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9.13 pm

Mr. Jeffrey M. Donaldson (Lagan Valley): My party welcomes the additional initial investment in the national health service, which for Northern Ireland means a total of £2.7 billion extra over the next five years. In 2003–04, we will get an extra £73 million, rising to £1 billion in 2007–08.

I note the Chancellor's proposal for the appointment of an independent auditor for the NHS in England. I hope that that measure will be replicated in Northern Ireland. It is important that we get proper scrutiny and accountability of how money is spent on health because we think that we are not getting value for money. The appointment of an auditor in Northern Ireland would be welcome.

I want to enter a note of caution. Northern Ireland spends more per capita on health than England. In fact, our health care spending is on a par with that of France, yet we still have among the longest waiting lists in the United Kingdom. As Opposition Members have said, it does not always follow that additional expenditure on the health service equals reduced waiting lists. That has been our experience in Northern Ireland, which is why we need to look at bureaucracy in the health service and take steps to ensure that the extra money gets to the point of delivery and reaches our constituents at the point of need. The key test of the success of this welcome investment will be the extent to which waiting lists are drastically reduced in Northern Ireland and throughout the United Kingdom.

On families and children, we support the Chancellor's measures to introduce a new child tax credit from 2003, and to increase the working families tax credit from June 2002. In addition, the child care element of the new working tax credit, which will allow families to receive extra tax credits to meet up to 70 per cent. of their eligible child care costs, is a significant improvement which will especially benefit families who are most in need. In Northern Ireland, these reforms should see some 250,000 people benefit to the tune of £600 million from next April, and we welcome that additional investment in the family and children.

Staying on the theme of children, we welcome the additional capital investment for expenditure in our schools. I note that this money will go directly to the schools, but the £2,500 for a typical primary school and £7,100 for a typical secondary school will not go far. The primary and secondary schools in my constituency will not find it difficult to spend that extra money, and I would have liked to see more capital expenditure made available for schools throughout the United Kingdom.

On business, the economy in Northern Ireland is heavily dependent on small businesses, which are at the heart of our economy. I welcome the proposal to reduce the small companies corporation tax rate from 20p to 19p, and to consider further steps to reform and modernise the corporation tax regime. Although I welcome the additional reliefs on capital gains tax for business to

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encourage investment and entrepreneurial activity, and the proposals to simplify VAT for small businesses, more needs to be done to help the business sector in Northern Ireland.

The new tax credit for research and development will also help Northern Ireland companies, which have an excellent record for innovation. The Ulster Unionist party has been concerned at the lack of investment in R and D by some of the larger companies in the Province, and we hope that this new tax credit will be an incentive to those companies to invest in research and development for the future.

High transport and energy costs continue to impose a disproportionate burden on business in Northern Ireland, in comparison with other parts of the United Kingdom. The freeze on fuel duty rates is welcome, but it does not go nearly far enough to ease the situation. The high fuel duty rates in the UK seriously disadvantage the road haulage industry in Northern Ireland, and the cost of this is inevitably passed on to business and, ultimately, to the consumer. With a land frontier next to a eurozone country whose fuel duty rates are much lower than ours, our retail petroleum industry has been devastated by the differential between those rates. As a result, fuel smuggling has increased substantially in Northern Ireland, and the result of that has been the closure of a large percentage of retail petrol outlets in the Province. We would therefore have welcomed a decrease in the fuel duty rate in the United Kingdom, which would have helped Northern Ireland's road haulage and retail petroleum industries.

We welcome the announcement of the introduction of a distance-based lorry road user charge that will make foreign lorry operators pay towards the costs that they impose in the UK. Obviously, as Northern Ireland has a land frontier with the Irish Republic, we will see the benefit of that. However, I cannot understand why the Government are delaying the introduction of the new charge to 2005 or 2006. The British road haulage industry wants those reforms to be introduced at the earliest opportunity, and that is especially true in Northern Ireland, where our haulage industry is under enormous pressure. I urge the Chancellor to reconsider the timetable for the introduction of the new charge and to implement it at the earliest possible opportunity. We shall monitor the proposed consultation process with the road haulage industry and shall want firm action to be taken to alleviate the pressures on that hard-pressed industry.

The decision to increase duty on cigarettes will once again increase the likelihood of cross-border smuggling in Northern Ireland. That will undoubtedly have a detrimental impact on the tobacco industry in the Province and throughout the United Kingdom. The black market in smuggled cigarettes and fuel in Northern Ireland is booming, primarily filling the coffers of the paramilitary organisations that are at the heart of such smuggling and racketeering. We need the Government to take action to deal with that, not only by tackling crime, but by reconsidering duties on those products. Smuggling must be deterred, not encouraged. Such encouragement may be inadvertent, but it is the end result. The problem must be addressed by reforming the duty regime for those products. That will be a key element in closing down the smuggling that is the scourge of our economy in Northern Ireland.

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We welcome the Chancellor's announcement that in Northern Ireland the proposed tax relief for aggregates in respect of processed products will be backdated to 1 April 2002 on receipt of European Union state aid approval. That is to ensure that no levy is paid on aggregates that are used to make such products in Northern Ireland in the tax year 2002–03. My party has lobbied hard to gain recognition for the special circumstances of the quarry industry in Northern Ireland, and the announcement of further relief is a welcome step in the right direction. Nevertheless, we shall continue to press the case for consideration of those special circumstances and for further relief to be given to the quarry industry in respect of the introduction of the aggregates tax.

