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14 Nov 2002 : Column 163—continued

BILLS PRESENTED

Health (Wales)

Secretary Peter Hain, supported by the Prime Minister, Mr. Secretary Prescott, Mr Chancellor of the Exchequer, Mr. Secretary Blunkett, Mr. Secretary Milburn, Mr. Secretary Murphy, Mr. Secretary Smith, Mrs. Secretary Liddell and Mr. Don Touhig, presented a Bill to make provision about Community Health Councils in Wales; to establish and make provision about the Wales Centre for Health; and to make provision for the establishment of, and otherwise about, Health Professions Wales: And the same was read the First time; and ordered to be read a Second time tomorrow, and to be printed. Explanatory notes to be printed. [Bill 1].

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Extradition Bill

Mr. Secretary Blunkett, supported by the Prime Minister, Mr. Secretary Prescott, Mr. Secretary Straw, Mr. Secretary Murphy, Mrs. Secretary Liddell, Secretary Peter Hain and Mr. Bob Ainsworth, presented a Bill to make provision about extradition: And the same was read the First time; and ordered to be read a Second time tomorrow, and to be printed. Explanatory notes to be printed. [Bill 2].

Regional Assemblies (Preparations)

Mr. Secretary Prescott, supported by the Prime Minister, Mr. Chancellor of the Exchequer, Mr. Secretary Blunkett, Secretary Margaret Beckett, Mr. Secretary Darling, Mr. Secretary Milburn, Ms Secretary Hewitt, Mr. Secretary Clarke, Mr. Nick Raynsford and Mr. Christopher Leslie, presented a Bill to make provision for the holding of referendums about the establishment of elected assemblies for the regions of England (except London); for reviewing the structure of local government in regions where the holding of a referendum is under consideration; for implementing the recommendations of such reviews; for the Electoral Commission to give advice in connection with the establishment of assemblies; for payment of grant in connection with the activities of regional chambers; and for incurring expenditure in preparation for assemblies and in connection with the transfer of functions to them: And the same was read the First time; and ordered to be read a Second time tomorrow, and to be printed. Explanatory notes to be printed. [Bill 3].

Community Care (Delayed Discharges etc.)

Mr. Secretary Milburn, supported by the Prime Minister, Mr. Secretary Prescott, Mr. Chancellor of the Exchequer, Mr. Secretary Smith, Secretary Peter Hain, Mr. Paul Boateng and Jacqui Smith, presented a Bill to make provision requiring social services authorities to make payments in cases where the discharge of patients is delayed for reasons relating to the provision of community care services; and to enable the Secretary of State and the National Assembly for Wales to require certain community care services provided by social services authorities to be free of charge to persons receiving those services: And the same was read the First time; and ordered to be read a Second time tomorrow, and to be printed. Explanatory notes to be printed. [Bill 4].

WELSH GRAND COMMITTEE

Motion made, and Question put forthwith, pursuant to Standing Orders Nos. 107 and 108,


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(a) the Chairman shall interrupt proceedings at Four o'clock; and

(b) at the conclusion of those proceedings a motion for the adjournment of the Committee may be made by a Minister of the Crown pursuant to Standing Order No. 108(5) (Welsh Grand Committee (sittings)).—[Mr. Heppell.]

Question agreed to.

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Orders of the Day

Debate on the Address

[Second Day]

Order read for resuming adjourned debate on Question [13 November],


Question again proposed.

Health and Pensions

1.33 pm

The Secretary of State for Health (Mr. Alan Milburn): The Queen's Speech has at its heart a commitment to public services. Government Members stand for public services because we stand for a fairer society. For us, public services are social justice made real. On the national health service, we stand where we have always stood—for an NHS that is paid for by all and available to all, and provides patients with care that is free, based on the scale of their need, not the size of their wallet.

The NHS plan that we published two years ago sets out how we can build on those values to implement our programme of investment and reform for the health service. The Bills in the Queen's Speech drive forward the reforms, just as the Budget drove forward the investment. Just six years ago, spending on the NHS was falling in real terms. By 2008, it will have doubled in real terms. There is a similar story for social services. Whereas just six years ago, real terms spending there was rising by just 0.1 per cent. a year, it is now set to rise by 6 per cent. a year. Britain today has the fastest growing health care system of any major country in Europe.

The Budget laid to rest the decades-old fallacy in this country that somehow or other we could have world-class health care on the cheap. We cannot. A cheap health service delivers what the Conservatives delivered: cuts of 60,000 hospital beds, cuts of 23 per cent. in nurse training places and of 25 per cent. in general practitioners in training, and 400,000 more people waiting for hospital treatment at the end of their term in office than at the beginning. If we want world-class health care, it has got to be paid for. We on the Government Benches believe that it is right to ask people to pay a little more in tax to get a lot more into the national health service.

