had when we came to office, with thousands more to come.

There is a long way to go, but the people working in the NHS are doing a great job to improve services for patients. Now we can build on the progress that they are making.

Last year at this time, I indicated that all health authorities could expect to receive a minimum revenue increase of 6 per cent. in 2002-03. That 6 per cent. is more than health authorities received in four of the last five years under the Conservatives. In fact, I am now able to go further than I was planning to do at this time last year. Rather than growth of a minimum of 6 per cent. next year, I can tell the House that no health authority will receive less than 9.3 per cent. growth next year.

The next financial year will be the last under the existing formula for deciding how NHS resources are distributed to local health services. From the following year, there will be a new formula and, subject to Parliament, resources will go directly to locally run primary care trusts for the first time, as part of the Government's wider programme to devolve ever more power and resources to the NHS front line.

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The resources that I am allocating today for 2002–03 are being distributed according to the existing formula. As the House is aware, that formula has been widely criticised for failing to get health services to the areas of greatest health need. It has also been criticised for failing to reflect fully the additional costs that the NHS has to bear in those parts of the country where labour market and housing costs are highest. Last year, I announced two major changes better to reflect health needs on the one hand and labour market costs on the other. I am building on those changes for the year ahead.

First, health inequalities scar our nation. Poverty and deprivation bring not only excess morbidity and mortality, but extra costs to local health services. Next year, for the first time, I have reflected in the formula the costs associated with tackling high rates of infant mortality alongside the costs associated with conditions such as cancer and heart disease. The resources to tackle health inequalities within health authority budgets will therefore rise next year by 14 per cent. The £148 million that we are making available to recognise the areas of greatest health need will benefit towns and cities in the north and midlands as well as the poorer parts of the south of England.

Secondly, I am increasing the resources available within health authority budgets to help the local NHS in those parts of England where living costs are highest. This year, for the first time, we introduced cost of living supplements for 100,000 qualified nurses, midwives, health visitors, therapists and radiographers who work in the highest cost parts of the country. In London, staff receive up to £1,000 a year on top of their salaries and London weightings. Elsewhere, they receive up to £600 a year more. Those cost of living payments are already helping the NHS to recruit and retain staff.

I have received a number of representations from right hon. and hon. Members, and from local health services, from areas where the supplements are not yet available. I have decided, first, to increase to more than £100 million the resources allocated to fund the cost of living supplements. They will continue to be paid to the areas currently receiving them. However, I have decided that from next year, in addition, the scheme will be extended to cover East and West Kent, North and South Essex—[Interruption.] I am glad to see that the hon. Member for West Chelmsford (Mr. Burns) is pleased for once—Northamptonshire and East Sussex, Brighton and Hove. Every health authority in London and the south will now receive extra resources in recognition of the higher costs that they face.

Every part of the country will benefit from the significant increases in funding for health authorities that I am announcing today. The average health authority budget will rise by £39 million or just under 10 per cent. Health authorities will be expected to work with local primary care trusts on deciding how best those resources are spent. Within those allocations there are extra funds for cancer, heart disease and mental health services alongside new resources for information technology and for primary care.

In addition, more than £400 million will be available to secure extra capacity to treat more NHS patients. It will be for local health services to decide how best to spend those resources, but they may be spent in NHS hospitals, in the private and voluntary sectors, and in community and social services.

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The extra resources will need to secure improved services in the priority areas that count most for patients—better emergency care, shorter waiting times for treatment, and improvements in cancer, heart, mental health and elderly care. By the end of the next financial year, we expect nine in 10 NHS patients to be able to see a GP within 48 hours, and the maximum waiting time for a hospital operation to have fallen from 18 months today to 12 months. That is still too long, but it is the shortest maximum waiting time in the history of the NHS and a staging post towards shorter waiting times still.

Investment alone, however, will not secure the improvements in care that staff are striving to achieve and which patients rightly want to see delivered. The NHS will need to use these extra resources to drive forward the NHS plan reform programme. There are now national standards for the first time, and an independent inspection regime to assure them. There are more freedoms and more rewards for the good hospitals, alongside more help, support and—where necessary—intervention for the worst. Resources and power are being devolved to front-line services and staff, and there is now a more sensible relationship between the public and private sectors which means that we can provide more NHS care for more NHS patients.

These reforms are about putting the patients first. Our aim must be to create a more decentralised, more diverse and more responsive health service, capable of offering patients better services and greater choice.

Today, we are publishing proposals that will for the first time give patients an explicit choice over where they are treated in the NHS. As we said in our election manifesto, the investment and reforms that we are making mean that, by 2005, every patient needing hospital treatment will be helped by their GP to choose not just the date but the location of that treatment. The resources that we have now mean that we can make a start next year on introducing this new system, under which patients will be choosing the hospital, rather than hospitals choosing the patient.

We will start with those patients who have been waiting longest for treatment, and with those who have the most serious clinical conditions. Today, as the House is aware, thousands of patients have been waiting for a heart operation for more than six months. Waiting times are shortening, but they are still too long.

Therefore, I can tell the House today that, from the middle of next year, every patient in England who has waited for a heart operation for six months will be able to choose between hospitals—in the public sector or the private sector, in this country or abroad—that can do the operation more quickly. The choice will be theirs.

The initiative for heart surgery marks the start of a wider programme to improve patient choice and speed up treatment. Other pilots will be developed over time.

We will be discussing these proposals with patient, professional and health-care organisations so that the proposals can guarantee high clinical standards for patients and good value for money for taxpayers.

Many patients may choose not to exercise a choice. Many will prefer to wait at their local hospital, even if that means a slightly longer wait. Some patients will prefer to

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travel to get faster treatment, but the point is that, for the first time, the choice will be the patient's. Moreover, that choice will no longer be between waiting longer for treatment or paying for treatment.

There are two distinct views about the future of health care in our country. The Opposition seem to believe that more and more people should have to pay for more and more treatments. In contrast, the Government say that patients should be able to choose without having to pay.

The principles of the NHS are the right principles for Britain. They are that treatment should be free at the point of use, paid for through general taxation, and supplied according to need rather than a person's ability to pay.

The investment and reforms that we are making will create a service delivering quicker, higher-quality care for millions of NHS patients. The resources that I have announced today will mark a further step towards a better and faster health service—a national health service for all the people of our country.

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