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Dr. Reid: First, the target should be clear. Secondly, with every month that passes, we announce some further measure, and we continue to examine other measures, so what I am doing on this issue is as clear as it can be to anyone. Thirdly, the chief medical officer and chief nursing officer have been as open as they can about their advice, including in publications. Fourthly, I keep making excuses for the hon. Gentleman, who has never been in government, but I may say that officials' advice has not conventionally been made available externally. I am doing nothing more than any other Minister has ever done in this position.
The hon. Gentleman is entitled to criticise me if he feels that there are failings in what I am doing, but he is not entitled to imply that the figures have somehow been plucked out of the air with the connivance of leading officials in my Department, including some people who I dare say are as qualified as him, although I know that he brings an esteemed civil service background to this matter. He knows about officialdom and has held official positions, so it is a pretence for him to say that the advice that he gave to Ministers would be randomly issued or made public even on rare occasions. That is not the convention.
Mrs. Patsy Calton (Cheadle) (LD): Perhaps I can help the Secretary of State. What we are looking for is some practical measures that would lead to a reduction in MRSA, apart from the obvious measures on hand cleanliness and so on. What steps are he and his Department taking on bed occupancy rates, which the medical profession believes have an impact on MRSA, and on the availability of single rooms, which enable isolation?
I do not want to spend all day on this matter, as I thought that most of the problems were known to everybody. They include old and crumbling buildings,
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lack of hygiene, shortage of staff, high throughput and the increasing immunity of methicillin-resistant Staphylococcus aureus itself. I could go on and on about the individual items that are part of this complex problem. What are we doing? We are building new hospitals, employing new staff and banning the two-tier contracting out of cheap cleaning services. We have gone through a range of such issues one by one. Having identified potential causes, we are going through them and applying a remedy to each. People are perfectly entitled to think that MRSA is a tragedy and a huge problem, as it is, and they may even think that the Government have not been doing enough about it, but it is not right to imply that one party or another has a particular solution or that the Government are unwilling to listen to or act upon any sensible advice.
That is why I start my speech by saying that we know of the many challenges that we face. MRSA is one of them, but it is by no means the only one. As I said, we recognise that there is more to do, but it is also a matter of pride to all Labour Members that the nation's direction in both health and education is clear. In both, we will provide a future for our people that is fair for all of us and personal to each of us.
In the past few years, after several decades of what I consider to be a lack of ambition, we have started to make considerable progress in service delivery in both health and education. Even our worst enemy would accept that there has been significant progress. In health, cancer and coronary heart disease survival rates are only the clearest indicator of success. That is how we should judge our health service; not on the inputs, but on whether lives are saved and are being improved. All those things, incidentally, are missing from the present way of analysing efficiency in the national health service.
Let me mention two of the most obvious improvements, which are due to the efforts of national health service staffpeople who are continually run down as being inefficient, unproductive and uncaring, and who feature on the front pages of some newspapers every time something goes wrong. Let me give two figures that are to the credit of those staff. There has been a fall in the premature death rate from cancer of 12.2 per cent. in the first six years of this Government.
It may be, but is it not a good one and should we not celebrate it? If we celebrate a 12.2 per cent. fall in the premature death rate from cancer, should not all of us, including those on the Opposition Front Bench, doubly celebrate a 23.4 per cent. fall in premature coronary heart disease-related deaths, as it was six months ago? If we celebrate that astounding reduction in premature deaths, should we not also celebrate today when I tell the House that that reduction is no longer 23.4 per cent., as in the first six years of this Government, it is now 27.1 per cent.? I can hear the cheers from the Conservative Benches.
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Those figures alone mean that 125,000 people are walking the streets of this country who would not have been doing so only 10 years ago. That is not some abstract statistic; 125,000 more people are alive, and do you know what, Mr. Deputy Speaker? That counts as a fall in productivity in the national health service, as those people are not going into hospital for full consultant episodes. Would it not be nice if Conservative spokesmen occasionally explained that, and explained that better health for people outside should be included in the figures? Rather than running down NHS staff, they should say that they will continue to campaign with us to remedy the measurement of good health care.
