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3.15 pm

Mr. Win Griffiths (Bridgend): First, I heartily endorse all the remarks of my right hon. Friend the Secretary of State for Wales about my former colleague and neighbour, the late Sir Ray Powell, and also the words of encouragement for my new neighbour, my hon. Friend the Member for Ogmore (Huw Irranca–Davies) who, I am sure, will be my colleague for a very long time. There is no truth in the rumour that both of us were two inches

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shorter at the end of the by-election campaign than we were at the beginning, or that we were beginning to develop webbed feet, although there was a lot of rain in those three weeks.

The hon. Member for Ribble Valley (Mr. Evans) is right to say that I want to talk about the heath service in Wales, if only to correct one or two slightly false impressions and the spin that was given to remarks that I made to The Western Mail a couple of weeks ago. This House is responsible for the money that goes to the Welsh Assembly for spending on public services and promoting prosperity in Wales. In addition, this House passes the primary legislation that the Welsh Assembly implements in Wales.

I want to consider the health service in particular because it is fundamental—good health is what people want most of all. In simple money terms, the Government's record is excellent. Since 1997, the rate of increase in spending on the health service year by year has not been far off 10 per cent. Under this Government, and certainly since the establishment of the Welsh Assembly, spending on health in Wales has been three or four times above the rate of inflation. Spending has risen from just over £2 billion in 1997, when we came to power, to almost £3.5 billion this year. Next year, it will be almost £3.75 billion.

A lot of money is spent on the health service in Wales—more per capita than in England. In Wales, we spend about 13 per cent. more per capita than is spent in England. Of course, that has implications for how the Barnett formula works. I shall not make that the thrust of my remarks—I merely point out that it is an issue.

Mr. Wiggin: I am curious about how the Barnett formula works. I visited my local hospital and found that at least 10 per cent. of patients in the hospital in Hereford had come over the border from Wales. Is it not true that not only has health spending gone up in Wales but that there is a multiplier effect as Welsh patients are not going to hospital in Wales?

Mr. Griffiths: This is a united kingdom, and there is a flow of patients from both sides of the border. There is no district general hospital in Powys and for many patients the closest hospital is in Hereford. I do not think that we need to make too much of that.

Lembit Öpik: Does the hon. Gentleman agree that as that has been the situation for many years, it would not distort the figures in the way that the hon. Member for Leominster (Mr. Wiggin) suggests?

Mr. Griffiths: Not at all. The fundamental issue is that more is spent on health care per capita in Wales than in England, which needs to be considered in the context of the Barnett formula.

I am not revealing anything new today. I first raised the subject more than two years ago, but I am pleased to come back to it because of the remarks of the hon. Member for Ribble Valley. We also need to consider some of the comparisons between the health of people in Wales and in England. For example, hospital admissions are 18 per cent. higher in Wales than in England and admissions to accident and emergency units are 17 per cent. higher. Some 20 per cent. more prescriptions are issued in Wales

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per capita than in England. There are 19 per cent. more visits to doctors in Wales than in England. Reporting of long-term illness is 28 per cent. higher in Wales and the mortality rate, adjusted and unadjusted, is also higher. There are 19 per cent. more cancer registrations of men in Wales than in England, and 14 per cent. more for women; and deaths from heart disease are 19 per cent. higher in Wales. It is therefore not surprising that we spend more on health care in Wales.

This illustrates the difficulty that we have in dealing with these problems in Wales. However, we are spending more money and there are a lot of good news stories about the health service in Wales. Tomorrow I believe that the new St. David's hospital will be opened in Cardiff, in the constituency of my hon. Friend the Member for Cardiff, West (Kevin Brennan). In November of this year a new district general hospital will be open on the Baglan moors in the Bro Morgannwg health trust. The trust covers my constituency but the hospital will primarily serve Aberavon and Neath. A new community hospital has at last been agreed for Porthmadog—we were talking about it when I was a Health Minister in 1997–98—and there will also be a new community hospital in the Rhondda. That is about £35 million worth of investment.

