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Dr. Ladyman: The hon. Gentleman became a Member of Parliament in 1997, at the same time as me. Does he remember the manifesto on which he stood? It promised a grand total of £540 million a year extra for the national health service—half the sum that the Government put into it. Liberal Democrats intended to raise that money through changes to the national insurance system. Why was it right then but wrong now?
Dr. Harris: The hon. Gentleman needs to go back to our manifesto, because the funding was not intended to come from the national insurance system.
Dr. Ladyman: Here is the manifesto.
Dr. Harris: Let me deal with the point. Our commitment has always been over and above existing Government spending plans, not to burn the money that Labour found for investment but to add to it and to be honest and say that if people want decent public services they have to pay for them. I therefore believe that the hon. Gentleman deceived his electorate twice. Before people claim that they will save the NHS or invest in public services, they must specify the source of the money. In costed manifestos that were audited independently for two elections, we stated that funding for education would come from a penny on income tax. In the last election campaign, we said that money for the health service would be raised through an increase in the top rate of income tax. Does the hon. Gentleman believe that that is an honest and progressive way of raising the money? Will he answer that?
Dr. Harris: Perhaps he is more honest than he was in the general election campaign.
Dr. Ladyman: The hon. Gentleman began by challenging me to go back to the Liberal Democrat manifesto, which I have. It states:
- "We will:
Invest more in the NHS. We will invest at least an extra £540 million every year in the NHS to pay for our policy priorities."
Dr. Harris: The hon. Gentleman has the misfortune of being patently incapable of quoting and of facing an author of the document, my hon. Friend the Member for Truro and St. Austell. If the hon. Gentleman has the courage to provide the quote, we can refute his words. We have been clear about the matter. [Interruption.] All the fuss from Labour Members is simply defensiveness because they did not have the guts to do what they have
subsequently done. They did not have the courage to put to the electorate before an election the fact that income tax or other taxes must increase to pay for public services.
Dr. Harris: I can take as many interventions as Labour Members like, but they are on dangerous ground. However, I shall give way first to my hon. Friend the Member for Truro and St. Austell.
Matthew Taylor (Truro and St. Austell): My hon. Friend might find it helpful to know that our 1997 manifesto proposed cuts in employers' national insurance contributions, funded by the carbon tax, which the Government adopted in a different form through their energy levy.
My hon. Friend might also find it helpful to reflect on the fact that while we proposed an upfront increase of £540 million for the health service after the election, the Labour Government were elected on a pledge to save the NHS, but imposed two years of real-terms cuts by adopting Conservative Budget proposals.
Dr. Harris: They went further. They not only stuck to Tory spending plans, which were savage for public services, but found resources to fund tax cuts for the well off, beyond published Conservative spending plans. That was simply twisting the knife
Mr. Parmjit Dhanda (Gloucester) rose—
Dr. Harris: They want more. I shall give way to the hon. Member for Gloucester (Mr. Dhanda).
Mr. Dhanda: The hon. Gentleman has not answered the question put by my hon. Friend the Member for South Thanet (Dr. Ladyman). Is it true that the 1997 Liberal Democrat manifesto proposed only an extra £5 billion for the NHS, when the Government provided an increase of £20 billion in three years?
Dr. Harris: The hon. Gentleman mentions a £5 billion increase proposed by the Liberal Democrats. That sounds like Treasury calculations in a press release, given the Government's history of triple counting.
We are worried about not only the method of raising the money and the fact that it is not progressive, was not honestly advertised, is late and, in the case of the employers' national insurance increase, self-defeating, but the way in which it is spent. We are worried about whether it will go to the parts of the health and social care organisations where it can be most effective, or be channelled specifically to achieve political targets without making the maximum impact on patient care. We are worried about the way in which the Government continue to manage the health service through too much interference, centralisation and structural change for the sake of change, not the benefit of patients.
