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Ms Hewitt: Is some cases, an intermediate care bed in a community hospital is a good way of bringing someone out of an acute hospital, but in other cases it is better to bring them straight home with the full support of the patient support team.

Mr. Ian Austin : On the matter of patient care, will my right hon. Friend confirm whether it is indeed the case, as my research has shown, that the number of MRI scans has increased under this Government from 473,000 in 1997–98 to 858,000 in 2003–04, and that the number of heart operations has increased from 39,000 to 65,000—[Interruption.] The more Conservative Members go on, the more statistics I can read out about—[Interruption.]

Dr. Julian Lewis : On a point of order, Madam Deputy Speaker. I realise that the Government are suffering from the fact that they are labouring on Benches that are heaving with all of about half a dozen of their own Back Benchers, but is it in order for a Government Back Bencher to intervene or ask a question on the basis of reading a script that was overtly handed to him by one of his own—[Interruption.]
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Madam Deputy Speaker: Order. The House must come to order if I am to deal with a point of order—although it is not, in fact, a point of order for the Chair.

Ms Hewitt: As my hon. Friend the Member for Normanton (Ed Balls) pointed out earlier in the debate, the Conservative party has just fought an election campaign on the basis of a patient's passport policy that would take between £1 billion and £2 billion out of the NHS to subsidise private health care for the few. That would not solve the deficits where they exist in the minority of trusts—it would add to them and devastate the care that the NHS is able to offer right across our country. That, of course, is absolutely in line with the Conservative policy of looking after the few and not the many. The investment that we are making—[Interruption.]

Several hon. Members rose—

Ms Hewitt: No, I will not give way.

The investment that we are making in our national health service will continue—and so will the reforms and improvements. As we give patients more choice and a stronger voice, as we have more diverse providers but more freedom to innovate—as I saw at the Gateway centre this morning—and as we ensure that money follows patients with payment by results, we will give every hospital and every provider a real incentive to look at how they are working, to compare themselves with the best, to change their ways of operating, to move services from acute hospitals to community settings and to focus on prevention rather than simply cure. In other words, we will deliver the best possible health care with the best possible value for money.

Mr. Henry Bellingham (North-West Norfolk) (Con): Will the Secretary of State give way—please?

Ms Hewitt: No.

We will invest more money than ever before in the NHS. Our constituents can see the improvements. Most NHS organisations are not only delivering improved, better and faster care, but living within their means. That is what we expect from every part of the national health service. I am proud—and every hon. Member on this side of the House can be proud—of the additional investment that we are making.

Several hon. Members rose—

Madam Deputy Speaker: Order. It is for the Secretary of State to decide when or whether she gives way.

Ms Hewitt: Madam Deputy Speaker, I am proud and we are proud of the more than 78,000 extra nurses and 27,000 extra doctors employed by the NHS, and the 500,000 more operations being carried out every year. With more patients treated and more lives saved than ever before, we will continue on our path of investment and reform. That stands in striking contrast to the policy of the Conservatives, so I commend our amendment and our programme to the House.
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4.59 pm

Sandra Gidley (Romsey) (LD): I am pleased to debate this subject today, and I am delighted that the Conservatives have made it clear that they are committed to the provision of

There has been some doubt about that in the past—a doubt that was echoed by Labour Members when they queried the Conservatives' reluctance to commit to funding the health service, and their voting against the £8 billion funding increase associated with the increase in national insurance levels. However, the most important task for us today is to examine Labour's record after eight years in government, and to consider why, despite record levels of investment, many local health services are lurching from crisis to crisis, like a drunk on a Saturday night who grabs at anything in an attempt to stay upright.

I shall return to the question of the deficit shortly, but at this point I want to be fair and to acknowledge that some things have got better. When I was first elected in 2000, my postbag was full of letters from constituents who had been waiting years for hip replacements or hearing aids, or waiting months for heart operations classified as urgent. Such problems have been sorted out to an extent, but others are emerging in our local health services. I suspect that my experience is similar to that of many Members, in that today's issues for my constituents are the rationing of certain treatments and medicines, fear of MRSA, and the reorganisation of local health services. In an unprecedented development, NHS staff are writing letters to whistleblow on changes that they are particularly unhappy with. Such changes often mean a relocation of health services or a loss of hospital beds.

Mr. Mark Francois (Rayleigh) (Con): Is the hon. Lady aware that in the run-up to the general election, the Government were pushing very heavily a brand new diagnostic and treatment centre at Fossett's Farm, in Southend, to relieve pressure on Southend hospital, but once the election was safely out of the way, they promptly cancelled it? Does she think that a shocking and awful thing to do? The people of Essex certainly do.

