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Mr. Yeo: If the Secretary of State would like to wait, let me provide the clarification of the patients passport policy that he may be seeking. It is designed to give patients and their doctors more control over how and where people are treated and it will help to reduce waiting times by enabling all patients to have access to the entire national health service, not just to their local hospital or the hospital to which their doctor says they must go. For the first time, and under a Conservative Government, the national health service will become a truly national service. All aspects of NHS provision will be available to every patient.
Like the Government, the Conservative party believes that the private sector has a contribution to make in reducing waiting times. Indeed, I read in The Times this morning that the Government seem to think that the private sector has a rather big contribution to make in reducing waiting times—no matter at what cost. We may be a bit more careful about that. The patients passport will therefore also enable NHS patients to gain access to the private sector, to all those independent providers of treatment to whom they have been previously denied access. That treatment will become available to them under the patients passport, and the precise basis on which that access will be granted is a matter on which we are now consulting.
Dr. Reid: The hon. Gentleman is taking advice. You can take advice from anyone you like, Mr. Deputy Speaker, but you cannot square a circle.
Mr. Deputy Speaker (Sir Michael Lord): Order. First, the Secretary of State must use the correct parliamentary language, and I suggest that interventions should be a little briefer.
Dr. Reid: I want to ask the same question that the hon. Gentleman did not answer the last time that I intervened. Will he confirm that, even with the public subsidy of half the price of an operation in the private sector, someone who cannot afford the other half will not be entitled to have that operation in that sector? In other words, there will be no equity of access in the NHS for those without the money.
Mr. Yeo: Just because the Secretary of State did not like my previous answer does not mean that I will try to give him a fresh one. I have explained exactly what our policy aims to do, what it will achieve and the basis on which it will be available to all NHS patients. I am confident that the public will see the merits of our policy, just as some people have already seen the merits of the announcement that was made a few weeks ago about extending the availability of the patients passport to 17 million patients who suffer from chronic conditions—something that the Government have overlooked and neglected. Shortly after we made it clear that the scope of the patients passport would be extended in that way, I found that it received strong third-party endorsements.
Mr. Burstow: Will the hon. Gentleman give way?
Mr. Yeo: I must make a little progress; I will give way in a moment.
Let us consider some of the ways in which progress has been made in improving both the nation's health and the NHS itself. No one welcomes those improvements more than I do. It is excellent news that progress has indeed been made in some respects, and I warmly congratulate all those staff whose hard work has contributed to those achievements—the doctors and nurses, all the other health professionals, the back-up staff and, of course, the managers, too. For example, let me join in welcoming the news, announced by Cancer Research UK, of a significant drop in UK cancer deaths. That progress has been made over the past generation and reflects the work not only of the health staff, to whom I have paid tribute, but of the researchers, cancer charities and fund raisers.
We are also thankful for the reduction in death rates from coronary heart disease, which must largely be attributed to advances in medicine and technology. The Secretary of State referred to the increased use of statins, which have played an important part in helping to manage the disease, and stents have substantially reduced the requirement for coronary heart bypass surgery. Progress has also been made in providing cataract surgery for those who need it and the waiting times for that surgery are finally showing signs of improvement.
I am glad that the Government have recognised the part that treatment centres can play in achieving such goals, but while we join in celebrating those good things—of course, there are others that I do not have time to mention—there is another side to the picture, about which the Secretary of State is more reluctant to speak. The fact that he was at such pains to misinterpret Conservative policy will not prevent me from telling the truth about Labour policy.
Mr. Alan Milburn (Darlington) (Lab): On Conservative policy, the hon. Gentleman is responsible for education policy, as well as health policy, for the Conservative Front-Bench team. Can he explain why it would be permissible, under his patients passport policy, to allow a privately paid top-up for patients to go privately in health, when he would stop that happening under his pupils passport?
Mr. Yeo: The right hon. Gentleman tempts me greatly. I noticed the dismay among Labour Members last Thursday, when my hon. Friend the Member for Westmorland and Lonsdale (Mr. Collins) explained in detail the basis of our pupils passport. Indeed, as the right hon. Gentleman says, we have made it clear what the scope of that passport will be. I have made it clear this afternoon that we are consulting on the detail of how the patients passport will be usable in the independent sector. The dismay that the Secretary of State for Education and Skills showed last Thursday may provide us with some pointers about what the Government are afraid might happen as far as the patients passport is concerned.
Mr. Milburn: Will the hon. Gentleman explain whether consultation is another word for confusion?
Mr. Yeo: In the Government's mind, I am sure that it very frequently is.
Let us look at the facts. Despite an increase in spending of 38 per cent. since 1999, activity levels in hospitals have risen by less than 5 per cent. We have to consider whether the outcomes that are achieved represent real value for money from the point of view of both patients and taxpayers given the huge rise in spending on the NHS that has taken place. The think-tank, Reform, pointed out in January that the increases in both hospital admissions and out-patient appointments have been slower since 1999 than they were in the previous decade. Despite this 38 per cent. increase in spending, the number of GPs has risen by only 4 per cent. over the period and the number of midwives by only 3 per cent. Where is all the money going? It is going to meet the targets that Ministers keep setting to satisfy the control-freak instincts of new Labour. Managers have had to be hired at almost double the rate of nurses.
A chunk of the money went on the Modernisation Agency, a typical new Labour invention that was described by the Health Service Journal as the flagship of the Government's health care reforms. The body was formed just three years ago for the purpose of—I quote from the latest departmental report—
- "supporting the NHS and its partner organisations in the task of modernising services and improving experiences and outcomes for patients."
- "to maintain its innovation and to make modernisation move into the mainstream of the NHS."
