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John Mann: My hospital has a new accident and emergency unit, which was created in the past two years. Has not the hon. Gentleman's hospital also had one?

Mr. Lidington: The straightforward answer is no. If the hon. Gentleman looks back at the history of the health service under 18 years of Conservative government and five years of Labour government, he will find that there are examples under both Administrations of particular units being redeveloped and new facilities provided. At the moment, the Government—certainly in the form of the

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Labour party chairman—have admitted that performance in public services is patchy and in some cases has been getting worse. There is a vast gap between the improvement that people expect, and believed that the Government had promised them, and the standards being delivered.

The Government would have us believe that the answer is simply to enable large amounts of public money, raised through additional taxation, to be spent on the health service, without the thorough reform that is necessary. To spot the problems with that we need only look at Scotland and Wales, where spending is much higher than in England but the service is worse in some important respects, and becoming worse still.

Of course our constituents want more to be spent on health care, and so does my party. I want to make that clear beyond question to the Chief Secretary. People also want the United Kingdom's health service to match and, if possible, surpass the highest standards that patients can find in other developed countries. Again, so do we. The Government are in danger of underestimating the extent to which members of the public now assess, with increasing interest, the service available in some European countries in particular, and ask why treatments and waiting times provided by our partners in Europe are better, in certain key respects, than those in the national health service. They want to know why we cannot learn lessons from the experience of our neighbours.

Mr. Tom Harris (Glasgow, Cathcart): Perhaps the people to whom the hon. Gentleman refers are employed by Conservative central office. Opinion polls have shown that 70 per cent. of the nation warmly welcomes the Government's commitment to funding the health service publicly. How can he say that the general public view is that the service should not be funded in the way that we propose?

Mr. Lidington: I am disappointed that the hon. Gentleman maintains such a closed mind on the subject. The same opinion polls show that the public do not believe that the measures announced by the Government will deliver the improvements in health care that they want. Polls also show increased readiness to look at experience elsewhere, especially since some patients from south-east England in particular have begun to experience treatment in European hospitals as a consequence of measures introduced recently by Ministers.

Mr. Andrew Smith: While on the subject of open minds, perhaps the hon. Gentleman could open his mind a little and share his thinking with us; otherwise, when the public judge these matters they will conclude that he and his party are in an intellectually and politically bankrupt position. The Conservatives say that they recognise the need for extra money for the health service and that they respect certain of its principles, but they will not say how much they would put in and where they would get it from. Will he give the public an idea of how much extra money he is talking about, and where he would find it?

Mr. Lidington: The right hon. Gentleman protests too much. He has heard what our position is from my right hon. Friends the Leader of the Opposition and the shadow Chancellor, and from other Conservative Members.

Mr. Smith: What is it?

Mr. Lidington: The right hon. Gentleman knows that we are committed to giving the people of this country a

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health service of world standard to which everyone will have access, and that we believe that top-quality health care should be available to the British people irrespective of their ability to pay. He is right that we have not yet produced a finished, costed policy proposal, but I remind him that when my right hon. Friend the Member for Chingford and Woodford Green (Mr. Duncan Smith) was elected Leader of the Opposition roughly seven months ago, he instituted a thorough policy review including, naturally, a review of our policy on health care.

The public would expect of a party such as mine, which suffered a right clobbering in two successive general elections, a period of careful and thorough reflection on its policies.

Mr. Mark Hendrick (Preston) rose

Mr. Lidington: They would expect Conservatives to examine the experience of other countries, and to offer clear and costed proposals when we have completed that period of analysis. That is what we shall do—and well before the next general election.

Mr. Andrew Smith: Yesterday's Financial Times states:


Is that true?

Mr. Lidington: No. The timing of our announcement will be determined by our satisfying ourselves that we have the right policy mix to provide the top-quality service that people expect and are entitled to, and by our working out how that service should be financed and what it will cost. We can then put forward detailed proposals that will stand up to the rigorous debate and scrutiny that we will be happy to submit them to.

Mr. Hendrick: Will the hon. Gentleman give way?

Mr. Lidington: No, I shall not give way again now. I have given a clear explanation of where we stand on this matter.

The way to secure the improvement that people want is to learn from the experience of others. We should not, as the Government would have us do, close our minds to lessons from abroad on how we could modernise and improve the quality of health care.

Matthew Taylor (Truro and St. Austell): As the hon. Gentleman does not want closed minds, he is presumably aware that a large range of systems exists throughout Europe: from the Danish system that, although a little more decentralised than ours, is similar in most respects, to the French system, in which people pay to see their doctor. As he suggests, all European systems deliver quicker treatment for patients and shorter waiting times. However, that can surely be attributed not to the existence of many different funding systems—including systems such as ours—but to the fact that every single other country has more doctors per head of population.

Mr. Lidington: I have already told the House that we accept the need for additional resources for health care.

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We must get right the amount of money that goes into health care, but we also need a much greater degree of decentralisation and devolution of decision-making powers than exists under the current system. The record shows, however, that we are not going to get that from the current team of Ministers. We further need to decide on a way of funding the health service that will lever in resources in the quantity achieved by the European countries to which the hon. Gentleman refers.

Matthew Taylor: The hon. Gentleman is unsure about how to reform funding, but he agrees that we need more doctors. He and his party agree that we need to put more money into social services, so that we can pay for care for elderly people in residential and nursing homes and in their own homes, thereby freeing up hospital beds. Why, therefore, should we wait to implement those measures until his party has come up with an alternative that it has yet to think of? Why not act now and spend the money on social services, and on the provision of the extra doctors whom he agrees are needed?

Mr. Lidington: The hon. Gentleman is ignoring the fact that the Government were elected five years ago, and again last year, on a programme of promised improvements to the health service. We believe that reforms are needed to deliver those promised improvements in quality. The Government have not come forward with the necessary proposals for reform, and on those grounds we do not believe they have justified the tax increases that they propose today. I am only sorry that the hon. Gentleman has been left alone in the Chamber today by his colleagues and I wish that he had been able to persuade more of them to attend.

We intend to hold the Government to their word, both on the reforms that they have promised but failed to deliver to the health service and on employees' contributions to national insurance. The Chancellor, in his evidence to the Treasury Committee in December last year, said that he had made a pledge not to raise income tax because the Government "wanted to reward work". He said that that was


It would be hard to devise any measure better calculated to blow a hole in that strategy than an increase in taxation that hits only those people who are in work. As the Institute for Fiscal Studies has pointed out, the increase in contributions and the removal of the ceiling


Other groups at work will be hit disproportionately hard. We have about 100,000 older women and widows on low pay who rely on their husbands' pension provision through the national insurance system and pay only 3.85 per cent. rather than the standard 10 per cent. rate. A 1 per cent. increase in the rate payable by those mostly older women, many of whom are now approaching retirement, means an effective rise of a quarter in the contribution that they pay to the Treasury.


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