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Dr. Reid: First, whatever the hon. Lady thought about the deficiencies of what I said, I hope that at least she welcomes the fact that I prioritised chronic care in terms of people and resources and gave it the attention that it should receive. I do not blame her at all for raising one specific charitable cause and asking me to agree immediately to pay that £17 million. I know she will understand if I do not give her an instant decision on that. I look forward to even closer work between the state sector and the charitable sector. I know that the National Society for Epilepsy and others do a huge amount of good. I do not know the details of the case, but I hope she will write to me about it. I will demur from making a rash decision. We have had enough cobbled-together
 
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decisions from the Opposition Front Bench in the past few days without my making a sudden one before giving the matter the fullest consideration.

Tony Wright (Cannock Chase) (Lab): The health service is now improving dramatically, and if we can avoid the idiocies of the Conservative party, it will continue to do so. I was interested in what my right hon. Friend said about giving guarantees to patients on waiting times. Can he tell us exactly what he means by guarantees in that context and what will happen if the guarantees are not met?

Dr. Reid: What I mean is that we already have plans, from December next year, at the point of referral, which is when a patient goes to the doctor, to put in the technology, establish the rights and customs and put in the resources to ensure that people are not simply told, "You will go to your local hospital, but go home; it will write to you in due course, perhaps in a week or a month, to tell you when you will go." We have already established a system in which people will be given not only a degree of choice—a choice between four other hospitals or treatment centres apart from their own—but an ability to book online at their convenience a time and date that is most convenient to them. We are going to retain that arrangement, but in addition, by 2008—we will be able to have the IT in place by that time—people will be able to get rough information about other hospitals and treatment centres throughout the country to enable them to say that they want to go somewhere else in England.

I should point out that, as we reduce the waiting times and increase the capacity, the normal expectation would be that fewer and fewer people would want to exercise that choice, but they will have the right to do so. If they discover that the area that they choose cannot meet the 18-week time limit, they will have the right to say that they want to be treated somewhere else or to go ahead and say that they choose to wait longer to get their treatment. If an offer from the primary care trust is not met within 18 weeks, that will be reflected in the assessments that are made by the health care commission, which eventually feed through to the allocation of resources.

Sir Nicholas Winterton (Macclesfield) (Con): I am sure that the Secretary of State will agree that hon. Members in all parts of the House have shown total commitment to the health service. With that in mind, I wish to follow up the point raised by the hon. Member for Romsey (Sandra Gidley) in respect of chronic and long-term medical conditions. Will the Secretary of State give the House a commitment that the Government will look at funding long-term chronic conditions and that they will not expect people to pay either in full or in part when they have diseases such as Alzheimer's, and also not expect them to be charged by social services when they need to go into a nursing home for ongoing care and treatment? That is critical. The situation has been neglected by successive Governments, and I believe that it is an injustice that needs to be rectified.

Dr. Reid: First, I understand that some people in all parts of the House are committed to the national health
 
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service. I do not question that, although it applies to some people, not all. Secondly, I understand the point that the hon. Gentleman makes and the passion and sincerity with which he makes it. It is a difficult choice. Of course, I would not want it to be thought that we do nothing for the chronically ill, and I have made further announcements today in that regard. We help with social work costs, and the idea of the community matrons—I mentioned that there will be 3,000 additional ones—is to help people to stay at home rather than go into homes. We pay all the medical care and, for about 70 per cent. of people—I speak from memory—all the personal care. We try to make that distinction at the same time as using the money efficiently in allocating the £1.7 billion that would otherwise be spent in giving everyone free personal care. We think that we are making the right decision. I do not pretend that it is an easy judgment. Of course, we keep it under review every time we look at expenditure, but I cannot tell him today that we are going to change the position.

Ms Dari Taylor (Stockton, South) (Lab): I warmly welcome my right hon. Friend's statement, which I believe was powerful and persuasive. In particular, I see community matrons as an excellent innovation, but I am seeking reassurance. Labour's 2001 manifesto stated:

"We will give more patients choice."

I have no problem with that, but I am seeking reassurance that the choice that we are making available to patients will be free at the point of use. I am most particularly seeking reassurance that, when that choice is given, we will be giving it because we have high-quality services.

Dr. Reid: I can absolutely give my hon. Friend that assurance. Those of us on the Labour Benches have known too well over the decades how the incantation of "We are all free to choose to buy a Rolls-Royce" and the theoretical freedoms that are always espoused on the Conservative Benches mean nothing if we do not have the means to exercise that choice. Indeed, the whole mission of the party in which I was brought up was converting that theoretical choice for the many into real choice by giving decent wages and public provision. That will be the case. We will not introduce charges, unlike the Opposition. What we will do is take the public services, which are already fair, and make them more personal by building them around the convenience of today's individuals.

Rev. Martin Smyth (Belfast, South) (UUP): The Secretary of State has referred time and again to the national health service and to England, Scotland and Wales. Has he consulted his colleague who deals with the health service in Northern Ireland, bearing in mind that some of the specialist units have to be located in England or elsewhere other than Northern Ireland because its population is too small?

May I also press the Secretary of State on provision for general practitioners? I am aware that some GPs in Northern Ireland have been told that they cannot even get a guarantee that they will move into new premises in 2005. I will take up the matter with the appropriate
 
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Minister, but it is important that, when we are talking about a national health service, it is just that, and not simply an English national health service.

Dr. Reid: The hon. Gentleman will allow me to explain that the only reason why I did not mention Northern Ireland and referred to Scotland, Wales and England was that I was speaking in the context of a choice between the Conservative and the Labour parties. He would not want me to misportray the important role that he and his party play in Northern Ireland. Of course, the facilities that are used here and extended to the people of Northern Ireland will continue. We keep in close touch with the Under-Secretary of State for Northern Ireland, my hon. Friend the Member for Basildon (Angela Smith). The last point is a matter for her, but I will see that we bring to her attention the fact that the hon. Gentleman has raised it today.

Jon Trickett (Hemsworth) (Lab): On the subject of choice, is it not clear that there are now two visions for the national health service in this country? When people reflect on those two visions, the choice of the nation will be the vision espoused in my right hon. Friend's excellent statement.

In an organisation as large as the NHS, the devil is often in the detail. Will my right hon. Friend or one of his colleagues please meet me and one or two hon. Friends to discuss the situation in Pontefract hospital, where an inherited cumulative deficit appears to be inhibiting the further development of the NHS? In particular, will he ask one of his officials to look at the case of Mr. Jason Day in Featherstone, a constituent of mine who was diagnosed as suffering from multiple sclerosis? The money is available for beta interferon to be prescribed to him, but there appears to be a financial problem with the clinic allowing the diagnosis to take place. I would be grateful if he could look into those matters.

Dr. Reid: I can give my hon. Friend that assurance. Indeed, I think that the Minister of State, Department of Health, my right hon. Friend the Member for Barrow and Furness (Mr. Hutton), has begun to look at some of those matters, and he will be happy to continue his discussions with my hon. Friend.

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