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10 Apr 2003 : Column 475—continued
Mr. Kelvin Hopkins (Luton, North): Would it not be sensible to bring such agencies into public ownership, as public services, so that they are non-profit making?
Mr. Burstow: In a way, the Government tried that with the establishment of NHS Professionals—their answer to the cost of agency nurses. That body was set up to manage bank nurses and other agency nurses to provide a service to the NHS. However, that form of nationalisation produced a poorer service, which was rejected by many trusts.
We need sensible strategic planning for the use of agency staff rather than the panic measures currently being adopted. Only 18 months ago, an Audit Commission report concluded that there was not
enough planning in the use of agency staff; they were merely being used as a firefighting measure to plug gaps as and when. The lesson to be drawn is that, if we want family friendly practices throughout the economy, we should be seen to have adopted them in the NHS. People are voting with their feet and leaving the NHS to work for agencies, where they find the flexibility that they are not given when they work directly for the NHS.There are questions about the pressure on the NHS to hit Whitehall targets that often relate not to genuine clinical needs but to other Government ambitions. For example, the Government set a target of four hours for waiting in accident and emergency departments. In March, they carried out a snapshot survey to find out how things were going. The problem with taking a snapshot is that everyone lines up for the photograph to make it look as though they are doing a good job. During the week of the Government's snapshot survey, extra agency staff were brought in, overtime was increased, and training courses and scheduled operations were cancelled so that the right figures were achieved.
Maintenance in the health service is also a problem. When the Government took office, the cost of the maintenance backlog to deal with the peeling paint in the crumbling buildings of our health service was £2.8 billion. The Labour Government were going to save the NHS in 24 hours. What is the situation six years later? The figure for the maintenance backlog is £3.4 billion and rising. PPP has not solved that problem. What are the Government doing to deal with that long-term maintenance backlog?
The Chancellor rightly talks of the need for long-term investment in the health service. He commissioned the Wanless inquiry, which we welcomed. We subscribe to many of its findings. However, we were puzzled by the fact that Wanless said time and again that health and social care were sides of the same coin and that they needed to be seen as part of a whole system, yet Wanless was denied the possibility of inquiring into the adequacy of social services resources. Surely it is time to hold such an inquiry, not least given the integral relationship between the two parts of the system. The NHS can begin to deliver many of the Government's targets only when its social care partners are properly resourced. That is why it is disturbing to learn that in the past six years 124,000 fewer households received home care—a 25 per cent. reduction in the number of people receiving care in their own homes. Is it any wonder that there are still problems with delayed discharge? Instead of tackling the underlying causes, a system of fines has been passed into law that will damage working relationships on the ground, but will not solve the problems. Is it not time to have a Wanless on social services funding?
My final point on the national health service concerns prescription charges for the chronically ill. Wanless described that situation as
- "not logical, nor rooted in the principles of the NHS".
The Budget is built on a number of assumptions by the Chancellor—untested favourable assumptions about growth and investment by the business sector. It is time that the Chancellor subjected his whole Budget to an independent audit by the National Audit Office. It should not be for the Chancellor to choose the assumptions that he submits—the NAO should be able to look at the whole Budget so that we know whether we are basing our debates on firm assumptions rather than on woolly, ungrounded and unfounded assumptions.
The Chancellor has spent six years producing Budgets that make our tax and benefits system more complicated. He has been slow to invest in our public services and he has remained in denial about the crisis in our pensions system. The problem that results is an imbalance in the economy as a whole. Manufacturing is in recession and there are serious problems of investment in the business economy. Unless the Government begin to tackle that imbalance and ensure that the long-term growth forecasts are not just Mickey Mouse figures but a reality, we will not be able to pay for the increased borrowing—which we support—to provide improvements to public services. As a consequence, the Government's whole strategy will start to unravel, allowing the case of others who wish to make cuts in public services to be heard more effectively. That is the danger of the strategy that the Chancellor outlined. It is a high-risk strategy, and I hope that his luck holds; otherwise public services will suffer. For our constituents, that will be the biggest concern of all.
Mr. Deputy Speaker (Sir Michael Lord): Order. Before I call the next hon. Member, I remind the House that the debate must conclude at 6 o'clock. There were three statements, so time is very limited. I ask Members to exercise a reasonable amount of discipline in making their contributions so that a maximum number of Members can be called.
4.44 pm
Mr. Parmjit Dhanda (Gloucester): Conservative Members' comments, not only today but yesterday, have focused on waste and bureaucracy. I suppose that that is what I would have expected. Yesterday, however, I went to the Library and dug out an interesting document—a research paper on parliamentary
questions, debates and contributions, which was released last week. I discovered in it that between 13 June 2001 and 7 November, one Member of the House, who shall remain nameless—at least for the time being—managed to ask 3,036 questions more than his nearest rival: 18 oral parliamentary questions, at the cost of, I think, £299 each, plus a staggering 4,206 written parliamentary questions at £129 a pop. Most of them were about waste and bureaucracy, at a cost to the taxpayer of more than half a million pounds. Not only do Tory policies cost us more, but Tory politicians cost us a lot more. That is an example of bureaucracy and waste if ever there was one.Once the dust has settled on the Budget and we look back at headline figures, four key areas will come to mind with regard to their impact on my constituency. On employment, health, education and pensions, the national figures grab attention. We are down to under 1 million unemployed, and we have the highest ever employment level. On health, by 2008, we will have some 80,000 more nurses and 25,000 more doctors. On education, we have a settlement by which we are moving towards spending 6 per cent. of GDP on our children's education. A range of measures has been introduced for pensioners over the years, but those announced yesterday will be particularly welcome to campaigning groups in my constituency.
Sometimes, however, those measures can seem a long way away from the working man and woman on the streets of Gloucester, and the statistics do not seem to relate to them in their day-to-day lives. I can understand that. As a constituency MP, I relate most to measures such as the new deal, which has reduced youth unemployment in my constituency by 75 per cent. When Labour came to power in 1997, 347 young people under the age of 25 in my constituency were out of work. Remarkably, that figure has been cut to 71. As a result of other measures introduced by the Chancellor in the past six years, a staggering 1,297 Gloucester people have been taken off benefits during that period. I remember working as a cleaner during my holidays for just £2.30 an hour. I am proud to say that, under this Government, in October this year, the national minimum wage will be £4.50, and we are looking at implementing a minimum wage for younger groups, too.
When we talk in statistical terms about growth, productivity and how we compare with the rest of the G7, it can be boring for the man in the street. The single most important factor, which I mentioned in my intervention on my right hon. Friend the Secretary of State for Work and Pensions, is the improvement in living standards. If we look back over the past 50 years, this country has experienced the greatest improvement in living standards since post-war times. That is hugely significant.
I mentioned the minimum wage and the difference that it is making. Clearly, the Tories were against when it was introduced, although I think that they are in favour of it now. I do not know exactly what the Liberal Democrat policy is on the minimum wage: it is Thursday, so I think that they are against it at the moment. I gather that instead of the council tax, they propose a local income tax, although we do not know at what level that would be set. A figure of 3p in the pound
has been mooted, but in an internal document leaked last week, they said that they did not want to be drawn extensively on the level of that income tax.
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