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Mr. Stephen Dorrell (Charnwood) (Con): I begin by    joining the hon. Member for Huddersfield (Mr. Sheerman) in congratulating my hon. Friend the Member for Lancaster and Wyre (Mr. Wallace) and the hon. Member for Swansea, East (Mrs. James) on their maiden speeches. Sadly, it is some time since I made my maiden speech, but one's first contribution in a new Parliament is an opportunity to reflect at least briefly on the vote of confidence received from the constituents.
 
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As the hon. Member for Swansea, East noted, being elected to this House should always be a humbling experience, whether it be for the first time or, as in my case, for rather more than the first time. In congratulating my hon. Friend the Member for Lancaster and Wyre, I must say that I detected a certain robustness of tone which I think that we shall come to enjoy in the years ahead. I look forward to his contributions to other debates, in particular in respect of matters to do with law and order and other topics for which the necessary traditions and expertise apparently still reside in Lancaster.

It is a cliché that public services lie at the heart of modern political debate, but anyone who doubted that had only to listen to the reaction on the doorstep during the recent general election campaign. That reaction, and the evidence from opinion polls, made it clear that electors considering the performance of a modern Government put the delivery of health care and education services that match their aspirations at the very heart of their choice at the ballot box. Hon. Members of all parties must take that very seriously. The signal from voters also reflects a growing disparity between what they expect to receive from the core public services of health and education and what they receive in reality when they visit a school, hospital or GP surgery.

That is not unlike what happened in the British economy in the 1970s, when a dangerous disparity developed between what we wanted to achieve and what we managed to achieve. As every hon. Member knows, that led to a radical reform of the way in which the economy works—a reform that is now common ground across the House. It is no exaggeration to say that a similar process of rethinking the delivery of health and education in the modern world now faces the Government and all political parties if we in this House are to be seen to take this matter as seriously as our voters take it at election time.

I shall deal with two sectors of the public service, apart from schools and hospitals, that illustrate some of the more difficult and uncomfortable choices that we will have to face up to. The first sector is the universities. We heard a lot during the election campaign from the Government, and a little from the Lib Dems, about how the Conservative party planned to introduce new charging regimes for public services. It is a matter of history that the NHS has three charging regimes, one for dentistry, one for opticians and one for prescriptions. Two of those three charging systems were introduced not by Conservative Governments but by Labour Governments. More importantly, and much more recently, the core public service of the delivery of university education was subjected to a new charging regime for tuition, introduced in the last Parliament by the present Government. Therefore, I accept no lectures from the Government on charging regimes in public services. Across those four specific examples, the score for introducing new charging regimes is 3–1 to Labour. That is a convenient party political point, but it has some uncomfortable lessons that need to be taken more generally into account.

We must recognise that some difficult issues must be addressed in the university sector. The British university system has fallen behind other comparative systems, in
 
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particular that in north America, in terms of available resources and the degree of comfort with which university staff work within that sector. If we wanted a university system in which professional people felt that their professionalism was undervalued and subject to too many targets, it would be hard to find a better example than our present system. That is not a party political point, because the target setting started under the last Conservative Government. We have to develop a system in which universities trust more in the professionalism of those who work in them. We need to see universities more as private sector institutions, which—strictly speaking—they are, delivering a service to their students.

I must say to my right hon. and hon. Friends on the Front Bench that I think that the Conservative party went up a dead end when it opposed the introduction of tuition fees. Reform of the public services involves reassessing the balance between individual and collective responsibility, and accepting that some matters that were regarded in the post-war world as the responsibilities of the taxpayer will increasingly have to be regarded as responsibilities that the individual at least shares with the taxpayer. The Government were right to conclude that the university sector was a good place to start.

The universities are one area of public service that needs to work through difficult issues. The other area that I wish to mention is NHS dentistry, for which I used to be responsible. Nobody can surely believe that the model for the provision of NHS dentistry is one that we should admire or claim great credit for. The fact is that access to public services should be one of the key determinants of whether our policy mix is right. Access to NHS dentistry is too often denied to people who should—we would all agree—have ready access to those services.

NHS dentistry is another area where the issue of charging for public services arises. It has an appalling charging regime, not because charges are always wrong but because, unlike private sector insurance schemes for the provision of medical or clinical care, the charges are imposed on the patient at the time of clinical need—despite the formulation that the hon. Member for Northavon (Steve Webb) used. If we are to introduce further charging, we must think about establishing a way for the patient to accept shared responsibility without imposing the charge at the moment that they might be put off from accepting care that they need by the financial consequences.

I raise those two services—universities and dentistry—because I do not believe that any party in the House will accept the suggestion that we should abolish all charges for them and go back to total state funding. We need to think through how we can make co-payment—that dreadful jargon word—consistent with the core principle everyone should accept: equitable access to those services for all who should have access to them, when they need them and without regard to the financial consequences.

I end with a rhetorical question: does anybody seriously believe that the issues I have raised in connection with dentistry and universities are unique to those services?

5.36 pm

Rosie Cooper (West Lancashire) (Lab): I am grateful for this opportunity to make my maiden speech. I compliment and congratulate my hon. Friend the
 
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Member for Swansea, East (Mrs. James) and the hon. Member for Lancaster and Wyre (Mr. Wallace), who also made their maiden speeches this afternoon. It is with trepidation and humility that I begin mine.

I choose to speak in this debate because of my direct experience of our fantastic national health service and my desire to see it flourish in the 21st century, and also to allow me to do what my constituents expect of me—to be an active and effective advocate and representative for them in the House. Today, I begin that in earnest.

