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9.22 pm

Mr. Simon Burns (West Chelmsford) (Con): I join the Secretary of State in congratulating my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) on calling this debate. I am delighted and privileged to be taking part in a debate celebrating 60 years of the national health service.

I have heard many history lessons this evening. I was not even born in 1946, when the legislation went through the House, or in 1948, when the health service was established. However, I know from experience, throughout my life as a user of the health service, that in principle it is second to none. The national health service is what this country wants, and it is what I passionately believe in. It is ludicrous—indeed, I find it quite baffling—to try to make complaints about an era in which we were not alive. If one worked on that argument, one could say that the Labour party still wanted to take us out of Europe, that it supported CND or that it did not believe in war, as George Lansbury, its pacifist leader in the 1930s, proclaimed. However, that is nonsense, because life has moved on, and so have circumstances.

As my right hon. Friend the Member for Charnwood (Mr. Dorrell) and other hon. Members said, it is right that we should all be united on the basic premises and principles of the national health service, even though we may argue and have differences of opinion about how it should be organised and how it should evolve to continue providing a first-class health service for the people of this country.

Why is the NHS so important? Why is this national institution so popular with the vast majority of people in this country, who are more than happy, as I am, to pay their tax pounds to have free health care at the point of use for all who are entitled to use it? One of the reasons is this. In the 1930s, Franklin Roosevelt talked of the four freedoms: freedom from fear, freedom from want, freedom of speech and freedom of worship. I believe that there is a fifth freedom. Some hon. Members have talked about the American experience. If we exclude those people who qualify for Medicaid and Medicare, because of their financial poverty or their age, there are more than 40 million people in the United States—working families—who cannot afford health insurance. They do not have the freedom from fear of the next health bill landing on the mat, which might financially destroy their family. They do not have the freedom from fear that illness might come into the family, either to a child or to a parent, which might financially cripple them. Since 1948, because of our national health service, everyone in this country has had the freedom from those fears.


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I passionately believe in and support the national health service, whether it is under a Labour Government or a Conservative Government. Let those people who say that Conservatives are not committed to the health service look back over the past 60 years. They will see that Conservative Governments were in office for 35 of those 60 years, and nothing was done under those Governments to undermine the principles of the national health service or to seek to destroy it—[ Interruption.] I resent people taking cheap opportunities to try to score party political points when there is no basis in fact for that argument.

Mr. David Anderson (Blaydon) (Lab): Will the hon. Gentleman give way?

Mr. Burns: I will not give way, because there is not much time.

We have differed in our approaches over the way in which we believe the health service should operate. There has been too much of a propensity—certainly under this Government, but also under Conservative Governments in the past—for politicians to interfere when they come into office, and to feel that they have to prove their stamina and machismo by making changes, sometimes, it seems, just for the sake of it. The national health service has had too many changes and reorganisations under successive Governments. It is suffering from a surfeit of change and from fatigue. It needs to be able to settle in with what it has, and to get on with the job that it is meant to be doing—providing first class health care for all.

That is the challenge to politicians of all political parties. The reorganisations and changes have inevitably led to money being wasted and, certainly over the past 11 years, in certain areas, to almost going full circle and coming back to square one, with upheaval and waste of resources in between. That, too, has to stop. We need a health system in which the medical practitioners, who are the best qualified to make the judgments, make those judgments for the furtherance of patient care, rather than one in which politicians dictate from Whitehall what they believe should be happening. To give the health service that freedom, within its existing principles, would be a tremendous step forward that would benefit patient care and the working of the health service, as well as saving money from waste that could then be reinvested in patient care, which is the most important thing.

We can all find problems in the health service in our constituencies, but this debate is not an appropriate time to express those criticisms. There are other opportunities to make those speeches in the House. Today, we are celebrating the health service. We must celebrate the tremendous people who work day and night to look after patients and to provide patient care: the nurses, the doctors, the consultants and the often-forgotten ancillary workers who are so crucial to the delivery of health care and the working of our hospitals. They are the unsung heroes of the national health service; they are the people at the front line of patient care and health care, who do so much that is too often unrecognised—not through ingratitude, but because they do their job so well that they become seamless in the whole provision of health care. To them, we owe our thanks and a debt of gratitude for all they do; we should not forget that.


