| Previous Section | Back to Table of Contents | Lords Hansard Home Page |
Earl Russell: My Lords, I hope that the noble Lord, Lord Saatchi, will not be in too much of a hurry to say
that money is not the answer. Unit costs have been reduced for 26 years, I think. We cannot put that right overnight.
Lord Saatchi: My Lords, I thank the noble Earl. I did not say that I thought that money was not required—of course it is. I hope that I have pointed out that the scale of the sums required to bring our standards up to those of others is so vast that it makes the tinkering that takes place completely inadequate.
The poor people whom I have described pay the most tax and receive the worst services in return. They should not have to accept for another day that deadly combination of high tax and the worst public services.
8.54 p.m.
The Minister for the Cabinet Office and Chancellor of the Duchy of Lancaster (Lord Macdonald of Tradeston): My Lords, I too would like to thank the noble Baroness, Lady Sharp of Guildford, for this debate on the state of our public services. It has been a useful exchange of views, highlighting once again the volume of experience and sweep of knowledge that we have in the Chamber. I shall try to cover the major points raised but, given time constraints, I shall not be able to deal with all of them. I shall write in reply to any material points not addressed.
I accept immediately that we have a great deal more to do to improve life in this country. Thanks to the decisions taken since 1997, there has been real progress. I shall try to persuade your Lordships of that. That progress will accelerate in the coming months and years.
Our first job was to put the economy right. A strong and stable economy has produced over a million more jobs. Because there are more people than ever in work and action was taken to reduce the national debt, the country can now afford record and sustained investment in our public services to employ extra staff and modernise equipment and infrastructure. So the Government are committed to creating accessible high-quality and properly funded public services during this Parliament to ensure that we provide equality of opportunity for all our citizens. That is our goal for this Parliament, and we are pursuing it with, I hope, a relentless focus.
We need responsive high-quality public services that visibly provide value for money. They should be locally accountable, transparent and built around the needs of the users or consumers—our citizens—who pay for them through their taxes. We must provide people with the best value for their hard-earned money.
I shall pick up some of the points made by the noble Baroness, Lady Sharp of Guildford. I enjoyed her impressionistic tour of European horizons but, as was said by my noble friend Lord Faulkner of Worcester, it is never easy to find the right comparisons. In France, for instance, doctors earn about half of what they would earn in the United Kingdom. French nurses are much underpaid in comparison with ours. Operational costs there are higher than ours. As for the
trains, to which my noble friend referred, there is not the regularity and convenience of service in France that can be found on British railways. If noble Lords would like to try a trip on the Berlin metro or go through Switzerland, through Zurich or Geneva, they could admire the surprisingly creative graffiti on those railways.Noble Lords ask why are our public services poorer. Surely, we can agree that it is because of decades of under-investment. The noble Baroness, Lady Sharp of Guildford, referred to the 6.5 per cent increase for health. That is slightly below the figure that we would use, 7.3 per cent. I hope to address some of the other issues that were raised, such as the morale of staff and recruitment problems, when I talk about the principles of reform. The noble Baroness is wrong to say that we cannot recruit more staff because of the decline in morale or because of conditions. In fact, staffing throughout the public sector has increased by 140,000 since 1997, and it is rising. In the health service, we have recruited 31,000 more nurses since 1997. We achieved our targets for nurse recruitment two years before the deadline that we had set. We are making progress. The Budget next week will no doubt be a tight settlement for some departments, as ever, but we will see that progress sustained.
As the noble Lord, Lord Ezra, said, I have taken copious notes. What I cannot reply to now I shall share with colleagues and reply to noble Lords. I defer to the noble Lord, Lord Ezra, for his wide experience of business. He has been a distinguished public servant. I listened to him with great respect. He was right to draw attention to the problem of stop-go investment and the lack of sustained investment over the years. The most effective services will come not just from investment but from investment and reform. We must have both, and that is what the Government are pursuing.
Investment in the key services is now at record levels but, as the noble Lord said, it must be sustained. In the past, halting investment and progress, only to jump-start it when things improved, caused all the damaging dislocation that we have seen, nowhere more markedly than on the London Underground. As a result of the sound economic management that the Chancellor has imposed, we have been able to provide much additional investment for our public services. For example, we have the biggest, most sustained four-year increase in health spending, with the highest ever percentage of GDP—7.3—going in in 2001-02. We have increased UK education spending to 5 per cent of GDP for 2001-02. Those levels of investment mean that there are more resources and more people to serve the public, including the 140,000 that I mentioned.
Baroness Maddock: My Lords, the Minister talks about the extra public servants, but we are aware that many teachers and nurses leave their profession
rapidly. Many trained teachers go to do other jobs. Do the Minister's figures include people who are leaving the professions?
