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Mrs. May: It is a good job that my husband is not present to hear the hon. Gentleman suggest that he could prove it to me, but the hon. Gentleman's speech revealed a refreshing approach from a Back-Bench Labour Member. He said that the monolithic structure of the health service was a problem and that money was not the only answer. He cited several examples of the way in which innovative thinking should be introduced into the health service to solve the problems. I suggest to the Secretary of State for Health that he watches out for his job, because it sounds to me as though the hon. Member for Dartford has rather more ideas about the future of the health service than the Secretary of State has.

We made an amazing discovery in the speech—I have to say that it was a shambles of a speech—made by the hon. Member for Oxford, West and Abingdon (Dr. Harris). We know that the Liberal Democrats say one thing nationally and another thing locally and that Front-Bench Liberal Democrat Members disagree among themselves and have different policies, but what we heard tonight was a Front-Bench spokesman for the Liberal Democrats disagreeing with himself within five minutes in his own speech. He denied, but then confirmed, that the Liberal Democrats are considering charging for access to the NHS.

Mr. David Miliband (South Shields): I am sorry to interrupt the hon. Lady; I am genuinely grateful to her for mentioning charging. When we last debated public services in the House, the shadow Chancellor refused to repeat his party's manifesto commitment to an NHS free at the point of use. Does she support the shadow Chancellor or her manifesto, on which she stood for election at the last general election?

Mrs. May: I would have more reason to answer the hon. Gentleman if his party knew what its own policy on the health service was—it does not know, as I shall go on to say later in my speech.

We heard particularly powerful contributions from my right hon. Friends the Members for South-West Norfolk (Mrs. Shephard), for Hitchin and Harpenden (Mr. Lilley) and for Wokingham (Mr. Redwood). My right hon. Friend the Member for South-West Norfolk made the very valid point that it is time that the Government took responsibility for being in government and for their record in government. Her criticism was particularly trenchant when she talked about the Government's complete failure to understand the needs of rural areas.

My right hon. Friend the Member for Hitchin and Harpenden made a number of very important points about the difference between official figures on teacher vacancies and the reality faced—day in, day out—by schools throughout the country. He pointed out what seems absolutely clear to everyone but the Transport Secretary: the Strategic Rail Authority 10-year plan for the railways fails to deliver what is needed—an increase in capacity. As my right hon. Friend the Member for Wokingham said, money is being thrown down the drain to advisers and consultants because Railtrack is in administration, while the Government completely fail to set out their criteria for bidders to take over Railtrack and to take it out of administration.

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Let us come to the state of our public services. An insight was given into that recently by the Deputy Prime Minister in his speech to the Fabian Society. He spoke about part of his own constituency and said that it was not unique. He then said:

"Across the land are neighbourhoods just like it—where public services have let people down, badly."

With observations like that, perhaps it is little wonder that the Deputy Prime Minister is now being rubbished by the likes of the Minister for Europe.

Phil Hope: Will the hon. Lady give way?

Mrs. May: No, I will not give way.

The Secretary of State for Health in replying to this debate attempted to paint a different picture—one of delivery in the health service. Of course, that picture is totally at odds with the experience of patients who wait hours on trolleys and who return from holiday to find that their operations have been cancelled while they have been away and that they have been taken off the waiting lists.

The 2,000 more people waiting for operations for more than 12 months than were waiting in May 1997 and the 400,000 people waiting just to get on the waiting lists know the painful reality of the Government's failure to deliver on the NHS. I will give the Secretary of State for Health his due; he did say one interesting thing during his speech—that we have a very good Transport Secretary. That is the first time in the House that I have heard a Minister refer with such warm words to Lord Birt.

My hon. Friend the Member for Woodspring (Dr. Fox), in a powerful opening speech, reminded us clearly of the extent of new Labour's failures in health, education, transport and law and order. The list goes on. As he said, the problems faced lie in the very ethos of new Labour, because the Government's propensity to centralise, micromanage and interfere—overlaid with the obsession with spin that is so characteristic of new Labour—has led to problems in the public services.

