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Mr. Howard rose—

Mr. Brown: I will give way in a minute.

We will take no lectures from the Conservative party about meeting targets. The shadow Chancellor was a member of the Cabinet when inflation, which they said would be low went up to 10 per cent; when interest rates, which they promised would come down went up to 15 per cent; when public borrowing increased to 8 per cent; when 1 million people in manufacturing lost their jobs; and when unemployment went up to 3 million. The right hon. and learned Gentleman has no basis on which to

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lecture us—he is the last surviving member of the 1992 Cabinet on the Conservative Front Bench, and he should be ashamed of what he did.

Mr. Howard: Can I now invite the Chancellor back into the real world? Can he confirm that on the last two occasions on which he set growth targets for the economy, he woefully failed to deliver? As for class sizes, can he confirm that his target was to eliminate the number of pupils in classes of over 30 by September 2001, but in September 2001 there were 8,000 five, six and seven-year-olds in classes of over 30, and the figure has doubled since 2001? It is going up, so how can he conceivably say that he met that target?

Mr. Brown: The right hon. and learned Gentleman exaggerates the position, as he did throughout his speech. On growth, we said that we would raise the trend rate of growth of the British economy, and that is what we have done. We have raised the trend rate of growth from 2.5 per cent. to 2.75 per cent.

How would it be possible for us to do any more on class sizes or any other aspect of education if we accepted the shadow Chancellor's recommendation to cut education expenditure? Under the Conservatives, there were 50,000 fewer teachers; under Labour, there are 25,000 more.

Mr. David Laws (Yeovil) rose—

Mr. Brown: I will give way in a minute.

The great thing about this debate is that we now have the Conservative party's policy documents before us, allowing us to compare what would happen to cost-effectiveness, choice, delivery and the elimination of waste under a Conservative Government with what is happening under a Labour Government. In the last few days, the Conservative party has helpfully published a document entitled "Setting Patients Free". Its theme is moving patients into the private sector by subsidising payment for private operations. It would be helpful for us to compare the effect of that with what the health service is achieving.

We know that the number of out-patient attendances in the NHS has risen under a Labour Government from 11.5 million to 12.9 million. We know that the number of elective admissions has risen from 4.5 million to 5.5 million. But what would happen under the Conservative party's proposals? What would be the cost of operations, as against the cost in the NHS? Can we judge how many people would get operations under the Conservatives' proposals? What would the cost of those operations be? What is the effect of the Conservatives' proposals on administrative waste, and on choice and delivery?

I have a document helpfully published this morning on the internet—not a PhD thesis, just a document from BUPA. [Interruption.] Nobody can claim that the BUPA document has been "sexed up". The cost of a heart bypass, as BUPA helpfully told us today—this is a 10 per cent. rise on the cost that we were told a few weeks ago—is £11,500 to £14,500. The cost of hernia treatment under BUPA is £1,400 to £1,950. The cost of a knee replacement is £8,500 to £10,800. The cost of a hip replacement is £7,000 to £9,000.

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The interesting thing, and the reason why I cite those figures, is that they allow us a comparison with the costs in the national health service, so we can now see whether the Conservative policy—[Interruption.] Is the shadow Chancellor denying that the Conservative policy is to subsidise people having private operations? Is he denying that the Conservative policy is to put public money into subsidising private health insurance? If that is the case, are we not entitled to ask, on the basis of the Conservative motion today, what is more cost-effective, what helps reduce administrative costs, and what will deliver the most operations?

Let me give the House the figures. Conservative Members will be interested, because they will have to explain this to their constituents during the forthcoming elections. Let us see which is more cost-effective. A hip replacement under BUPA costs £7,000 to £9,000, according to the table issued today. What is the NHS tariff? It is £4,500. A knee replacement costs £8,500 to £10,800 under BUPA. What is the NHS cost? It is £4,800—half as much. What is the cost of varicose veins treatment under BUPA? From £1,400 to £1,900. What is the cost in the NHS? It is £1,000. A hysterectomy—

Mr. Howard: Will the Chancellor give way?

Mr. Brown: I am happy to do so, if the right hon. and learned Gentleman can confirm those costs.

Mr. Howard: If the cost of operations in the private sector is so much more than in the national health service, perhaps the Chancellor can explain to the House why the number of people who have elected to go to the private sector for those operations has tripled since the Government came to office—300,000 a year, compared with 100,000 a year when Labour came to office. Is not that whole tirade from the Chancellor doublespeak for saying that the NHS is more cost-effective because people cannot have their operations on the NHS? They have to wait so long for their operations on the NHS that they pay to go private instead.

Mr. Brown: No. The reason why I mention the figures is to show that if you want to give patients a better deal, you invest more in the NHS, which is half as expensive as investing in the private sector. The shadow Chancellor and the shadow health spokesman know very well that what they are proposing is that people be invited to pay twice as much in the private sector as in the NHS, but what would be more cost-effective for the country would be to build up the capacity of the NHS by spending more, rather than investing in private care.

Dr. Liam Fox (Woodspring): Will the Chancellor give way?

Mr. Brown: I am happy to give way to the man who told the Conservative Medical Society that his aim was to run down the national health service and to prove that it could never work.

Dr. Fox: If the Chancellor is giving such great hope to patients in the NHS, perhaps he could explain one figure—the Government's own figure, which said that last year, despite the increase in expenditure, the number

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of admissions to NHS hospitals fell by 0.5 per cent. What does that say about value for money under the Government?

Mr. Brown: The number of elective admissions to the NHS has risen from 4.5 million to 5.5 million. The number of out-patient admissions has risen from 11.5 million to 12.9 million. The hon. Gentleman cannot deny that more people are receiving operations, being admitted and getting treatment, and that more operations are occurring.

The policy question that the shadow Chancellor has not faced up to, as he has given way to the shadow Health Secretary on the question of funding, is that the first public expenditure commitment that he made was to put money into private medicine. The second commitment that he made was a tax commitment to give tax relief to private medicine. He has got to explain to this House why it is more cost-effective to put money into private medical care when the cost per operation is twice as much.

Mr. Michael Jack (Fylde) rose—

Mr. Brown: I shall give way to the former Minister.

Mr. Jack: Will the Chancellor tell the House what the current level of national health service expenditure is in buying operations from the very suppliers that he has mentioned? Will he also tell us how much the national health service is spending to send patients abroad? I have asked two questions, so can he give two answers?

Mr. Brown: The national health service—the right hon. Gentleman will agree with me on this—is absolutely right to buy operations in the private sector where there is spare capacity and everybody receives their operations free of charge in a national health service that is free at the point of need. The policy question that the Opposition have not worked through is why it is in the interests of the country to invest substantial additional amounts on building up capacity in the private sector when the cost per operation in the private sector, on the basis of the figures that he has not denied, is twice as great as in the public sector.

Gregory Barker (Bexhill and Battle): Is the Chancellor aware that his lectures on cost-effectiveness will ring very hollow indeed with my constituents? Women in my constituency who are waiting for radiotherapy treatment following breast cancer surgery are having to wait up to 24 weeks under this Government, when their surgeon says that they should be waiting three or four weeks. That figure has spiralled under his Government. It does not matter what the price is in the national health service if the treatment is simply not available.

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