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Mr. Wilshire: Surrey and Sussex.
Mr. Lansley: The Surrey and Sussex SHA, which also covers the constituency of our hon. Friend the Member for Reigate and which anticipates deficits of more than £20 million.
The debate was pretty much a walkover. We know what the link between the NHS and the Budget is. As my hon. Friend said, the Chancellor is in the casino; he is playing not with his own chips, but with ours, and he looks like he might lose. When he cannot manage the risks, who will take the losses? It will be the NHS that has to pay. Just as we have seen him do in the past, the Chancellor will make promises on which it is impossible for him to deliver. The Conservatives have the policies that will ensure that we can support the NHS with the resources that are required to improve health care to the standard that we need, and those resources will not be prejudiced by future demands for additional taxation or a collapse in the public finances. Only under the Conservatives can the NHS be safe.
9.44 pm
The Economic Secretary to the Treasury (John Healey): We have had a good debate. I shall do my best to deal with the points that have been raised in the time that is left to me, which will be less than the time that was available to the hon. Member for South Cambridgeshire (Mr. Lansley). I shall pay particular attention to those who contributed to the debate and still remain in the Chamber.
A central fact at the heart of the Budget statement and this debate is that since 1997 Britain has sustained growth through not one but two economic cycles. Since 2000, our growth has outperformed the EU area, Japan and even the United States. Since 1997, Britain is the only developed country that has grown in each and every quarter in spite of the recent world downturn, and
in spite of our record, which was that Britain was usually first in and last out and suffered more in any world downturn that we experienced.On Wednesday, my right hon. Friend the Chancellor of the Exchequer confirmed that last year the British economy grew by 2.3 per cent., meeting the Treasury's expectations and confounding the predictions of Opposition Members and many individual commentators. It was only in November 2003 that the shadow Chief Secretary to the Treasury said:
- "There are now growing threats to growth and stability."
- "The Chancellor has misrepresented Britain's economic prospects in the past and he is now once again being less cautious than independent experts."
This economic position is supported—it will continue to be supported—by the fiscal discipline that is at the heart of our strategy for long-term stability. We have met our fiscal rules. In addition, debt this year is just 33 per cent. of national income. Net borrowing is 2.4 per cent. of GDP and falling over the forecast period. Both figures are lower than in the past, and both are lower than the rates of our major competitors in the industrialised world. The challenge now is to combine this new confidence in Britain's economic potential with a new determination to make the long-term reforms and investment that will secure stability and growth for the future.
My right hon. Friend the Chancellor of the Exchequer set out in the Budget some of the necessary investments that we have to make in science, education, skills and enterprise in our country's wealth-creating and job-creating base. He made it clear that he will not neglect the need for long-term investment and will impose an annual balanced budget rule. A policy in contradiction of that, whether imposed by a future Government or by a rigid interpretation of the European stability and growth pact, would repeat the mistakes of Britain's stop-go past and put at risk our stability and growth. It would be a return to stop-go for the economy and a go-stop for public services. My right hon. Friend the Member for Darlington (Mr. Milburn) and the hon. Member for Sutton and Cheam (Mr. Burstow) made the link between a sound economy and strong public services much clearer in their contributions.
My right hon. Friend the Member for Darlington said that health investment performs an economic function. He added that NHS reforms have delivered health benefits and economic benefits. He went on to say that the same is true in spades for education and child care. That is why the debate has been dominated by public service spending plans. At the same time, it is an essential part of the debate about Britain's economic management and prospects for the future.
The hon. Member for South Suffolk (Mr. Yeo) made what he termed an important announcement. He said that a future Tory Government would not introduce tax
relief on private health care insurance. That is the unmistakeable sound of a hasty retreat. It is the unmistakeable sign of a policy that is at sixes and sevens. Neither the hon. Gentleman nor the hon. Member for South Cambridgeshire answered the challenge of my right hon. Friend the Secretary of State when he asked, given the patient's passport plan, how could they honour the pledge that was made this afternoon that there would be equal access to all in the NHS, free at the point of delivery.Let us be clear: the plans for health and the health passport would take money out of the NHS to subsidise the private health care industry. It would be used to help the privileged few to jump the queue. Most hard-working families could not afford the £8,000 that they would need to find for a heart bypass operation. They would not be able to find £5,500 for a knee operation, or £4,000 for a hip replacement operation. It is a plan to promote private health care and it would end an NHS free at the point of use—that is what the hon. Member for South Suffolk espoused as the new Conservative path.
Pupil passports were mentioned in the debate, and Conservative spokesmen are at sixes and sevens over that policy too. On 22 February, the shadow Chancellor said that the money for pupil passports could be used for "cheap private schools" and that parents could top it up. Over the next fortnight, that was confirmed, repudiated, reconfirmed and repudiated again. On 11 March, the shadow Chancellor ruled out using the passport at fee-paying schools. Five days later, the hon. Member for South Suffolk said that parents could spend the passport at fee-paying schools, but could not top it up. The policy has changed half a dozen times in half a dozen weeks, so can anyone be confident that it is not about to change again? It is clear, however, that money will be taken from mainstream schools to subsidise the private education sector and help the privileged few at the expense of every other pupil and student.
