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The Parliamentary Under-Secretary of State for Health (Mr. Liam Byrne): Our debate this evening has been very good if, in places, a little less consensual than the debate earlier this afternoon.

In some ways, this debate underlines how far the health service has moved under this Government. When we were elected in 1997, the public's priority, and therefore ours, was to lift the NHS off its knees and rebuild the services that had been ground down over
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18 years under the Conservative party. We had to end the inequity of GP fundholding, under which some patients could jump to the top of the queue without rhyme or reason. In particular, we had to rescue our hospitals because, of course, some one in 10 people were languishing, waiting for an operation for two years or more.

The situation today is somewhat different: 100,000 extra staff, the biggest hospital-building programme ever and, as a result, the shortest waiting lists since records began. Indeed, on 31 December 2005, just 12 patients had been waiting over six months for care. The result, of course, is that people are now living longer. The death rate from circulatory heart disease is down 31 per cent., and the death rate from cancer is down 12 per cent. That benefit is especially felt by older people; life expectancy in the over-65s is rising and the level of vaccinations among those over 65 is at an all-time high. Delayed discharges are down by two thirds, and 1.7 million bed days have been saved through the changes that this Government have introduced.

Now, having stabilised the NHS, the question facing us is how we move forward. Not only have we introduced new choices of hospitals, but last week we laid before the House our White Paper, which is important because it signals a new direction of travel for the NHS, with greater personal care, greater access to primary care services, a shift of resources into prevention, which I think Conservative Front-Bench Members decided to welcome, and a far better relationship between the NHS and local government.

If the NHS can deliver on that agenda, there is a great prize here to be won—great inroads into health inequalities. Over the past seven years we have made great strides in creating far more opportunity in this country, so surely our challenge now, after the longest record of economic growth and after putting more people into work than ever before, is to make sure that everybody, in every community, has the health and well-being to seize those new chances. That is exactly why we have to update PCTs and ambulance trusts, not because of the damaged legacy that we inherited in 1997, but for the opportunities of 2006.

Mr. Lansley: Will the hon. Gentleman give way?

Mr. Byrne: I know that the Conservative party is firmly fixed in listening mode at the moment, so if the hon. Gentleman will forgive me, I plan for him to listen just a little longer.

My hon. Friend the Member for Leicester, East (Keith Vaz) asked why we have to change—why we have to adapt. Governments have been talking about the need for a shift in the balance of primary care since the 1920s. In 1976, Baroness Castle set out in "Priorities for Health and Social Services" her ambition to move care into the community. The truth is that over the next four years and the subsequent 18 years of Conservative Administrations, we did not achieve that shift in the balance of care. This time, we have to make sure that the shift takes place. I am happy to give my hon. Friend an assurance that the new fair funding that we have introduced will stay in the places to which it has been awarded.
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We have to make sure that, where appropriate, PCTs are coterminous with local authorities. We have to make sure that they are strong enough to hold GPs to account. We have to make sure that they can connect effectively with local communities because that is the only way that they will deliver on the ambitions that we set out in the White Paper.

Julia Goldsworthy: Will the Minister give way?

Mr. Byrne: I shall address the hon. Lady's remarks directly in a moment, if she will have a little patience.

My hon. Friend the Member for Waveney (Mr. Blizzard) put a powerful case for one of the two options in his local consultation, saying that it was the healthy option, the people's PCT. I am sure that what he said was heard clearly by those local health professionals managing the consultation. I am happy to give him an assurance that there is no template.

My hon. Friend's near neighbour, the right hon. Member for Suffolk, Coastal (Mr. Gummer), did himself no favours by quoting answers to named day questions. Frankly, it was shameful of him not to recognise the advances that have been made in his local NHS. It is not worse than 30 years ago, and it is an insult to the performance of NHS staff in his area to pretend that waiting lists and death rates have not come down thanks to the new funding that we have put in, which I might add he voted against—I think—not on one occasion but on four occasions over the past three years.

The hon. Member for West Suffolk (Mr. Spring) added that he was frustrated with the way that funding was not geared to areas of need, but that is exactly what the new funding formula has done. He knows full well that £73 million extra is going to his PCT over the next few years. He has the opportunity over the next few years to distinguish himself by having a conversation with the right hon. Member for Charnwood (Mr.   Dorrell), who is chairing the policy review on health.

Mr. Spring rose—

Mr. Byrne: The hon. Gentleman has the opportunity to say that his party's fiscal rule that the proceeds of economic growth should be shared between public service investment and tax cuts should not apply to the health service, and he should ensure that the right hon. Gentleman comes out with a clear commitment to match our levels of investment.

Mr. Spring rose—

Hon. Members: Give way.

Mr. Byrne: Turning to—[Interruption.]

Mr. Speaker: Order. I must be allowed to hear the Minister. I have to hear what he is going to say.

Mr. Byrne: Turning to the west midlands, the hon. Member for Lichfield (Michael Fabricant) made a powerful and persuasive case in which he underlined and celebrated the achievements of Staffordshire ambulance service. It is indeed an ambulance service
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from which many in the country could learn. He was, perhaps, over-hasty in writing off the performance of the rest of the west midlands, but there is a clear message that we should take from his remarks, and it was underlined by my hon. Friends the Members for Newcastle-under-Lyme (Paul Farrelly) and for Stoke-on-Trent, South (Mr. Flello): there must be localisation of control. Surely the question in this consultation, though, is how we export that excellence, not just to other parts of the west midlands but to other parts of the country, and how we ensure that Staffordshire gets better in future. Surely it has not reached its full potential.

My hon. Friend the Member for Carlisle (Mr. Martlew) was dissatisfied with current arrangements and welcomed a change. I know that his input into consultation arrangements will be well informed by his previous experience.

The hon. Member for Wyre Forest (Dr. Taylor) had a great deal to say about consultation. I was heavily involved in consultation on the White Paper. I would recommend it to Members in all parts of the House. There could well be more listening to be done on health policy.

I listened very hard to the hon. Member for Falmouth and Camborne (Julia Goldsworthy). I was trying to detect any hint of what Liberal Democrat health policy might be. I know that the right hon. Member for Ross, Skye and Lochaber (Mr. Kennedy) instigated a sweeping policy review not long ago, saying that he would approach it with a blank sheet. That blank sheet, it seems, is his legacy, and from tonight's debate we can deduce that it will withstand the test of time. I can think, therefore, of no better quote than that of the former vice-chair and chair of the Hodge Hill Liberal Democrat party, who led a mass defection to Labour on Saturday night. He said that there is a lack of leadership not just in Westminster but in local communities. I think that I can see what he meant.

Julia Goldsworthy: Will the hon. Gentleman give way?

Mr. Byrne: No, I must address the remarks made by Conservative Members.

We did not hear too much—

Julia Goldsworthy: Will the hon. Gentleman give way?

Mr. Byrne: No, I will not give way, because I have a bit more to finish.

We did not hear too much about the Conservative alternative. It remains a bit of a mystery, wrapped in an enigma, wrapped in a taskforce, although the alternative for health benefits from quite sensible leadership. We were not expecting an apology for voting against the National Insurance Contributions Act 2002 or against the Finance Acts of 2002, 2003 or 2004, but I thought that we might have heard a little clarification about the new fiscal rule of the right hon. Member for Witney (Mr. Cameron). Are the fruits of growth to be shared with tax cuts, or—

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