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Mr. Austin: Will my hon. Friend give way?

Mr. Denham: No, I must make progress.

There is broad acceptance that overall scrutiny of the local NHS should be led by democratically elected councils and their scrutiny committees. My hon. Friend the Member for Wakefield (Mr. Hinchliffe), who chairs the Health Committee, has suggested putting more councillors on CHCs, but I think that a point of principle is at stake: the ultimate right of scrutiny should lie with a

10 Jan 2001 : Column 1177

democratically elected body, not an appointed one. My hon. Friend wishes to capture some of the expertise that has existed on CHCs, and local authorities can do so when they appoint members to the scrutiny committees.

The issue of a national patients forum has been raised. As my right hon. Friend the Secretary of State announced earlier, we have accepted a proposal from the patients forums and other organisations to fund a project to consider the best way to strengthen the patient's voice nationally.

Having dealt with community health councils and patients forums, I turn to free nursing care. Under the current system, nursing care is provided free for anyone ill in hospital or at home, but those who are ill in nursing homes must pay for it, subject to a means test. That has long been wrong and unfair, and the Bill tackles the problem head on. In future, nursing care will be free in every setting.

Much of tonight's debate has centred on whether we should go further. The House should recognise that we are taking an historic step. The previous Administration did not take such a step during their 18 years in office. Indeed, in the previous Parliament, that Government's solitary proposal was to force more people to buy private long-term care insurance. As always when the choice is between extending the NHS and relying on private insurance, they relied on private insurance. Free nursing is a major step forward. We have gone further than the royal commission in defining nursing care, which is another good step forward.

The Liberal Democrats say that we should simply spend the extra £1 billion required for free social care. The simple truth is that spending £1 billion on free social care would not improve the quality of care for a single elderly person. Care provision needs improving, and we shall invest £900 million a year above current provision on improving intermediate care and related services, helping more elderly people to return to their homes, and supporting them more effectively in their homes. Indeed, it will help to prevent them from having to go into hospital in the first place.

The hon. Member for Woodspring made an important point, saying, in sharp contradistinction to what has been said by the hon. Member for West Dorset (Mr. Letwin)--the shadow Chief Secretary to the Treasury--that he would guarantee to match our spending proposals across the whole Department of Health budget, including social services. As the hon. Gentleman knows, social service spending comes primarily not from the Department of Health but from the Department of the Environment, Transport and the Regions. Under our proposals, less than £2.3 billion of personal social services will come through the Department of Health in 2003-04, and nearly £10 billion from the standard spending assessment.

We must ask whether the hon. Gentleman's spending guarantee covers the £10 billion-worth of social services funding provided through the SSA. Is the answer yes or no? If the hon. Gentleman does not rise to answer, we must rightly assume that the Conservatives have given no guarantee on social services spending. The cuts that they wish to bring about in every constituency will include cuts in spending on social services. The hon. Gentleman does not answer, so we have it confirmed by his inactivity that there is no guarantee that the Conservatives will match our spending on social services, and that his words about care for the elderly are nothing but hot air.

10 Jan 2001 : Column 1178

Question put, That the amendment be made:--

The House divided: Ayes 128, Noes 352.

