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Mr. David Tredinnick (Bosworth): Will the right hon. Gentleman give way?

Mr. Milburn: It is not about complementary medicine, is it?

Mr. Tredinnick: The right hon. Gentleman is ever generous in giving way. It does happen to be about that.

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I just wanted to ask him whether he intended to include in his package anything that would bring in some of the 60,000 complementary therapists to increase the supply of practitioners in the health service? If he did so, he would have an automatic 15 per cent. increase in people who could treat patients. I beseech him earnestly to consider that issue.

Mr. Milburn: We continue to examine complementary therapies and complementary medicine, but as I have said to the hon. Gentleman before, I cannot take such decisions: they must be taken by the clinicians. [Interruption.] I do not know whether the hon. Gentleman is demonstrating part of the therapy that he advocates. He cannot have his cake and eat it. He cannot say that we should do more and then, when we do, argue that it is centralisation. Nor can he say that we should do more and then argue, and vote, as he will tonight, against the extra investment in the national health service. If he wants an extension of mainstream medicine and other therapies, he must accept that the NHS needs extra resources. I urge him to vote with us in the Lobby tonight.

It is worth comparing this five-year Budget with the five years between 1992 and 1997. Now the NHS will grow by 7.4 per cent. in real terms, whereas then NHS budgets rose by 2.7 per cent. a year in real terms. Social services funding, which rose in that same period by less than 0.5 per cent. a year, will now rise by 6 per cent. a year in real terms.

David Taylor (North-West Leicestershire): Does my right hon. Friend acknowledge that the laudable targets in the NHS plan will fail if social care is inadequately funded? Although the extra £300 million that was announced in the Chancellor's Budget last week is most welcome, there has been a long period of chronic underfunding that has led to a gap of at least £1 billion in local authority social services budgets. In that context, how does it help to penalise local authorities for things for which they are not responsible, such as the crisis in residential care in some areas?

Mr. Milburn: I do not accept what my hon. Friend says. In any terms, these increases in funding for social services are very generous. It is worth recalling that social services budgets rose by less than 1 per cent. in real terms before this Government came to office, whereas they are now rising by 3 per cent. in real terms, and we are about to double that to 6 per cent. in real terms. It is absolutely right that social services have the opportunity to use those resources wisely and well. If I know social services, they will use the new incentives to improve and expand the range of services for elderly people.

Dr. Evan Harris (Oxford, West and Abingdon): I accept what the right hon. Gentleman says about poor funding in real terms up to 1997. Is he aware of the figure for real-terms growth in social services, which he and his predecessor controlled between 1997 and 1999? He will not find it in the Wanless report, because those two years are missing. Does he accept that it was less than 0 per cent. in real terms, and that we are now paying the price, as his hon. Friend the Member for North-West Leicestershire (David Taylor) has just acknowledged?

Mr. Milburn: The hon. Gentleman is like a broken record. He has only one tune and it is always the same—

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"More, more, more." However much we give, he always wants more money. He has to accept that when we came to office the public finances were out of control, inflation was back in the system and interest rates were rising. All those had to be sorted out.

We could not make the investment in our public services until we had achieved stability in the public finances and the economy. Frankly, if the hon. Gentleman and his party had been in office, we would have experienced precisely the veering between boom and bust that occurred when the Conservatives were in power, because they would not have had the discipline to do what was necessary to sort out the public finances.

Dr. Liam Fox (Woodspring): May I explore the detail of the point made from the Back Benches by the hon. Member for North-West Leicestershire (David Taylor)? If the changes proposed by the Secretary of State are introduced this year, and given current bed blocking in the NHS, what is the Department's estimate of the cost to local government?

Mr. Milburn: I am not sure that I have a figure for that off the top of my head.

Dr. Fox: You should have.

Mr. Milburn: Well, what I do know is that since we put extra resources into social services on top of the 3 per cent.—the extra £300 million that we distributed in November last year—delayed discharge from hospital has been falling. In September last year, about 6,400 elderly people were needlessly in hospital when they were ready for discharge but there was not adequate provision in the community. Today, the figure is about 4,700, but we must get it down further. To do that, we need not just more investment but reform of the system.

Frankly, as I go round the country—the hon. Member for Woodspring (Dr. Fox) must find this, too—I see that there is a lottery as to whether health and social services can work together in partnership. Basically, that relies on good relationships locally. I do not believe that elderly people, people with a mental health problem or people with a disability should have to rely on happenchance as regards whether a local authority and an NHS trust want to work together. There should be a positive incentive to ensure that they work together.

Mr. Bill O'Brien (Normanton): My right hon. Friend is making an important point about the relationship between local social services departments and the health service, and the changes will provide a better service for the elderly and the chronically sick and disabled. Will he consider the representations made by SIGOMA—the special interest group of municipal authorities—and, as we need that co-operation between the health authorities and the social services, meet SIGOMA representatives to discuss the progress that can be made in that relationship?

Mr. Milburn: Either the Minister of State, my hon. Friend the Member for Redditch (Jacqui Smith), or I would be extremely happy to meet representatives, and we shall of course discuss the detail of the proposals, but it is worth bearing in mind the fact that the hon. Member for Woodspring, who is the first to suggest that we should look abroad to other parts of Europe for the solution to

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all the problems in the NHS, might have reminded the House from the Dispatch Box that the proposal that we are discussing for England is precisely that which has worked in Sweden, Denmark and other countries. It has brought delayed discharge from hospital—the misery of so-called bed blocking—down to much more acceptable levels. The hon. Gentleman is always urging us to look abroad, except in respect of policies that we are implementing at home.

Jim Knight (South Dorset): I fully support the reform of the system and the Secretary of State's commitment to delegate the responsibility, but I am sure that he accepts that there is concern about whether there will be sufficient resources to fulfil that responsibility, particularly in counties such as Dorset, which are attractive retirement areas and where there is extreme pressure on the care sector. Can he give me any reassurance about those retired communities?

Mr. Milburn: Clearly we need to ensure that the resources are targeted to the right places and my hon. Friend will be aware that we are reviewing the distribution of resources not only for the NHS, but for social services. Most hon. Members accept that neither the SSA system for distributing local government finance, nor the system for distributing NHS resources, is quite right. I hope that, as we review the system, we will be able to take into account exactly such problems as my hon. Friend has described.

Geraint Davies (Croydon, Central): Is my right hon. Friend aware of the MORI poll in today's Financial Times? It shows that the tax and health package proposed by my right hon. Friend the Chancellor makes this year's Budget the most popular for 25 years. People do not think that the Budget will necessarily be good for them, but they recognise that it is good for the country's health service and economy. They do not want to return to an era of failure and cuts, which is what a Conservative Government would bring.

Mr. Milburn: My hon. Friend is absolutely right—as is the MORI poll, I suspect. My right hon. Friend the Chancellor has done the right thing by the country, although it was not necessarily the easy thing. He has raised the resources to secure the investment needed to put the NHS on a sustainable long-term footing. Even now, I ask Opposition Members contemplating voting against the Budget this evening to think again. It will not be credible for them to stand up in the Chamber—still less in their constituencies—and argue for more resources for their local services if they are not prepared to back investment across the whole health service.


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