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Mr. Gibb: I know that this is not the direct field of the Secretary of State for Health, but he may be aware of Professor Timms's study of primary education. Professor Timms conducts huge amounts of random testing on primary schools, the results of which are not published. His conclusion is that the real improvement is only one third of what the Government claim for English in primary schools and only two thirds of what the Government claim for maths in primary schools.

Dr. Reid: The hon. Gentleman plays a prominent role on the Education and Skills Committee, in which I think that matter will be discussed in the next 48 hours. I am not an expert, but I know that a discussion, in which he is no doubt involved, is taking place about the statistics. Importantly, nobody has said that substantial improvement has not occurred, and we are arguing about the rate of improvement. That is a legitimate argument, but that is not always reflected in some of the comments made by Conservative Front Benchers.

Those real, practical changes are a product of our core values. The matter means something to Labour Members given our commitment to fairness, about
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which we feel passionately. However, the improvements are more than that, and I want to address head on the remarks made by the hon. Member for South Cambridgeshire. Those improvements are also the product of determined, driven, systematically sustained reform programmes. We know that every pound wasted on health expenditure means that someone waits in pain longer or someone dies earlier than they should do.

We know that every pound wasted in education expenditure is a life's chance wasted for somebody, which is why we have been so committed to matching the investment of money with driving forward efficiency and reforms. I want to examine some of those reforms, which the hon. Member for South Cambridgeshire threw aside as immaterial in rather a churlish fashion. We have become more efficient. For instance, last year I announced that we would cut the number of posts in the Department of Health by 38 per cent., which involves 1,400 posts, and we are now well through that process.

I listened carefully to the comments made by the hon. Member for South Cambridgeshire about how to run an efficient organisation. He said that the percentage of top managers should not be too high, but a little modesty and humility would not be out of place: some 3 per cent. of the NHS work force is top management, but, as far as I can see by counting the number of Front-Bench posts in the Conservative party, 53 per cent. of the Conservative parliamentary party are senior managers—Front Benchers.

We will certainly do our best to reduce the number of Conservative MPs at the next election, but I have gone a huge way to reducing the number of people in the Department of Health by 38 per cent. We are already well into that process and a lot of money, which can be invested in the front line, has been saved. In May this year, I followed that up by announcing that we aim to halve the number of arm's-length bodies that support the NHS.

That was the target, but I do not know whether the hon. Member for South Cambridgeshire thinks it worthwhile. Should we not have had a target? Should we have wandered around talking about the matter, without any objectives whatsoever? [Interruption.] We will reduce Department of Health staff by about 5,000, expenditure by about £500 million and the number of arm's-length bodies from 38 to 20. All that money will go into front-line care.

Today, I have gone further, by publishing exactly how that will be done. I have published the next steps—the hon. Member for South Cambridgeshire referred to them—in implementing the review of NHS arm's-length bodies to ensure that the NHS gets most of the money locally and an efficient central service that offers value for money. The aim of the cuts in bureaucracy that we, the Labour Government, are implementing is to ensure that every spare penny that can be spent on the front line is thus spent.

I used the word "cuts", but there is a difference between us and the Tories. When the Tories cut health spending, they cut training places for doctors and nurses. The hon. Member for West Chelmsford
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(Mr. Burns) looks astounded. Let me remind him of his party's history. Those who do not know their own history are obliged to wander aimlessly in the dark, so I will enlighten him about the last Conservative Government. Under the Tories, nurse training places were cut—I wonder how much Conservative Front Benchers can recall of their slash and burn—by 25 per cent. We are constantly told that we need more GPs. Under the Conservatives, GP training places were cut by 20 per cent. And what is the deepest personal concern expressed by Conservative Front Benchers every time they stand up? It is dentistry. No one will be surprised to hear, however, that the last Conservative Government closed two dental schools, which led directly to the staff crisis that we inherited and the requirement that this Government reinstate those places.

When the Conservatives cut, they cut training places, front-line staff and the essential provision of care. When we restrict the budget on bureaucracy, we increase the number of nurses caring for the public—there are now 77,500 more than under the Conservatives. That is not enough, by the way, so God knows how understaffed we were when that lot left office. When we cut bureaucracy, we put it towards increases in training. Another 178 dentists per annum will be trained, more GPs than ever will be in practice and in training and more nurses than ever will be employed by the national health service.

Above all, we shift the emphasis and the benefit from providers to consumers—the patients themselves. Through the bulk buying of drugs, for example, we will use the power of the NHS to do what the Conservatives used to take a pride in—run an efficient business.

Dr. John Pugh (Southport) (LD): If I follow the Secretary of State's argument, he seems to be saying that it is not necessarily a good thing to cut administrators in hospitals, but it is necessarily a good thing to cut administrators in the Department of Health? Why is that, and are those two points of view congruent?

Dr. Reid: I have great respect for administrators, officials and managers. I have never been one of those who say that administrators do not add value. The idea that doctors would run their surgeries without receptionists or that surgeons and consultants would spend their valuable time not operating on and treating patients but on doing all their typing is absurd—it could come only from the mind of a Conservative Front Bencher. [Hon. Members: "What mind?"] Indeed, that is a contradiction in terms. It is absurd to suggest that a national health service, especially one of our size, can be run with much less than 3 to 4 per cent. senior management given that organisations in the private sector, including in private health, are running at three or four times that level.

If one is prepared to throw away the dogmatic obstructions that have sometimes curtailed those of us on the left of politics, one can use the size and power of the NHS to enhance efficiency inside and outside it—for instance, through the bulk buying of drugs. The recent pharmaceutical pricing regulation scheme agreement with the drug companies will save the NHS nearly £2 billion over five years. That money is going not to the drug companies but to the front line of services for the patients of this country. Through the bulk buying of
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private sector health care, the NHS has succeeded in driving down not only the price of private operations for the NHS itself, delivered free at the point of need, but the price of private health care provided to insurance companies. We are leaving more operations for the NHS at the same time as driving efficiency in the private sector. Conservative Members know that, which is why they are sitting bemused, asking, "Why weren't we doing this?"

Mr. Simon Burns (West Chelmsford) (Con): We did.

Dr. Reid: Let me tell the hon. Gentleman what they did. They bought from the private sector at one-off spot prices of 150 per cent. of the price of NHS operations. The average price of our bulk buying at the moment—it is still going down—is about 108 per cent., including a start-up premium. As a result of judicious buying from the private sector, we are being given roughly the same as NHS prices.

If the hon. Gentleman wants to make contrasts in efficiency, that is a fair point—let us do it. Everyone knows that the Conservatives' policies are unfair, but they have an air of efficient business men about them. That is an illusion. Their plans are grossly inefficient, apart from being unfair. Let me tackle this head on. They believe that we should spend billions of pounds of taxpayers' money—currently £65 billion, rising to £110 billion—throughout the United Kingdom with no targets whatsoever: no objectives, no aims, no management targets, no concrete expression of their ambition. "Abolish all targets", they shout—not, "Let's have a managed transition" or "Let's have centrally driven objectives, as any business would, while we change the system", but the instant abolition of all targets. They would pour more than £60 billion of taxpayers' money into the NHS with no targets, no objectives and no drive for reform. That is today's Conservatives. They are economic anarchists throwing out billions of pounds of taxpayers' money and hoping that it will arrange itself on the floor in neat patterns and with some degree of productivity. The NHS would be the only service organisation in western Europe, public or private, to be spending billions of pounds with no objectives. How absurd can a political party become?

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