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Dr. Liam Fox (Woodspring): I am grateful to the Secretary of State for that statement, and I am glad that it was he who made it. No one was sure whether he would deliver it, or whether it would be the Prime Minister or the Chancellor of the Exchequer, as it is increasingly unclear who in the Government makes health policy. However, I am not sure whether the Secretary of State's function today was to be piggy in the middle, or tethered goat.

Given the publicity from the Secretary of State this morning, people will be surprised to discover that the promises on a six-month waiting maximum and the choice to be available thereafter will apply only to heart patients. That is welcome, but it is rather different from the spin being applied this morning by Ministers and members of the press. It is more about saving Ministers' skins than patients.

In 1998, the Chancellor told us that Labour would be spending £21 billion extra over the next three years. Indeed, the Prime Minister told us in July last year that the NHS had already benefited from the biggest sustained increase in its history. Has anyone noticed any difference? Patients are waiting longer to see their general practitioner, to be seen in accident and emergency departments and to have operations. Now we are told that simply spending more money will make a difference.

In his spending statement last year, the Secretary of State said that improved co-operation between health and social services would mean

Yet, by the Government's own admission, the number of delayed discharges—or blocked beds—has soared. There are nearly 6,500 blocked beds in England alone. Some 15 per cent. of all beds in Birmingham are blocked, with 19 per cent. in Hampshire and 18 per cent. in Brent and Harrow.

Last year, the Secretary of State told us that the increased money would mean real progress in the Government's NHS targets. Waiting to be seen in accident and emergency departments would take an average of 75 minutes and the maximum wait for out-patient appointments would be three months. Yet the Audit Commission tells us that not only are things getting

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worse, since 1998 they have been getting much worse. There are now 400,000 people on the waiting list for the waiting list. No progress has been made. The Labour party chairman said that, under Labour, the NHS is going backwards.

Last year, the Secretary of State said that £4 billion more would be available for front-line services. Some £3,732 million was made available. However, pay review body staff costs came to £500 million and to £250 million for non-pay review body staff. Medical price inflation was £300 million, the new pension contribution rates cost £372 million and the waiting times initiative came to £400 million. The maximum amount that was available for front-line services was £560 million. Indeed, if the national service frameworks cost more than the estimates, there may well have been a negative figure for core functions.

That is why the right hon. Member for Hartlepool (Mr. Mandelson) said in The Guardian today of the Government's spending:

Can the Secretary of State answer some specific questions? How much does he estimate, in today's settlement, for the costs of change? The Bill reorganising the NHS, which is passing through the House, will cost money. How much? What estimate is in the settlement for pay effects for the next year? What estimate is there for the cost of drugs currently being approved by the National Institute for Clinical Excellence? What estimate does he make for the cost of reducing working hours for doctors? What estimate does he make for the costs of waiting time initiatives? What cost does he estimate for the national health service frameworks? How much does he estimate will be spent by the NHS in the private sector in the coming year in what he describes as a more sensible relationship with the private sector? The Prime Minister has not been very good at his sums this week. I hope that the Secretary of State will do better when he gives us answers to those questions.

We can have no longer have confidence in what the Secretary of State promises. He talks about decentralisation, yet is centralising the financial relationships. He talks about choice, yet his party abolished extra- contractual referrals and fundholding, which gave genuine choice. He talks today of more money, yet 40 per cent. of NHS hospital trusts in England are forecasting a deficit this year, with their financial position likely to worsen in 2002.

Before the Labour party came to office, it promised that things could only get better. In the NHS they are actually getting worse.

Mr. Milburn: I am grateful to the hon. Gentleman—for what, I do not know, but at least for only a brief series of questions. I will run through the issues that he raised.

On delayed discharges and bed blocking, the hon. Gentleman is aware that we have allocated a further £300 million for social services. Indeed, my right hon. Friend the Secretary of State for Transport, Local Government

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and the Regions was able to announce further rises for social services for the next financial year. The interesting question for the hon. Gentleman is whether he is prepared to match those funding increases. He certainly failed to come up with the answer to that question before the election; perhaps he can do so now.

The hon. Gentleman asked where the money went during the last financial year. It has gone on paying for more staff, better wages and more buildings. An extra £300 million is being made available for new drugs for cancer and heart disease. We are making efforts to get rid of Nightingale wards in our hospitals. More operations are being carried out and waiting times are falling. There are improvements in cancer and coronary heart disease services. For the first time in 30 years, there are more hospital beds and a huge hospital building programme.

The hon. Gentleman asks about the overall costs of our programme for change—devolving power from health authorities to primary care trusts. In fact, that will save money: £100 million, which we will invest in child care services. He asks how much money we shall be committing to waiting times initiatives—as he calls them—and to building up NHS capacity in order that NHS hospitals can perform more NHS operations on more NHS patients: the amount will be about £400 million.

The hon. Gentleman asks about the role of the private sector. As he is aware, I announced at a recent meeting of the Select Committee on Health that we would be doubling the amount of money available for the NHS to contract with private sector hospitals to carry out more NHS operations. If local primary care trusts and strategic health authorities want to do more, that is a matter for them. The hon. Gentleman constantly urges devolution, so I hope that he will support it when it happens.

However, the hon. Gentleman did not express in his statement the attitude of the Conservatives towards the national health service. He did not say whether he supports the Leader of the Opposition and the shadow Home Secretary who called the national health service Stalinist. Is that the hon. Gentleman's view? Does he believe that the national health service is Stalinist? I remind him what the national health service is: the national health service—[Interruption.]

Mr. Deputy Speaker (Sir Michael Lord): Order. The Secretary of State should be answering the questions, not asking them.

Mr. Milburn: I have answered a load of questions put by the hon. Member for Woodspring (Dr. Fox). I have answered the questions about NICE. I have answered the questions about how much money will be going into waiting initiatives—[Interruption.]—how much money is being invested in waiting.

The most basic question—the hon. Gentleman will not ask it because he dare not—is whether the Conservatives would match our spending plans. The answer to that question is that they would not, because they do not want to build up the national health service—they want to run it down.

Dr. Brian Iddon (Bolton, South-East): The poor health of my constituents has been cited in several reports—from the time of the Black report to the present day. My right

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hon. Friend knows that I have constantly made representations to him and his predecessor about the fact that the Wigan and Bolton health authority was second from bottom on meeting funding targets in 1997. The position has not advanced greatly since then. Can my right hon. Friend give my constituents an assurance that those gross inequalities in financing will be addressed as a result of the excellent statement that he has just made?

Mr. Milburn: I am grateful to my hon. Friend for his comments. He has been a constant advocate of reform of the formula—rightly so. We all recognise that the current formula is far from perfect, although I suspect that it will be difficult to find a perfect formula. However, the changes that we have made mean that this year the Wigan and Bolton health authority will receive an increase in funding for local health services of 10.17 per cent.—the largest increase for any health authority in the north-west. I hope that that is a step towards addressing the concerns that my hon. Friend has constantly raised.

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