Lord Macdonald of Tradeston: My Lords, I shall turn to some of the details of recruitment into teaching, for instance, where not only do we have more teachers but we have more teachers in training as well. I believe the noble Lord, Lord Mackenzie, said that we have more police now than ever before and more local government employees.
Earl Russell: My Lords, I wonder whether I could ask the Minister, not again, to quote that figure about recruitment for teacher training. Most of the people who come to ask me to write letters for them for that profession say, "I do not intend to do it; it is only just in case I cannot get anything else".
Lord Macdonald of Tradeston: My Lords, I shall note that less than scientific observation from the noble Earl, Lord Russell. However, let me point to the contribution made by the noble Baroness, Lady Warwick of Undercliffe. I have listened, obviously with some trepidation, to the scale of funds that she felt were required. Of course, I am unable to anticipate the Budget or the spending review, but I am sure that we would all support the Prime Minister in his emphasis on the importance of higher education. The Chancellor and the Secretary of State for Education will be locked in discussions about how to try to satisfy some of the needs which will have been put persuasively by the noble Baroness and by Universities UK.
As regards the achievements so far, I would ask your Lordships not to underrate what has been achieved. I listened with admiration to the gloomy elegance of the noble Earl, Lord Russell, and, indeed, to the remarks about the "Titanic" from the noble Lord, Lord Saatchi. I believe that there is in the United States a National Association of Pessimists which holds its AGM every year on the anniversary of the sinking of the "Titanic". I am told that its motto is, "Behind every silver lining there is a black cloud". I believe that that has loomed behind many of the speeches that we have had today.
On a positive note, in education we have been focusing on standards, choice and behaviour, and we have improved the standards in numeracy and literacy in primary schools. There are now 75 per cent of 11 year-olds reaching the required standard in English, compared with more than 50 per cent in 1997. We have reduced class sizes—fewer than 1 per cent of children between the ages of five and seven are now in classes of 30 or more. We have 11,000 more teachers in post and there are record numbers of students in higher education—87,000 more than in 1997. Participation in adult basic skills courses has risen more than 600,000, surpassing the targets that we set in the Learning Age Green Paper. Therefore, there are positive aspects in education and we must not be so doom laden.
I now turn to health. We have been putting the National Health Service on the road to recovery with increased investment, increased resources and better treatment. We are two years into the National Health Service Plan, but I would recommend to noble Lords the report of the chief executive of the Department of Health which came out today. The report indicates that average waiting times for in-patients and out-patients have fallen, as has the maximum waiting times. Last year 80,000 patients waited more than 15 months for an operation; today, only two people are waiting more than 15 months. However, I am told that the Conservative Party has challenged that and claims that there are four people waiting rather than two.
Another figure suggested in the report is that only 500 patients are waiting more than six months for an out-patient consultation. Last year there were 400,000 patients. There are shorter waiting times for patients with serious conditions such as cancer and coronary heart disease. In the ambulance service, 28 of the 32 services have hit the target of responding to 75 per cent of the most urgent calls in eight minutes. I could go on; I have a couple of pages of examples like that—positive changes that have happened in the National Health Service.
I welcome the supportive comments made by the noble Lord, Lord Clement-Jones, about the work being done by Derek Wanless. I hear what noble Lords say about the hypothecation, but we believe that it has drawbacks which outweigh its advantages. We recognise the benefits of diversity of provisions. The noble Lord, Lord Clement-Jones, suggested that there would be fewer beds and staff because of a fixation on PFIs and PPPs. By my figures, that simply is not true. There are more staff available now than ever before and we have more beds. Therefore, that is just not so.
I agree that there should be better procurement skills. We have set up an Office of Government Commerce, very well led by Peter Gershon from the private sector. We are trying to build in procurement skills and management skills right across the Civil Service, as well as across the rest of the public sector. Therefore, we, too, in government worry about targets, and targets that perhaps are not as exact as they should be, just as one would in business. Again, let me say that if you cannot measure things it is very difficult to manage them. The Treasury did reduce the number of targets quite markedly between its first spending review and the second. Therefore, I believe that a process of refinement is going on there. I shall turn to some of the issues raised by the noble Lord when I deal with the question of public sector reform later.
I shall just skip quietly over my pages and pages of examples of progress in the health service and turn to the issue of crime, which was dealt with by my noble friend Lord Mackenzie of Framwellgate. Even in crime, one of the most intractable areas faced by any government, as your Lordships will have heard we are making progress. Surely, it is as striking to noble Lords as it is to me to hear the noble Lord, Lord Mackenzie, say that crime, according to the British Crime Survey,
has fallen by 22 per cent since 1997. Burglary has fallen; car crime has fallen; and, indeed, violent crimes have fallen. All have fallen quite markedly.That clearly is not the general view held outside, and we in Government will certainly have to work much harder, especially in high profile areas such as street crime. We are trying to bring together those who have a stake in that problem and work with them to try to tackle the problems—working closely with the police in the areas which are suffering worst.
