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Mr. John Bercow (Buckingham): Perhaps uncharacteristically, I should like to put an entirely non-partisan question to the Secretary of State. Is he aware that 1.4 million people have been diagnosed with diabetes, but that another estimated 1 million people have not been diagnosed? Is he also aware--I suspect that he is--that serious complications can result from late diagnosis, including heart trouble, kidney failure and even blindness? In the light of those disturbing facts, will he endorse the call by Diabetes UK for commitment to the diabetes pledge, which is a pledge for the Government to commit themselves to a thorough and continuing screening programme?
Mr. Milburn: The hon. Gentleman makes an extremely important point. Diabetes is a disease that affects very many people in our country. If it is not diagnosed and treated early, it can have precisely the effects that he described.
The hon. Gentleman will be interested to know that I hope over the next year or so to put together a new blueprint for improvements in diabetes services. The new national standards will apply everywhere, and not just in one part of the country. He will be aware that there is a lottery in care in diabetes services, but that lottery has existed for too long in too many NHS services. However, the choices that we have made and the investment that we are putting in means that we can change that.
For example, the hon. Gentleman will know that diabetes patients need the support of social services as well as of the NHS. The question for him is whether the shadow Chancellor will promise at the Dispatch Box to match the Government's increases in spending on social services and on the NHS. The hon. Gentleman should understand that I mean not only the social services spending that comes from the Department of Health, but the local government spending through the Department of the Environment, Transport and the Regions. The hon. Gentleman's constituents--those who are diabetes patients, and those who are not--will be listening carefully to what the shadow Chancellor has to say on the matter.
The Government are to increase public spending by 3.7 per cent., but the shadow Chancellor, in contrast, has committed the Conservative party to spending rises of just 2.25 per cent. a year, or even less. How will the Opposition fill the spending gap? That is the challenge that they face. If they grow spending at just 2.25 per cent. a year, they will have to cut the Government's spending plans by more than £16 billion by 2003-04. If they postpone cuts for just one year--as they now say they will--they will have to find more than £10 billion of cuts over the following two years.
As the Opposition have failed already to find £8 billion of savings to close the spending gap, there is precisely no chance that they will find £10 billion in savings unless they do what they have promised to do in the past--cut into the country's vital public services. Those services--health, education, transport and the fight against crime--are now under threat from the choices made by the Conservative party and the shadow Chancellor. They have chosen unaffordable tax cuts, instead of investment in our key public services.
Mr. Milburn: The hon. Gentleman says that that is wrong, but he should read more carefully what the right hon. Member for Kensington and Chelsea has had to say on the matter. Otherwise, he--and, I suspect, his constituents--will be in for a surprise at the next general election.
Mr. St. Aubyn: Surely it has entered the Secretary of State's brain that the tax cuts proposed by the Conservatives amount to £8 billion, not £16 billion. They have all been carefully costed outside the areas of health and education that we are discussing this afternoon.
Mr. Milburn: Careful costing is not the preserve of the right hon. Member for Kensington and Chelsea, his Front-Bench team or today's Conservative party. They cannot commit to invest to modernise the NHS, so that is why they are now committed to privatising it. We know that from what the shadow Chancellor and other Conservative Members have said. The shadow Chancellor could not have made it clearer. I think that it was in October last year that he told the "Today" programme that he expected those who were able to do so to make "a little extra contribution".
The Opposition's policies do not make sense. Their sums do not add up: they are unaffordable, unsustainable and unbelievable. The choice before the country could not be clearer--between policies that bring economic stability and policies that would bring a return to boom and bust, between sustained investment in public services and a return to cuts in public services, and between an expanding, reforming NHS and a contracting, privatising NHS.
I believe that the House will not be overly grateful to the Secretary of State for coming here this afternoon and making a series of announcements that we all read about in this morning's newspapers and heard about from this morning's media. It is typical of the Secretary of State and of the Government to display such discourtesy towards, and contempt for, the House of Commons.
