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Kevin Brennan: My hon. Friend is right to say that the Liberal Democrats' argument is nonsense. In their 1997 manifesto they promised to spend £540 million extra on the health service. We spent more than that on the health service during that Parliament. They promised to fund increases by putting up taxes on cigaretteswhich the Government didand by tinkering with national
Phil Hope: Tripe may be too polite a word to describe the contribution of the Liberal Democrats. It was interesting that the Liberal Democrat spokesman signally failed to answer the question that my hon. Friend the Paymaster General asked about exactly how the Liberal Democrats were going to fund their proposals. What was it they announced today for their manifesto at the next election? I think I heard it said that they would abolish all prescription charges. I think that free eye tests and free dental checks were mentioned. It will be interesting to read the Liberal Democrats' manifesto. Their current spending plans do not match what we are putting into the NHS, and they would put extra costs on top, which they do not have a clue how to fund.
Phil Hope: There is another reason why this debate is important. Why do we need to put more money into the NHS? The Labour Government have spent five years investing in the NHS. In my area, we have a totally refurbished accident and emergency unit. We have a new orthopaedic centre, a new endoscopy suite and a new eye care ward. I have a list here. There has been hundreds of thousands of pounds of new investment under a Labour Government in the past five years, which I am proud of and which my constituents are benefiting frombut all is not right in the NHS. We would not be here raising money through national insurance contributions and putting through wholesale reforms of the NHS if all were well with the world. We know that it is not. That is why we have the Bill. We need more resources and more reform.
There are still huge problems to be addressed, but unlike the Tories and the Liberal Democrats, instead of running down the nurses and doctors who work in the health service, instead of rubbishing what has already been achieved, we acknowledge what we have achieved, but rightly say that we have a lot more to do.
I shall now make a small constituency pointa plea to the Economic Secretary to the Treasury, who is now on the Front Bench. I know that she does not have responsibility for health care spend, but forgive me if I make the point that a recent report by Northamptonshire health authority showed that Corby had the highest inequalities in Northamptonshire. Corby people have the lowest life expectancy, the highest levels of coronary heart disease, the highest death rates from cancer, the worst rate of respiratory diseases and the highest levels of child poverty in Northamptonshire. Therefore, Corby desperately needs the extra investment. Increased spending on the NHS is literally a question of life or death
This is not just about the treatment that people receive from their general practitioner, or their hospital operation. We all have people with those particular needs in our constituencies, but I want to emphasise what I call the softer side of health care, which is about preventing ill health. The money should be used to promote a healthy lifestyle. Activities such as the sure start programme, which is partly funded by the health service, make a real difference to children and families in the poorest estates in my constituency.
In the rural area of my constituency, we have some innovative schemes run jointly by health and social services. We have a hospital at home service, funded by the NHS but allowing patients in rural areas to return home sooner than they would otherwise do after their operations. We have heard a lot of nonsense from the Opposition about bed blocking. We know that bed blocking causes a squeeze in the system because people cannot leave hospital, but we are putting the resources in. We are investing in social services and in provision such as intermediate care for elderly people, so that people can leave the NHS when they have had their treatment and recuperate away from the hospital bed, freeing that for another person to be treated. In a place near home, or even in their own home, they can receive the treatment that they need after an operation.
Corby has many needs that still need to be met. That is why I support the Billto raise the money to meet the needs of my constituents. We need a new cardiac diagnostic centre for people in the town because we have such a high level of coronary heart disease. We need improved dental services. There cannot be one hon. Member who does not know of problems with the delivery of good dental care in his or her constituency. We also need better services for people with cataractsbasic ways of delivering services, which can be improved through raising resources and reforming the NHS as we are doing at the moment.
The Tories' contribution today was shambolic. They have not said that they will match our spending plans, yet they say that they believe in an NHS free at the point of delivery. How will they pay for the expenditure that is clearly needed for an NHS free at the point of delivery? They hide. They do not say how they will do it. They say, "That will be explained in four years' time at the general election"but that is not good enough. The challenge is on the table. Would Conservatives charge patients for their care? Would they force people into private health insurance?
We have seen some clues to what the answers may be. We have heard the shadow Secretary of State for Health publicly state that he wants to break the link between the NHS and health care. We have heard the shadow
Mr. Christopher Chope (Christchurch): What does the hon. Gentleman think about the 250,000 people who last year had to pay for their health care by using their own money to obtain operations and appointments?
Phil Hope: That almost indicates the Tory mentality exactly. Their answer is not to provide a decent NHS but to offer tax incentives for people who have the money to get a better health service. They want a two-tier health serviceone standard for the rich who can afford it and a second-class health service for those who cannot. That is the essence of Conservative philosophy.
Ann McKechin (Glasgow, Maryhill): Is it not the height of hypocrisy for Conservative Members to talk about the rise in national insurance, because last time they were in government they increased national insurance in 1995 but cut benefits? This Government may be increasing national insurance, but they are doing it for the benefit of the whole population.
Phil Hope: My hon. Friend is absolutely right. That is the essence of Labour's approach: a fair form of raising taxation to be distributed equally, so that people in most need do not have to worry about whether they can afford to have an operation, because it will be provided for them through the NHS. Under the Conservatives, people would wake up and say, "Can I afford that operation? Should I put a bit by? How will I afford to pay for my visit to the doctor?" Can hon. Members imagine a Conservative world where people wake up every morning thinking, "I hope I don't fall ill today, because I haven't any money in the bank to pay for an operation"? That may be the Conservative world, but it is not the world that I want to live in.
Mr. Bill Wiggin (Leominster): The hon. Gentleman will understand that those 250,000 people who have paid for their operations are waking up thinking exactly the things that he has just mentioned. I understand why he is so excited about the expenditure that the Government are promising, but if things do not get better, at what point will he recognise that that expenditure alone has not been enough?
Phil Hope: I will know that I do not have to worry when the Conservatives decide to vote for the NHS for the first time in their historywhen they decide tonight to walk through the Aye Lobby to support the Bill in favour of a national insurance contribution increase that will fund year on year the kind of health service that we want. This is not just about money. We know that. It is also about reform. I hope that in years to come the Conservatives will walk through the Division Lobby with Labour, voting for a reform of the NHS that will deliver a fair and efficient health service, as well as the money to go with it.
This is a fundamental choice between left and right; it is back to good old politics. This is what we are about: an NHS funded through general taxationa comprehensive system free at the point of delivery, and delivered according to people's need, not their ability to pay. When the Conservatives walk through the No Lobby they will be saying, "Look after yourself." That is the choice. It is a simple choice. Strangely enough, the Liberal Democrats will vote with us, despite the contribution of their spokesperson earlierand I know that the Conservatives will vote against. I know that people in my constituency will welcome the fact that we are making a historic decision, and I am proud to be part of it.