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8.12 pm

Mr. Hilton Dawson (Lancaster and Wyre): It is a great pleasure to take part in this debate on a very fine Budget indeed, even when suffering from a raging sore throat—highly appropriate in a health debate.

I have been sitting here for some time reflecting on the words of Opposition Members, which have often been elegantly expressed, although not as seductively as my hon. Friend the Member for West Bromwich, West (Mr. Bailey) might like to claim. The last few hours have been most instructive, because although we have heard fine words, pleas for debate, and good, intelligent points being made, we have heard no passion, commitment or determination to address the problems of the health

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service. The point of the Opposition is to oppose, but in nothing that the Conservatives have said has there been any hint that, if this country were unfortunate enough to have them back in power, they would ever take on any of the real issues in the health service, invest properly in it or accord it the high priority that it needs.

I am going to stop using the term "health service" now, and start talking about health and social services, because this has been a Budget for social services. It is not true that we have not seen any investment or results in social care over the last few years. The quality protects programme, to name but one, has produced tremendous benefits by addressing the serious problems—bequeathed to us by the Conservative Government—of lack of support for young people in care, and by investing in residential care, fostering and adoption, advocacy and services for the most vulnerable children in society.

The point of this Budget is that it will allow local authorities to build their base budgets and develop their base-line services for social services, and to build on those opportunities. Most importantly, it will allow local authorities to address the serious issues facing elderly people in our constituencies—issues right at the interface of health and social care. They relate to the quality of care afforded to older people, the range of services that we provide for them, the way in which we deliver those services, and the need to ensure that they reflect the needs, wishes, feelings and views of those individual older people.

Thanks to the 6 per cent. increase for social care, councils will be able to increase fees to stabilise the care home market, and to work properly in partnership with the private and voluntary sectors. Councils will be able to develop different forms of care—rehabilitative care, for instance. They will also be able to offer older people more choice in the sort of care that can be made available to them in their own homes.

More important than anything that has been said in the Budget debate so far are the words and prescriptions of the Wanless report. Wanless explicitly says that health and social care are inextricably linked. The Government know that poverty and poor health are inextricably linked, and they recognise that the mechanisms of health and social care are inextricably linked. Those mechanisms are related to how long older people stay in hospital, to the quality and range of services that can be provided, and—most importantly—to the quality of life of older people and the way in which their range of needs can be met.

The excellent Wanless report points out that substantial increases in resources are needed, and the Government are introducing a 7.4 per cent. increase over five years for health and a 6 per cent. increase for social care. Wanless also says, however, that his review had neither the time nor the resources to develop a whole systems model and approach to reorganising care in the future. He had no time to build projections for social care at the same level of detail as he did for health care.

The Government cannot rest on their laurels over what has been achieved through this Budget; they need to move on. There needs to be an immediate extra study of the trends affecting social care to ensure that projections of need, of finance and of the sort of modernisation that is required just as much in social care as in health care are fully integrated, and that health and social care are brought together to meet the holistic needs—the all-round

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needs—of people living in our communities. That will require major work by the Government and also by the local authorities.

My local authority, Lancashire county council, is having a difficult experience at the moment; it is reviewing its provision for older people, which has been a painful process. I fully support the need to review services, but this review has not, so far, been developed in conjunction with health care—although health and social services need to work together—with the private or voluntary sectors, or with other organisations. The review has certainly not been conducted in close partnership with older people living in the community, or in residential care in Lancashire, or with their carers and families.

The opportunity offered by the Budget, the strictures of the Wanless report and the work that the Government have done on the NHS framework and to build capacity need to be taken to heart by local authorities and all agencies that work with older people so that all those measures are successful. We need to end the uncertainty for constituents throughout Lancashire. We need to stop the bickering between vital parts of the care system and to redevelop services so that they work in partnership on the basis of what the Government have laid down. We need to work back from the patient and carer so that we define their needs and how to provide services.

Health and social services need to adopt a corporate social responsibility across organisational barriers. They need to integrate staff and planning processes, to be quality driven and to derive from shared visions of how services should be delivered. Our services need to take a long-term perspective, to take account of the fact that there is an ageing population and to be financially and professionally viable. If we take the Wanless recommendations on board and develop an integrated projection for the future of health and social care in conjunction with the Budget proposals, it is clear that the Government are giving organisations such as Lancashire county council an opportunity to improve services.

I trust and hope that the social services department and the health service in Lancashire respond to those opportunities. I also hope that the private sector gets around the table with those agencies to deal with the problems properly so that from now on they work together in a true partnership. It is especially important that they work with elderly people in residential care and the wider community, and their carers and families, so that we develop the high-quality health and social care services that people need. We have to put the bickering, falling out, uncertainty and sheer anxiety of the past few months behind us.

8.22 pm

Mr. David Amess (Southend, West): "They've taken leave of their senses"; "It's a disaster"; "I can't believe what they've done"; "They've broken their general election promises"; "They've got it completely wrong"—those are just a few examples of the responses to the Budget that I received when I recently campaigned in the local elections. Where on earth the opinion pollsters get their ideas from, I do not know. They should come to Southend, West where they will find that the verdict of the electorate is that the Budget is a complete and utter disaster.

