| Previous Section | Index | Home Page |
Madam Deputy Speaker: Order. Once again, I implore the House to hear these important statements with some civility.
Mr. Lansley: Thank you, Madam Deputy Speaker.
The Secretary of State says that he has now converted to the idea of offering a choice. He might mention that to the rest of his party, because most of them have not. But how lacking in ambition is it for the Government to say that by 2008 people should be able to choose which hospital they have treatment in? It is another illustration of the Government's lack of ambition. We said yesterday—again, if imitation is a form of flattery, I suppose we should feel flattered—that patients should be able to choose where they have their treatment. We want that to be true for elective surgery at the end of 2005. Perhaps there is a practical reason why that will not be possible—for example, the NHS programme for IT not implementing the electronic booking system in 2005 as the Government said it would. Perhaps the Secretary of State will tell us whether that is the constraint on extending choice in 2005, as we intend to do.
The Secretary of State also says that the Government are going to set a new target for waiting times. What they are proposing is that people wait four and a half months for treatment in four years' time. He says that that will be 10 weeks on average. Of course there is a bit of a debate about what the average waiting time is. We are told many times that the average waiting time has gone down, but a letter from the permanent secretary at the Department of Health says:
"we are admitting a higher proportion of long waiters off the list and the median is rising."
So there it is: the median—the average—wait is rising in the NHS, and the permanent secretary to the Secretary of State's own Department tells me that that is true.
24 Jun 2004 : Column 1457
The Secretary of State's ambition is in four years' time to make everyone in the NHS wait as long as the average now. We are told that the average wait is about 10 weeks. In fact, it is more like 13. In four years' time, the right hon. Gentleman's ambition is for the average waiting time to be virtually no different from what it is today. What has happened to the Government's ambition? We said yesterday that we want waiting lists to be a thing of the past. Four years ago in the NHS plan, the Government said:
"Traditional waiting lists for surgery will become a thing of the past."
There you have it, Madam Deputy Speaker. That is the difference between us and the Government. They had ambition and they failed; we have ambition and we are going to deliver. The choice for the public is clear: it is between a Conservative party that has the ambition to make waiting lists a thing of the past and a Labour party that wants patients to be left to wait.
Dr. Reid: That seems to have had a salutary effect on the hon. Gentleman's audience. In congratulating him on his appearance on the Front Bench, I must say that he was a bit let down by his colleagues. Only 19 of them were present, and one of them, who has now woken up, fell asleep during his contribution.
Let me try to deal with the hon. Gentleman's comments. I have now discovered why he does not understand the idea of reducing waiting times: he does not even understand the definitions. The truth of the matter is that for 60 years under successive Governments—it did not matter which Government were in power—the definition of a waiting time applied to only one third of the patient journey. It applied only to the period after the diagnosis to the treatment table. That was the only part that was measured. In other words, all the time waiting for a diagnosis and before it—the time between the GP visit and the first consultant visit—was disregarded. It was a hidden wait. So what we have measured for 60 years has been the last third. That last third, which is 10 weeks on average now, was years under the Conservatives.
I am not saying that that one last third will be 10 weeks in four years' time; I am saying that the whole journey—from beginning to end—will be an average of 10 weeks. So the Conservative Government gave us waiting times of years for one third of the journey and we are going to give the people of this country access within weeks for the whole journey. That is the difference between us.
Before I deal with the deficiencies in the NHS that the hon. Gentleman picked out, I will deal with choice. He said that we are promising today what he promised yesterday. That is not true. We are promising to put in the means to get to the end result of giving people real choice. Two things matter for choice. People would prefer to have the best treatment available at the end of the street, in the local hospital, with quick access. The biggest driving force for making people say, "I'd like to go elsewhere", is the lack of capacity in the system and long waits at the local hospital.
Yesterday, the Conservatives promised to give us unlimited waits by removing the targets on waiting times, and reduced resources by taking £1.5 billion out of the NHS for the minority in the private sector. They
24 Jun 2004 : Column 1458
made a deceitful, hypocritical and disingenuous promise to the British people yesterday, and today we are setting out the means to give people a real choice.
I shall deal with the hon. Gentleman's point about deficiencies in the NHS. Yes, there are grave deficiencies in the NHS. Yes, there are shortages of midwives and of radiologists. Yes, there are still problems of new hospitals needed, new equipment needed and more nurses needed. However, by heaven, after 224,000 more staff—
Mr. George Osborne (Tatton) (Con): All managers.
