Those two remarkable speeches were followed by that of the hon. Member for Pendle (Mr. Prentice), who reminded usmore a revelation than a reminder for Opposition Membersthat at the parliamentary Labour party meeting on Monday, the Prime Minister had urged Labour MPs to attack Conservatives on the so-called marketisation agenda, as the Prime Minister is alleged to have put it. The hon. Member for Pendle thought, Goodness me, recognising that that seemed to be the pot calling the kettle black. Moreover, he then said that the Government had Maoist tendencies in pursuing a ceaseless recovery and reorganisation programme.
My right hon. and hon. Friends made many good speeches. My right hon. Friend the Member for East Hampshire (Mr. Mates) spoke about the importance of continuing commitment to our community hospitals and my hon. Friend the Member for Mid-Sussex (Mr. Soames) coupled praise for local NHS staff with concern for the future of medical provision in his area.
My hon. Friend the Member for West Chelmsford (Mr. Burns) made a very powerful and balanced speech about delay to a new facility, despite all the promises that had gone before, and the necessary closure of an organisationsomething that he supported, so long as it was replaced by anotherand about the disappointment that has attended the process. The speech that followed was a plea by my hon. Friend the Member for Banbury (Tony Baldry) not to downgrade the Horton general district hospital in his constituency.
Many Labour Members spoke, but it would take up too much time to recite the points that they were seeking to make. However, it was a question of deciding at what point in the 10 minutes allocated to all Back-Bench Members that the rose-tinted spectacles fell and the word but was used to launch the plea that they wanted to make about their own constituencies to try to stop the Government doing what they were about to do, or to ask the Government to do something that they had already indicated that they were not prepared to do. That was quite characteristic and particularly notable in the speech of the hon. Member for Bedford (Patrick Hall). However, it is fair to say that there were some honourable exceptions, not least the hon. Member for Pendle, but also the hon. Member for Northampton, North (Ms Keeble), who spoke quite late in the debate and made a constructive set of criticisms, to which I hope Ministers were listening carefully.
Rob Marris: To try to avoid the ding-dong to which the hon. Gentleman refers and in the interests of trying to make the NHS better, will he tell us what three steps the Conservative party would take to improve productivity in the NHS?
It is very interesting that, ever since I have been a Member, the hon. Gentleman has always asked that question, whatever the subject. He ought to reflect on the very significant and strategic offer that my party is makingto try to remove the politics from the NHS, to stop politicians from meddling in the NHS and to create independencewhich is in sharp distinction to the view expressed by the hon. Member
for Waveney (Mr. Blizzard), who proclaimed himself the arch meddler in the NHS.
Numerous other speeches were made, but time does not allow me to go into them. Instead, it would be helpful to hear serious responses from the Minister to the serious questions about the NHS work force, whose morale is being sapped by the concerns that are now attendant to all NHS organisations. Will he postpone the full implementation of the European working time directive from 2009 to 2012? I am sure that he can ask the Secretary of State about that, because she was responsible for those negotiations when at the Department of Trade and Industry. She now has responsibility for what we hope at the very least will be a push to amend the directive, given its effect, so that the challenges that now face NHS doctors can be met.
Will nurses and physiotherapists now be guaranteed a years employment, following their training, as happens in Scotland? At the moment, many people who have chosen to dedicate themselves to those professions find that they are not given the opportunity to build their experience immediately after they finish training. That is having a major effect on their employability, as they require hands-on experience to progress to become essential members of the NHS work force.
It would be very helpful if the Minister could tell us what evidence the Government have to show the true causes of job losses, redundancies, lost posts and the freeze on filling vacancies. Given the constraints, the financial crises that exist in so many of our NHS organisations, the working time directive and the staff shortages, what are the financial effects as against the desire to improve patient care and safety? Let it be said that no one is against all change, but change should take place only to improve patient care and patient safety, not for short-term expediency, to cover a financial crisis caused by financial incompetence.
On the NHS work force, we also have concerns about, for example, school nurses, hospital chaplains and dentists, but it is important to ask the Minister to ensure that he answers the specific, serious questions that have been asked today. That is what is required to make the NHS improve and build on the best.
The Minister of State, Department of Health (Andy Burnham):
This has been a lively and entertaining debate with a range of excellent contributions. Many of the contributions from Labour Members have told of an improving NHS that is on the way to ending long waits and that has new facilities and services. There have been measured contributions from the Opposition Members who sought to take a balanced view of how we see through some of the challenges that the NHS faces. We have also had, however, the road-to-Damascus speeches from the newfound defenders of the NHS on the Conservative Benches. Every single one of them without exception stood at the last election on a pledge to take money out of the NHS through the patients passport. Today we hear a different tune, and that gives the electorate a problem. Who means it and who does not? To help the House,
perhaps we could have a show of hands from those who have had a genuine change of heart about the NHS since the last election and those who are just saying anything to get elected. Perhaps we could see that now, or perhaps we will have to wait.
Gregory Barker: Will the Minister tell me what improvements there will be to the health service from making 2,000 expectant mothers every year travel 20 miles from Hastings, which is an area of social deprivation, and the surrounding area to the district general hospital in Eastbourne? What is improving the health service about that?
I will come to the politics later, but I first want to strike a note of consensus. The shadow Health Secretary talked about independence and he was right to uphold the independence of the National Institute for Health and Clinical Excellence in supporting the difficult job that it does. I applaud him for that.
