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9.55 pm
The Paymaster General (Dawn Primarolo): If the hon. Member for Christchurch (Mr. Chope) is in favour of the national health service, everyone listening to this
evening's debate will understand why the national health service is not safe in Tory hands: he made not one positive statement about the national health service.Many hon. Members on both sides of the House have contributed to the debate. Essentially, they broke into two camps: those who agree that the national health service needs more money and investment, although they may disagree on how the money is raised, and those represented by most of the Conservative speakers, who prefer to state why the national health service should not receive any more funding and why they believe it should be privatised and broken up. The notable exception was the hon. Member for Stratford-on-Avon (Mr. Maples), who made a thoughtful speech. I intend to return to some of the points he made.
My hon. Friend the Member for Gedling (Vernon Coaker) started the Back-Bench speeches. He pointed out that the Chancellor's Budget set out plans for an unprecedented increase in spending in the NHS, and proposals for financing that increase in spending in public services which ensure that the investment achieves results. The Bill will deliver the funding for a sustained improvement in the NHS—unlike the alternatives of private insurance or employer-based social insurance policies.
Our proposals mean that the NHS will continue to be available to all, without restriction, not based on ability to pay, and funded through general taxation. Despite repeated requests and challenges to commit themselves to a national health service comprehensively available and free at the point of need, Conservative Members continued to decline to do so.
Using the national insurance contribution means that the money is raised as fairly as possible. Employees and the self-employed will pay an extra 1 per cent. of all of their earnings above £89 a week, and employers will make the same contribution, acknowledging the fact that an efficient health service is also in their interests. After the changes to national insurance, British companies will still pay less towards the cost of their employees' health than many other countries, particularly European countries.
The hon. Member for East Carmarthen and Dinefwr (Adam Price) referred to the OECD study of the rising imposition on employment of social insurance taxes. He should remember that the 2002 OECD study "Taxing Wages" showed that the social contributions in the United Kingdom are significantly lower than those in our major European partners, and they will continue to be so. The very problem that many of our European partners are experiencing is of a social insurance nature and to do with the high cost of their health system.
In an excellent contribution, my hon. Friend the Member for Dagenham (Jon Cruddas) said clearly that because of the new tax credits, no family with an income of less than £18,000 a year will be worse off. The new tax credit system ensures that lower earners will still have an incentive to take jobs and increase their earnings. Together with the freezing of the income tax personal allowances, the changes allow for a substantial increase in investment in the NHS.
There are no broken promises. The Government promised not to raise the basic or top rate—[Interruption.]
Mr. Speaker: Order. Many conversations are taking place in the Chamber. The Minister is addressing the House, and she should be heard.
Dawn Primarolo: The Government said that there would not be a rise in the basic or top rates of income tax, and that the NHS would be rebuilt after decades of neglect. No promises have been broken.
Given the provisions that are set out in the Bill and the scale of the funding that is being directed to the NHS—from £65 billion this year to £105 billion in 2007–08—we can show that all the resources being raised by the increase in national insurance contributions are being directed to the NHS.
A few points were made about the quality of the health service, especially in Scotland. Questions were asked and observations were made, particularly about spending in Scotland on health care. In-patient waiting lists are about 8 per cent. higher in England than in Scotland. On average, people in Scotland have been waiting for admission for more than a month less than in England. Each year, there are about 10,000 more operations per thousand of the population in Scotland than there are in England. Investment is needed throughout the NHS in England, Wales, Northern Ireland and Scotland, but the clear reforms and the clear investment that the Government are making prove that the NHS can work.
There have been comments about the imposition of 1 per cent. and the likely effects on employers. Raising money through the national insurance system ensures that we spread evenly the burden of the increased raising of tax. We have never disputed that. It is not true, as some sought to assert, that because of the national insurance changes, employers would seek to reduce pension contributions, for example, or to move away from particular pension funds.
Commentators are already suggesting that employers should increase contributions into pension funds because such contributions, unlike pay, are not liable to national insurance contributions. When we consider the benefits to employers of a healthy labour force, of reductions in costs for ill health, of low inflation, of low tax and of a high-growth economy, we can see that Britain is still a good place in which to be an employer. It is a climate that ensures that employers can continue to grow.
