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The Earl of Onslow: My Lords, I congratulate the Government on realising, after five years in office, that there is something wrong with the National Health Service. Why is it necessary to increase funding when it cannot spend the money it has at the moment?
Lord McIntosh of Haringey: My Lords, I shall have to throw the noble Earl's congratulations back in his teeth. An understanding of the problems of the health service has been evident in this Government ever since we took office—and, indeed, for a long time before. A major part of the problem—but not all of it—has been underfunding. Spending on health services in this country under the previous government was 6.2 per cent of GDP. That has gone up from 6.9 per cent, to 7.2 per cent, to 7.4 per cent this year, with plans for 7.6 per cent and 7.7 per cent in the next two years. I think we can see the difference.
Lord Clement-Jones: My Lords, is the Secretary of State for Health correct in saying that a hypothecated health tax would be desirable?
Lord McIntosh of Haringey: My Lords, the Secretary of State has not said that a hypothecated health tax would be desirable. Clearly there are arguments for a hypothecated health tax—there are presentational arguments for a hypothecated health tax—but we have to look at what would happen if the revenue from a particular hypothecated tax was to go down rather than go up, and whether that would be desirable for the health service. That is another consideration to be taken into account.
Lord Boardman: My Lords, in the other place, the Prime Minister committed the Government to substantial additional expenditure on health services. Would it not be responsible for the Government to give some indication of how this very large sum of money is to be provided within the time span?
Lord McIntosh of Haringey: My Lords, our existing plans for expenditure on the health service within the period of the spending review are set out in the Pre-Budget Report and in previous Budget documents. There is no doubt about the capability of public finances to meet those demands. As to the future, after the next two years—in other words, under the next spending review—I have made it clear that the judgments to be made next summer will be based on extensive and independent analysis.
Lord Lea of Crondall: My Lords, although many of us welcome the conversion of the Opposition to EU benchmarking, would it not be logical to ask Members opposite the following: if they find that we are trailing behind on a particular benchmark, what financial proposals will they make to correct that?
Lord McIntosh of Haringey: My Lords, my noble friend is absolutely wrong—and it is seldom that I have to say that. The Opposition have not been converted to EU benchmarking in any sense. The Opposition are continuing to run two horses which are running off in opposite directions. On the one hand they are still residually attempting to claim that there will be tax cuts—indeed, Mr Michael Howard said only on Monday that the Conservatives would reduce the so-called tax burden to 35 per cent, which would mean a
#50 billion a year cut in public expenditure. On the other hand, they are attempting, not very convincingly, to match the commitments that this Government have made to the proper funding of the health service.
Baroness Cumberlege: My Lords, does the Minister agree that waiting times are now longer than they were when the Conservative government left office?
Lord McIntosh of Haringey: My Lords, there are many definitions of waiting times.
Lord McIntosh of Haringey: My Lords, that is a matter of fact. Waiting lists are down by 100,000, and the noble Baroness can take any other measure that she cares to choose.
The Countess of Mar: My Lords, first, will the noble Lord confirm that the Opposition are not responsible for answering Questions at Question Time? Secondly, why is it that in our small rural locality in Worcestershire you now have to wait up to a month to see a general practitioner? You can be dead by then!
Lord McIntosh of Haringey: My Lords, I do not know about rural Worcestershire, but in my part of north London you cannot get to see your GP as quickly as you ought to be able to do. Of course, there are defects in many parts of the country. That is why we have set targets for the specific question raised by the noble Countess; namely, the issue of waiting times to see a general practitioner.
Lord Saatchi: My Lords, on the crucial question of public health, would not people be more willing to forgive the Government for all their splits at the top between the Prime Minister and the Chancellor, their wriggling from pledge to aspiration, and their twists and turns over dates and amounts, were it not for the fact that this is the Government who rose to power under the cynical and ruthless banner X24 hours to save the NHS"?
Lord McIntosh of Haringey: My Lords, I have always found that scripted abuse goes down very badly in this House. The noble Lord has not added very much to the debate.
Lord Renton of Mount Harry: My Lords, does the Minister agree that in almost every European country the percentage of health spending that comes through private health insurance is higher than it is in this country? Furthermore, Mr Wanless has said that he did not look in any great detail at the operation of private health insurance in France and Germany. Surely it would make sense for the Government to look more closely at the effectiveness of private health insurance and what contribution it can make before taking any final decisions on how the NHS should be financed.
Lord McIntosh of Haringey: My Lords, I agree with part of the noble Lord's premise. I do not agree with the conclusion that he draws. Yes, it is true that in many other European countries expenditure on private health insurance is substantially greater than it is in this country. The preliminary report by Mr Wanless—which is a serious report of 222 pages—states that there is no evidence that to extend the role of private insurance in this country would improve the efficiency of our health service. Indeed, the evidence is in the other direction. In this country we have—I am not saying that this is the only judgment—probably the most efficient health service in Europe. We have better bed use. We have better equity, in the sense that fewer people are being deprived of treatment because of the cost. Of course, there are other considerations. However, the importation wholesale of other people's solutions, when they themselves are questioning them, is slightly dubious.
Lord Walton of Detchant: My Lords, does the Minister recall that, in a major debate on the National Health Service in this House on 21st November, one of the problems highlighted was that we have approximately half the number of GPs and consultants, in all specialties, compared with our European competitors? Is that not one of the major problems causing the difficulties that we are presently encountering in the NHS?
Lord McIntosh of Haringey: My Lords, I do not know that one-half of the European average is the correct figure. I do not have exactly that figure. But we have increased the number of nurses since 1997 by 17,000 and an additional 5,000 are in training. That is huge increase. We have also increased the number of doctors by 7,000 since 1997. Those are real achievements.
Lord Mackie of Benshie: My Lords, will the Minister— whom we all hold in high regard—tell the House whether the NHS could afford some throat pastilles for him?
Baroness Noakes: My Lords, can the noble Lord shed any light on the Government's target for NHS spending compared to the European average? Is that target to be achieved in 2005 or, as we now understand, 2006? How is the average to be calculated?
Lord McIntosh of Haringey: My Lords, the most recent figure for the European average is 7.9 per cent of GDP. Clearly, the figures are not immutable. Governments will make changes in their decisions on health spending, and changes in GDP will affect the average. The Prime Minister and the Chancellor have highlighted, very effectively and in vivid terms, the extent to which our health service does in some respects fall behind the best in Europe and the extent to which, in order to correct the position, the NHS needs additional resources which were denied to it by the previous government.
Business
Lord Carter: My Lords, between the two short debates this afternoon, my noble friend Lord Rooker will, with the leave of the House, repeat a Statement that is being made in another place on police reform. Following that, my noble friend Lady Symons of Vernham Dean will repeat as a Statement an Answer to a Private Notice Question in another place on the Government's policy towards recent developments in the Middle East.
Business of the House: Debates this Day
Lord Williams of Mostyn: My Lords, I beg to move the Motion standing in my name on the Order Paper.
Moved, That the debate on the Motion in the name of the Lord Goodhart set down for today shall be limited to two-and-a-half hours and that in the name of the Lord Taverne to two hours.—(Lord Williams of Mostyn.)
On Question, Motion agreed to.
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