The Opposition imposed a three-line Whip against extra health spending—not a soft three-line Whip, but a hard one. Amazingly enough, there was not a single Tory rebel in sight.

Mr. Peter Lilley (Hitchin and Harpenden): No one denies that the Government have accelerated

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expenditure, but can the Secretary of State confirm that the number of in-patient operations has grown more slowly since 1997?

Mr. Milburn: I think that I am right in saying—if not, I shall correct myself in writing to the right hon. Gentleman—that the number of hospital operations has grown by about 500,000 since 1997, the number of people seen in out-patients has grown by well over 1 million, and the number seen in accident and emergency has grown by about 500,000. However, the right hon. Gentleman must not become fixated by what happens in hospitals alone. I do not know about his constituency, but in mine, for example, procedures that used to take place in hospital are happening in the community, in out-patient departments, in GPs' surgeries, or in health centres. It is of course important that the appropriate care be given in the right place, but if he believes—I am sure that he is not falling for this fallacy—that national health service treatment is purely about hospital treatment, he has got it sadly wrong.

Conservatives often call for extra investment in their local health services, and I am prey to interventions from right hon. and hon. Members on such matters. However, if they are going to argue—as they do in interventions, Adjournment debates and questions—for more money for their local health services, they have to explain why they voted against more money for the whole health service. Conservative Members are not stupid—that is the preserve of the Liberal Democrats—and they know that resources deliver results. Why have we got 40,000 more nurses working in the national health service than in 1997? For the simple reason that we put the money in. Why are 10,000 more doctors working in the NHS? Because we put the money in. Why is the biggest hospital building programme in the history of the NHS happening, and why are there more, rather than fewer, beds in hospitals for the first time in 30 years? Because we put the money in.

Gregory Barker (Bexhill and Battle): No one doubts that, in keeping with the Secretary of State's comments, the taxpayer is paying a great deal more for the NHS than when Labour came to power in 1997. However, can he tell us why, after five years, 1 million people are still on NHS waiting lists?

Mr. Milburn: If I were the hon. Gentleman, I would exercise caution in two respects. First, when the Conservatives were in office for 18 years, they managed to increase waiting lists by 400,000. We have been in office for five years, and we have cut hospital waiting lists by 100,000. Secondly, it is no good his arguing that what is needed is more investment in the national health service if Conservatives are not prepared to put investment into it. We will not get waiting lists or waiting times down unless we grow the capacity of the NHS.

The hon. Gentleman must have read—I have read it, for heaven's sake—the Conservative policy document that was launched last month, entitled XLeadership with a Purpose". If ever a title expressed the triumph of hope over experience, that was it. The document states in bald terms:


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The hon. Gentleman and his right hon. and hon. Friends should be extremely cautious about arguing for more money for the NHS, unless they are prepared to vote for more money for the NHS.

It is true that waiting times for hospital operations are still too long, but it is worth recalling that the number of patients waiting more than 12 months for NHS treatment is down by 40 per cent., compared with March 1997. A year ago, the maximum wait for a heart operation was 18 months; today it is 12 months, and by next April it will be nine months. That is still too long, but the trend is in the right direction and, most importantly, during the past few years death rates for cancer have fallen by 6 per cent. and for heart disease by 14 per cent.

The Conservatives often say that they are opposed to our targets to reduce waiting times for treatment, yet they also know that waiting is the public's No. 1 concern about the NHS. By and large, once people get into the system they are satisfied with the quality of their treatment. Why? Because the doctors, nurses and other staff provide a high quality of service. It is the wait for that service that is the problem for far too many people. Does anyone seriously believe that waiting times would be falling so consistently had it not been for those targets?

We know what the Conservative strategy is. The hon. Member for Woodspring (Dr. Fox) expressed it eloquently when he said that the Conservatives have to persuade the public first that the NHS is not working, secondly, that it never worked, and thirdly, that it never will work. However, for millions of our fellow citizens the NHS is working. It is delivering high quality care for millions of people every week.

We should be candid about two things, however. First, although there is progress, there is a long way to go. Turning around decades of neglect is not a battle for the short term; it is one for the long term. We have a 10-year NHS plan for one simple reason: it will take time and effort, as well as sustained resources, to deliver the world-class health care that we all want.

Secondly, investment alone will not deliver. The NHS needs reform as well as resources. Why? Because the world has changed and the NHS must keep pace.


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