| Previous Section | Index | Home Page |
Dr. Reid: Will the hon. Gentleman give way?
Mr. Lansley: Just a moment. Under the next Conservative Government, it will be the responsibility of the Department of Health to expand the NHS work force.
I have not read the story in The Independent, but if it has reported our intentions accurately, the story will be that we do not believe in imposing targets on NHS hospitals and general practices. We are in the business of imposing targets on ourselves, not on the NHS—
Mr. Hutton:
What targets?
22 Jun 2004 : Column 1271
Mr. Lansley: Public health targets, for example. The Minister was not here for yesterday's debate. Pretty much every kind of target that ought to be imposed on the Government for public health and the work force is a target for the Department of Health, and the Department must take responsibility for meeting it. Changing the culture of the NHS means doing away with targets and performance management. Such a system is an attempt to run the NHS from the Secretary of State's desk instead of making responsibility lie where it ought—in hospitals that respond to the needs of patients. That is where performance management should be.
Dr. Reid: Presumably, that includes the targets that have reduced the scandalous two-year waiting times to nine months, and will reduce them to six months next year. That target will go as well, and we shall have unlimited waiting times.
I wish to understand the recruitment figures. Will the hon. Gentleman confirm that what he is saying is that if there is a shortage of midwives and radiographers nowadays, it is the fault of this Government but it would not be the fault of a future Conservative Government because they would have no targets for the number of midwives or radiographers in the first place?
Mr. Lansley: No, the Secretary of State is wrong about that.
Mr. Lansley: I will answer the question. The Secretary of State cannot intervene before I have answered his point.
Dr. Reid: Will there be any targets or not?
Mr. Lansley: I shall tell the Secretary of State. I have said it once, and I say it again: we will not impose targets on the NHS, but there are responsibilities for the Department of Health, and they include stimulating the—[Interruption.] I do not know what Labour Members find so difficult to comprehend. The point is that it will be for the Department of Health and the Conservative Government to manage their own responsibilities, and one of our responsibilities will be to create the circumstances in which there is a volume increase in the work force—doctors, dentists and nurses—available to the NHS. That does not mean that we need to impose performance targets on hospitals. The star rating system sets down 44 targets. None of them is a work force expansion target. If we abolish the star rating system, it does not mean that we have abolished the responsibility of the Department of Health to increase the work force of the NHS.
Dr. Reid:
The hon. Gentleman has just spent the past 10 minutes criticising the Government for not reaching the target for the number of nurses, midwives and radiographers. Is he telling us that he will not have such a target for the number of radiographers and midwives? Or will he have such an objective for the NHS? Is he saying, in other words, that while we are in power, to have such an objective number is to have a target, but
22 Jun 2004 : Column 1272
when he is in power, it will be left entirely to the local hospital to decide how many midwives and radiographers it employs?
Mr. Lansley: The Secretary of State has demonstrated three times that he does not understand. It is perfectly clear that—[Interruption.] I shall try once more and then I shall move on. We will have a responsibility as the next Conservative Government to expand the work force available to the NHS.
Mr. Lansley: As I have just said, in order to supply the diagnostic resources and personnel that NICE guidelines require, we would need substantially to increase the number of neurologists.
Dr. Reid: Will the hon. Gentleman give way?
Mr. Lansley: The Secretary of State cannot keep intervening.
In order for that to happen, we will have a Department of Health with responsibility to make available additional medical manpower to the NHS. It will then be up to hospitals to decide the extent to which they appoint additional consultants in order to provide that service, but the service will be set up.
Dr. Reid: Will the hon. Gentleman give way?
Mr. Lansley: No, I have finished now and the Secretary of State can sit down.
Mr. Lansley: The Secretary of State can sit down because only one person can speak at a time, and I am not giving way.
Mr. Deputy Speaker: Order. The Secretary of State must resume—
Mr. Deputy Speaker: Order. The Secretary of State must realise the position. He takes a vigorous part in debates and that is in order, but it is not in order to interrupt if the hon. Gentleman who has the Floor does not wish to give way.
Mr. Lansley: Thank you, Mr. Deputy Speaker. This is a short debate and the Secretary of State is trying to prevent other people from contributing to it. I shall not now have time to talk about the lack of dentists or the further issues relating to overseas recruitment. I hope that my hon. Friend the Member for Billericay (Mr. Baron) will be able to expand on those subjects when he winds up.
The Government have considered several ways to try to increase the NHS work force in the future. They have considered trying to increase overseas recruitment; stimulating the return to work of previous staff by
22 Jun 2004 : Column 1273
improving working lives; and increasing the supply of training places. Those are important, but one needs also to consider why people leave the NHS and why they change jobs—staff turnover is high. The Audit Commission considered that and the reasons include bureaucracy, poor resources, a lack of autonomy, a sense of being undervalued by the Government and the public, and unfair pay. We need to address all those issues, and the Government need to understand that bureaucracy and the lack of autonomy are seen as part of the reasons why people do not stay in their jobs in the NHS, why we do not see the return to work that we should among nurses and doctors and why we cannot recruit and retain as we would wish. We can attack those issues. We can cut the levels of bureaucracy and we propose to do so. We can give greater autonomy and freedom to the NHS to provide services and to respond to patients.
NHS professionals are valued by this House, and they should be valued, for the clinical care they give, for the choices they make and for the responsibility they take on—nurses, for example, are taking on greater responsibilities across the NHS—and they should be trusted and given the autonomy they want. We should set the NHS free. It will be our job to do so, and to give people the right to choose.
5.42 pm
The Minister of State, Department of Health (Mr. John Hutton): 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 which has resulted in increases of 19,400 more doctors and 67,500 more nurses since 1997; supports the extra investment in training which has increased the intake of medical school students by 61 per cent. and nurse training students by 53 per cent. since 1997; notes that over one million NHS staff will benefit from improved terms and conditions; recognises that the international recruitment of healthcare professionals has already made a significant impact on the delivery of NHS services; notes the Government's commitment to ethical international recruitment, with its robust Code of Practice, the first of its kind in the world, ensuring that NHS organisations do not recruit staff from developing countries without the agreement of their government; and welcomes the sharing and transfer of experience and ideas that international recruitment brings to the health service."
I congratulate the hon. Member for South Cambridgeshire (Mr. Lansley) on his elevation to the shadow Cabinet. I hope that he will not mind if I say how sorry I am that the hon. Member for South Suffolk (Mr. Yeo) will no longer be joining our debates on health, for the simple reason that he spent most of his time in his job as a shadow public services spokesman dumping the health policies that he inherited from the hon. Member for Woodspring (Dr. Fox). We all hoped that the hon. Member for South Suffolk would carry on a little longer. To give him credit, he eventually scrapped the top-up schools voucher, but he had not got round to scrapping the Tories' top-up hospital voucher—the NHS passport—under which a patient's access to treatment would depend not on their clinical need but on the amount of money in their pocket.
| Next Section | Index | Home Page |