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We must also ensure that our local communities have the best facilities and the finest equipment that money can buy to provide health care within the budgets that Governments provide. As my right hon. Friend the Member for Charnwood said, it is no secret that this Government have substantially and significantly increased health spending over the last eight years. I, of course, welcome that. I have to say, however, that they have been in an extremely fortunate position because the strength of the economy over the last 15 years has enabled them to generate the revenue to invest in health care. That is a benefit for all of us. The sadness has been that not enough of it has gone to front-line services. That is why it is crucial that we have mechanisms in an ever-evolving health care system to ensure that we get the maximum amount of money that the state makes available to the health service to front-line services in order to continue to improve and advance the treatment of our patients.

I conclude—I know that others want to participate in the debate—by saying that we should stop the nonsense of Labour Members trying to accuse Conservative Members of not believing in the health service. Government Members may not like it, but we do believe in it. There is no monopoly of caring and belief in the health service on the Government side: we all share an affection, a loyalty and a devotion to the health service. What we all want to do is ensure that it works at its finest, providing the greatest health care. We may have differences, which we can argue about until the cows come home, but no one should question the motives or the honourable intentions of Conservative Members just because it suits the political agenda of Government Members at election time.

9.32 pm

Dr. Richard Taylor (Wyre Forest) (Ind): With some exceptions, I have been desperately disappointed with this debate, which instead of being a celebration of 60 years of the health service, has descended into party political bickering. I was hoping, as there was no time limit, to devote a little time to reminiscing. I have been in the health service more than 50 years—much longer than most other people here—so I can remember the days when we had precisely three antibiotics: streptomycin, penicillin and tetracycline. We did not have MRSA because there were so few antibiotics that the bugs could not get used to them. We had aspirin, morphine and digoxin. We had largactil and the barbiturates, but no antidepressants, no tranquillisers, no beta blockers, no ulcer healing drugs, no ACE inhibitors, no statins—and I could go on for a long time. The “British National Formulary” in those days was absolutely useless, because there were no drugs to put in it.

We did not know how to do endoscopy, ultrasound had not come in, computerised tomography scans had not been introduced, and magnetic resonance imaging was a long way off. Diagnoses were still made the proper way by taking a careful history, making a careful examination and carrying out a few investigations to prove what a doctor was already pretty sure of. We were still in the days of William Osler, who wrote:


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I do not think that he expected both fingers to be in those places at the same time, because one would have had to be something of a contortionist, but that phrase makes the point that clinical skills were necessary.

There is not much time to reminisce, but let us remember what used to happen with heart attacks. All we did when I qualified was to put the patient to bed and hope. Patients were kept in bed for four to six weeks, and if they did not get a pulmonary embolism, the doctor was really lucky.

I was working at the London chest hospital when external cardiac massage was discovered. We were staggered by its effectiveness; people were awake when we did it. I was involved with the very first pacemakers used. Since then, the first major cardiac care breakthrough came in the 1980s with the invention of the clot-busting drugs and the ACE—angiotensin converting enzyme—inhibitors, which transformed the treatment.

We have come a vast distance with the treatment of heart attacks, with the immediate reboring of the arteries when necessary. We know how to prevent heart attacks, at least by attacking smoking, diet and high blood pressure and by using the statins. Now, the “British National Formulary” is the most prized document that any doctor carries with him, because if doctors use it well they cannot really make any mistakes with prescribing.

Any celebration has to give credit to the staff, the doctors, the nurses, the secretaries and the volunteers in the charities. Above all, credit must go to the patients, who are so tough, stoical and co-operative with the staff. I worked with patients with rheumatoid arthritis for a long time; it is a most painful, disabling disease. Until very recently it was uncontrollable, yet those patients remained cheerful.

