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Lord McIntosh of Haringey: My Lords, I believe that my response to the supplementary question of the noble Lord, Lord Renton of Mount Harry, made it clear that I agree with what the noble Lord, Lord Clement-Jones, has just said.

Lord Marsh: My Lords, does the noble Lord accept that many people will find what he says both deeply depressing and quite extraordinary? On virtually every count--whether it be fatalities in certain diseases, numbers of doctors or the proportion of GDP spent on healthcare--this country's health provision, regardless of which party is in power, is behind that of other countries; indeed, France is a classic example. Will the Minister agree that there is a benefit to be gained in trying to get more money spent on the National Health Service, and that the best way to do so is to encourage more people to contribute?

Lord McIntosh of Haringey: My Lords, I am glad to note that the noble Lord, Lord Marsh, is referring to the recent report of the World Health Organisation. However, the noble Lord should read that report with a little more care. Although it found that this country spends less of its GDP on health services in total, we stand at 18th in the world list, though that is not an ideal position to be in. We fall down badly--everyone agrees that this is right--on the responsiveness of our National Health Service to patients. That is a problem that we must certainly address. But it does not follow that the best way to improve our health services is to help to fund private medical services through our tax system. The real growth in NHS expenditure has been significant under this Government. We believe that that is the right way to move forward.

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Lord Peyton of Yeovil: My Lords, I am searching for some crumb of comfort in the noble Lord's answers. I believe he said that it was no part of this Government's intention to create barriers between the public and the private sectors of the health service. I hope that the noble Lord will learn from that answer and practise it. The immense inhibitions from which the health service suffers as a result of the sort of proprietary, defensive attitudes of the Government cannot be exaggerated.

Lord McIntosh of Haringey: My Lords, that sounded to me like an assertion, not a question.

Lord Renton: My Lords, would it help the Government to reach a decision in this matter if I mentioned that the only reason why I am still alive is that, last year, BUPA spent 10 times more on my medical attention than I had paid for my premium?

Lord McIntosh of Haringey: My Lords, the noble Lord, Lord Renton, got good value and we continue to get good value from his continued presence.

Lord Walton of Detchant: My Lords, at a time when the National Health Service is gravely understaffed in terms of doctors, nurses and medical laboratory scientific officers, and is having to turn to the private sector for assistance in carrying out operations, is it not now possible that pragmatism can overcome idealism?

Lord McIntosh of Haringey: My Lords, the impact of what the noble Lord, Lord Renton of Mount Harry, proposes, and of what we understand the Conservative Member Dr Liam Fox proposes, would be a continued brain drain from the National Health Service to the private sector, which would benefit no one.

Lord Saatchi: My Lords, the Minister not only insists on taking responsibility for the fact that 97 per cent of the amount of money spent on health is spent by the Government--the world record for a government share--but is actually proud of that. However, is he also proud of the conclusions of the detailed report, to which the noble Lord, Lord Marsh, referred, which shows that we are in 18th position in terms of standards of healthcare? Does he take responsibility for the fact that we are lower in the world table than such countries as San Marino, Andorra, Malta, Greece and Iceland?

Lord McIntosh of Haringey: My Lords, I am delighted that the noble Lord, Lord Saatchi, has read the report rather more carefully than the noble Lord, Lord Marsh. I take pride in the fact that 97 per cent of our health expenditure is public health expenditure. If we move towards insurance funding of health services--the United States is the classic example of this--we shall have poorer health services at considerably higher cost.

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European Single Currency

2.51 p.m.

Lord Blaker asked Her Majesty's Government:

    Whether the five economic tests proposed by the Chancellor of the Exchequer for joining the European single currency are closer to, or further from, being met than when they were first stated.

Lord McIntosh of Haringey: My Lords, the Chancellor of the Exchequer has said that we shall make another assessment of the five economic tests early in the next Parliament.

Lord Blaker: My Lords, I am grateful for that reply but does not the noble Lord agree that the economic tests are so amorphous, and the answers to them necessarily so subjective, that they are unlikely ever to provide the clear and unambiguous evidence of economic benefits for which the Prime Minister has called? Is not the real purpose of the economic tests to promote the idea that the economic problems are more important than the political questions and to provide a screen behind which the Government will be able to judge according to the state of the opinion polls when it is suitable to hold a referendum?

Lord McIntosh of Haringey: My Lords, I do not agree that the tests are amorphous and I do not agree that this is primarily a political decision rather than an economic one. As the Chancellor has always made clear, the economic tests apply to a successful single currency and to the circumstances under which the Government accept that there will be a pooling of sovereignty if we go into a single currency. But the tests of sustainable convergence, of flexibility, of investment, of financial services industry and of employment are by no means amorphous. They are capable of analysis and they have been subject to analysis, most recently by the International Monetary Fund.

Lord Shore of Stepney: My Lords, I am sorry that I cannot support my noble friend in what he has said. Seriously, there is only a flimsy intellectual case for joining on economic terms. It is a major political and constitutional issue. For the Government to go on ducking the issue and pretending that this is not the case is simply an exercise in dishonesty which gains us no respect on the Continent, where every other political leader accepts that the major purpose is to foster political union, is it not?

Lord McIntosh of Haringey: My Lords, I am not aware that my noble friend asked a question in any of that. I am sorry that he felt it necessary to use such language in an intervention.

Lord Taverne: My Lords, can the Government explain how they will avoid the euro becoming an issue at the next election? In particular, how can the Chancellor of the Exchequer argue, as he clearly

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intends to, that the Government should be re-elected because of his brilliant management of the economy and in the same breath state that he cannot possibly say that the state of the economy will be in a suitable condition for us to join the euro within a year or so of the next election? Is the Chancellor so blind that he cannot see that he is giving Mr Hague a superb opportunity to make him look foolish?

Lord McIntosh of Haringey: My Lords, I think that the noble Lord, Lord Taverne, has departed from the Liberal Democrat script in the final few words of his intervention. Certainly the Government intend to adduce the argument in the next election that the Chancellor has done a brilliant job of restoring the economy to health. We will do that because it is true. However, to say that we are trying to secure that there will be no reference to the single currency in the next election is quite unrealistic.

Lord Waddington: My Lords, surely the noble Lord must agree that a glance at the second test, which asks, "If problems emerge, is there sufficient flexibility to deal with them?", shows that these are not tests at all but matters of judgment, leaving the Prime Minister free to recommend abolition of the pound whenever he thinks that he can get away with it.

Lord McIntosh of Haringey: My Lords, the second test actually asks whether there is sufficient flexibility to cope with economic change. I see no difficulty in that.

Lord Peston: My Lords, I hope that I may break the rules and speak in favour of the European Community. I refer to the questioning that seems to take place all the time. It is a long time since I knew any economics, but the notion that any economic test could be exercised without judgment is rather far-fetched. Does not my noble friend agree that the tests lay down some sensible criteria but that it is up to someone--in this case, the Chancellor--to interpret them and put forward a view? Does not my noble friend also agree that that view will be subject to the test of many other people expressing their views, and therefore there is no problem?

Lord McIntosh of Haringey: My Lords, my noble friend is absolutely right. This Government have always said that, early in the next Parliament, on the basis of those tests, the Treasury will make an assessment; the Government will make a decision on the basis of that assessment; they will put that decision to the House of Commons and then to the people of this country in a referendum.

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