Division No. 45
[9.59 pm


Ainsworth, Peter (E Surrey)
Amess, David
Arbuthnot, Rt Hon James
Atkinson, David (Bour'mth E)
Atkinson, Peter (Hexham)
Baldry, Tony
Beggs, Roy
Bercow, John
Blunt, Crispin
Body, Sir Richard
Boswell, Tim
Bottomley, Peter (Worthing W)
Bottomley, Rt Hon Mrs Virginia
Brady, Graham
Brazier, Julian
Brooke, Rt Hon Peter
Browning, Mrs Angela
Bruce, Ian (S Dorset)
Burns, Simon
Butterfill, John
Cash, William
Chapman, Sir Sydney
(Chipping Barnet)
Chope, Christopher
Clappison, James
Clifton-Brown, Geoffrey
Collins, Tim
Cormack, Sir Patrick
Cran, James
Davies, Quentin (Grantham)
Davis, Rt Hon David (Haltemprice)
Dorrell, Rt Hon Stephen
Duncan, Alan
Emery, Rt Hon Sir Peter
Evans, Nigel
Fallon, Michael
Flight, Howard
Forth, Rt Hon Eric
Fox, Dr Liam
Fraser, Christopher
Gale, Roger
Garnier, Edward
Gibb, Nick
Gillan, Mrs Cheryl
Gorman, Mrs Teresa
Gray, James
Green, Damian
Greenway, John
Grieve, Dominic
Gummer, Rt Hon John
Hamilton, Rt Hon Sir Archie
Hammond, Philip
Hawkins, Nick
Hayes, John
Heald, Oliver
Horam, John
Howard, Rt Hon Michael
Howarth, Gerald (Aldershot)
Jack, Rt Hon Michael
Jackson, Robert (Wantage)
Jenkin, Bernard
Key, Robert
King, Rt Hon Tom (Bridgwater)
Kirkbride, Miss Julie
Laing, Mrs Eleanor
Lait, Mrs Jacqui
Lansley, Andrew
Leigh, Edward
Letwin, Oliver
Lewis, Dr Julian (New Forest E)
Lidington, David
Lilley, Rt Hon Peter
Lloyd, Rt Hon Sir Peter (Fareham)
Loughton, Tim
Lyell, Rt Hon Sir Nicholas
MacGregor, Rt Hon John
McIntosh, Miss Anne
MacKay, Rt Hon Andrew
Maclean, Rt Hon David
McLoughlin, Patrick
Malins, Humfrey
Maples, John
May, Mrs Theresa
Moss, Malcolm
Nicholls, Patrick
Norman, Archie
O'Brien, Stephen (Eddisbury)
Ottaway, Richard
Page, Richard
Paice, James
Pickles, Eric
Portillo, Rt Hon Michael
Prior, David
Randall, John
Redwood, Rt Hon John
Robathan, Andrew
Robertson, Laurence (Tewk'b'ry)
Roe, Mrs Marion (Broxbourne)
Rowe, Andrew (Faversham)
Ruffley, David
St Aubyn, Nick
Sayeed, Jonathan
Simpson, Keith (Mid-Norfolk)
Smyth, Rev Martin (Belfast S)
Spelman, Mrs Caroline
Spicer, Sir Michael
Spring, Richard
Stanley, Rt Hon Sir John
Streeter, Gary
Swayne, Desmond
Syms, Robert
Tapsell, Sir Peter
Taylor, Ian (Esher & Walton)
Taylor, John M (Solihull)
Taylor, Sir Teddy
Thompson, William
Tredinnick, David
Tyrie, Andrew
Viggers, Peter
Waterson, Nigel
Wells, Bowen
Whitney, Sir Raymond
Whittingdale, John
Widdecombe, Rt Hon Miss Ann
Wilkinson, John
Willetts, David
Wilshire, David
Yeo, Tim
Young, Rt Hon Sir George

Tellers for the Ayes:

Mr. Peter Luff and
Mr. Stephen Day.