The Minister of State, Department of Health (Mr. John Hutton): These issues have nothing to do with the Modernisation Agency.
Mr. Yeo: The Minister suggests that this has nothing to do with the health service, but I hope his Department will not claim that it is not aware of those facts. They were all set out in a letter sent to the Secretary of State by a student nurse in London last month, a copy of which was sent to me.
Mr. Stephen McCabe (Birmingham, Hall Green) (Lab): Given the hon. Gentleman's analysis, can he tell the House, based on his calculations, how much he estimates he could safely remove from the NHS budget without doing any damage to current levels of patient treatment or care?
Mr. Yeo: I am sorry that the hon. Gentleman has clearly not been listening to what I have said. The next Conservative Government will, in the first two years of the next Parliament, match the spending plans left behind by the Labour Government. I am confident that, in that period, we will identify further significant savings because of the extravagance and waste that the policies of the present Government have resulted in. We may then be able to discuss how to use those savings, some, most or perhaps all of which will be available for improved patient care.
To return to the Modernisation Agency, we cannot be sure how much taxpayers' money was spent on this very short-lived exercise, but I have seen a press release that suggests that the figure was well over £500 million. That sounds like an expensive three-year experiment. The Modernisation Agency, however, was a positive veteran when it got the chop compared with the National Care Standards Commission. That body had been going for only 18 days before it was told that it was going to be abolished. With an approach as chaotic as that, it is no wonder that patients despair of seeing the money that they are paying as taxpayers actually reaching the front line.
It is not only the way that incompetent Ministers waste money second-guessing managers and chasing headlines that is the problem. In too many areas, we are simply not making enough progress. Derek Wanless, the man chosen by the Chancellor to report on the state of the nation's health, pointed out some of the harsh
realities that Ministers prefer to sweep under the carpet. Death rates in England from respiratory diseases are worse than those in France, Sweden, Denmark, Canada, Australia, Finland, Germany and Holland, which are all countries with similar population structures, health care systems and per capita wealth to those of England. Britain also has the worst infant mortality rate among those countries and the second highest death rate from cancer in women. Incidentally, for 34,000 sufferers from ovarian cancer, the mean waiting time is almost 50 per cent. longer than in 1999.Deaths from MRSA—the hospital superbug—have more than doubled since 1997. Less than a month ago, the chief medical officer called that "shocking and unacceptable". That is a reflection of the fact that after seven years of a Labour Government, Britain has one of the worst rates of hospital-acquired infections in the western world. People are more likely to catch an infection in a hospital in Britain than in a hospital in France, Germany, Holland, Belgium, Spain, Italy, Sweden, Austria, Denmark or Ireland, as 100,000 people every year find out to their cost. Was that what the Prime Minister had in mind when he told voters seven years ago that there were 24 hours left to save the national health service? Labour promised that the money that it spent would allow it to get the basics right. Its inspection teams have given hospitals the all clear on cleanliness, but as today's edition of The Sun informs us, the truth is a very different story indeed.
Let us take tuberculosis. According to data released this month by the Health Protection Agency, TB in England and Wales has increased by a fifth since 1999. The chief medical officer points out that the rate of TB notifications in the London borough of Newham is worse that those of India and Romania. What has happened to the TB action plan, which we were promised would be in place early last year?
It is not only health outcomes that are worrying. In the last full year, the number of cancelled operations was significantly higher than in 1997. The latest quarterly figures show scarcely any improvement in the current year. Cancelled operations can be the result of a shortage of available beds, and there are 20,000 fewer beds now than there were in 1997. With more than 70,000 care home places lost since 1996, many because of Labour's obsession with over-regulation, it is no wonder that people are now queuing to get out of hospital as well as to get in.
Ministers like to tell us about the fall in the number of patients who have been waiting very long periods to go into hospital, but only last month, the chief executive of the national health service confirmed that average waiting times have actually increased. At the present rate of progress, it will take more than 60 years to clear the waiting lists.
Out in the community, things are not much better. The number of people receiving domiciliary care has fallen by almost 100,000 since 1997, which is a drop of more than one fifth. The number of health visitors is lower than it was under the Conservatives. The number of district nurses is also lower, and the number of people receiving community mental health care has fallen by almost 8 per cent. since 1997.
Even when the Prime Minister himself makes a promise, the situation is no better. At Labour's 1999 party conference, he promised that everyone would have the
- "chance to see their dentist".
- "firmly committed to making high quality NHS dentistry available to all who want it by September 2001".
Whenever Conservatives start to tell the truth about what is happening to the health of the nation, Ministers accuse us of talking down the NHS, but nothing could be further from the truth. We have the highest admiration for the dedication and professionalism of the thousands of people who work in the national health service, and I know that my views are shared by millions of patients. However, we all know that despite all their hard work and the fact that some progress has been made, the NHS could, and should, be better. Today, after seven years of the Labour Government and vast increases in spending, people whose hopes were raised so high are clearly and understandably disappointed. As an ICM poll showed last September, more than half of those surveyed thought that the NHS had got worse since 1997 and less than a third thought that it had got better.
The biggest obstacle to the further progress for which we all yearn is the attitude of the Secretary of State and his ministerial colleagues. [Interruption.] His meddling ways prevent front-line staff from getting on with the jobs that they have been trained to do. His insistence on targets frequently distorts clinical judgments and often has perverse consequences, like the waiting time target for new out-patient appointments at the Bristol eye hospital, which led to other follow-up appointments being delayed or cancelled, with the result that 25 people went blind. It is no wonder that morale among professionals is so low and frustration is so high. Last month, 500 doctors paid for an advertisement in which they said:
- "We once believed the NHS was the finest healthcare system in the world. Today few healthcare professionals would make that claim."
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