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Kevin Brennan (Cardiff, West): Will the hon. Gentleman give way?
Dr. Harris: In a moment. What the Wanless report does not show is that between 1997 and 1999, according to the Library, there were real-terms cuts made under Tory spending plans, imposed by the Government on the most vulnerable. [Interruption.] I note that the Paymaster General is yawning at this point.
The Paymaster General (Dawn Primarolo): Will the hon. Gentleman give way?
Dr. Harris: In a moment. Vulnerable people who use social services will want to know why the Government felt it possible to cut social services in real terms—after allowance was made for the additional duties funded by the special transitional grant—in those first two years. Was not that asking the most vulnerable social services users to pay for the Government's unfunded education promises in those early years?
Dawn Primarolo: I was listening closely to the hon. Gentleman, but will he return to the point made by my hon. Friend the Member for Harlow (Mr. Rammell)? I studied the shadow Budget produced by the Liberal Democrats not two months ago and the total spending raised for all public services, including health, would not match even what we are spending on health. Would the hon. Gentleman like to apply some of the honesty that he implores the rest of the House to apply by talking about what the Liberal Democrats have costed instead of his wish list?
Dr. Harris: I am delighted that the Minister is paying attention. If so, she will see that our investment in the early years of that projection, which is what our alternative Budget was due to cover, is higher and made quicker than what the Government promise. One of our main concerns about the Government's proposals is not only that they are one, two or five years too late to meet their commitment to save the NHS, but that they are slow to start. That is why not all the proceeds from NICs are going into the health service, particularly in the early years.
Dawn Primarolo: If what the hon. Gentleman says is true, the Liberal Democrats would need to raise more than the Government are currently raising to invest in the NHS. Will he now tell the House, as he recites his wish list, how much it would cost and where the Liberal Democrats would raise the money to pay for it? That is not in their shadow Budget.
Dr. Harris: It most certainly is in the shadow Budget. I take every opportunity to make the point that we would ask the best off in society to pay not the extra 1p NIC on
employees that trickles through as the only progressive measure, but 10p on the top rate of income tax on incomes of more than £100,000. That means that those who have done particularly well out of the Minister's Government—many of whom may have contributed to her party, we hear—would be asked to pay for the health service. If she looks at our figures, which have been independently costed, she will see that our funding matches what she is providing over the cycle, but that it provides more in the early years.
Dr. Harris: The Paymaster General has still not replied to my question, but perhaps the hon. Gentleman who is seeking to intervene can tell us why the Government cut social services funding in the early years. Does the Paymaster General now regret cutting social services spending in the first two years?
Mr. Webb: The Chancellor stood up on Budget day and announced that the economy would grow substantially faster than the Government had previously thought. The Government had billions of pounds, which provided these substantial extra sums for the health service. That information was not available to my hon. Friend when he set out our proposals.
Dr. Harris: That is the point we are making. The funds and the taxation that we promise are additional to Government projected revenues.
Dr. Harris: The hon. Gentleman will know and will be jealous of what we have been able to achieve in government in Scotland, and we could do more if the Labour party in Scotland had not shackled itself to the commitment not to raise fair taxes, which is what the Government did for far too long.
I question the Government's position on money following the patient; it is sad to see the Labour party parroting the Tory line on money following the patient, which it opposed when it was in opposition. The Labour party said that it would abolish the internal market. That internal market never really existed, except that money followed the patients for the services that were commissioned—which is the new Labour word for purchased—by fundholders. The Government have created primary care groups and primary care trusts, which are fundholders writ large. Now they are saying that money will follow the patient. But that does not mean more choice if the money merely follows the patient from queue to queue. People who write to me do not want a choice of which 12-month queue to join; they want access to their local hospital. A litany of local health services have been closed under the Government, so local choice has been denied, not increased.
What is the Conservative position on the future of the health service? The Tories are the second greatest danger to the health service, were they to come to power. It is clear that they do not love the NHS, because their strategy is to talk it down in the hope that they can persuade people to move to a different system that is palpably less fair.
