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Ms Hewitt: Perhaps the hon. Gentleman will let me have details of that.

By Christmas, we will have a maximum waiting time of six months for an operation—six months, compared with over 12 months, in many cases over 18 months and in some case 24 months under the Government whom the hon. Gentleman supported.

The Gateway centre is giving its patients what we want for all patients: the best possible health and the best possible health care, with the best value for money. It is particularly relevant to the debate that both the hospital trust and the primary care trust are achieving financial balance.

Mr. Ian Austin: Given the Opposition spokesman's pathetic refusal to reply to the questions that he was asked earlier, can my right hon. Friend give her estimate of the effects of cutting NHS expenditure by £2 billion,
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which was the pledge in the patient's passport, and of the effects on the NHS of cutting the national insurance increase, which the Opposition parties voted against? Can she explain what effect that would have on NHS finances and services?

Ms Hewitt: My hon. Friend makes an important point. [Interruption.] One estimate of the impact of taking out the £1 billion to £2 billion that the Opposition promised—or should I say threatened—at the general election to invest in their patient's passport would be a reduction by 9,000 consultants in the staff of the NHS, a massive reduction in care for NHS patients and a devastation of the NHS right across the country. [Interruption.]

Mr. Speaker: Order. The Chamber is getting very noisy indeed. The Secretary of State has come in good faith to speak to the House. We need some courtesy in the House.

Mr. Nigel Waterson (Eastbourne) (Con): The right hon. Lady has been generous in giving way. Now that she has visited Newham, will she come 60 miles south to Eastbourne, where she will find a hospital trust in crisis, with the worst bed blocking in the entire NHS, people being turned away from out-patients and the trust being required to make £17 million of cuts in the current year?

Ms Hewitt: In a moment, I shall discuss what is being done to deal with deficits, too many of which have built up over several years in health communities that have spent beyond their means, even though those means are significantly bigger than ever before.

Several hon. Members rose—

Ms Hewitt: I will not give way, because I intend to make progress.

I want to be fair to the Opposition, who have recognised in their motion that there has been "unprecedented" investment in the NHS in the past eight years. Eight years ago, we inherited a wholly inadequate NHS budget of just £34 billion, which we doubled to nearly £70 billion in 2004–05. By the end of 2008, the NHS budget will be more than £92 billion, nearly treble what it was when we entered office, which reflects the strength of the economy under the prudent economic policies delivered by my right hon. Friend the Chancellor. Conservative Members may claim that they support that extra investment, but they voted against the means to pay for it.

Ed Balls: In my constituency, we have more than 1,000 extra doctors and nurses as a result of extra investment since 1997. [Interruption.]

Mr. Speaker: Order. I cannot hear the hon. Gentleman, and I want to hear what he has got to say.

Ed Balls: I am grateful for your support, Mr. Speaker. Will the Secretary of State reassure my constituents that this Government will never introduce a patient's
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passport? Does she think that there is any prospect of a cross-party agreement to rule out such a proposal at future elections?

Ms Hewitt: My hon. Friend makes an interesting proposal. I can happily give him the reassurance that he seeks: we will never take money out of the NHS budget to subsidise private health care for the few, which is what the patient's passport involved. I am sure that Conservative Members will want to consider his proposal for a cross-party agreement before the next election.

I look forward to Conservative Members answering this question, which the hon. Member for South Cambridgeshire has refused to answer: what is Conservative party policy on the patient's passport?

Mark Pritchard (The Wrekin) (Con) rose—

Ms Hewitt: Perhaps the hon. Gentleman will tell us.

Mark Pritchard: The Secretary of State has said that record investment has gone into the NHS, but my constituents are asking why the Shrewsbury and Telford Hospital NHS Trust has a £14 million deficit and why they face huge cuts to local hospital services despite paying record national insurance contributions. I was going to raise a point of order, but I will not. [Laughter.]

Ms Hewitt: The hon. Gentleman showed great discretion at that point in his intervention.

In a moment, I will discuss the underlying causes of the deficits in a relatively small minority of NHS organisations. [Interruption.]

Mr. Speaker: Order. I appeal again to the House for calm. We must allow the speech to develop, but it is far too noisy.

Ms Hewitt: Thank you, Mr. Speaker.

As we consider the challenges ahead, it is worth remembering—we remember this, and so do our constituents—the size of the task that we faced eight years ago, when, as Derek Wanless found in his recent report, the cumulative underfunding of the NHS amounted to a staggering £267 billion by 1998. That was the scale of the challenge that we faced eight years ago and, as we look back over those eight years, we can see how much better services are within the NHS. But there is still even more to do. The challenges that lie ahead include dealing with the financial deficits that exist in about a quarter of NHS organisations.

At the end of the financial year 2004–05, the NHS as a whole had a deficit of around £250 million. That is less than half of 1 per cent. of total NHS resources. I would prefer—the whole House would prefer—to have no deficit at all, and in a moment I will explain how we are going to get rid of it. However, let me remind hon. Members of a fact that the hon. Member for South Cambridgeshire unaccountably failed to mention: in 1996–97, when the NHS annual budget was only £33 billion, the overall deficit was £460 million, which is almost 1.5 per cent. of a total budget that was, of course, far smaller.
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Kali Mountford : My right hon. Friend mentioned value for money. In that context, I offer her my personal thanks for a very helpful intervention in advising primary care trusts about the prescription of Herceptin. My constituent, Karen Gibson, starts her treatment today. Such new drugs are expensive in the early years of their administration and set us a challenge in achieving value for money in terms of the investment that has to go into an individual's health care. Should we not consider health expenditure in the round, with the outcome that patients get better?

Ms Hewitt: My hon. Friend is absolutely right. The measure of all this is in getting the best possible health for patients with the best possible value for money. Thanks to the wonders of medical science, many new drugs and therapies such as Herceptin are becoming available. Some of those are very expensive, and we must ensure through our reforms that we get the best possible value for money for every pound of taxpayers' money that we invest in the NHS.

Several hon. Members rose—

Ms Hewitt: I had better give way to the hon. Member for South Cambridgeshire, as he may wish to answer the question that he was posed earlier.

Mr. Lansley: In the expectation that the right hon. Lady would talk about the NHS deficit, I asked the National Audit Office for the figures on the cumulative deficit year by year. In 1997–98—the first year of the incoming Labour Government—the cumulative deficit was £26 million; in 2003–04, the last year for which figures are available, it was £276 million; and this year it is likely to be more than £520 million. Under this Government, the cumulative deficit has risen from £26 million to more than £500 million.

Ms Hewitt: I suspect that the hon. Gentleman is muddling up the NHS deficit with the overall picture including the Department of Health. The figures that I have are very clear. In 1996–97—in other words, the last year of the hon. Gentleman's Administration—the overall NHS deficit was £460 million.

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