Looking briefly to the future, what are the challenges? They have been mentioned—vastly increasing longevity, the incidence of dementia, and vastly increasing costs—and resources are crucial. We must optimise the use of resources. Economies must be made. The Government are to be congratulated on the better care, better value indicators, which at least make a start on making appropriate use of so many resources.

We must eliminate the medical errors, along with the immense costs associated with them, and we must get prioritisation correct. I was not allowed to use the word “rationing” in a debate not long ago, but health care rationing is crucial, and it demands an open, honest and widespread debate. If there was more money available—not by getting more, but by making better use of what we have—perhaps the National Institute for Health and Clinical Excellence would allow us to afford more drugs. If NICE were able to assess new drugs much more quickly, we might not have the huge problems of co-payments, which have been raised so frequently recently.

Reorganisations have been mentioned many times. When the Health Committee undertook an inquiry on foundation trusts, we listed the reorganisations between 1982 and 2003. There were 18 in those 20 years, and the pace of reorganisation has continued. We face perhaps the biggest change and reorganisation of all with Lord Darzi’s review. The one comfort is that he has said clearly that no changes are to be made until the replacement service is up and running. I hope that that happens.


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I am grateful that the Government have reaffirmed the principles of the NHS—that it is funded by general taxation and free at the point of delivery—and that those are immutable, but there is one vital bit of Bevan’s work that is missing. Bevan realised that we had to pay doctors and nurses the same across the country to get universality of providers and a real national health service. So a consultant working in London was paid the same as a consultant working out in the country. That achieved a real NHS. My sadness is that with the internal market and the purchaser-provider split, as well as the interests of shareholders in the large commercial organisations tendering for parts of the core NHS, there is a risk of seeing the NHS as we know it disappear.

I shall finish by talking about quality of care. I am delighted that the Secretary of State must have read the old proverb,

because he is persuading the nurses to smile. There is no doubt that cheerful, kind and sympathetic caring by doctors and others, and doctors and nurses who communicate with each other and with patients, will do away with most of the complaints that I receive. My problem is to know which to vote for: the motion or the amendment. Both have good points. If we have votes on both, I will have the greatest pleasure in voting for both.

9.40 pm

Mr. Stephen O'Brien (Eddisbury) (Con): It is a genuine pleasure to wind up this debate to mark the 60th anniversary of our national health service. The debate has allowed contributions from all parts of the House expressing both personal and national gratitude for the unparalleled institution that we call our national health service, and above all for its staff.

The NHS is the Conservative party’s No. 1 priority. We are not unique in that—it is the No. 1 priority of the people of this country. We have committed ourselves to it financially, and have laid out foundational policy to preserve and enhance its strength. We have the determination to trust front-line staff with decisions, and to set our NHS free from politically inspired micro-management. We have brought forward this motion to celebrate our NHS, and we are glad to use our Opposition time in that way.

As is the case with Members on both sides of the House, Conservative Members are unequivocal advocates for and supporters of the NHS. I am proud that my mother was an NHS nurse who started her training in the late 1940s, shortly after the founding of the NHS, and retired in the late 1980s. I am also married to a nurse; by that stage, the qualification was no longer as a state enrolled nurse, but as a registered general nurse. My family also uses the NHS, and I am glad that we have had excellent treatment and outcomes.

In this 60th anniversary year, I pay tribute to the hard-working front-line staff in the NHS, and the volunteers who, together with the many charitable organisations, support and care for patients, day in and day out. As my hon. Friend the Member for West Chelmsford (Mr. Burns) said in a powerful and impassioned speech—I am sure that the House will turn to it, and that his constituents will be proud—the Conservative party, among many others, has supported the principles of the NHS from its outset. There is a strong national consensus on the
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values of the NHS. The British people are rightly proud of it as an institution of whose values we can be proud internationally. We are rightly proud that everyone has access to high-quality care on the basis of need, regardless of their ability to pay.

We all have stories of the hard work of front-line professionals when both we and our families have been under the care of the NHS, and will have heard similar stories from our constituents. We also take up those times when the NHS, for all its great benefits and values that we are keen to celebrate, occasionally fails to meet its own standards.