Sandra Gidley: I can understand why local people think that dishonest, and presumably there are other such examples from elsewhere, but I am not aware of any specific ones.

Mr. David Burrowes (Enfield, Southgate) (Con): Will the hon. Lady give way?

Sandra Gidley: I was struck by the number of Members who tried to intervene earlier to discuss the problems in their health economy, but I will not give way just yet as I want to develop my argument.

The one question that is common to nearly all the letters that I receive from constituents, no matter what issue they are raising, is: where has all the money gone?
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The NHS Confederation recently produced a briefing—not for this debate, I hasten to add—to try to answer that very question. Its summary states:

Some 20 per cent. of the new investment was spent on employing additional staff, and 30 per cent. was spent on additional pay for existing staff. The confederation's view is that that has led to people being treated quicker and more effectively, but the opposite view has been espoused from some quarters that although this money is welcome, the staff pool merely expands to meet the available budget. One problem has been a failure to ensure that the right services receive the right money.

Another major area of NHS spending is the drugs budget. In 2004–05, 686 million items were dispensed in England—an increase of 5.6 per cent. on the previous year. The drugs bill has risen by 46 per cent. since 2000 and now stands at some £8 billion. I do not share the view, espoused today in The Daily Telegraph, that that is a scandalous waste of money. Better prescribing has in many cases led to better outcomes. The prescribing of statins, for example, the current annual cost of which is £70 million, has the benefit of saving an estimated 9,000 lives a year. I am sure that those people are very grateful for that investment. Another claim on NHS resources has not been mentioned. The cost of inflation-proofing pensions has been transferred from the Treasury to the Department of Health—a classic case of the Treasury giving with one hand and taking away with the other.

It is also worth mentioning the NHS IT project, a huge investment amounting to more than £6.2 billion over 10 years. Unfortunately, the process seems to be dragging on somewhat, so far with little apparent benefit for patients. For example, the choose and book system for hospital appointments was due this December, but will be at least a year late. Predictably, Richard Granger, the man in charge of the scheme, has said that that is not his fault and claims that responsibility for the late delivery lies with the policy people at the Department of Health. If the Secretary of State is able to elaborate on the problems at the Department, I am sure that we would all be very interested.

To date, only 20,000 appointments have been booked. To put that in proportion, I can tell the House that about 9.5 million appointments are made every year, and that the target was to have 250,000 trial appointments booked by last December.

The NHS faces other significant cost pressures, such as those incurred by clinical negligence cases and the implementation of NICE guidance. However, the NHS Confederation is most interesting when it comes to the subject of why the service needed the extra money in the first place. It notes that Wanless analysed the state of the deficit under the previous Government, especially as a result of the tight financial settlements of the 1980s and 1990s, and then states that that cumulative deficit

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I stress that the confederation is talking there not about the present situation, but about one that pertained some years ago. It also said:

That led to cuts in cleaning and catering budgets, and the confederation added that

It reported that that affected the health service's approach to the prescribing of new drugs, as well as to matters such as buildings maintenance, staff shortages, staff training and new equipment.

At one stage, there was a freeze on the appointment of new consultants. In that, we might have come full circle, as the BMA has received reports from various quarters of a proposed freeze on consultant recruitment, and says that there is a threat of redundancies among consultants. The Royal College of Nursing has tracked the accelerating effects of the deficits since January, and only last week expressed concerns about the possibility of widespread nursing redundancies. Beverly Malone, RCN general secretary, said:

I do not think that any hon. Member would say that the contribution made by nurses was of little value, but it is a matter for concern that the RCN should feel it necessary to put that on the public record.

That is the background, but I want to return to the situation that exists today. Overall, the NHS has just about squeezed in on budget, but about one trust in six is in deficit. The problem is getting worse, and the National Audit Office has said that 12 SHAs ended the financial year 2004–05 in deficit, compared with seven the previous year.

Earlier, the Secretary of State said that financial managers responsible for a lack of prudence had been moved out of the way. I pay tribute to the new chief executive of the Hampshire and Isle of Wight health authority, Sir Ian Carruthers. He has a very good strategic overview, wants to keep services, and seems to be the only person who understands how all the trusts meld together. However, it is somewhat disappointing that his failed predecessor should have been given a plum job in Whitehall. It might be an interesting exercise to see what happens to failed SHA chief executives, and find out whether all of them have been given similarly cushy numbers.

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