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Andrew Selous (South-West Bedfordshire) (Con): On a point of order, Mr. Speaker. Given that we have learned in only the past few days that a battalion of the Royal Regiment of Fusiliers could be cut and that a decision will be taken this week, have you received any indication that Defence Ministers intend to make a statement to the House? The cut could be made despite the fact that the 1st battalion won more awards during the invasion of Iraq than any other battle group and that the 2nd battalion is the most experienced Northern Ireland battalion in the British Army. Do you understand the depth of anger that will be felt if there is no ministerial statement on the matter before a decision is taken?
Mr. Speaker: I know that the hon. Gentleman is worried about the regiment in his area, but there are Defence Ministers on the Treasury Bench and I have no doubt that they will take note of what he said.
Mr. Chancellor of the Exchequer, supported by Ms Secretary Hewitt, Mr. Secretary Johnson, Mr. Paul Boateng, Dawn Primarolo, Mr. Stephen Timms and John Healey, presented a Bill to restate, with minor changes, certain enactments relating to income tax on trading income, property income, savings and investment income and certain other income; and for connected purposes: And the same was read the First time; and ordered to be read a Second time tomorrow, and to be printed. Explanatory notes to be printed [Bill 9].
Mr. Secretary Darling, supported by The Prime Minister, Mr. Secretary Prescott, Mr. Chancellor of the Exchequer, Mr. Secretary Blunkett, Mr. Secretary Reid, Mr. Secretary Murphy, Mr. Secretary Hoon, Mr. Peter Hain, Mr. David Lammy, Mr. David Jamieson and Charlotte Atkins, presented a Bill to make provision about road traffic, registration plates, vehicle and driver information, motorway picnic areas and private hire vehicles: And the same was read the First time; and ordered to be read a Second time tomorrow, and to be printed. Explanatory notes to be printed [Bill 10].
Order read for resuming adjourned debate on Question [23 November],
We, Your Majesty's most dutiful and loyal subjects, the Commons of the United Kingdom of Great Britain and Northern Ireland in Parliament assembled, beg leave to offer our humble thanks to Your Majesty for the Gracious Speech which Your Majesty has addressed to both Houses of Parliament [Mr. George Howarth.]
Mr. Speaker: I inform the House that I have selected the amendment in the name of the Leader of Her Majesty's Opposition.
Mr. Andrew Lansley (South Cambridgeshire) (Con): I beg to move, as an amendment to the Address, at the end of the Question to add:
"but deplore the absence of any measures in the Gracious Speech which would reduce the burden of centrally-imposed targets, bureaucracy and regulation on the NHS and the Education Service; call on Ministers to implement urgently the action needed to deliver cleaner hospitals and to strengthen school discipline; regret the omission of measures to abolish top-up fees; note that legislation to reduce the size of Ofsted will merely reverse part of the huge increases in its staffing levels since 1997; reject the Government's intention to impose additional fees on those attending further education colleges and deprecate the damage this will cause to adult and vocational education; further regret the carry-over of the School Transport Bill, which will impose extra financial burdens on hard-working families; are concerned at the failure to take forward legislation on mental health in a form that would protect the rights of people with mental health problems and promote their access to treatment; further regret the lack of any proposals in the Gracious Speech to provide effective public health services; and further deplore the absence of measures to promote freedom and independence for health and education professionals or effective choice of patients and parents.".
Today we move on to debate health and education. My hon. Friend the Member for Westmorland and Lonsdale (Mr. Collins) will later address in detail the education measuresor perhaps the lack of themin the Queen's Speech.
The Queen's Speech offered no forward momentum to raise standards in the NHS or our schools. Three years ago, Labour said that it put schools and hospitals first, but they are now being pushed to the back of the queue by Home Office measures prompted by the Government's failure on law and order. We have no health Bills and nothing that would help to raise standards in our schools. There is no vision for our NHS or any room for the politics of hope in the Queen's Speech.
At the heart of the reforms for which the NHS is crying out is the reduction of centrally imposed targets, bureaucracy and the burden of regulation, but the Queen's Speech contains no measures from the
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Secretary of State for Health to move us in that direction. Indeed, in the few days since the Queen's Speech, we have heard from the Healthcare Commission that it proposes the abolition of star ratings, for which Conservative Members have been calling for a long time. We demonstrated, and many people throughout the NHS entirely agreed, that star ratings were a crude and misleading measure of performance in the NHS. They were centrally imposed by Ministers, but as soon as the scheme was taken out of the hands of Ministers and put into the hands of those who are genuinely charged with delivering improvements to the NHS, the conclusion has been reached that star ratings must be abolished.
The Government have offered nothing in the Queen's Speech to reduce the burden of targets. People throughout the NHS know that they distort priorities, and we have discussed this many times. Indeed, my right hon. and learned Friend the Leader of the Opposition has stood at the Dispatch Box and challenged the Prime Minister to get rid of targets that force those responsible for infection control measures in hospitals to keep beds and wards open when they should be cleaned for infection control purposes. The National Audit Office has made it clear that those people are overruled by managers in pursuit of the Government's centrally imposed targets. That is a disgrace, but it is only one of a range of illustrations of how targets that are centrally imposed by Whitehall are distorting the national health service's priorities.
The Government told the National Audit Office that by 200304, their NHS plan would bring bed occupancy down to 82 per cent., but that has not happened in practice. All the trusts throughout the country with the top 20 rates of methicillin-resistant Staphylococcus aureus have a bed occupancy higher than 82 per cent., and it is more than 90 per cent. in several. We will not get cleaner hospitals by using the Government's central targets; we will only achieve that in the absence of their interference.
Even the Government do not believe in their targets. They set a target for reducing the backlog of maintenance in the NHS. The target was the reduction by a quarter of a backlog measured at £3.1 billion by the end of 2004the end of next month. Last Thursday, however, the Department of Health concluded that it was measuring the target using a flawed methodology, so rather than adhering to the target, it said that it would recalculate the figures. In place of the backlog of maintenance, which would now be not £3.1 billion but £3.2 billion, it has arrived at what it calls, using typical jargon,
I suppose that the risk in mind was that the target might not be hit. The Department would have had to announce its failure to make any progress towards addressing the £3.1 billion backlog, but insteadlo and beholdits estimated risk adjusted backlog has become £638 million. How interesting.
The Government do not believe their own targets, but neither do people who work in the NHS. The Government trumpeted the fact that four-hour waiting targets for accident and emergency departments had
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been met, but only last week, the Nursing Standard carried a report of the Royal College of Nursing Emergency Care Association annual conference. It said:
"nurses speaking from the floor claimed there was widespread misreporting of the figures that are signed off by chief executives. Some endorse so-called 'gaming', the practice by which patients are transferred only in the final minutes before breaching the target . . . One delegate, who wanted to remain anonymous, won applause from nurses for saying that her trust 'lied' over the A&E waiting time figures it presented."
The charitable view is that the Department does not know what is going on in the NHS, but the uncharitable view is that it would rather present figures than understand and be honest about what is happening.
We need fewer targets and less bureaucracy. The cost of bureaucracy in the NHS has increased from £3 billion in 1997 to £5 billion. The number of central administrators in the NHS is rising three times faster than the number of doctors and nurses. I recently visited a hospital at which I was given a list of the inspection bodies that visit it. It is visited by 42 inspection bodies. I referred to that during a meeting at which the Healthcare Commission was represented, but its chief executive said, "No, it isn't 42. We've been counting them and it's 102." Of course the Secretary of State does not believe that, but the Healthcare Commission seems to be more in tune than he is with what is going on in the NHS.
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