Budget Statement

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Mr. Huw Edwards (Monmouth) rose—

Mr. Evans: Hang on a moment. Hon. Members may remember Viv Nicholson, who won the pools in

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the 1960s. She was the first big pools winner. When she was asked what she was going to do, she said, ''I'm going to spend, spend, spend.'' Within a short space of time, she was broke and had nothing to show for it. It is not just a case of the money that we have to spend, it is how that money is effectively spent.

What people want at the end of the day is an effective national health service. I do not think that there is anyone in this Room who does not want to see an improved national health service. However, after five long years of a Labour Administration, during which the people of Wales were told that things can only get better, we find that too many facets of the national health service have got decidedly worse.

Huw Irranca-Davies: Would the hon. Gentleman agree with a survey in The Times—that bastion of the Labour party—at the weekend, which showed that 74 per cent. of readers agreed that the national insurance rise would benefit public services?

Mr. Evans: I am grateful to the hon. Gentleman, but that does not get us away from the fact that the Government talk about inputs, and we are interested in output: value for money. We want every pound that is raised in taxation to be effectively spent.

If hon. Members were honest with themselves, they would acknowledge that the sometimes record amounts of money that are invested in the national health service could be spent more effectively. I know that the former Minister, the hon. Member for Cardiff, Central (Mr. Jones), knows that because he has made comparisons of the costs of certain operations. If only best practice were introduced, a substantial sum of money could be made available without any increases in taxation. That could be invested in frontline services.

Mr. Edwards: Will the hon. Gentleman give way?

Mr. Evans: In a moment. In Wales, spending on health is currently £1,166 per head higher than in England. Does that mean that Wales has a better health service than England?

I shall go through some of the statistics, although statistics, sadly, hide the individual misery felt by each person on a waiting list. The number of people in Wales on in-patient waiting lists for more than 12 months rose from 6,274 in March 1997 to 10,222 in February 2001. The number of those waiting for more than 18 months rose from 1,402 in March 1997 to 4,220 in February 2001. That is a rise of 47 per cent. in the number of people waiting more than 12 months and of 185 per cent. in the number waiting more than 18 months.

Chris Ruane: Will the hon. Gentleman give way?

Mr. Evans: In a moment.

In November 1998, 100,000 residents were waiting for a first out-patient appointment. In September 2001 that figure was 203,000. Welsh hospitals have a 10 per cent. vacancy rate for consultants and waiting lists of more than 200,000 for a hospital appointment, as I have said. There is just one consultant neurologist per 300,000 people in Wales compared with the recommended one per 100,000.

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More than £500 million has been wasted by the national health service in Wales during the past five years because of the massive variations to which I referred earlier. Caesarean sections at Glan-Y-Mor hospital cost £547 in 1997–98 whereas at Wrexham Maelor hospital they cost £1,945. There is a huge discrepancy there and we must find out why. Hip and femur replacements cost £2,589 at Pembroke hospital but £8,000 in Llandough.

In September 2001, 203,000 people in Wales were waiting to see a consultant for the first time, whereas in March 1997, the figure was 100,000. We have talked about independent audits, but a report by the Auditor General said that one third of NHS Wales buildings failed to meet health and safety and fire standards and that 1 per cent. were dangerously below those standards. One fifth of the estate in Wales is underused and £350 million needs to be spent to bring the buildings up to scratch. In Wales, there is one rheumatologist per 185,000 people whereas in Scandinavia there is one per 35,000, and there is not a single one in the whole of Dyfed and Powys. Yet one in four Welsh people suffer from arthritis. We are scouring the Philippines for nurses, when there is a problem of retention and those nurses are needed in the Philippines.

The list that I have read out should make us all ashamed. I do not think that Nye Bevan would beam to hear such statistics. They mean that things have got decidedly worse under the Labour Government. I want to ensure that the dedicated staff—the nurses and doctors—can deliver. They have a commitment to the NHS but, sadly, the bureaucracy and waste in the NHS has got decidedly worse, especially during the past five years. The reforms that Jane Hutt wants to introduce for the NHS will make that even worse. The bureaucracy, the extra bureaucrats and pen-pushers needed to deliver the reforms that she wants, will be great news for Rymans, for paperclips and pens, but very bad news for frontline health services.

