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9.31 pm

Mr. John Bercow (Buckingham): The debate has been stimulating and revealing in equal measure. My right hon. and learned Friend the Member for Folkestone and Hythe (Mr. Howard) opened it in characteristically incisive fashion. He made a series of specific and detailed points, which collectively constituted a penetrating critique of the Government's position. He also posed several challenges. I shall revert to the failure to respond to them shortly and with appropriate relish.

Before I do that, I shall refer to some other important contributions. My right hon. Friend the Member for North-West Hampshire (Sir G. Young) made a typically measured, thoughtful and open-minded speech. He made an important analogy with the pensions industry. We should not skate over that; it cannot readily be dismissed.

The hon. Member for Truro and St. Austell (Matthew Taylor), who is a worthy sparring partner, disappointed me. I hope that he will not lose too much sleep over that. He drily and unimaginatively supported the retention of the status quo. New Liberal, old policy.

The hon. Member for Halton (Derek Twigg) said that he supported the average EU expenditure on health. However, when challenged to specify the amount of money that would be spent on health by the end of the Parliament, he was unable to answer. If I may so describe him, he was a horse that fell at the first hurdle.

The right hon. Member for Birkenhead (Mr. Field) made a characteristically effective contribution. He fired a shot across the bows of the Treasury Bench and warned of the dangers of willy-nilly increases in taxation. He is always polite, sometimes speaks in code and is invariably challenging to the Government. His strictures on the ration book state were welcome and timely. It is time that they were heeded.

My hon. Friend the Member for Sutton Coldfield (Mr. Mitchell) rightly denounced the Government for their cynical approach. He highlighted increasing problems with the provision of health care, excoriated the Government's reactionary attitude to the private finance initiative and demanded a proper, constructive and detailed debate on the inadequacies of the national health service.

Roger Casale: The Conservative party's attitude to public expenditure in general and the health service in particular proved to be the Achilles heel of the previous shadow Chancellor, the right hon. Member for Kensington and Chelsea (Mr. Portillo). As the hon. Gentleman is so close to the current shadow Chancellor, will he help him by ruling out once and for all the introduction of medical charges for NHS patients by the Tories?

Mr. Bercow: That contribution was as backward looking as it was ill targeted. I have learned my lesson; giving way to the hon. Gentleman is rarely worth the expenditure of time that it entails. He made a mess of his first effort; he would be unwise to make a second attempt.

In the course of my right hon. and learned Friend's contribution, he posed a series of questions to the Chancellor. Those questions fell into four categories and,

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if the Chancellor was able to add them up, there were 16 specific questions. In the category of questions on reform, my right hon. and learned Friend asked what the Chancellor had in mind, when the reforms would be implemented, what the criteria for the allocation of funds for expenditure by health authorities would be, and when the decisions would be made on those allocation criteria. Answers to those four questions came there none.

We move on to the second category of questions, which might neatly be encapsulated by the term "Adair", on the subject of the Adair Turner committee and, presumably, the potential report resulting therefrom. My right hon. and learned Friend pointed out that the Government had previously said that the deliberations and any ensuing report would be private. Was that, he inquired, still the case, or had the Government changed their mind? Would we be told what the conclusions of that committee were and, if so, when? Answers to those questions came there none.

We move on to the third category, relating to the absurd position at the heart of the Government of total inconsistency, confusion and argument on the subject of meeting the European average level of public expenditure on the health service. My right hon. and learned Friend asked the Chancellor whether he would clarify the Government's position. Was the objective a firm commitment, he asked, or did it amount merely to a vague aspiration? Would the spending on the average level in the European Union be based on the average level in 2000, 2001, 2005 or 2006? Would that average be based on the inclusion of the United Kingdom in the measurement, or would it exclude us? Would the assessment be based on weighted populations or merely on crude numbers? When would there be a delivery on the pledge? Would it be in 2005, in 2006, at some unspecified date in the future or—more likely—never? The Chancellor turns away now, just as he ducked my right hon. and learned Friend's questions earlier.

I shall remind the House of a trait that now bedevils the Chancellor. It is becoming monotonous, predictable, see-through and progressively more ineffectual every time he unwittingly or wittingly deploys it. In the opening sentence of the right hon. Gentleman's speech, he said—I repeat this for the elucidation of the House—that he would answer every single point that had been raised by my right hon. and learned Friend.

Derek Twigg: Will the hon. Gentleman give way?

Mr. Bercow: No, I will not.

I am very worried about the Chancellor of the Exchequer, because the shadow Chancellor put 16 specific detailed questions to him in a 20-minute speech, and in the course of a 25-minute speech, the Chancellor, having said in sentence one that he would answer all of them, conspicuously failed to answer any.

Derek Twigg: Will the hon. Gentleman give way?

Mr. Speaker: Order.

Mr. Bercow: Thank you, Mr. Speaker. I do not think that I need any protection from the hon. Member for Halton, but I am nevertheless grateful for your ministrations.