Comments have been made about the need to increase the number of care homes. Care homes and the care of the elderly stand to gain from higher NHS and social service spending. Increased resources for social services will include payments for more places for people who need that care. Personal social services spending is to increase by 6 per cent. in real terms.
The Bill will increase the amount of finance that goes into the NHS. It is a service that is valued and respected by our communities, even if it is not by the Conservatives. The Bill will ensure that the reforms take place and that the money is in place to ensure that we have a first-class health service for the people of this country. Investment must match reforms. We must have accountability. Money must go to front-line staff and primary care trusts to ensure that there is developing and improving care.
As my hon. Friends made clear throughout this evening's debate, this is a long-term strategy to put right the long-term problems in the national health service. It is a long march—no one is expecting immediate results—but with the finances and reforms provided in the Bill, at least this Government will be keeping their election promises and delivering a first-class health service.
Question put, That the amendment be made:—
The House divided: Ayes 134, Noes 357.
AYES
Ainsworth, Peter (E Surrey)
Amess, David
Atkinson, David (Bour'mth E)
Atkinson, Peter (Hexham)
Bacon, Richard
Baldry, Tony
Barker, Gregory
Baron, John
Bellingham, Henry
Bercow, John
Beresford, Sir Paul
Blunt, Crispin
Boswell, Tim
Bottomley, Peter (Worthing W)
Bottomley, Rt Hon Virginia
Brady, Graham
Brazier, Julian
Browning, Mrs Angela
Burns, Simon
Burnside, David
Burt, Alistair
Butterfill, John
Cameron, David
Cash, William
Chapman, Sir Sydney
(Chipping Barnet)
Chope, Christopher
Clarke, Rt Hon Kenneth
(Rushcliffe)
Clifton–Brown, Geoffrey
Collins, Tim
Conway, Derek
Cormack, Sir Patrick
Curry, Rt Hon David
Djanogly, Jonathan
Duncan, Alan (Rutland & Melton)
Duncan Smith, Rt Hon Iain
Evans, Nigel
Fabricant, Michael
Fallon, Michael
Field, Mark (Cities of London)
Flight, Howard
Forth, Rt Hon Eric
Fox, Dr Liam
Francois, Mark
Gale, Roger
Gibb, Nick
Gillan, Mrs Cheryl
Goodman, Paul
Gray, James
Grayling, Chris
Green, Damian (Ashford)
Grieve, Dominic
Hague, Rt Hon William
Hammond, Philip
Hawkins, Nick
Hayes, John
Heald, Oliver
Heathcoat–Amory, Rt Hon David
Hendry, Charles
Hoban, Mark
Horam, John
Howard, Rt Hon Michael
Hunter, Andrew
Jack, Rt Hon Michael
Jackson, Robert (Wantage)
Jenkin, Bernard
Johnson, Boris (Henley)
Key, Robert
Kirkbride, Miss Julie
Knight, Rt Hon Greg (E Yorkshire)
Laing, Mrs Eleanor
Lait, Mrs Jacqui
Lansley, Andrew
Leigh, Edward
Letwin, Oliver
Lewis, Dr Julian (New Forest E)
Liddell–Grainger, Ian
Lidington, David
Lilley, Rt Hon Peter
Loughton, Tim
Luff, Peter
McIntosh, Miss Anne
MacKay, Rt Hon Andrew
Maclean, Rt Hon David
McLoughlin, Patrick
Malins, Humfrey
Maples, John
May, Mrs Theresa
Mitchell, Andrew (Sutton Coldfield)
Moss, Malcolm
Murrison, Dr Andrew
Norman, Archie
Osborne, George (Tatton)
Ottaway, Richard
Page, Richard
Paice, James
Paterson, Owen
Pickles, Eric
Randall, John
Redwood, Rt Hon John
Robathan, Andrew
Robertson, Hugh (Faversham)
Robertson, Laurence (Tewk'b'ry)
Roe, Mrs Marion
Rosindell, Andrew
Ruffley, David
Sayeed, Jonathan
Selous, Andrew
Shephard, Rt Hon Mrs Gillian
Simmonds, Mark
Simpson, Keith (Mid–Norfolk)
Soames, Nicholas
Spelman, Mrs Caroline
Spring, Richard
Stanley, Rt Hon Sir John
Streeter, Gary
Swire, Hugo
Syms, Robert
Tapsell, Sir Peter
Taylor, Ian (Esher & Walton)
Taylor, John (Solihull)
Taylor, Sir Teddy
Trend, Michael
Turner, Andrew (Isle of Wight)
Tyrie, Andrew
Waterson, Nigel
Watkinson, Angela
Whittingdale, John
Widdecombe, Rt Hon Miss Ann
Wiggin, Bill
Wilkinson, John
Wilshire, David
Winterton, Nicholas (Macclesfield)
Yeo, Tim
Young, Rt Hon Sir George
Tellers for the Ayes:
Mr. Desmond Swayne and
Mr. Stephen O'Brien.
