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7.48 pm
The Secretary of State for Health (Dr. John Reid): I beg to move, To leave out from "House" to the end of the Question, and to add instead thereof:
- "welcomes the Government's record extra investment in the National Health Service; supports the Government's policy of linking investment to reform; notes that setting targets and monitoring performance against them are a vital part of the accountability process; welcomes the Government's determination to devolve power in the health service to the front line backed by three-year allocations of money to NHS organisations and clear delivery targets for the next three years; welcomes the positive effect of the right targets on staff morale, motivation and standards; welcomes the increases in capacity and workforce numbers, the greater availability of new and better drugs, the shorter waiting times and the greater choice available to all patients; notes that expenditure on NHS management as a proportion of the total NHS budget is falling; and supports the Government's commitment to a high quality NHS, responsive to the needs of patients, available to all free at the point of need."
It is ironic that the debate is taking place on the very day that the Leader of the Opposition set Wednesday as a target date for his opponents, who have a target of 25 letters being submitted. It is ironic that today we are debating a Conservative motion deploring targets. [Interruption.] I am sorry. The hon. Member for Woodspring (Dr. Fox) is getting frustrated. I hope I have not kept him away from letter writing or from composing a personal manifesto. He has a chance to shine tonight and I hope he takes it, because perhaps greatness awaits. I know that there is some scepticism
about his opportunities and his chances, but the Opposition are running out of options, so he must have some chance of greatness in the coming period.We make no apology for targets in pursuit of excellence. Targets bring—
Mr. John Bercow (Buckingham): Useless windbag.
Dr. Reid: I take it very badly that such an eminence grise of the House complains about my contributions. We await the day when the hon. Gentleman is standing at the Government Dispatch Box, but it may be a considerable time before any of the Opposition arrive on the Treasury Bench.
Targets bring focus, delivery and accountability. They are foreign to the Opposition because they also bring equity, which has never been a prime objective of the Conservatives. Of all the presentational aspects tonight, the one that grieves me most, though it is not unexpected, is the way that the efforts and achievements of 1.4 million staff who treat 1 million patients every 36 hours have been demeaned and condemned by the Opposition spokesman.
Dr. Reid: I shall give way in a moment. Every improvement that has taken place in the national health service has been brought about because of the determination and commitment of those who work in it. To hear every single improvement disparaged as the result of lying, fiddling and cheating by the NHS staff says more about the party that makes those allegations than about the NHS staff. I give way to the hon. Member for Woodspring if he wishes to withdraw half of his speech tonight.
Dr. Fox: It is a great pity that the Secretary of State must resort to such tactics and puts into our mouth words that were never there. It is especially disgusting, if I may say so, that he tries to suggest that we would denigrate the work of staff in the NHS. As I just said, they are the staff with whom I trained and worked. Unlike the Secretary of State, I have worked in the NHS. It is the staff who are keeping the NHS afloat, despite Government interference. The right hon. Gentleman might want to ask himself why the Opposition trust the professionals to exercise their judgment on patients, but he does not.
Dr. Reid: Every one of the words that I quoted was taken from the hon. Gentleman's speech—he can check Hansard: "fiddling", "cheating" and "lying". I could have gone further. He referred, at least by implication and possibly explicitly—we will read it in Hansard—to managers as micro-organisms being spawned. Not only did he use such language, but in almost 36 minutes he could not bring himself to admit that there had been any achievements or improvements by NHS staff.
I admit there are some deficiencies—I shall come to them later in my speech. I know the size of the challenge that we were left by the previous Government. I will not pretend that everything is all right, but an NHS whose every achievement is condemned by the Opposition is not an NHS that will march in the street for the return of a Conservative Government.
As anyone involved in any organisation, public or private, knows, targets bring focus, concentration of effort and delivery, as they drive effort and ingenuity towards achievable ends. Targets bring accountability because they not only distil the priorities of the public, but set the criteria by which promises can be measured. They bring a degree of equity because, for the first time, they provide the public with an equal right to access, and a right to judge whether the politicians are assisting in delivering an improved service, as they promised. Targets provide a degree of equity, not a privilege that only a few can buy—a point to which I shall return—but a right for everyone.
People want to know how quickly they can see a GP or how quickly they can have an operation. They want to know that we are doing all we can to reduce those times, and they want to know whether we are succeeding in reducing those times. The abolition of all those targets, as promised tonight by the Conservatives, would deprive the NHS of the drive and the resources to better the service that it gives, and would remove from the public any indication of whether the Government and the NHS are improving at all.
Furthermore, the absurd separation and implied dichotomy between the time that one has to wait, often in pain, for an operation, and the quality of the service that one perceives oneself as having received is a separation and dichotomy that can be made up only in the minds of those who, like some Opposition Members, have never had to wait for an operation because they have found other ways to jump the queue and get it quickly.
Mr. Andrew Turner (Isle of Wight): Where is the equity that the right hon. Gentleman has guaranteed to deliver, when constituents of mine have to travel three hours in each direction and spend £90 to get three children to an NHS dentist?
Dr. Reid: There is a distinct lack of equity in that situation. I assume the hon. Gentleman is referring to the Isle of Wight. I have no hesitation in saying that we have a mountain to climb in NHS dentistry. We have a huge challenge in respect of public health issues. Sexually transmitted diseases present us with a major challenge. All these things are true. I do not claim tonight that everything in the NHS is as it should be. I say to the House that things in the NHS are vastly improved over what they were six years ago, in every conceivable direction.
Dr. Fox: On the point made by my hon. Friend the Member for Isle of Wight (Mr. Turner), the Government have been in office for six years. In 1999 at his party conference, the Prime Minister specifically promised that within two years no one would be denied access to an NHS dentist. What went wrong?
Dr. Reid: We are trying, in circumstances not of our own making—in circumstances that we inherited—to improve almost every aspect of our health service, which was left under-invested, underfunded and in decline over a period of almost 25 years. Only last month we put another £35 million into NHS dentistry to try and improve the position that the hon. Member for Isle of Wight described.
There are many in the House who, from a position of authority and commitment to the NHS, could criticise us for not doing enough, but the Conservatives are the last people entitled to do so, since their policy is to reduce public expenditure as a whole and, even from that reduced amount, to divert money from the NHS to subsidise those who can already afford to jump the queue by going private, through the patient passport.
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