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Dr. Reid: I cannot confirm that the numbers have tripled. They increased in the first few years of the Government. However, given the lead time, as we reduce the waiting time for an operation from a couple of years to a maximum of 18 months, then 15 months, then 12 months, and, from three months ago, nine months—next year, no one will wait more than six months—the compulsion to go private is also reduced. People can continue to choose to go private—I have no problem with that if it is people's genuine choice. However, it must be a real choice; people must not be forced to go private because of inadequacies in the NHS. The more we address the quality, waiting times and waiting lists in the NHS, the less the compulsion for anyone, inside or outside the House, to go private.

Let me conclude the point about efficiency. We reject the inefficiency in the public sector through lack of targets and in the private sector through individual rather than collective purchase, which constitutes the Conservative party's policy. That policy is inefficient as well as unfair. Therefore, we have an entirely different philosophy from the Conservatives. Their policy would mean patients waiting in pain—the very subject that the hon. Member for Lichfield (Michael Fabricant) mentioned—because they would get rid of targets, waiting times would go up and about £1.5 billion a year of the capacity that reduces waiting time would be taken out of the NHS and put into a subsidy to enable those who are better off to jump the queue. It is as simple as that.
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Across the centuries in which the Conservative party has been around, an enormous amount of work has been put into intellectually justifying selfishness and greed—that is a matter of historical fact—but I have never seen anything that enshrines that as much as the patient's passport. It does not surprise me that the hon. Member for South Cambridgeshire could not bring himself to mention it once in his 40-minute speech, because the idea that people have either to wait endlessly in a queue, in pain for years, or to find £6,500 for their knee replacement is abhorrent to people in this country. I truly believe that. The Conservatives are not interested in a patient's passport unless it can be supplemented by another book—the cheque book. That is totally at odds with the philosophy of this country.

So, for our part, we claim not perfection, but solid, significant progress. We will continue that in sustaining our record investment and in transforming the way in which patients experience the health service with this increased capacity. In our health improvement plans, we build on what we have already done.

In education, my right hon. Friend the Secretary of State for Education and Skills has already produced more than 45,000 new day care places, which have been opened in disadvantaged areas as part of the biggest ever single investment to expand child care. That is also why 90,000 more 11-year-olds are achieving the expected level for their age in maths than in 1997 and why fully 8 per cent. more pupils achieve five A grades at GCSE than in 1997. Real opportunities are now being taken by so many of our young people. These achievements, efforts and energies are theirs, not the Government's.

I return to what I said to the right hon. Member for Charnwood: I do not claim this for the Government. I have said constantly, on and off the record, for 25 years that the biggest driver of social change in this country is people's ambitions—parents, pupils and those who take themselves out of disadvantage. It is the Government's role to give them the opportunity to do that and to reduce the barriers that prevent them from doing it and that make it more difficult to achieve for some people who are in different circumstances from others.

So, we will do that and go further. Under the previous Government, people sometimes had to wait years for an operation. This, again, is the subject that the hon. Member for Lichfield brought up. In 1997, the maximum waiting time that we inherited was over 18 months. That was scandalous—18 months for just a third of the patient journey from final diagnosis to treatment; it included nothing before final diagnosis. My aim is to speed up the whole patient journey from GP referral—first contact—right through out-patients, diagnostic tests and, finally, treatment.

That is why by 2008, from the time of referral to a family doctor to the door of the operating theatre, no one in England will wait more than 18 weeks—

Michael Fabricant: You hope.

Dr. Reid: Thus far, we have met every pledge and every target we have made. We will make this one as well, because NHS staff will respond to the challenge as they have in the past. This should ensure an average wait of about nine or 10 weeks. When the hon. Gentleman says he hopes that will be the case, I hope he
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is not implying that he and his colleagues hope it will not, because this would be a marvellous boon for people in this country—a maximum waiting time of 18 months for just part of the patient journey under the last Conservative Government and a maximum waiting time for the whole patient journey of 18 weeks under the Labour Government due to the efforts of NHS staff and investment from the taxpayer.

Our choice is for everyone, and we welcome today's chance to compare our records. This has been an enjoyable debate for me; I hope it has been enjoyable for our colleagues on the Opposition Benches. More than that, it has been informative. We now know that, under the Conservatives, waiting lists rose by 400,000; under Labour, they have come down by 300,000. Under the Tories, nursing places were cut by 25 per cent.; under Labour, they have increased by 62 per cent. Under the Conservatives, GP training places were cut by 20 per cent.; under Labour, the number of doctors training to be GPs has reached a record level in the past few months and there are 80 per cent. more doctors—that is eight-zero, Mr. Deputy Speaker, in case anyone thinks it is an exaggeration—training than only seven years ago.

