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Helen Jones (Warrington, North): It is a pleasure for me to speak in this debate, especially on a day when we have heard a statement describing how the increase that the Chancellor announced for the health service yesterdaythe largest-ever sustained increase in health service resourceswill be implemented.
This is a good Budget for my constituents. The child tax credit will provide a tremendous boost for many of my constituents on very modest incomes. The same applies to other measures announced by the Chancellor, such as the raising of pensioners' income threshold, which will take many pensioners out of the tax system altogether. That will be a marvellous boost for many of my constituents who have very small occupational pensions to top up their state pensions.
What I expect my constituents to welcome most of all, however, is what the Chancellor has announced for public services. They will welcome not only the health announcement, which builds on the £43 billion that we have already committed to the public services up to 2004, but our plans for education. Contrary to what the hon. Member for Newbury (Mr. Rendel) said, the Chancellor made it clear yesterday that education spending would continue to rise as a proportion of national income and that there would be an immediate £100 million extra for school improvements.
Those announcements are both economically and morally right. They are economically right because a sound economy can afford to invest in its public services, and if we are to create a society in which people are prepared to take risks, be enterprising and start new businesses, we need the underpinning of public services that makes them feel secure in doing that. The announcements are morally right because they show clearly that we have an obligation to one another in society and that we can achieve more by acting together to provide communal services than by acting alone.
I support the arguments for extra investment in public services that the Chancellor advanced yesterday. The Conservatives continually denigrate those services and have set out on a sustained mission to try to convince the public that public provision cannot and will not work, as a prelude to further privatisation. That is the same argument that we heard from the last Tory Government, but simply packaged more prettily. It is based on the fundamentally flawed belief that public services, far from being a help to individual effort, are a hindrance to it, and that libertarianism produces a better society.
That idea is based on a fundamental misunderstanding of the history of this country. All the great advances for individuals have been achieved through public provision at a very basic level: the provision of clean water, sewerage and mass vaccination did more for people's health than any individual effort could achieve. Public housing took people out of slums, and the creation of a
I always cite my own family as an example, not because we are in any way exceptional but because we are so typical. My grandparents brought up their children in the direst poverty. My older relatives still remember what it was like to have to struggle to pay the doctor if a child was ill or a new baby was born. There was no hope of staying on in education past 14. Yet my grandmother lived to see her grandchildren born in national health service hospitals, living in decent public housing and going to university. That was achieved not because we were clever or because we worked hardI do not believe that my generation ever worked harder than my grandparents didbut because the public provision was in place to make it possible.
We have to achieve that again for a new generation. Quite rightly, the public services that we put in place have raised expectations. People demand more of the services that we provide now. That is why what my right hon. Friend the Health Secretary said about a clear and proper audit of the extra provision for the health service is so important. Governments have a duty to tax fairly and spend wisely, but our individual citizens also have the right to expect that we will make it clear that the extra spending is truly improving provision.
Hon. Members' readiness to support that will speak volumes about their beliefs about the future direction of this country. The Conservatives' position is clear, however much they may try to obfuscate it: it is Thatcherism with a smile. They talk about better provision of public services and about the disadvantaged, while at the same time they are committed to cutting public spending to 35 per cent. of gross domestic product. That would have a profoundly regressive effect, giving tax cuts to people on higher incomes. The poorest and those on modest incomes will have to pay for it.
The hon. Member for Woodspring (Dr. Fox) kindly told us exactly how the Conservatives plan to pay for health care. They want more people to take out private medical insurance. The trouble with that is that schemes do not take on people who are sick, have a long-term chronic condition or are elderly. The Conservatives want more of what they call "self-pay". Do they mean hip operations that cost between £5,000 and £8,000, cataract operations that cost between £1,500 and £2,500 or people having to pay to see the doctor? They have not explained exactly what is involved, but it is clear that their plans would put an end to medical care free at the point of need, which has always been the key to health provision in this country.
In my view, it is much fairer and more equitable to fund health care through direct taxation, as the Government have decided to do. We must also be honest enough to tell people that we expect to see changes in the service for the money that we put in. There is no longer a something-for-nothing deal. Public services must be much more responsive, because what was appropriate for people's needs in the 1950s is not appropriate in the 21st century.
We have already seen that the public sector can deliver more responsive services if it is given the opportunity to do so. Examples are NHS Direct, walk-in centres and the personal medical service pilots. The one in my
The money will provide an opportunity to look carefully at the services that are currently provided and ask some fundamental questions about them. For understandable reasons, health care has been focused on acute services. I trust that now, with the extra money going in and the primary care trusts coming on-stream, we will be able to spend much more on community services.
The right hon. Member for Fylde (Mr. Jack) rightly mentioned the need for more chiropody and podiatry services. They are not glamorous services that attract a great deal of publicity, but they do more to keep elderly people mobile, prevent them from developing other diseases and keep them out of hospital than other services in the acute sector. Similarly, we need to make sure that therapy services are properly delivered and that we integrate hospital and community provision so that people have a proper package of care when they come out of hospital. That will end the revolving-door syndrome whereby patients leaving hospital do not get proper therapy and therefore have to be re-admitted.
The health service can be flexible and respond to changing needs only if we invest in front-line staff and allow them to take the lead in developing services. They are often fizzing with ideas. We have to accept that some of those ideas will not work, but we cannot make progress without drawing on the experience of the staff, not simply the extra doctors and nurses whom the Wanless report makes it clear are required, but other health service staff. Many are on low grades, but they have a great deal of experience to offer the health service. We should design a proper career path that rewards their commitment to public service with the ability to progress. The Government have made a start by allowing health care assistants to train as nurses and I hope that there will be more progress in future.
I conclude with a few words about education, which I hope to expand on at some future date. The Government have improved standards in primary education beyond recognition through use of the literacy hour and the numeracy hour, which, it is fair to say, were viewed with great suspicion at the beginning. We now need to focus on how we deal with secondary education, and to ask some fundamental questions about the values that we want to pass on to our children, and what they ought to be learning to equip themselves for a vastly more complex world than we ever had to face. We must address not just the teaching of basic subjects, but how we teach our young people to deal with the vast amount of information that they receive through various media. We must teach them how to discriminate between, and value, types of information.
We must look carefully at the practical skills that children need, and we need seriously to consider when we should begin language teaching in our schools, because we in this country have not been good at that. We must also look at how to develop scientific literacynot just the teaching of science, but an appreciation of how science has changed our world and how people can learn to assess scientific riskbecause recent examples have shown that our society is very poor in that regard.