Dr. Reid: —40 new hospitals and 2000 refurbished premises—[Interruption.] I am coming to the comment that the additional staff are all managers. Do not worry. On behalf of the staff, I will not miss the Conservative party and hit the wall on that question. If after all those injections of capacity we are still so short, does not that show how dilapidated the NHS was under the Conservative Government?
I shall deal with the figures that the hon. Member for South Cambridgeshire (Mr. Lansley) gave, which in so many areas were spurious. Yesterday, the Leader of the Opposition, from the Opposition Dispatch Box, made the most serious allegation in the most public forum in this country, impugning the staff of the NHS. He at least—now that it has been proven to be wrong—should have returned to the Opposition Dispatch Box and apologised to the House for misleading it. On behalf of his leader, who does not have the guts to do it, the hon. Gentleman should have apologised to the hard-working staff of the NHS. There are the time limits, where 20 months were mistaken for perhaps 14 weeks. That could have happened only to a Tory who was used to 20-month waiting lists for radiotherapy.
After reducing capacity in the NHS and introducing unlimited waits, the Leader of the Opposition then tells us that all waiting lists would be finished by the wave of a magic wand. It is Teletubby time in the House. The right hon. and learned Gentleman really believes that we are in La-La land. Yesterday, he gave us a cobbled together, incompetent, unfair and inefficient replay of the record of the Tory Government, which was a disaster for the NHS, and no one will believe otherwise.
Mr. Paul Burstow (Sutton and Cheam) (LD): I thank the Secretary of State for the courtesy of allowing me a chance to see his statement and the White Paper before he rose this afternoon.
Does the right hon. Gentleman agree that it is entirely right for Members to bring to the House concerns and complaints from their constituents so as to get justice done, but that it is an entirely different matter to come to the House and parade a constituency case as propaganda? Surely that should not be what we do.
Liberal Democrats have supported the extra investment that is going into the NHS. At the last general election we had the courage and conviction to make the case, and we voted for it in the House. However, that investment will be wasted if innovation is stifled by ministerial meddling. Does the right hon. Gentleman understand that one of the messages that many will take from the statement and the White Paper is that the Government still do not trust the NHS to do
24 Jun 2004 : Column 1459
the right thing? The culture of targets and tick-boxes, which ties the hands of doctors and nurses, gets in the way of clinical judgment and means that the sickest do not always get treated the quickest.
The Secretary of State has outlined his proposals for an 18-week target from the family doctor to the door of the operating theatre. Will he be honest with patients and start collecting and publishing diagnostic waiting times now? When will he start to publish all the waiting times for cancer treatments?
When it comes to choice, does the right hon. Gentleman agree that access to health care should never be based on a person's wealth, and that subsidising the better-off is no more than a gimmick in search of a blank cheque? On the subject of charges—the right hon. Gentleman has waxed lyrical about the founding principles of the NHS—why has he not taken the opportunity today to end the scandal of elderly people being charged for basic care? If more people are to receive intensive home care, will they have to raid their bank balances to pay for it? Is that what the Prime Minister meant yesterday by the right to charge—a right to charge the sick elderly, the frail elderly—for their basic care?
Why has the Secretary of State failed to announce a long overdue review of prescription charges, something that is particularly relevant to those with chronic and long-term medical conditions? The last such review was in 1968. Surely it is not fair that those who, for example, have diabetes get their prescriptions free of charge—rightly so—while those, for example, with cystic fibrosis do not. Surely that anomaly and that scandal should come to an end.
As for making most use of the investment that is going into the NHS—at a time when seven and a half hospitals, effectively, are being filled every year by those who pick up infections while they are in hospital—why does the White Paper say nothing about improving the way that infections are dealt with in our hospitals?
The future of the NHS, as the Secretary of State has said in his statement, depends crucially not only on services that cure people but on all services that prevent and postpone the progression of ill health. The White Paper sets some targets in that respect, but will the right hon. Gentleman say, for example, on smoking, that it is time to accept the overwhelming public health case and follow Ireland and other countries by banning smoking in enclosed public places?
As for obesity, is it not time to introduce clear front-of-package, traffic-light labelling on foodstuffs to give parents and other customers the information that they need?
The White Paper makes it clear that the Government do not trust the NHS to do the job. Under this Government, choice is for the pushy and the articulate, and under the Tories we know that it is about choice for the wealthy. The NHS must deliver choice for all. That means making sure that we have good quality health care delivered closer to home.
| Next Section | Index | Home Page |