---

Mr. Hutton: I will give way if the right hon. Lady will give me a second. In essence, she is asking to set a target or to quantify the extra number of school nurses that she wants. I am trying to say that we should like to see more school nurses working in the NHS, and the extra investment that we are putting into the NHS will help us to do so.

Mr. Lansley: Perhaps the Minister would care to explain something. If he turns to page 98 of the Department's annual report—I do not have it with me,
 
22 Jun 2004 : Column 1277
 
but I remember it—he will see the number of episodes of care provided by a range of community services. He will see that the number of health visitor episodes of care was 3.6 million in 1997–98, and that that figure has gone down to 2.9 million in the latest year. The number of district nurse episodes of care has gone down from 2.2 million to 1.9 million. That is a 1 million reduction in the number of episodes of care provided in the community by health visitors and district nurses. The Minister talks about community nursing services, such as school nursing services, but they have declined over the past seven years.

Mr. Hutton: As I keep saying to the hon. Gentleman and the right hon. Member for South-West Norfolk (Mrs. Shephard), we are investing significantly more in primary care, and I shall come on to what that means. There has been a slight fall in the number of community district nurses, which is regrettable, but that has to be set alongside a significant increase in the total number of nurses working in primary care. Something like 750,000 more activities have been undertaken in primary care than was the case a few years ago, so we are seeing a shift from secondary to primary.

Mrs. Shephard: The Minister has explained that more nurses are in the work force. My question to him was this, and I hope that he can now answer it: are the falling numbers in the school nursing service a result of a lack of a policy priority placed on their services by his Government?

Mr. Hutton: That is not a reasonable conclusion to reach from the figures suggested by the right hon. Lady. If she is patient, some of the Government's policies and proposals will become clearer.

During the Conservative party's period in office, it is inescapable—this is the only conclusion that the vast majority of the people of this country would recognise—that the NHS was run down and neglected. It had been allowed to fall seriously behind compared with health care systems in Europe and around the world. The idea that the period between 1979 and 1997 somehow represented a high watermark in the history of the national health service is totally risible. That is not how people remember things. It is not how anyone who worked in the national health service during that time would recall those years. People have not forgotten what the Tories did to the NHS. That is why we need to keep the facts clearly in mind when we consider the criticisms that have been made of this Government's record on the NHS.

In short, the NHS had neither the investment it needed nor the political support it required from the previous, Conservative Government to have had any chance whatsoever of meeting the health care needs of the British people. It is for those reasons that this Labour Government have followed a different policy on the NHS. They cut investment in real terms; we are increasing it. They subsidised private health insurance; we put that money back into the NHS. They let waiting times rise; we are ensuring that they come down. They cut the number of nurses in training; we are increasing them at a faster rate
 
22 Jun 2004 : Column 1278
 
than at any time in the history of the NHS. We are investing in new and improved terms and conditions for NHS staff; they did precisely the opposite.

In the past five years, 16 major new hospitals have been built and a further 10 are in the process of being built. In the last five years of the Conservative Government, they only managed to get two major new hospitals completed. At the same time, we have substantially improved more than 2,000 GP premises, and nearly 300 new primary care centres have been completed. That is because of the investment in the NHS, now rising at its fastest ever rate.

Spending will rise from £33 billion in 1997 to more than £58 billion this year. It will continue rising until 2008, when we will be spending £90 billion on our national health service. Real-terms spending in the NHS is increasing at very nearly three times the rate achieved under the previous Conservative Government. This extra investment has led to a 22 per cent. increase in the number of hospital operations and an 18 per cent. rise in the number of out-patient appointments. New drugs are becoming available more quickly. We have new services in primary care, such as NHS Direct and walk-in centres, treating and advising millions of people every year. The number of MRI scanners has doubled. CT scanners have increased by 60 per cent. We are doing hundreds of thousands more diagnostic tests every year. Most importantly of all, waiting times for an operation have halved. Twice as many people can now see their GP within two days as could in 1997.

Mr. John Baron (Billericay) (Con): The Minister paints a rosy picture, and there is no denying that there have been some good improvements in the NHS, but he mentioned waiting times. Does he accept that despite the massive increase in expenditure, average waiting times during the past four years have risen from something like 90 days to 99 days, and those are the Department of Health's own figures?

Mr. Hutton: That is not the case. I shall write to the hon. Gentleman and set him straight on that.

Mr. Baron: I am afraid that it is the case, because those were the Department's own figures. Will the Minister address the issue and explain why average waiting times have risen—a fact admitted by Sir Nigel Crisp?

Mr. Hutton: Let me write to the hon. Gentleman and sort that out.

There is no doubt that waiting times are falling, not rising, as they did under the Conservatives. Death rates from cancer and coronary heart disease are falling more quickly here than in any other country in Europe. The new investment going into the NHS is making a huge difference, which the Opposition refuse to acknowledge for political reasons, as that simply would not happen under a Conservative Government. We are investing for the future as well. The NHS training budget has doubled since 1997, and it is money well spent. It has allowed us to increase the numbers of doctors in training by over 8,000. The hon. Member for South Cambridgeshire made a claim about the number of NHS consultants, and compared the increase in their numbers in the past
 
22 Jun 2004 : Column 1279
 
five years with that in the last five years of the Conservative Government. We need to look at the totality of NHS doctors. In the last five years of the Tory Government there was a 12 per cent. increase in the number of NHS doctors. Since 1997, the number of NHS doctors has increased by 23 per cent.—double the rate under the previous Government.

Dr. Andrew Murrison (Westbury) (Con): I would be grateful to know how the Minister defines a consultant, because the British Orthopaedic Trainees Association, which came to see me this morning, was concerned that his figures included nurse consultants and consultant podiatric surgeons, who are not medically qualified. To what extent do his figures include such practitioners?

Mr. Hutton: We do not include nurse consultants or podiatric surgeons in our definition of consultants because they are not medically qualified doctors.

We have increased the number of doctors in training by over 8,000. Places at medical school have increased by 60 per cent.—the largest increase since the NHS was established. Four new medical schools have opened since 1997. No new medical schools were opened in the entire period of the Conservative Administration. Since the extra places at medical school came on line in 1999, nearly 5,500 more students have entered medical school in England. The extra investment has allowed us to increase the numbers of GPs in training by two thirds. The number of nurses entering training has increased by more than 50 per cent. Training places for therapists have increased by nearly 70 per cent. The numbers entering training as radiographers have doubled since 1997.

David Taylor: Does the Minister share my dismay and astonishment at the attitude of the hon. Member for South Cambridgeshire (Mr. Lansley) towards the difficulty of filling vacancies for midwives and radiographers, as he did not offer any new commitments? Will midwives throughout the land not be disappointed by the delayed delivery of commitment to the NHS, and will not radiographers see right through him?

Mr. Hutton: I do not want to labour the point about midwives, but my hon. Friend has highlighted a fundamental conundrum at the heart of the policies set out by the hon. Member for South Cambridgeshire. I shall return to his policy of no new targets for the NHS when I conclude. The record that I have described on recruitment and retention is one that the Opposition simply cannot match.

---