Abbott, Ms Diane
Ainsworth, Robert (Cov'try NE)
Alexander, Douglas
Allan, Richard
Allen, Graham
Anderson, Rt Hon Donald
(Swansea E)
Anderson, Janet (Rossendale)
Armstrong, Rt Hon Ms Hilary
Ashton, Joe
Atkins, Charlotte
Austin, John
Bailey, Adrian
Baker, Norman
Banks, Tony
Barnes, Harry
Barron, Kevin
Battle, John
Bayley, Hugh
Beard, Nigel
Begg, Miss Anne
Bell, Stuart (Middlesbrough)
Benn, Hilary (Leeds C)
Benn, Rt Hon Tony (Chesterfield)
Bennett, Andrew F
Bermingham, Gerald
Berry, Roger
Best, Harold
Blears, Ms Hazel
Blizzard, Bob
Blunkett, Rt Hon David
Boateng, Rt Hon Paul
Bradley, Keith (Withington)
Bradley, Peter (The Wrekin)
Brand, Dr Peter
Brinton, Mrs Helen
Brown, Rt Hon Nick (Newcastle E)
Brown, Russell (Dumfries)
Browne, Desmond
Bruce, Malcolm (Gordon)
Buck, Ms Karen
Burden, Richard
Burgon, Colin
Burstow, Paul
Butler, Mrs Christine
Campbell, Alan (Tynemouth)
Campbell, Rt Hon Menzies
(NE Fife)
Campbell, Ronnie (Blyth V)
Campbell-Savours, Dale
Cann, Jamie
Caplin, Ivor
Casale, Roger
Caton, Martin
Cawsey, Ian
Chapman, Ben (Wirral S)
Chaytor, David
Chidgey, David
Clapham, Michael
Clark, Rt Hon Dr David (S Shields)
Clark, Dr Lynda
(Edinburgh Pentlands)
Clark, Paul (Gillingham)
Clarke, Charles (Norwich S)
Clarke, Eric (Midlothian)
Clarke, Rt Hon Tom (Coatbridge)
Clarke, Tony (Northampton S)
Clelland, David
Clwyd, Ann
Coaker, Vernon
Coffey, Ms Ann
Cohen, Harry
Coleman, Iain
Colman, Tony
Connarty, Michael
Cooper, Yvette
Corbett, Robin
Corbyn, Jeremy
Cotter, Brian
Cousins, Jim
Cox, Tom
Cranston, Ross
Crausby, David
Cryer, John (Hornchurch)
Cummings, John
Cunningham, Rt Hon Dr Jack
Cunningham, Jim (Cov'try S)
Darling, Rt Hon Alistair
Darvill, Keith
Davey, Edward (Kingston)
Davidson, Ian
Davis, Rt Hon Terry
(B'ham Hodge H)
Dawson, Hilton
Denham, John
Dismore, Andrew
Dobbin, Jim
Dobson, Rt Hon Frank
Donohoe, Brian H
Doran, Frank
Dowd, Jim
Dunwoody, Mrs Gwyneth
Eagle, Angela (Wallasey)
Eagle, Maria (L'pool Garston)
Edwards, Huw
Ellman, Mrs Louise
Ennis, Jeff
Etherington, Bill
Fearn, Ronnie
Field, Rt Hon Frank
Fisher, Mark
Fitzpatrick, Jim
Flint, Caroline
Flynn, Paul
Foster, Rt Hon Derek
Foster, Don (Bath)
Foster, Michael Jabez (Hastings)
Foster, Michael J (Worcester)
Galbraith, Sam
Galloway, George
Gapes, Mike
Gardiner, Barry
George, Andrew (St Ives)
George, Rt Hon Bruce (Walsall S)
Gerrard, Neil
Gilroy, Mrs Linda
Godsiff, Roger
Goggins, Paul
Golding, Mrs Llin
Gordon, Mrs Eileen
Griffiths, Jane (Reading E)
Griffiths, Nigel (Edinburgh S)
Griffiths, Win (Bridgend)
Grocott, Bruce
Grogan, John
Hall, Mike (Weaver Vale)
Hall, Patrick (Bedford)
Hamilton, Fabian (Leeds NE)
Hancock, Mike
Hanson, David
Harman, Rt Hon Ms Harriet
Harris, Dr Evan
Harvey, Nick
Healey, John
Heath, David (Somerton & Frome)
Henderson, Doug (Newcastle N)
Henderson, Ivan (Harwich)
Hendrick, Mark
Hepburn, Stephen
Heppell, John
Hesford, Stephen
Hill, Keith
Hoey, Kate
Hope, Phil
Hopkins, Kelvin
Howarth, Rt Hon Alan (Newport E)
Howells, Dr Kim
Hoyle, Lindsay
Hughes, Ms Beverley (Stretford)
Hughes, Kevin (Doncaster N)
Hughes, Simon (Southwark N)
Humble, Mrs Joan
Hurst, Alan
Hutton, John
Iddon, Dr Brian
Illsley, Eric
Jackson, Ms Glenda (Hampstead)
Jackson, Helen (Hillsborough)
Jenkins, Brian
Johnson, Alan (Hull W & Hessle)
Jones, Helen (Warrington N)
Jones, Ms Jenny
(Wolverh'ton SW)
Jones, Jon Owen (Cardiff C)
Jones, Dr Lynne (Selly Oak)
Jones, Martyn (Clwyd S)
Jones, Nigel (Cheltenham)
Joyce, Eric
Kaufman, Rt Hon Gerald
Keeble, Ms Sally
Keen, Alan (Feltham & Heston)
Keen, Ann (Brentford & Isleworth)
Keetch, Paul
Kemp, Fraser
Kennedy, Jane (Wavertree)
Khabra, Piara S
Kidney, David
Kilfoyle, Peter
King, Ms Oona (Bethnal Green)