Perhaps that is best revealed by the Government's obsessions with plans. In the health service, we have had the NHS plan, the Wanless plan, which was going to be the answer, and the Secretary of State's new plan that was brought out last week.

However, perhaps transport is an even better example. The Government issued a 10-year transport plan. One year on, it is being reviewed. That is hardly surprising given that a hole has been blown in it by the fact that Railtrack is in administration. Last week, the Strategic Rail Authority issued another 10-year plan and the Secretary of State for Transport, Local Government and the Regions told us:

"No more vague aspirations or grand visions strong on rhetoric but weak on delivery. This plan is an agenda for action."

A 10-year plan for delivery, or is it? The Secretary of State gave an interview to the BBC's "On the Record" programme on Sunday and the following exchange took place:

"Mr. Humphrys: 'And that ten-year plan is now fixed. That is, that's there, that's solid, that's in concrete?'


The Secretary of State: 'The obligations are there. I've said though I want it reviewed every year, because there's no point in having a ten-year . . . '


Mr. Humphrys: 'So it's not really a ten-year plan then?'

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The Secretary of State: 'Well, it's a ten-year plan as we sit here today, but it's got to be flexible John, because if you set it . . . '


Mr. Humphrys: 'So there might be a different ten-year plan this time next year?'


The Secretary of State: 'It'll be the same ten-year plan, but we'll review it in the light of . . . '


Mr. Humphrys: 'So it might be different, but the same?'


The Secretary of State: 'Well. we'll explain.'"

Let me explain to the Transport Secretary that people are fed up with plans that fail to deliver improvements on the railways.

Who will be responsible for reviewing the plan? The Department for Transport, Local Government and the Regions, the No. 10 policy unit on transport, the No. 10 forward strategy unit on transport or the strategic transport unit in the Treasury?

One of the causes of the uncertainty in the railways is the fact that Railtrack is in administration. That has been made absolutely clear by the Strategic Rail Authority in its 10-year plan. No one knows how long Railtrack will stay in administration or what will replace it.

Again the Secretary of State made some interesting revelations in his "On the Record" interview. He told John Humphrys:

"'Well, you're assuming that the model that replaces Railtrack is going to be the same as Railtrack.'


Mr. Humphrys: 'We have to assume something because we don't know what it's going to be.'


The Secretary of State: 'Well, you don't, but in due course, and basically, I mean people say, why is it taking so long? This administration, you know, three, six months, is it going to take longer?'"

That was the Secretary of State's answer to the question of how long Railtrack would be in administration. While it is in administration, it is the Government's responsibility; it is neo-nationalisation. They were happy enough for it to be in the private sector when they took £155 million in windfall tax from it in 1997, but they will put it back in the private sector in the same railway structure as before.

The Secretary of State has delivered a 45 per cent. increase in train delays, demoralised staff, Railtrack in limbo and a strategic plan that depends on £34 billion of private sector investment that has been jeopardised by his action on Railtrack. Perhaps he would do the House the honour of telling us what the overall private and public sector investment figure is due to be under his 10-year plan. Some say it will be £67 billion. In his response, will he confirm that the overall investment figure is, indeed, £67 billion?

Of course, the railways are not the only problem: there is London Underground as well. The Prime Minister says that the public-private partnership will go ahead; the Secretary of State says it might not. We now read that it will all be okay because the Prime Minister has taken charge. Tony's roadshow is here: he is going to take his jacket off, roll his sleeves up and persuade people that a botched PPP for the underground is the answer when people know that it is not. As the Transport Commissioner for London said:

"it will . . . be the best thing since Barnum and Bailey".

The Government have presided over a shameful deterioration in public services. Patients are waiting longer, passengers are waiting longer, schools are waiting

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for teachers, and it is time that the Government stopped blaming others, accepted their responsibilities and started delivering on their promises.

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