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The Government have admitted that public sector employers will have to pay an additional £1.2 billion because of the increase in national insurance contributions. That shows the sheer absurdity of their position. First, they refuse to change and reform the public services, and we will therefore not get the improvements that we all want. Next, they increase employee contribution rates for many public sector service workers on whom we rely to improve services. Finally, they hit the services with a £1.2 billion tax bill in the name of raising more resources for the same services.
The Government promise a world-class service, but they fail to recognise that the world exists beyond the English channel. The challenge is to maintain the ideals of the NHS while borrowing the best from health care systems overseas. The Government have flunked that challenge.
Last week's Budget showed that the Government have run out of ideas. They promised to save the NHS in 24 hours, and they believed that public services would improve if they were centralised through directives, targets and performance agreements. They have failed on all counts. They promised a new approach but they have turned back to the only way that they know: higher taxes.
When Governments face a crisis, they go back to their instincts. The Government face a crisis in the NHS, and they have made it clear where their instincts lie. They pressed the panic button marked "higher taxes". Without change, we shall not see the difference or get the improvements that we all want, or deliver to the people of this country the health service that they deserve. Without change
David Taylor: On a point of order, Mr. Speaker. Could you advise us whether "Erskine May" describes this continuous rebuttal of would-be interventions as either intellectual weakness or political cowardice?
The Chief Secretary to the Treasury (Mr. Andrew Smith): On the foundation of all the steps that the Government have taken towards stability, to build enterprise and fairness in our country, there is one question right at the heart of this Budget and this debate. It is the only question on which the shadow Chancellor had anything to say. It is the question that he addressed in his leaflet in the general election campaign only last year, in which he said:
Mr. Barker: What does the Minister have to say to the 250,000 people who felt compelled to abandon the national health service this year and, without insurance, to dig into their life savings to save their own lives?
Mr. Smith: The way to address that challenge is precisely to put in the investment that this Budget provides. The hon. Gentleman and all his hon. Friends must tell usjust as they will have to tell the people of this countrywhether they believe in a health service that is free and comprehensive.
There was a very interesting contrast between the contributions of my right hon. and hon. Friends and those of right hon. and hon. Members on the Conservative Benches. My hon. Friends spoke positively, with knowledge, passion and conviction, about the national health service, as well as about what we are doing for enterprise and to encourage investment to build social cohesion in this country. I listened very carefully to the speeches by Conservative Members. [Interruption.] Yes, I did. The hon. Member for Woodspring (Dr. Fox) had the nerve to go on about GP recruitment when G str[Laughter.]when GP registrar numbers fell by 20 per cent. under his Government. Those numbers are
Dr. Fox: I am sorry about the right hon. Gentleman's Freudian slip there. He will know that the number of extra GPs in 199697 was 111, and that last year it was 18. I think that that record speaks for itself.
Mr. Smith: Those figures are completely unfounded. My right hon. Friend the Secretary of State for Health has demolished the hon. Gentleman's argument many times when he has quoted those figures. The number of GP registrars has risen by 40 per cent. under the Government after they had been cut by 20 per cent. under the Conservatives.
I listened to the right hon. and learned Member for Rushcliffe (Mr. Clarke). The right hon. Member for Kensington and Chelsea (Mr. Portillo) spoke only about the public-private partnership for London Undergroundperhaps it was his putative bid to be Mayor of London. I heard speeches by the hon. Members for Tiverton and Honiton (Mrs. Browning), for Southend, West (Mr. Amess), who gave his usual dispassionate appraisal of the situation, for Bexhill and Battle (Mr. Barker) and for Epsom and Ewell (Chris Grayling). My hon. Friend the Paymaster General took notes on the comments made by the right hon. Member for Horsham (Mr. Maude). I sat through all that and there was not one iota of a positive suggestion by the Conservative party on an alternative for the NHS.
Mr. Kenneth Clarke: The Chief Secretary may recall that that was because I talked about the Budget which, despite being a Treasury Minister, he has not mentioned in the first five minutes of his response. Does he recall my saying that in the last Budget, the Government cut taxation; that during the election, they promised not to raise taxation; and that now they are raising taxation across the board and imposing it on working people and those who employ them? Does he have anything to say on that subject, which does fall, I think, within his responsibilities?
Mr. Smith: I will take no lectures from the right hon. and learned Gentleman who was responsible for 22 tax rises, all of them based on broken promises. Moreover, we said in our general election manifesto that tax policy will be governed by the health of the public finances, by the requirements of public investment and by the needs of business, families and the environment. That was a promise made and a promise kept, just as we kept every promise we made in the general election campaign.
The right hon. and learned Gentleman did not say whether he believes in a health service that is free, comprehensive and available at the point of need. He is smiling, so I take it that he does. He is clearly one of those who still adheres to the old one-nation Conservatism that his colleagues who responded to the Budget have abandoned when it comes to the NHS.
The Budget recognises that the health service that was built in the 20th century was among the greatest achievements of an earlier generation. Renewing the NHS for the 21st century is among the great challenges for our generation. After decades of underinvestment, we needed significant new investment to rebuild it, so the Budget contains the largest sustained increase in spending ever announced for the NHS. We will ensure that the extra money, together with reforms, secures results. The new resources, backed up by reform, will make our NHS what it should befree at the point of need for everyone and the best insurance policy in the world.
The Opposition have not proposed a single alternative. The shadow Chancellor may consider it an achievement to go through a whole four days of Budget debate without one of his colleagues admitting the truth about their policies. I read in The Times yesterday that
The shadow Chancellor may think it preferable to say nothing on these issues, but with the passing of every day on which he fails to deny that truth, the British people will be more convinced that that is the Tories' plan for the NHS. On Sunday, the shadow Chancellor was given a perfect opportunity