The debate has been interesting and wide-ranging. My hon. Friend the Member for South Cambridgeshire (Mr. Lansley) set the tone in a way that accorded with how the House sees the NHS. He sought to ensure that we celebrated an NHS that is and should be, in many respects, above party politics. In a relatively short debate, he did not necessarily delve down into the policy and detail, but painted a clear, optimistic, enthusiastic vision for the future. It was heartening to note that the hon. Member for North Norfolk (Norman Lamb), whose opening remarks also celebrated the staff of the NHS, largely supported my hon. Friend. [Interruption.] Indeed he did. I am glad that we had the chance to put him right on the question of national targets, and that he can now enter that debate in the right spirit.

The Secretary of State, who has not been able to return to the Chamber, observed that he agreed with every single word of the Opposition motion. Indeed, all that the Government chose to do in their amendment was add to the motion. That set a tone that I think we all hoped could be sustained, but to everyone’s surprise it took the Secretary of State a further 15 minutes to deal with an historical obsession with 1948, and perhaps with 1946 as well.

If we are honest, all of us—Members throughout the House—will admit that when we talk to our constituents, it is clear that one thing that does not concern them is what took place in this Chamber in 1948. What does concern them is what will happen to their health service in years to come. That is why it is so important for us to demonstrate our ability to criticise what is happening, and to ensure that we are committed to the future.

Despite what struck me as unnecessary, somewhat inappropriate and disappointing partisanship on that score, one certainty emerged from all the speeches. It was articulated by the Secretary of State, and again by Conservative Members. What is clear is that there is no dispute but a total, not even qualified, consensus among Members throughout the House, on behalf of all the people of this nation, that we are committed to the operation and values of the NHS.

I was delighted that a former Secretary of State—my right hon. Friend the Member for Charnwood (Mr. Dorrell), who spoke with great authority and knowledge—was able to confirm the existence of that total consensus, and the adherence to those principles by all who represent the people of this country in the House. He rightly urged us to move on from what has, at times, been a sterile debate that has not resonated with what people think about the real issues, and to deal with the true debate on who is best placed to deliver what everyone wants to achieve: improving health outcomes
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in a way commensurate with the huge resources that the country is willing to commit to the NHS in which we all believe.

My right hon. Friend was also able to demonstrate that we have come full circle. He gave the example of the introduction by the current Government of commissioning, which had remarkable resonances with procedures and challenges that he and his immediate predecessor had experienced. There have been some wasted years, but we can move on. What my right hon. Friend urged the House to do, above all, was ensure that we retain our confidence in the NHS and learn to let go so that we—the politicians who are accountable in the House for the resources that are committed—can feel confident that the NHS, clinical and non-clinical, can deliver the outcomes that we want.

Mr. Peter Bone (Wellingborough) (Con): Is not the Government’s history one of missed opportunity? While doubling the amount of money spent on the NHS, they have increased output by only 29 per cent.

Mr. O'Brien: My hon. Friend has made an important point. This is not a question of party political partisanship; it is a question of the accountability involved in trying to make the resources committed commensurate with the results that we are all trying to achieve. That is to do with the operation of the NHS, and that is why—as my right hon. Friend the Member for Charnwood pointed out—it is right for us to have debates such as this in order to decide how best we can deliver the results that we all want.

The hon. Member for Wirral, West (Stephen Hesford) made a long speech that went round the houses and a number of parts of the Wirral. It left us wondering what debate he was contributing to, because it did not seem to relate to anything else that was going on. As for the all too short contribution by the hon. Member for Wyre Forest (Dr. Taylor), I think that while many us shared his disappointment that the debate had been diverted by some chippy approaches and contributions, we were grateful for the opportunity to hear his reminiscences, not least because he is probably the Member with the most experience of the NHS over a long period. He has committed himself to the health service throughout his life, and we salute him for that.

Staff, volunteers and charities support the increasing improvements in health outcomes that we all want to see in the NHS, and we should not lose sight of the importance of research and development, either. I pay tribute to the Secretary of State for emphasising that in his speech, as it is vital.


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