The Government are hoist on their own petard, because one of the strongest Tory arguments is that Labour put huge resources into the health service in their first four
or five years in office—a false argument—and the health service has not got any better. I think that the Government accept—it is certainly accepted by Wanless—that that funding was not the step change that they are now proposing.The Labour party cannot have it both ways. It cannot agree with us that the funding it is now proposing is required and is a step change, and also argue that that happened five years ago. We are not where we want to be already, because the Government have not put in the resources.
It would be fine if the Government had said that they were not going to put in the resources because no one wanted to pay more tax, so we would not save the health service. Instead, they stuck to Tory spending plans and provided only limited increases, and during that time they repeated announcements, triple counted and talked about billions of pounds. To the people who are now asking what has been delivered that made it seem as though the money had gone into the health service.
The Tory posters saying "You paid the taxes, but where are the teachers and the doctors" were only half wrong. The Government announced significant increases—although presumably from Santa Claus and not from taxation—but never put in those resources.
We do not have the health service we require, because we do not have the doctors, the nurses and the beds. The resources that the Bill will make available will provide those doctors, nurses and beds. I hope that the five-year delay and the Government's failure to be honest does not make it too late to save the NHS with the funds provided in the Bill, which we will support tonight.
7.4 pm
Phil Hope (Corby): A filibuster is traditionally used in Parliament when Members oppose legislation, not when they are in favour of it. Given the previous contribution, I am surprised to learn which way the Liberal Democrats intend to vote.
What we are doing in the Bill is historic. This is landmark legislation, and will place the national health service on a sound and robust financial footing. It puts a roadblock in the way of Tory plans to privatise and break up our national health service. The Bill produces a structural shift in the resources available to the NHS. That is the important point. It will provide a permanent future for health care, built on Labour's principles of a free health service based on need, not on ability to pay.
Under the Tories we experienced 18 years of deliberate disinvestment. Money was taken out of the NHS to pay for tax cuts. We know what happened. Every day we see all around us in our constituencies the legacy of that disinvestment. The Tories run down the NHS—I was sad to hear the Liberal Democrats doing the same just now—criticise it endlessly, and never accord it the success that it is having, so that people lose confidence in it. As people lose confidence in the service, in come the Tories with their plans for charges and private health insurance. They play on people's fears to force them down that route. They have no moral right to do that.
Mr. David Ruffley (Bury St. Edmunds): I do not want to interrupt the hon. Gentleman's robust start to his
speech, but should I deduce from what he is saying that any future increases in health spending that necessitate more Government money will come from national insurance increases rather than income tax increases? That seems to be the logic of what he is saying.
Phil Hope: The hon. Gentleman has hit on exactly the point I was trying to make. As a consequence of the 7.4 per cent. increase year on year that the Bill will generate, spending on the national health service from national insurance contributions will rise from £65 billion in this financial year to £105.6 billion in 2007–08. He is right to point out that as a result of the Bill, national insurance contributions will provide the robust financial security for the NHS that it never had under previous Tory Administrations. That is why the Bill is historic.
For a century, Labour has campaigned and fought for social equality and social justice, and for the fundamentals that matter in society, such as people's health. I feel privileged to be in the Chamber for the Second Reading of a Bill that is placing the NHS beyond the ravages of a Tory Government, and putting it in the hands of the people for its future longevity and sound delivery.
It is also significant that this is not just about a system of health care in the United Kingdom. If we get this right, it will be a model for other countries. It will show every western democracy and every emerging democracy in other parts of the world that we can deliver health care through general taxation that meets people's needs without forcing them to pay from their own pockets, without making the sick pay for being sick. We do not have to go down that route. The Labour Government in the United Kingdom are showing the world one of the most spectacular success stories. [Interruption.] Tory Members are shaking their heads. They cannot bear the thought that a Labour Government are showing the world how to produce one of the finest health services on the planet, which is fairly funded and efficiently delivered.
I could not believe it when the hon. Member for Oxford, West and Abingdon (Dr. Harris) said that national insurance contributions were not a progressive form of taxation. Of course they are. That is the point about national insurance: people pay according to how much they earn. Moreover, pensioners on low fixed incomes will not have to pay because they do not pay national insurance. As we know, pensioners use the NHS disproportionately; the older people get, the more ill they will be. How much more progressive can you get? Those who need the health service most will not have to pay for these extra resources.
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