NOES
Abbott, Ms Diane
Adams, Mrs Irene (Paisley N)
Ainger, Nick
Alexander, Douglas
Allan, Richard
Allen, Graham
Anderson, Janet (Rossendale)
Armstrong, Rt Hon Ms Hilary
Atherton, Ms Candy
Austin, John
Bailey, Adrian
Baird, Vera
Banks, Tony
Barnes, Harry
Barrett, John
Battle, John
Beard, Nigel
Beckett, Rt Hon Margaret
Begg, Miss Anne
Bell, Stuart
Benn, Hilary
Bennett, Andrew
Benton, Joe
Berry, Roger
Best, Harold
Betts, Clive
Blackman, Liz
Blears, Ms Hazel
Blizzard, Bob
Blunkett, Rt Hon David
Boateng, Rt Hon Paul
Borrow, David
Bradley, Rt Hon Keith (Withington)
Bradley, Peter (The Wrekin)
Bradshaw, Ben
Brennan, Kevin
Brooke, Mrs Annette L
Brown, Rt Hon Nicholas
(Newcastle E & Wallsend)
Browne, Desmond
Bryant, Chris
Buck, Ms Karen
Burden, Richard
Burgon, Colin
Burnett, John
Burnham, Andy
Cairns, David
Calton, Mrs Patsy
Campbell, Alan (Tynemouth)
Campbell, Mrs Anne (C'bridge)
Campbell, Rt Hon Menzies
(NE Fife)
Campbell, Ronnie (Blyth V)
Caplin, Ivor
Carmichael, Alistair
Casale, Roger
Caton, Martin
Cawsey, Ian
Challen, Colin
Chaytor, David
Chidgey, David
Clapham, Michael
Clark, Mrs Helen (Peterborough)
Clark, Dr Lynda
(Edinburgh Pentlands)
Clark, Paul (Gillingham)
Clarke, Rt Hon Charles
(Norwich S)
Clarke, Rt Hon Tom (Coatbridge)
Clarke, Tony (Northampton S)
Clelland, David
Coaker, Vernon
Coffey, Ms Ann
Cohen, Harry
Coleman, Iain
Colman, Tony
Connarty, Michael
Cook, Frank (Stockton N)
Cook, Rt Hon Robin (Livingston)
Cooper, Yvette
Corston, Jean
Cousins, Jim
Cruddas, Jon
Cryer, Mrs Ann (Keighley)
Cryer, John (Hornchurch)
Cummings, John
Cunningham, Rt Hon Dr Jack
(Copeland)
Cunningham, Jim (Cov'try S)
Cunningham, Tony (Workington)
Dalyell, Tam
Darling, Rt Hon Alistair
Davey, Edward (Kingston)
Davey, Valerie (Bristol W)
David, Wayne
Davidson, Ian
Davies, Rt Hon Denzil (Llanelli)
Davies, Geraint (Croydon C)
Davis, Rt Hon Terry
(B'ham Hodge H)
Denham, Rt Hon John
Dhanda, Parmjit
Dismore, Andrew
Dobbin, Jim
Dobson, Rt Hon Frank
Donohoe, Brian H
Doran, Frank
Doughty, Sue
Drew, David
Drown, Ms Julia
Dunwoody, Mrs Gwyneth
Eagle, Angela (Wallasey)
Eagle, Maria (L'pool Garston)
Edwards, Huw
Efford, Clive
Ellman, Mrs Louise
Ennis, Jeff
Etherington, Bill
Ewing, Annabelle
Farrelly, Paul
Fisher, Mark
Fitzpatrick, Jim
Fitzsimons, Mrs Lorna
Flint, Caroline
Flynn, Paul
Foster, Michael (Worcester)
Foulkes, George
Francis, Dr Hywel
