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14 Nov 2002 : Column 247—continued
The Secretary of State for Work and Pensions (Mr. Andrew Smith): As the hon. Member for Havant (Mr. Willetts) said, the debate has ranged widely—as is the case on these occasions—making it very difficult to do justice to all the interesting contributions from both sides of the House. However, one thing is clear: in the Queen's Speech this year, we can build on what we have achieved over the last five years in sorting out the economy, tackling poverty and social exclusion, getting people into jobs, investing in our public services and cutting crime. But as we recognised in putting forward the Queen's Speech, there is very much more to do, including in health and pensions, which we have been addressing today.
There has been a sharp contrast in the debate between the positive case that the Government can make and the weakness and contradictions from the official Opposition. While the Government can, on the basis of economic stability, carry forward investment matched by reform and opportunities matched by responsibilities so that we improve front-line service delivery, get to grips with antisocial behaviour and build a stronger society, it is clear that, despite some thoughtful contributions—I listened with great interest to the hon. Member for Wycombe (Mr. Goodman)—no coherent alternative is being advanced by the Opposition. So much for the 25 shiny new policies that they launched at their conference, which have been practically unmentioned during the debate. It is clear that the quiet man's approach is beginning to catch on on the Opposition Benches.
It is striking in these health debates that we always get at least one Conservative Member, and usually more, getting up and pointing to the health needs in his constituency, which invariably require more resources. The hon. and learned Member for Harborough (Mr. Garnier) made a powerful case for dentistry in his constituency, and good for him as a constituency Member. However, he asked Health Ministers whether they had been to the Chancellor to ask for more money. The Conservatives cannot put that argument across credibly while trying to convince people that they want lower public spending and to cut taxes nor, moreover, when they voted against the huge investment in the NHS that the Government are making.
Mr. Garnier: Let us assume that the Chancellor will not give the Department of Health any more money. How will the Government provide dentistry to Market Harborough?
Mr. Smith: As we have set out in our NHS plan and through the measures in the Queen's Speech, we will do that by devolving more power to localities, by putting more power in the hands of the front-line professionals and by structuring things so that there can be more response to local needs.
The hon. Member for Woodspring (Dr. Fox), who speaks on health for the Opposition, made a real doom-and-gloom speech in which he tried to persuade the public that the NHS was not working, that it had never worked and that it could not work; yet the Conservatives profess to believe in the NHS. He claims that administrators outnumber beds, but he does not tell
us that he includes within non-clinical staff hospital cleaners, porters, catering staff and receptionists, all of whom provide direct support to NHS patients. He claims that we cut training for GPs. Wrong; between 1997 and 2001, the number of GPs in training has increased by 40 per cent.
Dr. Fox: The Secretary of State for Health did not understand the point that was being made. It is not that the numbers in training have not increased. The point concerns the numbers who have been trained but have decided not to take up a career in general practice. That is the problem that the Government face. The proportion of those trainees going into general practice has fallen, despite the fact that the number of training places has indeed gone up.
Mr. Smith: I am glad that the hon. Gentleman accepts that we have increased the training of GPs. He ought to accept also that we would be in a much stronger position had the Conservatives not cut the training of GPs by about 25 per cent. There would have been 1,000 more GPs in the NHS now.
The NHS is working. Thanks to the efforts of staff, it is delivering for many millions of patients. We are ensuring that there are 39,000 more nurses and 10,000 more doctors; 1 million patients are treated every 36 hours; 300,000 more operations are carried out each year; and there is the first increase in general and acute beds in the NHS for 30 years.
I was very pleased to see my right hon. Friend the Member for Tyneside, North (Mr. Byers) in the Chamber. He underlined just how important it is to maintain the momentum behind radical reform, matching social justice with economic efficiency and matching rights and responsibilities. That is precisely what the Queen's Speech does, with its reform of the criminal justice system, the comprehensive strategy for tackling antisocial behaviour and our proposals for public service reform.