Labour Members, in pushing at an open door or facing an open goal with the lack of Conservative policy, talk about a health service that is universal, comprehensive
and free at the point of delivery, but they should consider the health service that they have delivered. It is not free at the point of delivery; there are prescription charges for those who are not exempt. Many believe that that is a regressive method of asking the sick to pay for the health service.Many people cannot afford to pay prescription charges for all their medication. Patients often ask my former colleagues in the health service to specify the prescription medicines that they do not need so much, so that they do not have to pay for them. We have made a commitment to try to remove the unfairness in exemptions for prescription charges. People believed that the Labour party might do that for cystic fibrosis sufferers, since it made a pledge in opposition to exempt those who survived into adulthood from prescription charges. Again, it reneged on that in government. Similarly, eye checks and dental checks are not free at the point of delivery, as the Liberal Democrats would wish them to be, not only because that is a fair way of doing things, but because it would encourage people—
Vernon Coaker: Free eye tests, free dental checks, free prescriptions—how much is all that?
Dr. Harris: If the hon. Gentleman had read our manifesto more than his colleague has, he would know. If such screenings were free, people would go for such checks, which would help them to have good health in the future.
Dr. Harris: I look forward to the intervention of the hon. Member for Harlow (Mr. Rammell).
Mr. Rammell: As usual, I have taken the opportunity to read the alternative Lib Dem Budget. Many people listening to the hon. Gentleman's last contribution will have gained the impression that the Liberal Democrats are in favour of abolishing prescription charges. Will he confirm that the alternative Liberal Democrat Budget—the only document on which he can be reasonably judged—does not propose to abolish prescription charges?
Dr. Harris: In the alternative Budget, we made it very clear that we would freeze prescription charges—[Hon. Members: "Ah!"] Well, I think that people who find it hard to pay prescription charges would prefer, in the first instance, a policy of freezing the charges that the hon. Gentleman's Government have increased year upon year. The increases in prescription charges under his Government—increases similar to those that he and his colleagues used to criticise when the Conservatives implemented them—have been significant in this Parliament.
We made it clear in our manifesto that we would seek to abolish prescription charges. If the hon. Gentleman looks at our next manifesto, he will see how that is going to be funded, because, unlike the Labour party, we say how we are going to fund our commitments. Rather than making empty promises to save the NHS—as Labour did five years ago, four years ago, three years ago and two years ago—without having the resources to do so, we will provide an indication of where those resources would come from.
Labour Back Benchers, in criticising the Conservatives, suggest that the NHS is somehow comprehensive at the moment. I do not blame the Labour party for the fact that it is not comprehensive, and that there is rationing, but it is important that those of us who want to save the NHS are at least honest about the fact that not every treatment is available to everyone who could benefit from it. Labour Members who campaigned on these issues know that, for example, someone suffering from multiple sclerosis will not necessarily have access to beta interferon. People wanting prompt surgical treatment might have to wait, sometimes for too long, and sometimes beyond the point at which their condition is operable. A whole series of drugs in cancer treatment, and in others, are not available to people.
The question that we all face today—it is also one that the Conservatives must address—is not whether there is going to be rationing but how much rationing there will be, and how comprehensive we can make the health service. That will depend on the amount of resources going in, the amount of preventive work that is conducted, which the Government often ignore, and the efficiency with which the resources are spent. So, let us not pretend that, under Labour, the health service is as comprehensive as we would wish. The Government have to recognise that, before they attack the Conservatives for seeking to make it less comprehensive.
I want to return to my earlier point about this not being the most progressive way of funding the health service. Income tax would clearly have been a more progressive way of funding this increase, and that is what we propose in our alternative Budget. The Chief Secretary was singularly unable to recognise that an increase in the top rate of income tax would ensure that those who were paying for an increase in funding for the health service were those most able to pay.
I gave notice to the hon. Member for Bolsover Mr. Skinner) that I intended to point out his rather ridiculous intervention in Treasury questions last Thursday. I know that I am taking my life in my hands by saying this, but I did give him notice. He argued that, because some pensioners pay income tax—he said that half of them did so, when it is actually one third—it was a bad, regressive tax, and that obtaining these funds through national insurance contributions was fairer. I do not know on what basis he feels that it is his job to protect the interests of Baroness Thatcher and her husband, who are wealthy pensioners living off a large unearned income and who will not pay a penny more on their national insurance contributions.
Before Labour Members argue that income tax is somehow regressive because wealthy pensioners would have to pay it, they must recognise that if we want to find the most progressive way of funding these increases in public services, we have to look at the better off who have done very well and ask them to pay a little more, in a fair way, before we ask people earning small amounts—as little as £5,000 a year—to pay more through national insurance. Before we ask those people to pay, we should ask the very wealthy.
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