Some £4.5 million has been allocated to the second phase of the children's hospital once the magnificent fund-raising effort has put into place phase 1, which has almost been achieved. There is £6.3 million going towards medical undergraduate facilities at Swansea. To illustrate how long all this takes, the decision was made in 1997–98 to increase the number of medical undergraduates in Wales, and that has to be planned for.

There are more nurses and midwives training and more will be finishing their training over the next few years than ever before. In the professions allied to medicine, there are increases in the numbers in training. The diatribe and criticism of the hon. Member for Ribble Valley cannot be accepted because when the Tories were in power, the number of beds in Wales was reduced and the number of nurses also took a dive. When the right hon. Member for Wokingham (Mr. Redwood) was Secretary of State for Wales, he almost reached the point of asset stripping both the physical and intellectual infrastructure of the health service. He left the Welsh health service in a deplorable state.

We are spending £10 million on the upgrade of the cancer facilities at the Singleton hospital at Swansea, with £5.5 million going to the accident and emergency unit at Morriston. Wherever we look, there is a tremendous increase in spending. Things are improving and more staff are coming on-stream, but we must accept, in the words of Dr. Bob Broughton of the British Medical Association, that we have had 20 years of under-investment and it will take a bit of time to turn the ship around. Some 88 additional consultant posts have been made available for Wales and £9 million has been allocated to the new clinical school in Swansea this year.

This year, 10,000 more patients have been treated in the health service than the year before. However, we have to accept that waiting lists in some areas are increasing. Fortunately, we can see a chink of light at the end of this gloomy and difficult tunnel: in areas where the Welsh Assembly has begun to target the waiting lists for heart disease and cataract operations, there has been a small reduction. Because I know that the Welsh Assembly is focusing on other areas as well, I am confident that over

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the next few years we will see a gradual improvement. I emphasise that it will be gradual because it takes time to get the staff in place for this work to be done. Even today there are many consultant posts in Wales waiting to be filled, not because they have not been advertised but because it is difficult to find the people to fill them. We need to be patient.

The Western Mail has said that £500 million more could have been available to spend on the health service in Wales over the past five years. Instead of saying that those figures are calculations of my own, it might be more accurate to say that I dumped all the information published by the NHS Executive on the cost of the 100 most popular hospital in-patient and day-case treatments on my assistants and asked them to work on those figures. What they came up with is that in 1996–97, if all hospitals in Wales had reached the average for just those treatments carried out in every hospital, there would have been a saving of about £24 million which could have been invested in the health service. If all hospitals had reached the average of the best three, the saving would have been almost £100 million which could have been invested in the health services in Wales.

I was trying to tell The Western Mail that if the Welsh Assembly were to look carefully at where hospitals were most efficient and effective in carrying out their work, it would be possible to have substantial additional funds available to spend on the health service in Wales and make a significant impact on waiting lists. In fact, I have already put that point to the Minister for Health and Social Services, Jane Hutt. Over a five-year period, I guess that between £400 million and £500 million could have been invested in the health service in Wales. The Welsh Assembly is looking at these specific problems and I am sure that we will see an expansion of the hospitals which are proving to be the most effective in Wales. Therefore, I am encouraged by what is happening. Despite some of the gloomy headline statistics, I believe that the chinks of light showing in matters such as heart disease and cataracts will be rolled out across other specialisms. I am confident that in four or five years we will see a much improved health service in Wales that we will be happy talking to our constituents about.

Mr. Wiggin: What does the hon. Gentleman think about the increased bureaucracy? I appreciate that he did not research those figures himself, but the principle is laudable. I am curious because the five health authorities will be abolished in April next year to be replaced by 22 local health boards with similar powers. Those will be backed by as many as 12 partnerships and three area offices. The latest plan for health in Wales is to replace the five existing health authorities with 37 organisations. It is hard to understand how the Government have managed to increase spending by so much and achieve so little. In the words of the right hon. Member for Llanelli (Denzil Davies)—

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