Budget Statement

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Chris Ruane: Send him a form.

Huw Irranca-Davies: I may well do that.

We heard a lot this morning that was very complimentary about the Budget—rightly so. However, the hon. Member for Montgomeryshire has consistently pointed out that the idea originated with the Liberal Democrats. I believe that he agrees with that statement. What an amazing latter-day conversion to democratic socialism. We welcome him on board.

However, the hon. Member for Ribble Valley is the best new membership hopeful. Curiously, I find that I am in great agreement with him on one significant measure, so I will hold his membership form ready. He has stated categorically, time and time again, that investment must be accompanied by reform. We are in agreement; every hon. Member on this Bench says that

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we must have reform. The worst possible thing that we can do is to chuck money down a black hole. We want to deliver more nurses, more consultants, more teachers and so on. After the sitting, I will be waiting outside ready for the hon. Gentleman's signature.

I shall speed through my contribution, as other hon. Members wish to speak. Elin Jones, the Assembly Member and the shadow economic Minister, stated:

    ''New Labour's Budget is offering nothing to help deprived areas. The majority of tax cuts and exemptions are for large companies which do not exist in Wales.''

I could respond to that, and speak about the 1 per cent. tax cut for business and the 19,000 Welsh companies that will benefit because they will not pay corporation tax on taxable profits up to £10,000; I could talk about the 73,000 Welsh companies that will benefit from the streamlining of VAT; I could go on, but other hon. Members want to contribute to the debate. [Hon. Members: ''Go on.''] No, I will not go on, because despite my welcome for the Budget, I also have some words of caution. There is a danger of over-promising, and of raising expectations, because delivery must go hand in hand with reform. There have been too many initiatives over the years. In the 1930s, there were streams of initiatives to regenerate the valleys; they have come and gone. They were not monitored effectively and there was no follow-through; we need such measures now and I hope that the Secretary of State will ensure that we get them.

We need greater investment in the electronic and tarmacadam infrastructure of Wales and the valleys to ensure that benefits are spread up into the hinterland as well as down the M4 corridor. Other hon. Members, too, will want the benefits to be spread throughout Wales.

The biggest challenge that we face is a legacy of the many years when people in our constituencies were told, ''Turn away from employment. You can't do it. You are not entrepreneurs; you do not have the vision. Forget it. Turn your backs on it.'' We are starting to wrestle with the challenge to change people's mindset and make the message clear. We want people to say, ''Yes, we really can do this. The Government will put the framework in place for innovation; now let us get businesses, academics, entrepreneurs and everyone else together to turn our valleys and Wales around.''

I have information, which I shall be happy to pass to hon. Members, on innovative Welsh companies that show that in research and development, and in high-tech industries, Wales can deliver world-class companies. The picture is not as black as Opposition Members paint it; yes, there is a lot to do, but we are getting on with it. Opposition Members should support the initiatives rather than painting Wales blacker than black.

Finally, we have had an interesting philosophical debate on the Budget statement over three days in the Chamber and in the Committee. The question is whether business has a fundamental role in the public services, and a civic duty. The answer must be yes.

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Opposition Members cry, ''There is a wolf at the door. This is hammering private companies,'' but it is not a wolf—it is a measure for more nurses and more doctors. When the Opposition knock the investment being made and the partnership approach of business and the citizen, they knock the future of our health and public services.

5.9 pm

Mr. Edwards: It is a pleasure to follow the first speech to the Committee by my hon. Friend the Member for Ogmore. I congratulate him on his election to the House and on his outstanding maiden speech in the St. David's day debate.

I shall confine my comments to the implications for the national health service of this Budget, which will be seen as the one that sustained the NHS into the 21st century and reaffirmed the principle of a national health service funded from general taxation and free at the point of delivery. My constituents overwhelmingly believe in the basic principle of the national health service. They do not relish the prospect of taking out private health insurance, which creates a two-tier health system such as that in the United States, where insurance premiums are based on people's health status, where the old pay more to be insured than the young, where the sick pay more to be insured than the healthy and the chronically sick become virtually uninsurable.