The hon. Member for Northavon raised questions about independent sector treatment centres. May I point out that we pay significantly less for operations done through the private sector using this system than the extra premium that was paid in the past? He mentioned physios, as did many others, and there are genuine issues there. We are working with the Chartered Society of Physiotherapy to address these matters. We have removed physiotherapy from the list of shortage occupations for work permits and are working with NHS employers to make more junior posts available. However, I take his point on that.
The hon. Member for Wyre Forest (Dr. Taylor) made a measured and important speech. He more than anybody knows the interplay between the NHS and politics and the important issues that that raises. He congratulated my right hon. Friend the Secretary of State on the referral of more cases to the independent reconfiguration panel and he had important things to say about urgent care and the delivery of urgent medicine without necessarily having to have the back-up of other acute facilities. I look forward to hearing how his meeting with the NHS chief executive goes.
The hon. Gentleman made points about the private sector, as did my hon. Friend the Member for Pendle (Mr. Prentice). I assume that the hon. Gentlemans constituents are like mine and want 18-week maximum waits for treatment from the end of 2008. I also assume that he does not want stranded NHS capacity all round the country once we have met that target, so I hope that he will take it on board that, when it is sensible to use the private sector to help the NHS, we will continue to do so.
My right hon. Friend the Member for Rother Valley (Mr. Barron) authoritatively demolished the Tory campaign pack that was mentioned in the debate. He shredded the figure of 20,000 job losses. People can draw their own conclusions, but it is dangerous information that the Tories are seeking to put into the public domain. My hon. Friends the Members for Dudley, North (Mr. Austin) and for Burnley (Kitty Ussher) did a forensic analysis of Tory health policy and the dissembling statements from the Conservative party. They tore them to pieces.
My hon. Friend the Members for Wigan (Mr. Turner), for Hackney, South and Shoreditch (Meg Hillier), for City of Durham (Dr. Blackman-Woods) and for Kingston upon Hull, North (Ms Johnson) made excellent speeches and powerful arguments against the moving of funding away from the parts of the country that have the most severe health inequalities, as has been advocated in the Oppositions policy document. I am sure that the whole House will have heard their comments.
My hon. Friend the Member for Waveney (Mr. Blizzard) was in the middle of praising the James Paget hospital when there was an astonishing moment. The hon. Member for West Chelmsford (Mr. Burns), for whom I have great respect, intervened to ask my hon. Friend to comment on a rumour about a hospital being scheduled for closure. My hon. Friend batted it away, but we have seen a new political tactic of circulating rumours about hospitals, even on the Floor of this House.
Andy Burnham: I will not give way. It was a tactic used by the Liberal Democrats at the last general election regarding Christie hospital in Manchester, Withington, which led to Keith Bradley losing his seat. My hon. Friend the Member for Bedford (Patrick Hall) also mentioned how rumours have been started about Bedford hospital that he says have no truth. He too raised points about the serious issues facing NHS finance, which were echoed by my hon. Friend the Member for Northampton, North (Ms Keeble). I assure him that I took on board what he had to say, and we will return to the points that he raised.
Having started a rumour about someone elses hospital, the hon. Member for West Chelmsford made a plea for his own, and I will look at the points that he raised about the PFI scheme in his constituency.
Then we had two former Tory Health Secretaries. One, the right hon. and learned Member for Rushcliffe (Mr. Clarke), amazingly in a debate on the NHS work force and issues to do with NHS staff, attacked Agenda for Change and the system that has delivered better pay for thousands of workers in this country. It was unbelievable.
Andy Burnham: I will not give way. I almost had to pinch myself. In a debate on NHS staff, a Tory Member of Parliament was taking away the credit for paying cleaners and porters more than the pittance that they received under his Government. What else can we expect from a member of a Government who called ambulance workers glorified taxi drivers?
Mr. Clarke: On the Governments own figures, at least £600 million of the amount that was needed for all those pay rises was not provided to NHS employers, and that probably more than anything else has led to the financial crisis that they are all facing. Is that the way to run the human resources policy and the budgeting of the biggest employer in western Europe?
Andy Burnham: Such points are left to local discretion. The right hon. and learned Gentleman is compounding the point: he is again making an argument against Agenda for Change during a Conservative-inspired debate on protection for NHS staff. Todays pose is that the Tories are the friends of NHS staff. Their campaign pack has a petition, no less, to show support for the staff of our NHS. NHS staff will remember driving past advertising billboards at the last election. How hard is it to clean a hospital? the Tories sneered from those billboards. It was a derogatory swipe at NHS cleaners that was no doubt authorised by one of the campaign chiefs, Mr. Bring me sunshine himself, the right hon. Member for Witney (Mr. Cameron). We see in the campaign pack a tissue of inaccurate figures and shameless contradictionsa document that is completely intellectually dishonest. Like the right hon. Gentleman, I have not done many real jobs in my life, but I was once responsible for preparing such documents, and that is one of the worst of its kind that I have seen.
On fairer funding, the document urges councils to pass a motion to provide funding to reflect accurately the burden of disease, but then it urges Tory activists to criticise the funding given to Greater Manchester primary care trusts, which have the lowest life expectancy in the country, where people get sicker younger, and where there are more people living with chronic disease. The Tory version of fairer funding means taking funding from areas such as Greater Manchester. Will the hon. Member for Altrincham and Sale, West (Mr. Brady) be campaigning this weekend on that dodgy document? I very much doubt it.