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Alcohol Services

Ross Cranston accordingly presented a Bill to require local authorities and health authorities to provide alcohol services in their areas to address the needs of people with alcohol problems, to produce joint five-year strategic projections and annual service evaluations and plans; and to establish joint commissioning arrangements in their areas for the purchase of alcohol services: And the same was read the First time; and ordered to be read a Second time on Friday 19 July, and to be printed [Bill 124].

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Orders of the Day


Order read for resuming adjourned debate on Question [22 April].


Motion made, and Question proposed,

Question again proposed.

Budget Resolutions and Economic Situation

3.38 pm

The Secretary of State for Health (Mr. Alan Milburn): Mr. Speaker—[Interruption.] It gets better—[Interruption.] Oh yes. [Interruption.] Opposition Members are in a frisky mood today. Before I start, I have to draw the attention of the House to the fact that Budget resolution No. 6, as it now appears on the Order Paper, has been slightly amended. In the course of finalising the drafting of the biodiesel provisions—[Interruption.] I should be grateful if there were no interventions on this one. It became apparent during that process that it would be clearer if excise duty on blends of biodiesel and diesel could be dealt with as a separate item and not under existing powers to make orders relating to fuel substitute. The changes in the proposed resolution enable that to be done. [Interruption.] I hope that that is clear. If there are technical questions, my right hon. Friend the Chief Secretary to the Treasury is here, thank God.

Last week, my right hon. Friend the Chancellor of the Exchequer announced a Budget for enterprise and hard-working families, and above all, a Budget to put the national health service on a sustainable footing for the long-term. It deals with funding not for a single year, as used to happen when the Conservative party made Budgets. It is a Budget not even for three years, but for five years, so that the national health service can plan ahead with confidence and stability for the long term. After years when the economy veered between boom and bust—[Interruption.] I knew that that would get

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Opposition Members going. After those years, this Budget is built on the sure foundations of the economic stability that we have created.

Conservative Members often claim that there was a golden legacy, but the legacy was far from golden. Inflation had peaked at 10 per cent; interest rates had peaked at 15 per cent; borrowing for just one year stood at £50 billion; the national debt had doubled; and 3 million people were out of work. It is this Government who ended that mismanagement of our economy.

Mr. Desmond Swayne (New Forest, West): On the legacy and health service reform, only a year or so ago, the Secretary of State said that it was vital that the NHS remain the monopoly supplier of medical services so long as a Labour Government were in office. It is only recently that he has changed his tune, and although I welcome that change, the difficulty is that we have had five years of very little reform.

Mr. Milburn: That is completely untrue. In fact, Conservative Members argued with me for four or five years that we needed better ways of ending the lottery of care in the national health service. That is why we created the National Institute for Clinical Excellence, a reform which they opposed. They argued that we needed tighter inspection systems, so we introduced the Commission For Health Improvement, which they opposed. They argued for greater devolution, so we invented primary care groups and primary care trusts, which we can now take further. I would argue that all those aspects of reform are delivering services for patients.

Chris Grayling (Epsom and Ewell): If the Secretary of State has devolved power to primary care groups, why does my local group have to deal with 380 different targets set by central Government? How does that help patient services?

Mr. Milburn: In terms of standards, it is important that we get the balance right. The hon. Gentleman would be the first to complain if cancer patients in his area did not receive the same standard of service as those in other areas. The need to get the balance right is true of every health care system in the world, but what has characterised the national health service for 50 years is that the balance has been wrong. There has been too much centralisation and not enough decentralisation, and we can now put that right.

On taking office, our first job was to put the economy and public finances on a sure footing. Today, we have the lowest inflation in Europe, an employment rate higher than any of our major competitors, the lowest unemployment for almost 30 years, and interest rates that have not been lower for almost 40 years. Our opponents warned that the minimum wage would cost 1 million jobs, but in fact, there are 1.5 million more jobs in the economy than when we took office.

None of that has come about by chance. It has happened because of the choices that we have made: new fiscal rules, Bank of England independence, and new programmes to create jobs and make work pay. All those initiatives were introduced by this Labour Government,

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and all were opposed by the Conservatives. Every time we were making the right choices for Britain, they were making the wrong choices. Tonight, when they vote against this Budget, they will get it wrong again. They will vote against the biggest sustained growth in resources that the national health service has ever seen. Over five years, investment will grow in real terms by an average of 7.4 per cent. a year.

Mr. Julian Brazier (Canterbury): May I return the Secretary of State to the subject of the Commission For Health Improvement? Its recent report on acute hospitals in East Kent is damning of management beyond belief. It condemns them for failing to take lessons on board, and for failing to make essential communications with medical and nursing staff, whom it commends and describes as overworked. Does he intend to rubber-stamp proposals to waste a fortune reorganising hospitals in east Kent, or will he reconsider them and listen instead to many local commissions, all the local branches of the Royal College of Nursing and four out of six local councils, which recommend that the proposals be thrown out?

Mr. Milburn: I shall of course consider the commission's report. As the hon. Gentleman is aware, we are looking very carefully at the situation in his area, and it is true that problems exist there. Although they are partly the result of changes in the make-up of local services—he has been raising that issue with my hon. Friends for some time—they are also partly the product of a shortage of resources. The question for the hon. Gentleman this evening is whether he is prepared to back this Budget and the extra investment in it. He cannot make such complaints and then vote against the extra resources.

Mrs. Angela Browning (Tiverton and Honiton): The Secretary of State read out a list of credits for which he claimed ownership for the Government. Will he take ownership of the fact that, under new Labour's stewardship, as a nation we have dropped from ninth to 19th in the world competitiveness league; for the fact that our exports have been in deficit every month for the last four years; and for the fact that productivity growth, which used to be higher, has now slowed? When he hears those things or fails to mention them, does he hear a warning bell in his head that perhaps things are not going to get better after all?

Mr. Milburn: The hon. Lady's claim would have more credibility if in her constituency and those of her right hon. and hon. Friends employment was not up; if unemployment was not down; if there were not more people in work with better protection, a minimum wage and a working families tax credit; and if the economy was not doing better than our major competitors in Europe and across the developed world. The country is moving forwards, not backwards, and the hon. Lady should have the honesty to acknowledge that.

For the benefit of the House, it is worth putting the new resources for the national health service in perspective.

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