There is no doubt that there are problems in the national health service. I am concerned about the long waiting times in my constituency, especially in the orthopaedic sector. Many of my constituents have been waiting for a considerable time for hip replacements and other orthopaedic operations. There have been concerns about repeated cancellations for operations and treatment, especially at the Royal Gwent hospital. There has been an over-reliance in Gwent on certain procedures at the University College hospital in Cardiff. There has also been great concern about the cancellation of procedures such as angiograms. I hope that there will be investment in the health service's capacity to undertake such procedures in hospitals such as the Royal Gwent and Nevill Hall. I have made several representations about the diminution of NHS dentistry in Abergavenny and Chepstow. I hope that the additional investment that the Assembly recently announced will remedy that situation.

There have been recent successes. Capacity has increased. There is a new community hospital in Chepstow in my constituency, which is the first new hospital to be opened in Wales under the Government. There is a new day surgery unit at Nevill Hall hospital, where there are important plans to develop services. There are also exciting plans for a new health and social care facility in Monmouth, which will be the first of its kind in Wales. However, there is a need to ensure full value from the staff in the service. The Government are committed to investing in the training and education of doctors and nurses: in Wales, 500 more nurses and 400 more doctors are being trained than last year.

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However, we need greater value. My recent inquiries confirm that only 60 per cent. of the consultants in the Gwent Community Health NHS trust have full-time contracts. Some of them may practice privately within certain prescribed earnings limits. The remaining 40 per cent. do not work full-time for the health service. A major inquiry conducted by the Select Committee on Health found that the proportion was higher in England, and that there was a clear correlation between the most lucrative areas of private practice and the longest waiting lists. That situation must be rectified, and I hope that the Government will succeed in negotiating new consultant contracts. It cannot be right that when a significant number of doctors attain consultant status, they can decide what fraction of the week they wish to work for the national health service to maximise their earnings from private practice. That is not permitted in other public services. Neither senior police officers nor senior ranks of the Army can work for the police or the Army for part of the week, and for other organisations for the rest of the week. The capacity of the NHS could be increased if all consultants worked full-time for the NHS. They deserve to be rewarded for agreeing to have full-time contracts.

Our health service also depends on a vast army of nurses who are committed to serving patients but are constrained by the constrictions placed on them by the elitism engendered by the medical profession. When the Prime Minister launched the national plan for health in July 2000, he said that

    ''the role of nurses will be radically enlarged and old barriers to modern working removed. A qualified nurse has had at least three years training. It is wrong that, in many places, nurses are unable to make and to receive referrals, to admit and to discharge patients, to order tests, to run clinics and to prescribe drugs. Those old rules will be swept aside and nurses in every hospital will have that opportunity.''—[Official Report, 27 July 2000; Vol. 354, c. 1257.]

The need for such reform is vital to end the demarcation between the medical and nursing professions.

In my view, the Government lost two years in establishing the national plan for health: it should have been instigated on the formation of the Labour Government in 1997. However, the Government's emphasis was on removing the internal market that the previous Government created, and removing the distinction between fundholding and non-fundholding GP practices. A health service that wants to advance must address the inequalities in health. The hon. Member for Ribble Valley quoted Professor Townsend, who was a member of the Black commission that reported on health inequalities; the previous Conservative Government swept that report aside without consideration.

The evidence shows significant health inequalities in Wales. I represent one of the more advantaged areas in terms of health and social status. The report of the Chief Medical Officer for Wales demonstrates that differences of as much as 50 per cent. exist between the better-off and the worst-off areas, particularly in the south Wales valleys. We need a health service that will invest in prevention. That report contains disturbing evidence about young people's lifestyles. At the age of 15, 20 per cent. of males and 29 per cent. of females

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are smoking and 58 per cent. of males and 50 per cent. of females drinking alcohol. Whereas 50 per cent. of males take regular exercise, only 19 per cent. of females do so.

There are important challenges. Wales has a high prevalence of coronary heart disease, hypertension and anxiety. Cancer rates are higher in Wales than in England and a higher proportion of people in Wales report limiting long-term illnesses than anywhere else in Britain. Improved health status is inextricably linked to attacking social exclusion. The Government have shown their commitment to that and to reducing health inequalities, but that must go hand in hand with the record investment that the Government are putting into the national health service.

5.16 pm

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Prepared 24 April 2002