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ROYAL ASSENT
Madam Speaker: I have to notify the House, in accordance with the Royal Assent Act 1967, that the Queen has signified Her Royal Assent to the following Acts:
Consolidated Fund Act 1998
Fossil Fuel Levy Act 1998
Wireless Telegraphy Act 1998
Nuclear Explosions (Prohibition and Inspections) Act 1998
The Secretary of State for Health (Mr. Frank Dobson):
Madam Speaker, yesterday's Budget has, rightly, been well received. It confirmed new Labour's reputation for economic competence. It was a Budget for enterprise, a Budget for work and a Budget for families, and it was a Budget for our national health service.
The £500 million the Chancellor announced yesterday takes to £2 billion the extra money that the Government have put into the health service in the 10 months we have been in power. That £2 billion in ten months is about £5 million extra for the health service for every single day of the coming year. That is more than the Tories ever planned, and even more than the Liberals promised.
I intend to put that money to very good use. At the general election, we promised to save the national health service and to modernise it. We have kept that promise, as we keep all our promises. We have saved the national health service; we are modernising it. We are doing that in partnership with the million people who work in the health service. We have asked them to work in new and better ways, and we have matched that by extra funds.
When we took over, waiting lists had been rising since 1995, and record numbers of patients were waiting for treatment. I made it clear that the first priority for the NHS was to ensure that the health service avoided a winter crisis. I asked the people working in the health service to make contingency plans, to break down the Berlin wall between hospitals and community and social services, and to make sure that emergency and urgent cases were treated promptly.
NHS and social services staff responded magnificently. The Government provided an extra £300 million, and, with the help of the 1,500 special schemes introduced this winter, the NHS has treated record numbers of emergency cases and record numbers of people off the waiting lists.
As top priority was given to emergencies, waiting lists have grown despite all the hard work of the staff. I set that priority, and the health service met that priority--I congratulate it on doing so. That effort was not simply a one-off for the winter, however; it was a long-term investment for the future. It has put in place new partnerships between general practitioners, hospitals and social services to tackle long-standing problems, which had denied some people high-quality treatment at home or in the community. Those new partnerships will endure.
Now we shall build on those partnerships. We shall bring the same combination of investment and modernisation to bear down on waiting lists. Today, I can spell out that our top priority for the coming year is to reduce waiting lists, using the extra £500 million that my right hon. Friend the Chancellor announced in his Budget yesterday. That £500 million comes on top of the extra £1.2 billion for the NHS next year that had already been announced.
Of that extra money, £417 million will be invested in the health service in England. Three hundred and twenty million pounds of that will go directly into cutting waiting lists; it will be invested in more operations, more surgical and medical sessions, more doctors, more nurses, and more flexible seven-day working. It should result in the biggest increase in the number of operations in the history
of the NHS and the biggest ever cut in waiting lists. The money will be earmarked and targeted to deliver what patients most want--shorter waiting lists.
Each health authority and trust will have to play its part, and each will be set a challenging individual target. The waiting lists action team will step up its advice and support, and performance will be closely monitored in every part of the country. Best practice will be identified and spread, and everywhere standards will be driven up. There will be rewards for those who hit their targets and sanctions for those who do not. The chief executive of the NHS, Alan Langlands, will oversee performance in meeting those targets; he will regularly report to me personally.
The rest of the extra money will also be invested in cutting waiting lists. The flow of operations will be maintained by building on the success of the new ways of working that were pioneered this winter, and through better primary, community and mental health services. We shall also start to modernise the waiting list system, which is archaic. Some of the extra money will be spent on pioneering new streamlined appointment systems so that day case patients can book the date that suits them for an operation. Again, we shall manage the new investment closely to ensure that our objectives are delivered.
I said last year that the waiting lists were like a supertanker--it would take time to slow them down, longer to bring them to a stop, and even longer to turn them around. Waiting lists are still growing, but, as our measures bite, we shall halt the rise, and, by the second half of the year, they will be coming down. Through targeted investment, good management and innovative change, we shall do better than the Tories ever did. In the 18 years of Conservative government, the number of people on waiting lists rose by more than 400,000. In the next 12 months of a Labour Government, the numbers will fall, and will continue to fall.