Chris Ruane: The hon. Gentleman gave a lengthy list of statistics for people waiting to see consultants. Is he aware that it takes 17 years to train a consultant? The consultants available to treat people today will have started their training in 1985, at the height of the Thatcher regime.

Mr. Evans: The hon. Gentleman will know that record investments were made in the national health service when the Conservatives were in power. Everyone accepts that.

Part of the problem is that the expectations of everyone in Wales were cruelly raised during the period before the referendum on the Welsh Assembly. We were told then that things would be absolutely marvellous when the National Assembly came into being, but matters have got decidedly worse. Brian Gibbons, the Deputy Health Secretary in the National Assembly, has admitted that the health service is in a worse state than when the Conservatives left office. Such things as a cash injection of £28 million to tackle coronary heart disease should have meant dramatic improvement, but we know that only £8 million of that reached frontline services and £20 million went elsewhere.

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Mr. Edwards: Will the hon. Gentleman give way?

Mr. Evans: In a moment.

We have discussed the need for more doctors and nurses. On 30 March, John Osborne, an ear nose and throat specialist at Ysbyty Glan Clwyd, spoke about the shortage of consultants in hospitals throughout Wales. He said:

    ''It's a very worrying situation. It's a more stressful job today, and people are retiring early. In the short term there's a problem. I think people will have to travel further for services''.

All hon. Members' constituents in Wales will face that problem.

Mr. Simon Thomas: I actually agree with much of what the hon. Gentleman says about delivery—as would Labour Members if they examined their hearts. The Budget sets out expenditure in excess of the EU average level. However, on delivery, does he sympathise with my constituents in Ceredigion, where an NHS dentist unfortunately died a couple of weeks ago? Anyone now seeking an NHS dentist in north Ceredigion is advised to go to Milford Haven, some 70 or 80 miles away.

Mr. Evans: The hon. Gentleman is absolutely right. He knows his constituency. I am sure that his mailbag is full of letters, each of which supplies another anecdote but means misery for the people involved—those on waiting lists, for example. The Morriston hospital in Swansea has the longest waiting list in the developed world for burns and plastic surgery—people are having to wait for nine years. In the United Kingdom in the 21st century, it cannot be acceptable for someone needing such a service to be expected to wait nine years. The problem must be dealt with. I say to the shadow Secretary of State for Wales—

Mr. Murphy: I am the real one.

Mr. Evans: I was getting a little ahead of myself.

I say to the Secretary of State for Wales, with all the extra money going into the NHS, we must ensure that it will pay dividends. More money is going into Wales, but it is not paying the dividends.

Lembit Öpik: I listened with interest to the hon. Gentleman's analysis of what is wrong in the NHS. Will he furnish me with his view of why, under the Conservative Government, there was approximately half the number of acute hospital beds in Wales?

Mr. Evans: As the hon. Gentleman knows, the usage of those beds, not the length of time people stay in them, is important. People are staying in the beds far too long, blocking them and creating an acute problem—we all accept that. We must ensure that, when operations are finished, people are moved into other care beds or back home to receive care. Patients staying in hospital, blocking the beds and preventing others from getting in has become a genuine problem.

The First Secretary, Rhodri Morgan, says that he wants a world-class health service. Among others, he is currently scouring the world for people to work in our NHS. We are going to Spain and the Philippines for our nurses and Germany for our consultants while we are sending our patients to France. Indeed, it looks as though we are scouring the whole world to help the NHS in Britain to work. At the same time, the

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Government say that we can learn nothing from other countries about how the NHS should be funded.

I believe that we have a lot to learn and we should be open-minded. That is why my hon. Friend the shadow Secretary of State for Health has been talking to consultants, doctors and people involved in other health services to find out how they work. We will shortly introduce proposals to show how we can ensure that the money going into the NHS is better spent.

Kevin Brennan: Far be it for me to give electoral advice to the hon. Gentleman's party, but is he aware that he is in danger of falling into Sven-Goran Eriksson syndrome—flirting with Italian and Swedish models instead of concentrating on the domestic front, which will bring only trouble to him and to his team

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Prepared 24 April 2002