I shall pass over the contributions of the hon. Member for Sutton and Cheam, who is not in the Chamber, and of my hon. Friend the Member for Luton, North (Mr. Hopkins) who, sadly, is no longer in his place. He welcomed the public investment, and I know that he will warn his constituents of the jeopardy to transport and the other things that he mentioned if the Opposition should ever assume office. The right hon. Member for South-West Norfolk (Mrs. Shephard) takes a special interest in biofuels, and she makes sure that I do too. I appreciate her welcome for the Budget measures that she described as positive. I accept that she wants us to go further, but she will welcome the confirmation in the Budget that we are prepared to consider and consult on a biofuels obligation. The right hon. Member for Fylde (Mr. Jack) and my hon. Friend the Member for Sherwood (Paddy Tipping) will do so too, and I look forward to further representations from the right hon. Member for South-West Norfolk and the all-party alliance that she has established.
The hon. Member for North-East Bedfordshire (Alistair Burt) was poetic about the undisturbed peace in Biggleswade last week. I am glad that he welcomes the extension of the VAT scheme as a zero rate on the repairs of listed churches. He was concerned about the
Macmillan Primrose appeal, and asked me to investigate. In recent months, I have been much more heavily involved in the issue than he might expect, and I can confirm that the Government have given a commitment that the NHS will meet the VAT costs of projects deemed to be priorities of local cancer networks.The right hon. Member for North-West Hampshire (Sir George Young) wanted a stronger link between NHS investment and improvements in the service—a point to which I shall return. He asked about photodynamic therapy for people with macular degeneration. I suspect that he knows that the National Institute for Clinical Excellence issued guidance in September, and in the same month the Department of Health issued guidance to vary the usual three-month funding directive because of the need both to expand services for those patients in a planned way and to recruit and train staff across the country.
The hon. Member for North Dorset (Mr. Walter) raised the case of a constituent and funding for his treatment. It is impossible for me to respond, but I am sure that my right hon. and hon. Friends from the Department of Health will consider it, along with the comments of the hon. Member for Spelthorne (Mr. Wilshire), who made a heated contribution about the position of his local NHS trust. The hon. Member for North Dorset complained about the operation of NHS Direct, but last year it received more than 6.3 million calls—almost three times the number of calls it received three years ago. Increasingly, it is gaining the support of patients and the medical professions, and it is part of the reformed service delivery that we need in future. He tried to use detailed figures to argue that the Budget showed that the Government will break the golden rule and that it confirmed tax rises in future.
The hon. Member for Bury St. Edmunds (Mr. Ruffley) tried to do the same. I say to them both that precisely the opposite is true. We have kept every promise that we have made on tax and we will continue to do so. We have met the fiscal rules that we have set and will continue to do so. We have set out our commitments to invest more in public services. We have shown that they are fully funded, and they are fully funded on the cautious case that one would expect of a Government.
The hon. Members for Reigate (Mr. Blunt) and for Bury St. Edmunds commented on productivity in the NHS. The definition of productivity is narrowly focused on what consultants do, and they make up only 7 per cent. of what the NHS does. I remind hon. Gentlemen that in March 1997 over 30,000 patients were waiting more than 12 months for treatment. At the end of January this year the figure was 36.
My hon. Friend the Member for Birmingham, Hall Green (Mr. McCabe) mentioned coalmine methane, and I will consider the points that he made. I remind him that we have already exempted the generation of electricity from coalmine methane sources from the climate change levy, and we have put in place an unprecedented level and length of support to underpin the renewables obligation.
Despite the Opposition's efforts to run down the improvements, our past investment in health was demonstrated by the practical changes that my hon.
Friends the Members for Plymouth, Sutton (Linda Gilroy) and for Newcastle-under-Lyme (Paul Farrelly) described in their constituencies. Every Member of the House can see that progress is being made in their constituency. In my own area in South Yorkshire there are 1,170 more nurses attending to patients in the NHS now than there were in 1997. Our investment in health nationally has already led to an increase of 67,500 nurses and 19,000 doctors since 1997. We have funded the largest ever hospital building programme, improved GP premises, increased the number of beds and decreased waiting times for operations and emergency care. In answer to the hon. Members for Reigate and for North-East Bedfordshire, I point out that last year elective admissions increased 21 per cent. on 1997. That is equivalent to almost 1 million extra hospital admissions. That is no trifling increase in output, as the hon. Member for Reigate suggested.In the Budget we have allocated an additional £100 million to NHS research and development. I am glad the hon. Member for South Cambridgeshire (Mr. Lansley) welcomed that. Together with increases to the Medical Research Council, we expect the increase to exceed £150 million per year.
On education, we have announced in the Budget £8.5 billion extra for UK education in 2007–08 compared with 2005–06—an average annual increase of 4.4 per cent. in real terms across the 2004 spending review period. There will be more bad news for the education sector if the Tories get in. Andrew Neil asked the shadow Chancellor the day after the Budget whether he would match the extra spending on education. The answer:
- "No, we'll stick with our plan."
The shadow Chancellor has committed the Tories to 5 per cent. cuts in the law and order budget. That is the equivalent of sacking 1,300 police officers. At a time when we are stretched in Iraq, Afghanistan and Kosovo, he has committed them to cut the defence budget by 5 per cent. in real terms. It is not just that they leave us defenceless at a time when we need defence, insecure when we need security and weak when we are in troubled times. It is worse than that. All the major investments we need for the future, they would cut. The very drivers of prosperity would be cut—science cut, skills cut, transport cut, apprenticeships cut, university places cut, further education courses cut and workplace training cut. This Budget and this Budget debate make clear the choice before the British people: cuts, charges and privatisation under the Tories—
It being Ten o'clock, the debate stood adjourned.
Debate to be resumed tomorrow.
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