My hon. Friend the Member for Hampstead and Highgate (Glenda Jackson) voiced apprehension about foundation hospitals but said that she was open to argument. My right hon. Friend the Secretary of State for Health will shortly publish a prospectus, which I think will address the concerns of the hon. Member for Oxford, West and Abingdon (Dr. Harris). As the innovation and development of foundation hospitals goes ahead in practice, I hope that my hon. Friend and my right hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson) will be persuaded of the merits of the approach.
From my constituency experience—like that, I am sure, of many hon. Members—I believe that, given the strength of community, patient and staff support for good local and indeed specialist hospitals, giving them a bigger say, through a stakeholder council, with greater freedom to respond to local needs, will certainly result, as my hon. Friend the Member for St. Albans (Mr. Pollard) said, in improvements and give a greater sense of local ownership, responsibility and achievement, consistent with the strongest traditions of mutuality and co-operation that have been so important to our party.
I want to respond to the points on pensions made by the right hon. Members for Hitchin and Harpenden (Mr. Lilley) and for South-West Surrey (Virginia Bottomley). They, and the hon. Member for Havant, asked whether it was the Government's policy to put the whole pensions issue to a royal commission. As I told the Select Committee recently, it is vital that the difficult policy choices confronting us on pensions are faced up to in our forthcoming Green Paper—as they will be—and not simply parked in a commission. The public would not thank us for that. I do not, however, rule out the possibility of external bodies helping us to develop the way forward on specific issues, once the policy has been set after consultation on the Green Paper. I announced just such a proposal at the CBI last week, when I said that we wanted to create an employers' taskforce on pensions, to pull together examples of good practice, to spread and promote that good practice and to ensure that employers, along with the TUC, are fully involved in the further development of pensions policy.
My hon. Friend the Member for Cardiff, West (Kevin Brennan) made some important points about the position of employees affected by scheme closures, such as those at ASW. We can all imagine how dreadful it is for people who were counting on those schemes to provide a substantial proportion of their retirement income to have that cut away from them. We should never understate the anxiety and anger to which that gives rise. There are existing measures to protect the members of those schemes, but I understand the shortcomings to which my hon. Friend referred, including the situation when directors, often with privileged information, jump ship before the problems really hit.
Of course we are considering all those matters in the Green Paper, and they will be an important part of the national debate, which must go wider than just the Government, as we develop our policy. Within what has been a voluntary system, there is a balance to be struck between the protection afforded to those who are in a scheme, and requirements that could mean, if they are overly burdensome, that more schemes close or are never established in the first place. We cannot escape responsibility for dealing with that balance.
My hon. Friend the Member for Stalybridge and Hyde (James Purnell) spoke of a third way between voluntarism and compulsion, which I think was described as Xassertive choice". I look forward to discussing that concept with him further. Compulsion has always struck me as something that is either there or is not, but his inventiveness in devising third way solutions is legendary. I await the detail of his proposal.
I am obviously unable to tell the House this evening what will be in the Green Paper, but I can confirm that it will be published later this year. I have set out the principles that we need to follow: fairness; security in retirement; informed choice for consumers on the savings and pension products available; simple and proportionate regulation; ensuring that incentives are effective and well-understood; promoting employment among older workers; and flexibility, which gives individuals more choice about the pace at which they retire from the labour market. In carrying those principles forward, we will need to build on partnership
between Government, employers, employees and the financial services industry. In so doing, we need to ensure that the particular needs of different sections of the population are addressed. Here, I should emphasise the position of women, which, as the Liberal Democrats have pointed out, has often been neglected in respect of pensions policy.The challenge is to build on the changes that we have already made—the way in which we have strengthened the state system—so that more employers and individuals can, and do, make provision for their pension. As I told the TUC and the CBI, we need to take a hard-headed look at the options. We need reforms that have the confidence of business, as well as trade unions. We need to recognise that it is no good preaching at workers to save if they lack the means to do so, or if they lack confidence in the products available. However, it is no good loading employers with so many requirements—so much red tape or so many costs—that they cast off any responsibility for helping their employees to build up a pension. It has to be worth while for employees to save. They must be confident in what they will get in return, and it must be easy for employers to contribute.
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