Kingham, Ms Tess
Kirkwood, Archy
Ladyman, Dr Stephen
Lawrence, Mrs Jackie
Laxton, Bob
Lepper, David
Leslie, Christopher
Levitt, Tom
Lewis, Ivan (Bury S)
Lewis, Terry (Worsley)
Liddell, Rt Hon Mrs Helen
Linton, Martin
Livsey, Richard
Lloyd, Tony (Manchester C)
Llwyd, Elfyn
Lock, David
McAvoy, Thomas
McCabe, Steve
McCartney, Rt Hon Ian
McDonagh, Siobhain
Macdonald, Calum
McDonnell, John
McFall, John
McIsaac, Shona
Mackinlay, Andrew
Maclennan, Rt Hon Robert
McNamara, Kevin
MacShane, Denis
Mactaggart, Fiona
McWalter, Tony
McWilliam, John
Mallaber, Judy
Marsden, Gordon (Blackpool S)
Marshall, David (Shettleston)
Marshall, Jim (Leicester S)
Marshall-Andrews, Robert
Martlew, Eric
Maxton, John
Meacher, Rt Hon Michael
Meale, Alan
Merron, Gillian
Michael, Rt Hon Alun
Michie, Bill (Shef'ld Heeley)
Michie, Mrs Ray (Argyll & Bute)
Milburn, Rt Hon Alan
Miller, Andrew
Mitchell, Austin
Moffatt, Laura
Moonie, Dr Lewis
Moore, Michael
Morgan, Ms Julie (Cardiff N)
Morley, Elliot
Morris, Rt Hon Sir John (Aberavon)
Mudie, George
Murphy, Rt Hon Paul (Torfaen)
Naysmith, Dr Doug
Norris, Dan
O'Brien, Bill (Normanton)
O'Brien, Mike (N Warks)
O'Hara, Eddie
O'Neill, Martin
Öpik, Lembit
Organ, Mrs Diana
Pearson, Ian
Perham, Ms Linda
Pickthall, Colin
Pike, Peter L
Plaskitt, James
Pond, Chris
Pope, Greg
Pound, Stephen
Prentice, Ms Bridget (Lewisham E)
Prentice, Gordon (Pendle)
Prosser, Gwyn
Quin, Rt Hon Ms Joyce
Quinn, Lawrie
Radice, Rt Hon Giles
Rammell, Bill
Rapson, Syd
Raynsford, Nick
Reed, Andrew (Loughborough)
Reid, Rt Hon Dr John (Hamilton N)
Rendel, David
Robertson, John
(Glasgow Anniesland)
Robinson, Geoffrey (Cov'try NW)
Roche, Mrs Barbara
Rogers, Allan
Rooker, Rt Hon Jeff
Rooney, Terry
Ross, Ernie (Dundee W)
Rowlands, Ted
Ruane, Chris
Russell, Bob (Colchester)
Russell, Ms Christine (Chester)
Salter, Martin
Sanders, Adrian
Sarwar, Mohammad
Savidge, Malcolm
Sawford, Phil
Sedgemore, Brian
Shaw, Jonathan
Sheldon, Rt Hon Robert
Shipley, Ms Debra
Simpson, Alan (Nottingham S)
Singh, Marsha
Skinner, Dennis
Smith, Rt Hon Andrew (Oxford E)
Smith, Angela (Basildon)
Smith, Rt Hon Chris (Islington S)
Smith, Miss Geraldine
(Morecambe & Lunesdale)
Smith, Jacqui (Redditch)
Smith, Llew (Blaenau Gwent)
Smith, Sir Robert (W Ab'd'ns)
Soley, Clive
Southworth, Ms Helen
Spellar, John
Starkey, Dr Phyllis
Steinberg, Gerry
Stevenson, George
Stewart, David (Inverness E)
Stewart, Ian (Eccles)
Stoate, Dr Howard
Strang, Rt Hon Dr Gavin
Stringer, Graham
Stuart, Ms Gisela
Stunell, Andrew
Sutcliffe, Gerry
Taylor, Rt Hon Mrs Ann
Taylor, Ms Dari (Stockton S)
Taylor, David (NW Leics)
Taylor, Matthew (Truro)
Temple-Morris, Peter
Thomas, Gareth (Clwyd W)
Thomas, Gareth R (Harrow W)
Thomas, Simon (Ceredigion)
Tipping, Paddy
Todd, Mark
Touhig, Don
Trickett, Jon
Truswell, Paul
Turner, Dr Desmond (Kemptown)
Turner, Dr George (NW Norfolk)
Turner, Neil (Wigan)
Twigg, Derek (Halton)
Tyler, Paul
Tynan, Bill
Vaz, Keith
Vis, Dr Rudi
Walley, Ms Joan
Ward, Ms Claire
Wareing, Robert N
Watts, David
White, Brian
Whitehead, Dr Alan
Wicks, Malcolm
Williams, Rt Hon Alan
(Swansea W)
Williams, Alan W (E Carmarthen)
Williams, Mrs Betty (Conwy)
Willis, Phil
Winnick, David
Winterton, Ms Rosie (Doncaster C)
Wood, Mike
Woodward, Shaun
Worthington, Tony
Wray, James
Wright, Anthony D (Gt Yarmouth)
Wright, Tony (Cannock)
Wyatt, Derek

Tellers for the Noes:

Mr. David Jamieson and
Mr. Clive Betts.

Question accordingly negatived.

10 Jan 2001 : Column 1181

Main Question put forthwith, pursuant to Standing Order No. 62 (Amendment on Second or Third Reading):--

The House divided: Ayes 320, Noes 44.

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