By April next year, I expect hospital waiting lists in England to be shorter than the 1.16 million record level that we inherited from the previous Government. That is the target. Delivering that target will be a significant stepping stone towards fulfilling our pledge to reduce, in this Parliament, waiting lists by 100,000 from the level that we inherited.
The target is ambitious, but I am confident that, provided we do not encounter a dreadful winter or major epidemic, we can meet it. [Hon. Members: "Ah."] Fools opposite apparently think that the system could cope with a major epidemic; perhaps they think that we could cope with the arrival of an asteroid. I am confident that the target can be met, because our ambition to cut waiting lists is shared by the people who do the work in the health service, as well as by the people who need operations.
The Budget was a defining moment, because it showed clearly what new Labour means: enterprise, efficiency and fairness going together. The Government's sound management of the economy has enabled us to find more money for our priorities, and in particular for health. As a result, there can be extra investment.
I am determined to ensure that patients and taxpayers get full value for that investment. That will require modernisation and reform, and I know that the staff of the
NHS will match our commitment with their own. It was a new Labour Budget for a new health service, delivering on our promises to the people at the general election.
Mr. John Maples (Stratford-on-Avon):
In the general election campaign, the Labour party made a specific promise: to reduce waiting lists by 100,000. The Secretary of State talks a lot about ambitious targets and supertankers, but I wonder whether the electorate would have been so impressed if they had known that it was a five-year promise. Somehow, reducing waiting lists by 20,000 a year does not sound quite so impressive. Even he should be able to turn a supertanker round in less than five years.
Since the general election, far from falling by 100,000, waiting lists have risen by 100,000, and they have almost certainly continued to rise this winter, and will probably do so this summer. Labour made another promise, intimately connected with waiting lists: to spend more money than us, every year. Our spending plans were criticised in the most exaggerated and emotional terms and denounced as inadequate. Has Labour done better? No, it has not. [Interruption.]
Labour Members do not like this figure, but, for 18 years under the Conservatives, the national health service budget increased by an average of 3.1 per cent. a year over and above inflation. Under Labour, the increase for last year and next year will average 1.8 per cent.
Yesterday, the Chancellor said that there would be £500 million more for health, but the Red Book details show that the increase is only £420 million for England, of which only £340 million is being spent on the NHS. Why is England getting only 84 per cent. of the money, when it got 90 per cent. of the winter emergency money? According to the Red Book, which many members of the Government have clearly not read, England is getting £420 million out of the £500 million. What is the other £80 million--the difference between the £420 million allocated to the Department and the £340 million for the NHS--to be spent on?
Will the Secretary of State confirm that hidden away in the Red Book was an increase in the estimate of inflation for next year; that the estimate of the gross domestic product deflator was raised from 2.75 per cent. to 3 per cent.; and that that will reduce real spending in the NHS by £90 million? When that is taken into account, the £500 million becomes not £420 million or £340 million but £250 million extra in real terms for the NHS in England.
The Secretary of State says that he intends to spend £320 million on reducing waiting lists, and that he will get us back to where he started in two years' time. What an achievement: he will have turned his supertanker 360 deg, and gone absolutely nowhere in two years. Will he go a little further and promise the House that his pledge to reduce waiting lists by 100,000 from the figure that he inherited will have been fulfilled by May 1999?
Can the Secretary of State confirm that the national health service budget increased in real terms by only 1.27 per cent. in 1997-98; that, even with the extra £500 million announced yesterday, the increase in real terms will be only 2.3 per cent. in 1998-99; that the average real-terms increase between 1979 and 1997 was 3.1 per cent.; and that, if the NHS budget had continued
to be increased at the same rate under Labour as it was under the Conservatives, the NHS would have an additional £940 million to spend next year?
3.31 pm
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