Galloway, George
Gapes, Mike
Gerrard, Neil
Gibson, Dr Ian
Gilroy, Linda
Goggins, Paul
Griffiths, Jane (Reading E)
Griffiths, Nigel (Edinburgh S)
Griffiths, Win (Bridgend)
Grogan, John
Hain, Rt Hon Peter
Hall, Mike (Weaver Vale)
Hamilton, David (Midlothian)
Hancock, Mike
Hanson, David
Harman, Rt Hon Ms Harriet
Harris, Dr Evan (Oxford W)
Harris, Tom (Glasgow Cathcart)
Harvey, Nick
Healey, John
Heath, David
Henderson, Doug (Newcastle N)
Henderson, Ivan (Harwich)
Hepburn, Stephen
Heppell, John
Hermon, Lady
Hewitt, Rt Hon Ms Patricia
Heyes, David
Hill, Keith
Hodge, Margaret
Hoey, Kate
Holmes, Paul
Hope, Phil
Hopkins, Kelvin
Howarth, George (Knowsley N)
Howells, Dr Kim
Hoyle, Lindsay
Hughes, Beverley (Stretford)
Hughes, Kevin (Doncaster N)
Hughes, Simon (Southwark N)
Humble, Mrs Joan
Hurst, Alan
Iddon, Dr Brian
Illsley, Eric
Ingram, Rt Hon Adam
Irranca–Davies, Huw
Jackson, Helen (Hillsborough)
Jamieson, David
Jenkins, Brian
Johnson, Alan (Hull W & Hessle)
Jones, Helen (Warrington N)
Jones, Kevan (N Durham)
Jones, Lynne (Selly Oak)
Jones, Martyn (Clwyd S)
Joyce, Eric
Kaufman, Rt Hon Gerald
Keeble, Ms Sally
Keen, Alan (Feltham & Heston)
Keen, Ann (Brentford & Isleworth)
Keetch, Paul
Kemp, Fraser
Kennedy, Jane (Wavertree)
Khabra, Piara S
Kidney, David
King, Andy (Rugby & Kenilworth)
King, Ms Oona (Bethnal Green)
Kumar, Dr Ashok
Ladyman, Dr Stephen
Lamb, Norman
Lammy, David
Lawrence, Mrs Jackie
Laxton, Bob
Lazarowicz, Mark
Lepper, David
Leslie, Christopher
Levitt, Tom
Lewis, Ivan (Bury S)
Lewis, Terry (Worsley)
Liddell, Rt Hon Mrs Helen
Linton, Martin
Lloyd, Tony
Llwyd, Elfyn
Love, Andrew
Lucas, Ian
Luke, Iain
Lyons, John
McAvoy, Thomas
McCabe, Stephen
McCafferty, Chris
McCartney, Rt Hon Ian
MacDonald, Calum
McDonnell, John
McFall, John
McGuire, Mrs Anne
McIsaac, Shona
McKechin, Ann
McKenna, Rosemary
Mackinlay, Andrew
McNulty, Tony
MacShane, Denis
Mactaggart, Fiona
McWalter, Tony
McWilliam, John
Mahon, Mrs Alice
Mann, John
Marris, Rob
Marsden, Gordon (Blackpool S)
Marshall, David (Shettleston)
Marshall, Jim (Leicester S)
Marshall–Andrews, Robert
Martlew, Eric
Meacher, Rt Hon Michael
Milburn, Rt Hon Alan
Miliband, David
Mitchell, Austin (Gt Grimsby)
Moffatt, Laura
Mole, Chris
Moore, Michael
Morgan, Julie
Morley, Elliot
Morris, Rt Hon Estelle
Mountford, Kali
Mudie, George
Mullin, Chris
Munn, Ms Meg
Murphy, Denis (Wansbeck)