Mr. Dorrell: I am sure that all my hon. and right hon. Friends welcome, as the Secretary of State does, the improvements in public health outcomes that have occurred since 1997, but in the interests of avoiding party political game playing, perhaps he would also like to repeat to the House that there were sharp reductions in perinatal mortality during the period when the previous Government were in office, as a result not of what that Government did, but of improved medical practice in the national health service. Perhaps he will remind the House that, by 1997, average life expectancy in Britain was two years longer than in 1979. I do not remember ever claiming in public that one lived two years longer under the Tories.
Dr. Reid: The right hon. Gentleman may have missed it, but I did not once claimI repeated the point three timesthat the achievement was down to the Government; I claimed that it was down to NHS staff. I ask Conservative Members to do what the right hon. Gentleman did in 30 seconds and what Conservative Front Benchers were unable to do in 38 minutespay credit to the NHS. That is what I object to.
I celebrate when lives are saved through the NHS. All Labour Members celebrate the fact that, 60 years after the formation of the NHS, a young child born in this country will live nine years longer than they would have done before the NHS was founded. Although the right hon. Gentleman is never churlishhe has led that vast organisation, with all its faults and virtuesI cannot hear roars of celebration from Conservative Front Benchers,
Conservative Front Benchers do not celebrate the fact that, compared with the peak, 456,000 fewer people are on waiting lists. Waits of more than nine months for hospital admission have reduced from more than 118,000, which was the last Government's legacy, to virtually nil today. Nineteen out 20 people are seen, diagnosed and treated by our NHS staff within four hoursa world record. I cannot hear roars of applause from Conservative Members.
None of those achievements is reflected in the efficiency gains. If one waits three months, three weeks, three days or three years, it makes no difference to the present method of calculating efficiency, which is why I have said that the current method is absurd. Rather than using those calculations to beat NHS staff over the head, let us point out that the practical improvements carried out by NHS staff are not currently represented in those statistics.
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Managers are the bête noire of the hon. Member for South Cambridgeshire. The NHS has about 38,000 senior managers, which is a ratio of about 3 per cent. to other staff and about one quarter of the figure in private health care. The 38,000 senior managers compares with about 400,000 nurses and about 130,000 doctors. Let us not use the weasel words that the number of managers has increased at three times the rate for doctors, because, although that might be statistically accurate, like damned lies, statistics can be misleading. It would be better to say, "However, that means an increase from 25,000 to 38,000 senior managers out of 1.3 million staff. The 38,000 figure compares with about 500,000 doctors and nurses and another 500,000 people who work in the other 71 professions in the NHS, 84 per cent. of whom provide front-line care." That is a balanced summary of what the NHS has achieved on manpower.
The hon. Member for South Cambridgeshire did not mention the huge improvements in health or, indeed, the huge improvements carried out under my right hon. Friend the Secretary of State for Education and Skills. Spending is up: since 199798, schools' recurrent funding has risen in real terms by £870, which represents a 30 per cent. increase per pupil to £3,740 in 200405. Class sizes are down: the overall pupil-teacher ratio in nursery, primary and secondary schools has fallen from 18.6:1 in January 1998 to 17.7:1 in January 2004, and hundreds of thousands of children are now in smaller classes. Teaching numbers are up: there are 28,500 more teachers since 1997. Teacher vacancies are down: they have been cut to 0.7 per cent. Most importantly for parents, standards are up. This year, the best ever primary results were achieved, with 53.4 per cent. of pupils achieving five or more GCSEs or GNVQs, and the highest ever number of students has been accepted at university.
Lives have been saved and improved. Yesterday's generation is living longer, today's generation is learning better and tomorrow's generation has a brighter future. That is not perfection, but, by any standards, it is substantial progress.
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