The hospital building programme, which ground to a halt under the Tories, is now the biggest in the history of the NHS, but the Tories want to abandon the first principle of the NHS, which is that treatment will be free at the point of need—once more, a policy for the few against the interests of the many.

The dividing lines for the next general election are clear. With Labour, access to operations will remain based on need, not on ability to pay; under the Tory plan, there would be charges for operations. With Labour, investment in the NHS will continue; under the Conservatives, there will be cuts and the diversion of money from the mainstream to subsidise the rich in jumping the queue. With Labour, guaranteed waiting times; under the Conservatives, unlimited waiting times once more. With Labour, queues cut; with the Conservatives, queues jumped, but only by the rich few. With Labour, an NHS fair to everyone and personal to each of us, not as the Tories want—timely health care only for those who can afford it.

That will be the choice when the time comes for the election. That time cannot come soon enough for me. I commend the Queen's Speech to the House.

2.57 pm

Mr. Paul Burstow (Sutton and Cheam) (LD): Indeed, the election cannot come soon enough. The sooner the better we can get on with it and dispose of the Queen's Speech and the legislation it contains, so much of which is about promoting fear rather than aspiring to hope and meeting the aspirations of this country.

This debate is about the inextricable links between health and education. As I listened to the Secretary of State rightly celebrate the significant improvements in survival rates in respect of cancer and coronary heart disease, I was thinking just how much that link comes into play. While undoubtedly it is right to celebrate and applaud the contribution that NHS staff have made to those successes with increased survival rates, the fact is that education messages over many decades that have
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resulted in more and more people giving up smoking have probably contributed even more significantly to those survival rates than anything else.

That is why we on the Liberal Democrat Benches take the view that education has a key part to play in the health of the nation—unlocking people's potential and enabling them to have opportunities to improve themselves and their lives. Education has a vital part to play in equipping people with the skills and knowledge they need to exercise an informed choice on their health, to take control of their health and, when necessary, take control of their own health care.

A number of Bills in the Queen's Speech relate to education, and I hope that my hon. Friend the Member for Newbury (Mr. Rendel) might catch your eye, Mr. Deputy Speaker, so that he can address some of them in more detail than I propose to do. However, I want to make one or two comments. The Secretary of State referred in his peroration to the dividing lines between the parties. This Queen's Speech contains a number of dividing lines, one of which is the Government's tendency to concentrate power in Whitehall, to centralise, to undermine locally elected authorities, and to set appointed and unaccountable quangos in place of democratically accountable local bodies. The education and schools Bill is just one of a succession of local government, health, education and policing Bills that have reduced local accountability and imposed national priorities.

Local authorities should have an enhanced role in co-ordinating services for school-age children. Is that not what children's trusts are meant to be all about? It makes no sense for the Government to champion integrated services with the Sure Start programme, which the Liberal Democrats support, only to abandon that principle when children reach the age of five. Local authorities should be given the opportunity to champion the co-ordination of services to ensure that no child is left behind.

On the issue of school inspections, which will also, I believe, be covered in that Bill, it is welcome that the Government are at last beginning to recognise that endless inspections are not the key to higher standards—that does not just apply to schools and education but to the health and care sectors. Instead, such inspections in schools increase the stress on teachers and pupils and take away valuable time from teaching. We hope that Ofsted will be able to move towards a more constructive role, auditing school improvement and offering advice about best practice, and that this legislation will therefore pave the way for that. But it is disappointing that the Queen's Speech does not provide similar opportunities with respect to the role of the Healthcare Commission and Commission for Social Care Inspection and, indeed, does not provide the opportunity to bring those two bodies together, so that, for the first time, we have one agency responsible for setting the framework of standards and regulation for the whole health and care sector.

The child welfare Bill, which is in its draft form for scrutiny in the House, appears to refer only to enforcement of rules after a settlement has been agreed. Our initial thoughts are that the changes are necessary but should occur before that point, to ensure that
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children do not get involved in long-running and emotionally damaging legal disputes. Indeed, figures from the Office for National Statistics show that 88 per cent. of non-resident parents are satisfied with informal arrangements reached outside the court, and that only 35 per cent. are satisfied with the outcome once they get to the courts. Surely that makes the case for far more pre-legal mediation and support services.

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