§ Mrs. Virginia Bottomley
The share of gross domestic product spent on the national health service from all sources has increased from 4.7 per cent. in 1978–79 to an estimated 5.8 per cent. this year—a rise of more than 1 per cent. Figures for the earlier period are not available on the same basis, but show a similar 1 per cent. increase in the share of GDP spent on the health service between 1970 and 1974. Between 1974 and 1979, however, health spending as a proportion of GDP rose by only 0.3 per cent.
§ Mr. Day
Will my right hon. Friend accept my congratulations—and, I believe, those of the whole House—on that record of achievement under Conservative control? Such a record was never matched or even dreamt of by the so-called friends of the NHS on the Opposition Benches.
Does my right hon. Friend agree that performance in the NHS can be measured not only by the amount that is spent but by the return in terms of health benefit? Does she feel that her recent White Paper will help to produce further achievements?
§ Mrs. Bottomley
I thank my hon. Friend for his comments. Indeed, the purpose of our latest White Paper, "Health of the Nation", is precisely to maximise the health gain that is achievable for the nation. Inevitably, any Secretary of State must achieve best value for money, but 959 real health gains can be achieved through concentration on disease prevention and health promotion as well as on the delivery of services. We are in the business of health as well as health care.
§ Mr. Robin Cook
Before the Secretary of State disappears in a puff of complacency about her expenditure, may I invite her to report on her income? Will she admit that, since 1979, the rate of increase in charges to patients has been double the rate of increase in spending; that the increase in prescription charges has been eight times the rate of inflation; that pay bed charges have risen tenfold; and that, on top of that, any dental patient who seeks treatment must pay three times more—provided, of course, that he or she can find a dentist to provide treatment? If the Government really want us to believe that they are committed to the NHS, will they stop turning it into a pay-as-you-go service?
§ Mrs. Bottomley
Charges have been part of the NHS since its early days. We must ensure that we maximise its ability to provide high-quality services. We have never provided such good dental care; we have never immunised so many children; life expectancy has improved over the past 12 years. On a number of criteria, health has been improving through the achievement of good value for money.
I worked in the health service when the Labour party was in power. Then, it was not a case of putting cash before care; it was a case of cash-free, care-free national health service. Expenditure was cut in real terms.