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The Minister of State, Department of Health (Jane Kennedy): I beg to move, To leave out from "House" to the end of the Question, and to add instead thereof:

I think that this is the first occasion on which I have crossed swords with the hon. Member for Eddisbury (Mr. O'Brien). I well remember the by-election in July 1999, when the hon. Gentleman only just held off a challenge from Labour. That near-success was almost entirely due to the excellent campaign, whose slogan was "Vote Labour or the fox gets it". None the less, it is a pleasure to see the hon. Gentleman at the Dispatch Box. He has consolidated his position in Eddisbury, on which I congratulate him. I wish him a long career as an Opposition spokesman.

The NHS is being restored to good health. It has more doctors, more nurses and better facilities. The revolution in quantity of care must, however, be matched by a revolution in quality of care, with equal access for all and no charges for operations. That means new types of health provision, more say for patients in how, where and when they are treated, and tackling ill health at source.

Mr. Graham Stuart: Will the Minister give way?

Jane Kennedy: I should like a moment to get into my speech, I will give way later, but I am very conscious of
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the 10-minute limit on Back-Bench speeches and—like the hon. Member for Eddisbury—I want to keep my remarks to a minimum if I can.

The phrases that I just used are the promises that we made in our manifesto. That is what these structural changes are set to achieve. I hoped that the hon. Member for Eddisbury would pay a bit more attention to the manifesto on which he stood at the last election. That manifesto pledged to implement the James report, which had a clear attitude to what should happen to PCTs. Only nine months ago, the Conservatives said that they would radically reduce the intrusive bureaucracy that the PCTs had become, removing 30,000 administrative staff and saving £636.6 million a year. We did not hear whether that was still the hon. Gentleman's policy. The thrust of his argument consisted of an objection to the reorganisation that we are proposing.

Mr. Nicholas Soames (Mid-Sussex) (Con): The Minister and I will agree that in the past five years the NHS budget has indeed increased substantially, while productivity has unfortunately failed to increase at the same rate. Does the hon. Lady agree that the NHS has one of the most committed work forces in the country, and that its biggest failure is the failure to engage properly with its professional staff—the doctors and nurses who are capable of delivering all the service changes that she proposes? Does she agree that much more needs to be done in that regard?

Jane Kennedy: It is a pleasure to see the hon. Gentleman restored to us in good health. When he is not here, the House is the poorer for it. His point is fair. When consultations are taking place, it is important for those who have strong views, particularly those who are most closely affected—patients and the staff who deliver services—to be listened to, and to be involved in the consultations.

Mr. Redwood : Will the Minister give way?

Jane Kennedy: I want to finish my comments about the motion.

In our manifesto, we said that by removing £250 million from the management costs of PCTs and SHAs we could redirect the resource to front-line NHS services. Within nine months, we are fulfilling our promise and the Conservatives are breaking the promises made in their manifesto. We have heard no word from them about what they would do about PCT administration. We may have turnaround teams assisting the NHS organisations that are struggling with deficits, but the Tories have a turnaround leader who changes their policy every five minutes.

Mr. Redwood: Can the Minister tell us how much the Department has spent in the past year on management consultants? Does she agree that we are suffering from a surplus of management consultants and a shortage of medical consultants?

Jane Kennedy: A tiny proportion of the amount that we spend on administration in the NHS is spent on consultants. I do not have the exact figure to hand. I will
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look into the detail, but I am confident that we use consultants to very good effect. That is demonstrated by the way in which services are improving.

Mr. Jim Cunningham (Coventry, South) (Lab) rose—

David Taylor (North-West Leicestershire) (Lab/Co-op) rose—

Jane Kennedy: I am spoilt for choice. May I make one more point on the James review, and then I will give way?

The James review recommended the abolition of strategic health authorities. In the motion we see that writ large, but we have heard nothing from the hon. Member for Eddisbury about who will oversee the expenditure of taxpayers' money in the regions, and who will maintain strategic oversight of service development across a wider geographic area. As my hon. Friend the Member for Wolverhampton, South-West (Rob Marris) said, it is a question not of reorganisation per se, but of what kind of reorganisation we take forward.

David Taylor: The House would agree that there is probably no magic number in relation to the size of population that is appropriate for a primary care trust, but if 150 primary care trusts covering the 50 million population of Great Britain—just over 300,000 people per PCT—seems appropriate, why are we getting rid of a successful one, Charnwood and North West Leicestershire, which serves a population of about 250,000, which is about the right size, which is big enough to deliver services, and which is effective and small enough to be accountable to the three MPs that represent its area? Why is that being absorbed into a 650,000 mega-doughnut outside the city of Leicester?

Jane Kennedy: My hon. Friend makes a strong point about the concerns in his area. I will come on to those questions in a moment, if he will allow me.

Mr. Jim Cunningham: Surely the answer to the Tory criticisms is that we do not hear so much now about people on trolleys who cannot get beds in hospitals. Had there been the deficits under the Tories that they are attacking tonight, we would have had hospital closures. Instead, under this Government we have new hospitals.

Jane Kennedy: I am grateful to my hon. Friend for his comments. His analysis is right.

Several hon. Members rose—

Jane Kennedy: I will make some progress, if I may.

I know that the reconfiguration of strategic health authorities, primary care trusts and ambulance trusts has aroused a great deal of interest. The Health Committee recently published a report that provides a helpful contribution to the debate. We will respond in due course to that report, but I am glad of the opportunity today to explain the position and what the
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Government are doing to change the structure of those organisations for the benefit of patients and to improve value for money.

Several hon. Members rose—

Jane Kennedy: May I make a little progress and then I will be happy to give way to the hon. Member for Bournemouth, West (Sir John Butterfill).

Investment in the NHS is rising rapidly—it has risen from £33 billion in 1997–98 to more than £90 billion in 2007–08—but that increase will bring us to the European average of GDP spent on health services, which shows how far behind the UK fell under the tender care of the Conservative party.

Sir John Butterfill (Bournemouth, West) (Con) rose—

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