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Hugh Bayley (City of York) (Lab): Will the hon. Gentleman give way?

Mr. Stuart: I will give way to the hon. Gentleman, who I hope will address this point. Labour Members suggested that there were real-terms cuts in health budgets under the Conservatives. That is completely untrue. Perhaps the hon. Gentleman will answer the key question of whether, according to the standard measurement of productivity in the NHS, productivity has been falling under this Government. Would not that explain the waste of all this money?

Hugh Bayley: Would the hon. Gentleman care to share with the House his party's plans for increasing productivity in the national health service?

Mr. Stuart: I would be delighted to do so. My hon. Friend the Member for South Cambridgeshire (Mr.    Lansley) repeatedly explains to Ministers—sometimes he even does it slowly—that the problem is one of centralised control, involving target setting. A further problem is the fact that 70 per cent. of the costs in local health economies are used to pay salaries and wages—

Hugh Bayley rose—

Mr. Deputy Speaker (Sir Michael Lord): Order. The hon. Member for Beverley and Holderness (Mr. Stuart) is answering the question that the hon. Member for City of York (Hugh Bayley) has just asked. It might be a good idea if the hon. Member for City of York waited until he has completed his answer.

Mr. Stuart: I am grateful to you, Mr. Deputy Speaker.

Who controls those salary and wage levels? Who    renegotiated the GP contract? Who was it who, brilliantly, agreed to pay more for less work? Who reorganised the out-of-hours service, so that the service is now denuded across the country? Who renegotiated the consultants' contract? It was this Government. It
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was Ministers. It is about time that Labour Members realised that Ministers are responsible in this House and this country for the running of our health system.

Hugh Bayley rose—

Mr. Lansley rose—

Mr. Stuart: I will not give way to the hon. Member for City of York now, but I will give way to my hon. Friend.

Mr. Lansley: I hesitate to stop my hon. Friend when he is in fine flow, but he might like to know, as might Labour Members, that between 1990–91 and 1997–98, hospital activity increased by 31 per cent. In the seven years after 1997–98, it increased by 19 per cent. If productivity had increased in the years since 1997, there would have been 1.4 million more operations in the national health service last year. [Interruption.]

Mr. Stuart: I am extremely grateful to my hon. Friend. In answer to the question from Labour Members, that is devastating. Apart from giggling and making snide remarks, I ask them to reflect on what has come from this Government's unprecedented spending. During the years when the Conservatives were in power, there were real, above-inflation increases in health spending every year and improvements in productivity. If the health service had continued to improve as it did under the Conservatives, waiting lists would have been removed altogether in this country. [Laughter.] Labour Members might want to laugh and cackle like hyenas, but their Government's target-driven, centrally controlled NHS is heading for absolute crisis and catastrophe. We have only seen the beginning of the job cuts and political unrest that will be unleashed by this Government's failure in health care.

If we examine the issue of productivity a little more, we see that this Government inherited the strongest economy in Europe when they came to power. It was Derek Scott, Tony Blair's former economic adviser, who said—

Mr. Deputy Speaker: Order. The hon. Gentleman must refer to the Prime Minister in the normal way.

Mr. Stuart: I apologise, Mr. Deputy Speaker. Derek Scott, who was the Prime Minister's former adviser, said;

In 1997, with the strongest economy in Europe, there was an unprecedented opportunity to transform health care in this country. Let us face it—the money has gone in. Spending has increased and, perhaps, as some have argued, it took a Labour Government to do that. It is even more true, however, that it will take a Conservative Government to bring back value for money for patients; to put health care, not cost savings, at the top of the priority list; and to ensure that we return to having care close to home, which no longer appears in White Papers.

In 2000, under the NHS plan, those of us involved in fighting for community hospitals were told, "You're saved. It's okay." What has happened? More than 1,500 beds have closed in community hospitals in this country. We then had the astonishingly named
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document, "Keeping the NHS Local". When I first came across it, I found it fascinating. I wondered whether it was a sideline, but I discovered that it was the Government's primary policy paper on health, against which everything should be measured. Members can imagine my shock when, new to this House, I found that my local services were being cut. They can imagine how that was compounded, although I was initially joyous, when the White Paper came out. A new Secretary of State was saying that no community services or facilities must close because of short-term budgetary pressures. She said at the Dispatch Box, where the Minister is currently smiling and laughing, that that should not happen. Across the country, it is happening.