As the noble Lord said, police numbers have risen by the largest amount for the past 20 years. A Police Standards Unit has been set up to measure performance accurately and to tackle variations in performance between police forces. I am sure that the noble Baroness, Lady Harris of Richmond, would point to the areas of pensions and early retirement as matters where the variations between forces are rather bewildering. National standards would, I am sure, be welcomed by the police as much as by the Government and local government.
I accept that there is too much bureaucracy and that the police suffer from it. As the Minister responsible for deregulation, I work with the Regulatory Impact Unit and its public sector team, trying to ensure that the police are allowed more time to work out of the station, where at present they spend almost 50 per cent of their time locked in unproductive paperwork and other matters. I agree that much has to be done together and I welcome the noble Baroness's support for the generality of the present proposals.
Turning to transport, again I am delighted to say that no longer do I have any ministerial responsibilities. However, as my noble friend Lord Faulkner of Worcester pointed out, we have taken decisive action over Railtrack. I understand the problems of the closure of the West Coast Main Line and the Network Railcard. However, I believe that the much improved atmosphere within the industry will help us move towards resolutions of those kinds of problems. The work being done by Richard Bowker at the Strategic Rail Authority will aid in that, as will increasingly the work of Ian McAllister and John Armitt. I know to my cost that the noble Lord, Lord Bradshaw, is an expert in these matters, but I am sure that he would accept that, whatever may be his reservations with regard to the new structures, we now have in place people who are deeply committed to the priorities of engineering and adequately resourcing the railways in a way that perhaps was not the case in the past. For that reason, I too welcome the new expertise being brought to bear on why the costs of construction have risen so grotesquely and why they seem so disparate when compared with the charges made for a mile of rail improvement in other countries.
We look to transport as an area where the biggest effort and investment must be made. Some £180 billion is still committed over the next 10 years. The Transport Plan, of which I was a part author, has within it mechanisms which allow it to be repositioned year on year. Obviously that work is under way at the moment.
I hope too that we shall see a resolution to the problems of London Underground in the near future so that the proposed £16 billion of investment for enhancement over the next 15 years can begin to move forward. However, again there are important areas of progress even in transport. Some 1,700 more train services are now running each day compared to 1996. We have seen a 22 per cent rise in the rail passenger kilometres travelled over the past four years. Journeys on the London Underground went up by 25 per cent between 1997 and 2001. Furthermore, noble Lords will be interested to hear that the satisfaction ratings of passengers using the London Underground are as high as they ever were. In some ways the Government are victims of their economic success. If a million more people are put into work, they then have to travel to work every day and that has exacerbated our problems.
I listened with great interest to the balanced and informed contribution of the noble Lord, Lord Chan. I accept that stresses are inevitably caused by structural change. We shall certainly bear in mind all of those issues and look to his areas of the national frameworks and the benefits that they can bring, as well as to shifting the balance of power towards greater involvement on the part of citizens and patients.
I shall conclude by pointing out that our programme of reform, which we believe must accompany our increased investment plans, will be based on both national standards and greater accountability. It will also be based on devolution, as the noble Lord, Lord Ezra, pointed out. It will encourage flexibility and an end to the rigid practices of the past. It will also try to increase choice.
I listened to the remarks of the noble Earl, Lord Russell, with great interest. Clearly his vocation is one of prophecy, but the pervasive gloom and profound anomie which he sees for the future is not a landscape that I would share. If he wants to talk about nurses working in accident and emergency departments, I should tell him that I was recently at the Homerton Hospital. There cannot be many tougher areas in London in which to run an accident and emergency unit. The staff there have been making splendid progress and I thought that their morale was high. The sense of vocation that the noble Earl wishes to encourage was surely encouraged by the Prime Minister in his speech at Newcastle, which resounded through the public service sector. So we can devolve and delegate more power locally as long as it delivers high national standards. Clearly, there will be tensions between the two, but we hope to keep those tensions in balance.
I should say to the noble Baroness, Lady Knight, that mixed wards are an unfortunate situation that we inherited from the party previously in power. We are trying our best to remove them. I cannot share her stand against over-familiarity and friendliness. I find that even civil servants are now calling me "Gus". I am sure that if staff are asked civilly they will be very happy to call people by their proper names. I take the noble Baroness's point.
Perhaps I should end by saying to the noble Lord, Lord Saatchi, that I welcome his conversion to the cause of the poor and the underprivileged. I believe that the policies of the previous government acted as agents for much of the social squalor we inherited. His conversion is welcome but it is not yet to me convincing. I believe that there has been an attack of political amnesia, which was redeemed by the elegance and diffidence of the noble Lord's delivery.
The Government's priority is to improve public services during this Parliament.
Next Section
Back to Table of Contents
Lords Hansard Home Page