The Government have spent six years trying to massage the media response, but even they must admit that the response to the Budget has been a disaster. Indeed,

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the day after the Budget was delivered, the Government would have struggled to find a headline that was sympathetic to them, and that includes in the two tabloids that most consistently support them. The City also gave the Budget a big thumbs down.

However, the reaction of Labour MPs was the most interesting to observe. They were extremely excited last week. They waved their Order Papers at the end of the statement and thought that it was marvellous. As soon as I observed their reaction, I knew that the Budget was an absolute disaster for the Government, and it could not have happened to nicer people.

My right hon. and learned Friend the Member for Rushcliffe (Mr. Clarke) made a magnificent speech in which he destroyed the reason behind the Budget. He outlined clearly just how the Chancellor has got it completely wrong. I also greatly enjoyed the speech by the hon. Member for Truro and St. Austell (Matthew Taylor). Long may he continue to make such unpleasant remarks about the Conservative party, further undermining the huge difference, thank goodness, between us and the Liberal and Labour parties. As long as the Liberals come up with such crazy ideas like the legalisation of cocaine, the general public will see what a complete shower they are.

In 1992, socialism was defeated and the ghastly new Labour party emerged, but last Wednesday Labour returned to type. It returned to the times when it said, "Whatever the problem is, we'll spend money on it and it will be solved." I was brought up in the east end of London on the ethic that every penny counts and people should spend money well, but this crazy Government waste money. In the past year, there has been a huge underspend in the Department of Health alone. I do not know how the Government think that £6 billion will fix things over the next five or six years.

The whole point of the NHS and its past successes is that it depends on human resources—the women and men who work in it. I know that the Labour party tries to cast aspersions on the Conservative party and to spread smears, but none of that will work any more. All Conservatives applaud the women and men who work in the health service. They do a magnificent job—it is the organisation that is wrong. Without root-and-branch reform, the Government's NHS plan will be a disaster. As ever with Labour, the plan was brilliantly written, giving the impression that the money will be well spent and that reform will follow. However, if one goes through it carefully, it is obvious that there are no big new ideas and that it will be a disaster.

The Conservative party believes in the NHS ideals, but Britain today is further from those than at any time since the NHS was founded. It is wrong that people should not be offered the best treatment regardless of their ability to pay, but that is what the Labour party has ended up offering the people of this country.

Waiting lists are rising again and hospital beds are blocked because care home beds have been closed, and all that is the Government's fault. During the Committee consideration of the Health and Social Care Bill the Government would not listen. They were telling us that they would get all the care home owners together and

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listen to their concerns, but certainly in my constituency it is too late and many care homes have closed. They are looking to develop other services for local residents.

The odds of surviving cancer in Britain are among the lowest in Europe. Last year, 250,000 people without any insurance paid for their operations—more than ever before. The Budget is a missed opportunity. The Government say that they have analysed systems in other countries and we have nothing to learn from them, but they have the brass neck to send our patients abroad to have operations. What hypocrisy! We do have something to learn from other countries. Germany has no national waiting lists and Danish patients have a legal right to treatment within four weeks of seeing their GP. The Conservative party has a completely open mind about the lessons that we can learn from other countries.

Derek Wanless is continually mentioned. Quite how he has been brought so dramatically into the equation I do not know. In his report he expresses doubt that the Government's existing spending commitments can be used wisely. His report outlining a 20-year vision is already flawed by a lack of information and will have to be rewritten in five years.

Three hours ago, two or three Labour Back Benchers rather tamely intervened on the Secretary of State, but it is interesting that no Labour Member has referred to the letter from the Local Government Association which all hon. Members have received today. I am interested by the letter because the LGA represents all councillors throughout the country, and the letter is signed by Jeremy Beecham, for Labour; Gordon Keymer, a Conservative; Chris Clarke, a Liberal Democrat; and Milner Whiteman, who is independent.

The LGA says that the Government have got things completely wrong. It castigates them for failing to consult local government. This Government do not consult on anything, except perhaps asking those in a Cabinet meeting whether they want a rich tea biscuit or shortbread. The LGA letter says that central Government are already chronically underfunding social services and that there is a problem in the supply of residential care, for which local councils are not responsible. Labour Members will find that more and more of their local councillors castigate them.

Unlike the Government Whip, I have been listening to the debate for more than four hours. We all draw on our personal experiences of the NHS, and I have had four such experiences recently, two involving relatives and two involving friends. The first case is that of an aunt who is now dead. She was an honest, straightforward lady who deserved better treatment than she received from the NHS. That case has been going on for 18 months and the family will not give up the fight to get justice for her. The husband of another of my relatives was offered a care plan when he went home following NHS treatment, but it was never delivered.

At a very early age, the wife of a friend of mine died within 45 minutes of having a brain haemorrhage after coming home from work at the blood bank centre. She was the mother of four children. When I went with my friend to view his wife's body at the hospital—you can imagine the emotion, Madam Deputy Speaker—we were given an appointment time, and we did not see the body for an hour and a half. That is a disgrace, and the organisation was shambolic. The £6 billion will not fix that at all.

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Finally, perhaps the biggest insult of all concerns the guy who runs my office. He tripped over outside his property seven weeks ago, and the NHS failed to diagnose that he had broken his shoulder and the bones at the base of his thumb. He is well and truly messed up.

This Budget marks the end of new Labour, and for that the country and I rejoice.

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