Every time the Government announce more money for the national health service, they tell us that they will revolutionise the service, but nothing ever improves. Before the last election, the Prime Minister stood in front of posters that said that waiting lists would be shorter, but, in fact, they are longer. Doctors in today's national health service are forced to put Ministers' political priorities ahead of patients' clinical needs, which means that the sickest patients are often those who are made to wait the longest. There are 20,000 nursing vacancies in the national health service. The Government promised to end postcode prescribing, but they have not. They promised to end mixed-sex wards, but they have not. They have imposed dogmatic restrictions on new consultants, which means that many doctors could be leaving the national health service.
Mr. Milburn: Will the right hon. Gentleman clarify one aspect of policy? He has made much of matching our spending on the national health service. Will he give a cast-iron guarantee that, were there to be a Conservative Government, he would match our social services spending across the piece and not just in the Department of Health?
Mr. Portillo: The right hon. Gentleman has obviously forgotten a lot since he left the Treasury. The Government are not in a position to guarantee social services spending because much of it is controlled by local government.
This year's Budget, like all the Chancellor's Budgets, has unravelled very quickly. Now that we have had a chance to study the details, six points emerge. First, it is evident that the Chancellor's speech was, as usual, more spin than substance. That has become a new Budget tradition. Secondly, the Chancellor's claims about economic management completely ignore the golden inheritance that we bequeathed him. In his review of the economy, the right hon. Gentleman completely overlooked the fact that most of our competitors are doing better than we are.
Thirdly, the Budget continues the process of undermining this country's competitive position. Fourthly, it confirms that the Government plan a programme of unsustainable increases in tax and spending. Fifthly, the Chancellor continues his mission of taking money in taxes from those who can ill afford to pay them and forcing them to go cap in hand to the Government for benefits. Sixthly, the Budget did nothing to reduce Government waste and bureaucracy, so that despite the relentless increases in taxation that the Chancellor has imposed, our public services are actually getting worse. The Government have taxed more and delivered less.
Under this Chancellor, the Budget speech has become a series of soundbites, intended to mislead rather than inform. For example, the Chancellor claimed that the rate of increase in Government spending was to rise from 3.4 per cent. to 3.7 per cent., something that the Secretary of State for Health dwelt on towards the end of his speech. More plainly, the Chancellor meant that he had underspent this year by £3.4 billion, that he would underspend over three years by £5 billion and that the figure for 2003-04, which is the last year of his plans, is virtually unchanged. That is a very curious way of presenting his figures.
Similarly, the Chancellor greatly overdid his pre-Budget spinning. The House will remember that there was much talk of tax cuts in advance of the Budget. In the event, the Chancellor brought forth a mouse. The flagship of his tax cuts was his plan to widen the 10p band of income tax. Now that we have analysed it, it turns out to be worth 69p a week.
When people next go to the petrol station and see that Britain still has the most expensive fuel in Europe and that it still costs £50 to fill the tank of a Mondeo, I do not think that they will feel overly grateful to the Chancellor of the Exchequer for the fact that he has allowed them to keep an extra 69p. After 45 stealth tax rises, the right hon. Gentleman has responded with a miserly 69p.
The Chancellor approached the Budget with a very large surplus, but it is not his surplus; it is the people's surplus. The Government's money is not theirs; it is the people's money. The people have been overtaxed and they had every reason to expect that they would get their money back in this Budget.
The Chancellor was not much more frank when he spoke about the economy, which has been growing not, as he would like us to believe, since May 1997, but since the beginning of 1992. By definition, five of those nine years were under the previous Government. Unemployment has been falling not, as the Chancellor would like us to believe, since May 1997, but since the middle of 1993. Indeed, it has been falling more slowly since 1997 than it did between 1993 and 1997.
It is true--I give the Chancellor this point--that economic growth and falling unemployment enable Governments to spend less on debt interest and on benefits for people who are out of work, but the foundations that brought about those possibilities and changes were laid by the Chancellor's predecessors. In fact, the proud boast of this Government is that, uniquely among Labour Governments, they have not reversed the improving economic trends that they inherited--they have merely slowed them down.