HC Deb 25 April 1989 vol 151 cc797-9
10. Mr. David Nicholson

To ask the Secretary of State for Health whether he has any plans to privatise the National Health Service.

Mr. Kenneth Clarke

No, Sir, and I never have had any such plans.

Mr. Nicholson

Will my right hon. and learned Friend sanction a modest amount of public expenditure to enable a special courier to take, by motorcycle, a copy of this exchange to BMA house, Tavistock square, because the BMA may not be aware of that fact? Is it not highly regrettable that those who are in a position to know the truth should seek so fundamentally to mislead their patients and our constituents?

Mr. Clarke

I agree with that, but I do not think that the BMA believes that we have any intention of privatising the NHS, or that we ever had any such intention. I think that the courier should be diverted to Walworth road. As we have seen this afternoon, the Labour party has no particular contribution to make at this stage to the evolution of the review or the doctors' contract. It is continuing to fight a totally bogus battle against a proposition that only the Labour party believes was ever made.

Mr. Campbell-Savours

Has the Secretary of State seen a copy of the report that I am holding in my hand from the General Audit Office in America—the American National Accounting Office—to the House of Representatives? It deals with private health care in America, roundly condemns the principle of fixed budgets and says that they lead to a reduction in health care. Will he send a copy of the report to every Member of the House before the next debate on these matters so that we can learn the truth from the experience of general practitioners in the United States of America?

Mr. Clarke

I believe that the British health care system is superior to that in the USA. There are centres of excellence in the United States where extremely high standards of medical care are achieved. There are also centres of excellence where extremely high standards of management and use of resources exist. We could learn from that experience. However, my White Paper proposals have nothing whatever to do with taking the National Health Service in the American direction. We remain firmly committed to the principles upon which the National Health Service is based.

Mr. Nicholas Bennett

Given that there are wide differences in cost between different hospitals for the same operation, and that waiting lists vary so greatly, has my right hon. and learned Friend received from the BMA—or, indeed, from the Labour party—any suggestion as to how this matter might be dealt with? Is not the Labour party's only vision of the future of the NHS one that is safe for COHSE and NUPE?

Mr. Clarke

My hon. Friend touches on one of the important problems in the National Health Service, and given that there are these apparently inexplicable differences in performance from place to place, it must be a worthwhile objective to so organise the Health Service that we raise standards everywhere to the high level achieved in some places now. I have most certainly received no proposals from the Labour party on that or on any other subject relating to the review. I look forward to receiving constructive proposals from the BMA which address the main point of how to raise standards everywhere for the benefit of patients.

Mr. Robin Cook

Has the Secretary of State read his own White paper? Is he not aware that it is dripping with commitments to privatisation? Will he put the record straight and confirm that GPs with practice budgets will be expected to use NHS money to buy private treatment? Will he confirm that opt-out hospitals will be expected to use NHS facilities to bid for private patients? Will he further confirm that today's Finance Bill contains a cash subsidy to private medicine? Does it not speak volumes for this Government's lack of commitment to a public Health Service that the very first proposal from the White Paper to be brought before the House is a straight cash hand-out to private medicine?

Mr. Clarke

The right hon. Gentleman has impaled himself on a hook by making such an allegation about privatisation, and he can find no factual basis in the White Paper or anywhere else to justify it. What he is describing are proposals which ensure that patients and GPs have the maximum choice to use National Health Service money to get the best quality service where they can find it, and provided as quickly as possible. That cannot be described as privatisation. It is using the taxpayers' money to the best advantage of the patient, and it is absurd to claim that we should exclude doctors and patients from high-quality operations provided quickly because we are using excess private sector capacity at a low cost. That is an enhancement of the service and no kind of privatisation at all.

Mr. Robert B. Jones

My right hon. and learned Friend's answer will be regarded as what it is—clear and the truth. Would it not have been better if the BMA had kept to the truth instead of launching an outrageous campaign to frighten little old ladies and other poor pensioners?

Mr. Clarke

I certainly would welcome it if the BMA withdrew its untruthful leaflet and substituted one which tried to make constructive proposals on the contract. I certainly hope that all doctors will forbear from making untruthful allegations to elderly and vulnerable patients, so causing them needless alarm. The contract seeks to enhance services to elderly people and I trust that doctors will acknowledge that and seek to build on it.