My first act will be to inform hon. Members of the heritage and history of my constituency. Geographically, Lancashire West—or, as it is now known West Lancashire—borders the Liverpool conurbation to the south and Preston to the north. To the west lies the coastal town of Southport and to the east Wigan and Greater Manchester. That places us right at the heart of a thriving north-west.

The constituency is made up of several small villages, including Burscough, Parbold and Newburgh, which can be traced back to medieval England and the Domesday book, while the bulk of the population is concentrated in the towns of Ormskirk and Skelmersdale. West Lancashire is a mix of opposites: history and modernity, urban and rural, agriculture and industry, which are reflected in the type of issues that will exercise me over the course of this Parliament. They include rural transport, supporting farmers and agricultural producers, the long-awaited Burscough bypass, continued regeneration of the more deprived urban communities and the improvement and development of public services locally.

In the post-war era, a list of illustrious and infamous male predecessors have represented my constituency, including Harold Wilson, Douglas Glover, Harold Soref, Robert Kilroy-Silk, Kenneth Hind and Colin Pickthall. When I reflected on that list, the significance of my election to this place struck me. I am the first woman to hold the seat—a vindication of Labour's commitment to make the House more representative of wider society.

The recent election was the fourth successive election at which West Lancashire returned a Labour MP, making Labour the natural party of Lancashire, West. That is indeed a testament to the hard work and commitment of the local Labour party and of my immediate predecessor, Colin Pickthall—a fitting legacy. Having wrested control of the seat from the Conservatives in 1992, Colin went on to be a great champion of the people and places of West Lancashire. His approach to his responsibilities reflected a deep affection for the area even though, like me, he was not born in the constituency.

Colin dedicated his life to the advancement of Labour party values and to representing the people of Lancashire, West, both as an MP and, before that, as a county councillor. During 13 years as the MP, Colin presided over an upturn in the constituency's fortunes. Many improvements are a direct result of the Labour Government's commitment to equality of opportunity and social justice. Unemployment now stands at just 2.2 per cent. Colin has been instrumental in the regeneration effort, which has improved the quality of life for many people.
 
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Colin played an important role not just in the constituency but in the House, where he served as a Parliamentary Private Secretary at both the Home Office and the Foreign Office for the Secretary of State for Foreign and Commonwealth Affairs, my right hon. Friend the Member for Blackburn (Mr. Straw). In his retirement from the House, I wish Colin and his family good health, and I hope that he enjoys having time to pursue his interest in fell walking and poetry—it is well deserved.

On health, I have many years' experience of working in the national health service, culminating in being the chair of Liverpool women's hospital—a three-star hospital, although we believe that it has five: three awarded annually by the Department of Health, another for being one of only three hospitals in the country with CNST—clinical negligence scheme for trusts—level 2 for general and maternity services, and the fifth for the foundation status awarded last April. And for the record, it has the lowest rate of MRSA for a special hospital in the country.

Health service provision is a major issue in West Lancashire. The people of Skelmersdale, for example, were promised a new hospital more than 40 years ago, but it was never delivered. However, thanks to a Labour Government investing in the health service, the area now has a magnificent walk-in centre. I can personally vouch for the excellent quality of the service, after receiving a dog bite—the scars of campaigning.

West Lancashire wants the best and safest health service that it can possibly get, and as its MP, I will take a lead in working to realise those aspirations. To put that another way, delivery must be at the heart of the Government's every thought, decision and action. We must not let this once-in-a-generation opportunity to embed modern progressive values into our health service pass us by. The cornerstones of that new settlement are being put in place—foundation hospitals, payment by results and wider public involvement. I commend the Government on introducing such potentially radical reforms. We are witnessing a fundamental shift in the culture of the NHS.

Frustration is evident among my constituents: for many years, they have felt marginalised and powerless to get their voices heard in the health service. Many of the reforms now offered give them some redress and will enable them to effect change and influence priorities. Foundation hospitals return the health services to the hearts of the communities that they serve. With greater local freedom, local choice and local accountability, hospitals are better able to meet local needs. The people who live the day-to-day experiences of the health service, either as staff or users, will now have the ability to shape the future of the health service in their locality.

We are saying boldly that we must trust the people to make decisions in the best interests of the entire community and for individuals. We must back the judgment of health professionals to use the investment in health to deliver a more effective and responsive health service. Nowhere is that better captured than in the membership councils of foundation hospitals. The values of local control, local accountability, empowerment and choice are enshrined by bringing together health professionals, local people and lay members as the strategic decision-making body for foundation hospitals.
 
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Payment by results, which represents the most far-reaching reform in the NHS in recent memory, ensures a direct relationship between what hospitals deliver and funding. However, for all my support of those reforms, I must raise a note of caution: we must implement the reforms with care and attention to detail. We must not leave people behind in our eagerness to reform. There is a responsibility to encourage people to engage with the new governance arrangements.

What I am talking about is education. The underlying threat is that information inequality can serve to entrench health inequality. As a daughter of deaf parents, I fully understand the need for inclusivity and for information that enables people to make the right choices for themselves. At the same time vigilance is needed because certain aberrations and anomalies remain inherent in the payment-by-results system.

I thank previous Health Ministers for helping me to resolve issues that I encountered during my time at Liverpool women's hospital. I hope to be a voice from the front line on the Back Benches and to bring my experience to bear constructively. A successful national health service for the 21st century depends on getting the reforms right because we will otherwise have wasted a once-in-a-lifetime, or generational, opportunity.

Foundation trusts offer the opportunity for partnership between the professionalism and expertise of health care providers and the knowledge, first-hand experience and enthusiasm of our communities. That partnership can provide creative solutions to problems that we face and ensure that we have clinical excellence and a 21st-century, patient-centred health service, which is what we all need.

5.45 pm

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