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I simply say to the Chancellor that every time he says that he will deal with the points, he fails to do so. In four and a half years of observing and listening to the Chancellor, I have never heard a worse speech from him, either in the House or outside it. We know that the Government are in total disarray on hypothecation, on social insurance, and on specificity about the means by which the health service is to be funded. On the one hand, we have the position of the Chancellor—

Derek Twigg: Will the hon. Gentleman give way?

Mr. Speaker: Order. I do not think that the hon. Member for Buckingham (Mr. Bercow) wishes to give way.

Mr. Bercow: I am very happy to deal with the organ grinder, Mr. Speaker, but I am not all that interested in the monkey.

The reality is that the Chancellor is opposed by his right hon. Friend—I use the word "friend" distinctly loosely in this context—the Member for Hartlepool (Mr. Mandelson). He is also opposed by the Secretary of State for Health. Can he look for friendship to the Leader of the House, who somewhat undermined his position at business questions last Thursday? That seems unlikely, given that the two of them have barely been able to stand the sight of each other for the past 20 years.

Does the Chancellor have the support of his right hon. Friend the Secretary of State for Trade and Industry? Apparently, she is ditching him too, because she supports some form of hypothecation. Then we come to the Chancellor's colleague, the chairman of the Labour party and Minister without Portfolio, the right hon. Member for Norwich, South (Mr. Clarke). The right hon. Gentleman has already stitched up the Chancellor in Scotland by getting rid of his candidate for the position of First Minister. He has undermined him on other subjects too: he is second-guessing him on the euro, for instance, and he does not agree with him about this.

The Chancellor must really ask how many friends he has, and the answer seems to be not very many. If someone is rude to his friends, intimidates them, belittles them, ignores them, does not answer them and makes announcements on their behalf without even telling them until the last minute, is it any wonder that he will ultimately be disliked, vilified and plotted against? That is what is happening to the Chancellor.

If the Chancellor is the sort of Minister who offers a prescription before giving a diagnosis, it is a very good job that he opted to come into politics rather than becoming a general practitioner in our national health service. He specialises in not answering questions. Is it any wonder that productivity growth in British manufacturing is so bad, when the Chancellor's productivity in answering questions is even worse?

What does the Chancellor make of existing public expenditure on the national health service? He likes to see himself as the all-powerful figure, the dominant creature in the Government, dictating the course of events, in control of the show. I remind the House that, since 1997, the Government have been responsible for the failure to spend more than £5,000 million that the Chancellor and

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his right hon. Friend the Chief Secretary have allocated to spending Departments, but which they have not had the wit, competence or sagacity to spend. [Interruption.]

It is no good the Chancellor chuntering from a sedentary position in evident disapproval of what I am saying, when he has failed to do anything about that consistent underspend. The underspend in the NHS means that 70,000 heart bypass operations that would otherwise have been performed have not been performed. What has the Chancellor to say about the £10 billion a year that is being improperly spent in the health service—wasted on fraud, used in the context of bed-blocking, and devoted to sick pay, hospital-acquired infections and the rest?

Despite all that, the Chancellor has the sheer audacity to come to the House and defend his position on the ground of equity. He talks about an equitable national health service, which I interpret as meaning "fair". Does the Chancellor think it fair that people in this country are sicker than they were before? We Conservatives do not. Does he think it fair that more people are having to wait longer than ever before in Labour Britain? If he does, we do not. Does he think it fair that people are dying earlier in this country than they are, on average, in its European counterparts? We do not consider that fair or acceptable. Survival rates in this country for leukaemia, prostate cancer and breast cancer are all pitifully inadequate in comparison with those in the European Union.

Finally, we turn to the interesting issue of private expenditure. I leave the Government and the House to reflect on it. The Government are condemning the use of private funds, yet it is happening all over the country. A private trust recently raised no less than £14 million to assist in the rebuilding of one orthopaedic hospital trust: £2 million was spent on the orthotic unit, £4 million on the creation of a muscular-skeletal disorders research building, £6 million as a contribution to a £25 million private finance initiative project, and up to £750,000 on a hydrotherapy pool. I suggest that the Chancellor use the pool; it will not improve his expertise in health policy, but it might do something to improve his temper.

Where is that hospital? It is in the Oxford, East constituency. It is the Nuffield Orthopaedic Centre NHS trust, in the constituency of the Chief Secretary to the Treasury. I am not going to accuse him of hypocrisy because you, Mr. Speaker, would rule me out of order. I say simply that it is two-faced. It is an example of double standards. It reflects the difference between what the right hon. Gentleman wants to saddle the rest of the country with and what he is pleased to accept in respect of his constituents.

The British public are fed up with the clashing egos, the competing ambitions, the corrosive tensions at the heart of the Government. They are not interested in the Chancellor's ambitions. They do not like the unedifying spectacle. What they want is a decent health service, reliable provision, policies that translate care from a word to a deed for the majority of hard-working, long-suffering people in this country. The Chancellor's policy will not deliver. We are determined to produce a coherent, credible, costed and attractive policy that will deliver. [Hon. Members: "When?"] Members will hear of that policy in readiness for the next general election.

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