We welcome many of the provisions in the Budget, but it remains to be seen whether the tax increases to enable additional investment will result in the substantial improvements in health care and other public services that give people confidence that their taxes are being well spent. My constituents will measure the Budget's success by the extent to which it results in shorter waiting lists, increases the number of hospital beds available and delivers the best health care to them at the point of need. The final verdict on the Budget may have to wait until the people can make that judgment for themselves.

9.23 pm

Jon Trickett (Hemsworth): In the very limited time available to me, I want to reflect on the national health service.

Last year, my father was taken into hospital twice with an eye condition, and he eventually lost the affected eye. On two other occasions he was taken in, with blue flashing lights, for a broken femur. At Christmas, my mother was taken into hospital, where she was finally diagnosed as suffering from brain cancer.

I have spent hours every week in hospitals—great NHS hospitals—in the city of Leeds, and I think that I know as much about the NHS and how it works, from a patient's point of view, as is possible. I have met hundreds of patients, doctors, consultants, nurses and others, and I can speak with some knowledge about their feelings about the NHS.

I feel a moral obligation to a woman who died from brain cancer to argue for the national health service. It is apparent to everyone who uses it that it does not need reform, the private sector or any of the other remedies that are being discussed. The NHS is suffering from a simple lack of resources. The top and bottom of the matter is that there are not enough resources to make people better sufficiently quickly.

I congratulate the Chancellor on commissioning the Wanless report, which clearly and starkly states the extent to which the NHS is under-resourced. It estimates that we need an extra 300,000 staff, including 62,000 additional doctors and 108,000 more nurses, to reach the average standard for an acceptable NHS by 2022. Wanless demonstrates that people in this country are dying younger than they should because the NHS is suffering from a lack of resources. He uses a sinister phrase—"PYLL" or "potential years of life lost" because of an inadequately funded health service. Wanless compares us with many similar countries and shows that people in the United Kingdom die younger because of inadequate NHS funding.

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I have taken a special interest in cancer because of my mother's cancerous tumour. According to Wanless, 10,000 people a year die needlessly of cancer because the service is underfunded when compared with the European average. If we moved to the standard of the European best, 25,000 people a year who currently die of cancer would live. That shows the scale of the crisis in the NHS. It is simply wrong to suggest that there are systemic, structural or managerial failures in the health service. The problem is underfunding.

I will not join a conspiracy of politicians from any party to imply that better results can be achieved through reform. Wanless demonstrates that people in this country have to wait an average of 4.3 months to see a consultant when people in Germany can see a consultant the same day. The average waiting time to see a general practitioner in some of the comparator countries is 14 minutes, whereas in this country, 25 per cent. of patients have to wait a minimum of four days.

The NHS suffers from underfunding and under- resourcing, and Wanless shows that clearly. It is wrong for us not to spell out the facts to the nation, which, in any event, already understands them. I believe that 25 million patients a year go to see a GP. The figures are staggering, and people understand that the NHS is under-resourced.

Conservative Members make a fundamental misjudgment about our political culture at the turn of the millennium when they assume that they can appeal to the perhaps natural desire of people to keep more of their money in their pocket rather than paying tax. The country has moved on from the Thatcherite years. People want our services, especially the NHS, to expand, and they are prepared to pay for that. I congratulate the Government on finally taking the bull by the horns with today's Budget.

I have listened carefully to the debate. I left the Chamber only for a five-minute comfort break when an hon. Friend was speaking and I have therefore heard every Conservative speech. Not one Conservative Member made a positive comment about the NHS or the increase in expenditure. Opposition Front-Bench Members have not argued for an expansion of a publicly funded health service. That is lamentable; they fundamentally misunderstand the country's mood and the daily experience of families such as mine who have been through a crisis.

How shall we pay for the health service? My family, who are reasonably well off, could not possibly afford the care that they received from the NHS when my father lost his eye and then broke his leg, and my mother developed brain cancer. It is beyond our capacity, as a middle-class family, to pay for such services. There is only one way that middle-class families such as mine can pay, and that is through a publicly funded health service.

The Tories misunderstand the nature of the British people, who clearly comprehend that, although it is possible to pay for minor operations such as cosmetic surgery and perhaps possible to pay for a new hip, paying is beyond the capacity of many people when a mother or a father suffers the acute traumas from which my parents suffered.

I believe that among the various strata, apart from the super-rich, there is a broad social coalition that the Government should encourage. Those people say that there is only one way adequately to fund a health service that is currently inadequately funded, and that is by general taxation of one sort or another.

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The Chancellor has constructed an interesting taxation package, which is a mixture of measures on national insurance and holding down personal allowances. That is progressive to some extent, as poorer families will pay less than wealthier ones, but I would prefer an honest, straightforward income tax increase, which is progressive. After all, many families can afford to pay and would gladly do so. They understand that the strong should help the weak and that the rich should help the poor. That ethos, I believe, runs strongly through our country.

In a nutshell, there is a strong case for overcoming the new Labour fear of a middle-class revolt over tax. It is possible to build around health socialist policies that argue for progressive taxation and provide the massive injection of additional funds that is clearly necessary to develop the health service.

I feel passionate about this issue and I want to say much more. I have been through some horrendous experiences and I have seen miracles—people brought back from the dead by the skill of nurses, doctors and consultants. I have seen the most amazing things, which I would have liked to describe to the House. Perhaps the opportunity will arise in the next few weeks, but the Whip is indicating that I should sit down.

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