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Mr. Roger Williams accordingly presented a Bill to establish a Port Protection Authority to exercise those powers and responsibilities now exercised by port health authorities, trading standards authorities and HM Customs and Excise; to monitor the legality, quality and integrity of imported goods and to collect any duties upon them; and to report annually to Parliament on its effectiveness in carrying out its duties: And the same was read the First time; and ordered to be read a Second time on Friday 19 July, and to be printed [Bill 132].
David Taylor (North-West Leicestershire): Given the great emphasis placed on the proposed national insurance changes by the shadow Chancellor of the Exchequer, is my right hon. Friend surprised by his absence? Perhaps it is symptomatic of the shambles that is Her Majesty's Opposition these days.
Mr. Smith: That is a matter for the Opposition. I can only conclude that the shadow Chancellor did not relish debating the issues yet again this afternoon. I shall have more to say later about his record and that of his right hon. and hon. Friends.
We are continuing the principle established in the 1940s of raising resources towards the cost of the national health service through national insurance contributions. The Bill will allocate those resources to a modern health service, building on the Beveridge principles to provide a system of comprehensive care on which we can all rely and of which we can all be proud. An NHS free to all at the point of need has been the subject of a consensus that has endured for the past 50 years. It is the fairest and most efficient way of funding health care and it was, until the last general election, the policy of the Conservative party.
Together with far-reaching reform, the extra resources that we are providing will deliver a health service worthy of a consensus of support for the years to come. I believe that the British people will draw a sharp contrast between the clarity, purpose and energy of our proposals, and the vacuous, evasive and world-weary cynicism of the shadow Chancellor and the Conservative Opposition, saying in public that they do not know what their policy is, while saying in private that chargesthe shadow Health Secretary's self-pay systemare the way forward.
Mr. John Taylor (Solihull): I am grateful to the Minister for giving way. I should like to impart to him a piece of information. The proposed national insurance contributions will increase by £900,000 per annum the take from Solihull council alone as an employer, quite apart from the cost to its employees or all the other employers and employees in Solihull. In other words, there will be many, many millions of pounds annually of extra money from my constituency. I will do a deal with the Minister. If he will give us a 24-hour accident and emergency facility at Solihull hospital, he can keep the change.
Mr. Smith: I take it from those comments that the hon. Gentleman means that, having talked to his constituents in Solihull, he will support us if the extra money goes into the national health service and raises standards as we propose. Were he to do so[Interruption.] Either he wants the money for Solihull hospital or he does not.
Mr. Smith: We will spend the money in the way in which the patients and public of Solihull need it to be spent. Commitments and reforms are being introduced that will deliver higher standards, shorter waiting times and more nurses and doctorsthe very things that I am sure his constituents want.
Mr. Taylor: I accept that remark in the spirit in which it was made, and I will tell the right hon. Gentleman what the people of Solihull want: 24-hour accident and emergency facilities at Solihull hospital. That is what they want and what they have told me to tell him.
Mr. Smith: And I am sure that they want a national health service that is comprehensively available and free at the point of need. That is the commitment that this party and this Government are making, but which Conservative Front Benchers refuse to make. The hon. Gentleman might like to take that message back to the people of Solihull and indeed to reflect on it himself.
To increase resources, employees and the self-employed will pay an extra 1 per cent. of all their earnings above £89 a week, so someone on the median income of £410 a week will pay £3.70, and those on higher incomes will pay more, while those on lower incomes will pay less. Indeed, half of families with children will pay less overall because of the introduction of the child tax credit and the working tax credit. As employers have a strong interest in having a healthy work force, they will make an equivalent additional contribution. It was the Confederation of British Industry that estimated that workplace absence cost British business more than £10 billion in 1999. I am sure that many employers would regard investment in their employees' health and welfare as not only a social obligation, but an economic necessity.
The extra money that we are investing must secure extra results, so my right hon. Friend the Secretary of State for Health has already announced vital new reforms, including new financial incentives for hospital performance, greater freedoms for high-performing hospitals and trusts, powers and resources that are devolved to front-line staff and primary care trusts, reform of social services care for the elderly and a series of measures increasing choice for patients. For the first time in the history of the NHS, there will be independent audit, inspection and scrutiny of patient complaints with a duty to account and report to the public on money spent and standards achieved. In future, an annual report to Parliament will be prepared by the new independent auditor, accounting for the money allocated to the NHS, where it has been spent and the results of the expenditure.
There will be a new system of financial incentives for NHS organisations. Hospitals that can treat more patients will earn more money. Traditional incentives have worked in the opposite direction; indeed, the poorest performers have often received most financial help. We will therefore introduce a new system for money to flow around the health service, ending perverse incentives and paying hospitals by results. The incentive will be to treat more NHS patients more quickly and to higher standards.
Patient choice will drive that system. Starting with those who have the most serious clinical conditions, patients will have a greater choice about when and where they are treated. From this summer, patients who have been waiting six months for a heart operation will be able to choose a hospital that has the capacity to offer quicker treatment.
So on the basis of reform and modernisation, we have announced the largest ever increase in investment in the NHS, raising United Kingdom NHS spending on average by 7.4 per cent. in real terms each yearan annual cash rise of 10 per cent. not just for three years, but for five years.
Mr. Steve Webb (Northavon): The Chief Secretary said that the fairest way to fund the extra money for the health service was through national insurance. Does he accept that some of the richest people in the land live not on earned income but on dividends and investment income, and that they will not pay a penny towards the increase to help the health service? Would not it therefore have been fairer to use income tax?