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The Parliamentary Under-Secretary of State for Health (Mr. Liam Byrne): I congratulate the hon. Member for Wyre Forest (Dr. Taylor) on securing this debate and on contributing to health debates in this House over the years. I listened very carefully to what he had to say, because I suspect that after a lifetime's service to the medical profession, he knows a few things about the practice of medicine that I, being so new to this post, do not. Nevertheless, let me try to respond to the issues that he raised, and in so doing to set out why I believe that the Government have the right approach to modernising one of our most important—if not the most important—national institutions. I hope to be able to provide some comfort in respect of some of the points that he raised.
The NHS is a cherished and much respected institution and we all want to see it succeed in future. Over the last few years—and in the manifesto that we presented to the electorate in May—we have put in place the reforms to ensure the future success of the NHS, so that it becomes a service fit for the 21st century that we can be proud of. We believe that that service must remain true to two founding principles: care provided on the basis of need, not wealth; and each person having the same rights as everyone else.
Five years into our programme of reform—the NHS plan—we have already achieved a great deal. How do we know? We need look no further than three areas of delivery: staffing, waiting times and health outcomes. The hon. Gentleman mentioned staff, and today more doctors and nurses are working in the NHS than ever.
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There are 21 per cent. more staff overall, 21 per cent. more general practitioners and 44 per cent. more consultants. The hon. Gentleman mentioned the risk of changes alienating them. One development that will be important in making sure that that does not happen is the introduction of "Agenda for Change" and of the new GP and consultant contracts, which show that we are now investing properly in our staff.
Of course, achieving continuity of care will always be a challenge, but we must balance the issues that the hon. Gentleman pointed out against the right of every patient not to have a doctor who is tired. The introduction of the working time directive presents an opportunity to modernise, but we must of course pay heed to the hon. Gentleman's warning—to ensure that we do not just comply, but comply safely.
As a result of the new capacity that we have put in place, backed by the biggest hospital building programme in history, we have slashed waiting times. In-patient waits have fallen to nine months and will be down to six months by the end of this year. Already, nobody waits more than three months for coronary bypass grafts and cataract surgery. More than 19 out of 20 accident and emergency patients are now seen within four hours; the majority are out in less than two hours. On top of this, new services are transforming access, giving patients faster and more convenient access to treatment. Some 6 million people have already attended NHS walk-in centres, and 15 million patients a year are contacting NHS Direct. Our goal, however, is to go further even than this by 2008. Our target is that no one waits longer than 18 weeks from GP referral for their hospital treatment.
All this—increased staff and better waiting times—is good news when we judge our record against what is probably the stiffest test of all, to which the hon. Gentleman alluded: what is happening to health outcomes. Here, too, there is good news. Premature deaths from cancer, coronary heart disease and suicide continue to fall. In fact, the number of premature deaths from lung cancer among British men is falling faster than in any other country. All this has been possible because we have backed our belief in the national health service with the reality of sustained, record real-terms investment. I thank the hon. Gentleman for pointing out what a difference that has made not just to the country, but to his own community in Wyre Forest and Kidderminster. From 2003–04 to 2007–08, we are increasing expenditure by 7.3 per cent., on average, over and above the rate of inflation. That compares with a figure of just 3 per cent. under the previous Administration.
Through this new investment, we have built the capacity to reduce waiting times, we have brought in more staff and we are giving patients faster access to high-quality care. As the hon. Gentleman adroitly pointed out, the challenge now changes, because with the new investment we have started to transform the NHS so that it becomes a truly patient-led health service. We want an NHS that treats every patient in the way they want to be treated and in the way that we ourselves and our own families would want to be treated.
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The hon. Gentleman made reference to the need to listen, and I could not agree more. We will simply not deliver a patient-centred NHS unless we take seriously the business of listening to patients, their carers and NHS staff. There is no better illustration of our commitment not just to listen but to respond than our reforms to ensure that choice is a reality for everyone in this country. People told us that they wanted more choice and control over their health care and services, and the hon. Gentleman agrees. They did so overwhelmingly. In 2003, something like three quarters of the sample said that they wanted to be more involved in decisions about their condition and treatment—and this was not a theoretical survey. In the coronary heart disease choice scheme piloted in London, about 86 per cent. of patients said that they would recommend it to other patients. What is more, early evidence from those pilots shows strong support for choice from patients of all social groups.
If choice is so important for patients, I believe that we are duty bound to respond. That is why increasing patient choice is at the heart of our programme of reform and why we are committed to giving people more choice across the entire pathway of their care—choice in the hospital they go to, choice in how they access medicines and primary care, choice in maternity services and, yes, choice over end-of-life care. That future is already becoming a reality. From the end of this year, patients referred to hospital will be able to choose from at least four providers, and by 2008 they will be free to choose any provider that meets NHS standards at NHS cost.
As the hon. Gentleman acknowledged, two important innovations support the new future. The first is the development of the choose and book service to help patients and GPs look at the choices available to them. It is a powerful way of giving patients an informed choice and of enabling both patients and GPs to manage their appointments themselves. I can reassure the hon. Gentleman by reminding him that thousands of clinical and other staff were involved in developing the pilots. Early evidence among the 53 sets of GPs involved has been positive. That is why the Government are confident that choose and book will work. The hon. Gentleman's expertise is welcome and I shall ensure that his advice is factored in.
The second important innovation is the revolution in the provision of information made available to people as they take health decisions. To support that ambition, we are taking forward a three-year national strategy to bring information into the 21st century. By giving people the right information at the right time with the support that they need to use it, we will go a great deal of the distance towards creating a true partnership between the patient and the health care professional.
That said, the biggest difference to many people served by the NHS, particularly to those with long-term conditions, will come from the mainstreaming of the expert patients programme—a generic, lay-led self-management programme for people living with long-term conditions. I was pleased to see that we committed ourselves in our manifesto to trebling the investment in the EPP. The EPP shows how we are listening to patients and responding to their desire to take more control, and that theme of listening will characterise our work over the next Parliament. Later this year, we will
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be rolling out a national programme of consultation with patients, staff and the general public about the future of hospital care in this country. I hope that the hon. Gentleman will make a contribution to that, as he has a great deal to offer. The message is that we want patients and staff working together to shape the future of our health service.
Clearly, we have made a good start in transforming the NHS, but we know that we still have a long way to go. We are only five years into our 10-year programme of reform and we will not let the pace of reform slacken. The hon. Gentleman mentioned independent procurement, but that involves only about 1.5 per cent. of the total number of procedures carried out in the NHS, rising to about 3 per cent. in a couple of years' time. I agree with much of what he said: we must get our procurement and treatment model right if we are to make progress.
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Madam Deputy Speaker, we will not achieve a future national health service of which we can be proud without the hard work and dedication of NHS staff. We know that our staff—doctors, nurses, physios, scientists, paramedics, porters, receptionists—are the foundation of the NHS and we know how committed they are to giving their patients high-quality care. I know that many of these changes that we have mentioned this evening are already making a difference to health care in and around Kidderminster and Wyre Forest. Only by working with patients and with our staff, in partnership and backed by new investment, will we deliver our vision of an NHS that really meets the needs of our modern society—a truly world-class NHS, of which yet another generation will be truly proud.
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