Murphy, Jim (Eastwood)
Murphy, Rt Hon Paul (Torfaen)
Norris, Dan
Oaten, Mark
O'Brien, Bill (Normanton)
O'Brien, Mike (N Warks)
O'Hara, Edward
Olner, Bill
O'Neill, Martin
Öpik, Lembit
Owen, Albert
Palmer, Dr Nick
Perham, Linda
Picking, Anne
Pickthall, Colin
Pike, Peter
Plaskitt, James
Pond, Chris
Pope, Greg
Prentice, Ms Bridget (Lewisham E)
Prentice, Gordon (Pendle)
Prescott, Rt Hon John
Price, Adam
Primarolo, Dawn
Prosser, Gwyn
Pugh, Dr John
Purchase, Ken
Quin, Rt Hon Joyce
Quinn, Lawrie
Rammell, Bill
Raynsford, Rt Hon Nick
Reed, Andy (Loughborough)
Reid, Alan (Argyll & Bute)
Rendel, David
Robinson, Geoffrey (Cov'try NW)
Rooney, Terry
Ross, Ernie
Ruane, Chris
Ruddock, Joan
Russell, Bob (Colchester)
Russell, Ms Christine (Chester)
Ryan, Joan
Sanders, Adrian
Savidge, Malcolm
Sawford, Phil
Sedgemore, Brian
Shaw, Jonathan
Sheridan, Jim
Short, Rt Hon Clare
Simon, Siôn
Simpson, Alan (Nottingham S)
Singh, Marsha
Skinner, Dennis
Smith, Rt Hon Andrew (Oxford E)
Smith, Rt Hon Chris (Islington S)
Smith, Jacqui (Redditch)
Smith, Sir Robert (W Ab'd'ns)
Southworth, Helen
Spellar, Rt Hon John
Squire, Rachel
Starkey, Dr Phyllis
Steinberg, Gerry
Stevenson, George
Stewart, David (Inverness E)
Stinchcombe, Paul
Stoate, Dr Howard
Stringer, Graham
Stunell, Andrew
Tami, Mark
Taylor, Ms Dari (Stockton S)
Taylor, Matthew (Truro)
Thomas, Gareth (Clwyd W)
Thomas, Gareth R (Harrow W)
Thomas, Simon (Ceredigion)
Thurso, John
Timms, Stephen
Tipping, Paddy
Tonge, Dr Jenny
Touhig, Don
Trickett, Jon
Truswell, Paul
Turner, Dennis (Wolverh'ton SE)
Turner, Dr Desmond (Kemptown)
Turner, Neil (Wigan)
Twigg, Derek (Halton)
Tyler, Paul
Tynan, Bill
Vaz, Keith
Vis, Dr Rudi
Walley, Ms Joan
Ward, Ms Claire
Wareing, Robert N
Webb, Steve
Weir, Michael
White, Brian
Whitehead, Dr Alan
Williams, Rt Hon Alan
(Swansea W)
Williams, Hywel (Caernarfon)
Winnick, David
Winterton, Ms Rosie (Doncaster C)
Wishart, Pete
Woodward, Shaun
Woolas, Phil
Worthington, Tony
Wray, James
Wright, Anthony D (Gt Yarmouth)
Wright, David (Telford)
Wright, Tony (Cannock)
Wyatt, Derek
Tellers for the Noes:
Angela Smith and
Mr. Ian Pearson.
Question accordingly negatived.
Main Question put forthwith, pursuant to Standing Order No. 62 (Amendment on second or third reading), and agreed to.
Bill accordingly read a Second time.
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