Between 1999 and 2003, spending increased by almost 30 per cent. The number of hospital treatments—Labour Members are quick to intervene but, strangely, they are not doing so now—went up by just 5 per cent. Ministers of this Government are grinning at that failure. Productivity has fallen and, as my hon. Friend the Member for South Cambridgeshire has said, the impact has fallen on the most vulnerable and ill in our society.

Recently, there was the case of Mena Rising, who was terminally ill in Westbury hospital. Despite the White Paper, the local primary care trust decided that that hospital must close. At five days' notice, because it had budgets to balance—let us remember the words of the health White Paper, which, as I said earlier, people now see as a sick joke—all the patients were moved. A check was done on Mena Rising, however, to see whether her GP was wrong to say that, as she was terminally ill, she should not be moved. They could not overcome that assessment, so she was allowed to remain alone in that hospital. All the other patients were moved on a Sunday and she died on the following Thursday.

That is the reality of new Labour's NHS. The failure to deliver value for money is a result of the failure of the Labour party to take as much care over spending as it does over the accompanying soundbites. This Government need to stop blaming managers for systemic failures that derive directly from their policy. They need to face up to the fact that never in the history of British government has so much been wasted by so few.

8.26 pm

Dr. Howard Stoate (Dartford) (Lab): It gives me great pleasure to follow that tour de force.

As probably the only practising doctor left in the Chamber, it gives me great pleasure to take part in this debate and to introduce some reality into what is a serious debate. No one is trying to downplay or belittle the overspends, which are causing significant pain in a number of constituencies throughout the country. It is important, however, to put that in context. We need to consider the enormous improvements in the health service over the past few years, which no one has yet mentioned.

It is convenient for the Conservatives to say that money is going in and not much is coming out. As a practising GP, let me tell the House that if I see a patient with suspected cancer now, I can guarantee that that
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patient will be seen by a cancer specialist within two weeks of my making the decision that there might be a serious problem. If it turns out that the person does not have cancer, so much the better. Nevertheless, the waiting time, anxiety and stress for that patient and their family has been reduced. The two-week waiting time has transformed that experience.

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

Dr. Stoate: I cannot give way, as there is very little time.

I can now say to a person who needs a new hip, "You will have that new hip within six months." It used to be one, two or three years. People were forced into the private sector. They did not want to go to the private sector, but they had no choice because little else was available unless they had private health insurance. That has been a fantastic achievement.

The new GP contract, which has had its first full year in operation, has transformed the management of chronic diseases in this country. It has transformed care for diabetes, heart disease, strokes and transient ischaemic episodes, and soon, in the next round of GP contract changes in April, chronic kidney disease. That is transforming patients' lives. It does not necessarily appear in the statistics or on the front page of the Daily Mail, but it is transforming people's lives in a way that was never possible before.

We talk of massive, catastrophic overspends. If the figures are correct and we turn out to have spent about 0.8 per cent. too much on the NHS, we should put that into context. It means that the average person on an average wage has ended the year with a deficit of £200. I do not believe that the average person on an average wage would feel that it was a catastrophe, a meltdown or a disaster to end the financial year with a loan of £200. It is the equivalent of my telling someone, "Go out and buy yourself something for £10" and their coming back and saying "It cost me £10.08". That is hardly a catastrophe, a meltdown or a disaster.

The Government have invested record amounts and are achieving record results as a consequence. I can now say to a patient in my consulting room, "I think that you should see a consultant." We can decide together which hospital would serve the patient best and I can book the appointment on my computer while the patient is still sitting in my consulting room. I can say, "There is your appointment to see a named consultant in a hospital of your choice on that particular day." The hon. Member for South Cambridgeshire (Mr. Lansley) laughs, but I wonder whether that was possible under the last Government.

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