HC Deb 03 December 1996 vol 286 cc780-2
3. Mr. Pawsey

To ask the Secretary of State for Health what is the current level of spending on the national health service; and what it was in (a) 1979 and (b) 1989 in real terms. [5612]

The Secretary of State for Health (Mr. Stephen Dorrell)

National health service total net expenditure in England is planned to be £34.4 billion in 1997–98. At constant prices, the equivalent expenditure in 1978–79 was £19.6 billion, and in 1988–89 was £26.5 billion.

Mr. Pawsey

I thank my right hon. Friend for that very revealing reply, which emphasises, as nothing else would, the Government's continuing commitment to the nation's health. Does my right hon. Friend agree that the evidence for that increase in spending can be found in every trust hospital and every fundholder's surgery and is experienced by every member of the public who goes for treatment?

Mr. Dorrell

My hon. Friend is absolutely right. Those figures represent a 30 per cent. real terms increase since 1990—an increase of three quarters since 1979. Most important for the future is the Prime Minister's commitment to year on year on year on year on year real terms increases in NHS spending. In this morning's Daily Mirror, the hon. Member for Islington, South and Finsbury (Mr. Smith) wrote an article. He said: Labour will match the Tories' plan for funding the NHS—we are very serious about that"— so serious that they will match it for year one. What about year two, year three, year four and year five of the next Parliament?

Mr. Simon Hughes

I believe that everyone will welcome what is a relatively generous settlement for the coming year, which has been secured by the Secretary of State and by the Government. The Secretary of State is correct to say that, even after this morning's speech by the hon. Member for Islington, South and Finsbury (Mr. Smith), the Government's financial commitment is considerably greater than the Labour party's.

If the Government are so committed, why is there not a similar commitment for the following years, which, according to the Chancellor's announcement, do not show any continuing real growth? Is not the truth that the Government are still always tempted to give tax cuts, such as those that they will vote through tonight, which only Liberal Democrat Members continue to oppose?

Mr. Dorrell

I am grateful to the hon. Gentleman for his recognition of a "relatively generous settlement", as he called it, for next year but, with respect, he is wrong about future years. The Red Book shows a real-terms increase, to which we are pledged, for national health service expenditure in year 2 and year 3. The Labour party refuses to give such a pledge. The hon. Gentleman was too generous to the shadow health spokesman, whose pledge for next year is not to volunteer back to the Treasury health money that this Government have committed to the NHS.

Mr. Dunn

Can my right hon. Friend confirm that the Government's commitment to the national health service allows the people of Dartford—

Mr. Jacques Arnold

And Gravesham.

Mr. Dunn

—to look forward to the construction of a new district general hospital early in the new year? Will he accept my thanks and pass them on to his Ministers and other colleagues who have worked so hard to bring about that result?

Mr. Dorrell

I am grateful to my hon. Friend. I was as pleased as he was by the health authority's decision last Thursday. If and when the hospital is built, as we intend that it should be, I am sure that it will benefit the citizens of both Dartford and Gravesham. I look forward to the day.

Mr. Chris Smith

Will the Secretary of State confirm, first, that he has cut capital spending on the health service by one third in the current year and next year and, secondly, that page 124 of the Red Book, which presents the control totals in real-terms figures, shows that, between 1998 and 1999, there is to be no real-terms increase in planned spending on the health service? Does not that show that the Chancellor has already torn up the promise given by the Prime Minister at the Tory party conference?

Mr. Dorrell

The hon. Gentleman is wrong on both counts. The Red Book makes it clear that the cash plans for the health service in year three are increasing faster than the GDP deflator. [HON. MEMBERS: "Real terms."] We plan for the health service in cash spending, as the hon. Member for Islington, South and Finsbury (Mr. Smith) is also committed to do. The cash spending for the health service in year three increases faster than inflation. Hon. Gentlemen might misunderstand me. Faster than inflation means real-terms growth. That is what the Government are committed to, what they have delivered for 18 years and what this Conservative Government will deliver in the next Parliament. The hon. Gentleman has only to wait and see.

Mr. Duncan Smith

Does my right hon. Friend agree that, notwithstanding the increase in the figures, one of the key points is the way that the service is delivered? It is more efficiently delivered now, so the pounds spent are spent on more people. I am particularly concerned about fundholding practices. The Opposition's position on fundholding is oblique. Will my right hon. Friend make it clear to the House that we seek to increase the number of fundholders, because fundholding has worked?

Mr. Dorrell

My hon. Friend is right to say that fundholding has worked. It is the option that has been chosen by almost 60 per cent. of GPs in England—because they believe that it is in the interests of their NHS patients that they should be come fundholders. My hon. Friend was wrong about the hon. Member for Islington, South and Finsbury. The hon. Gentleman made it crystal clear this morning that he intends to abolish fundholding—[HON. MEMBERS: "Hear, hear."] Hear, hear, Opposition Members say. If they really cared about health service patients, they would take the hon. Gentleman to one side and ask him why he intends, if he is ever given the chance, to deny to GPs working in the health service the option that they think is in the best interests of their patients. That is what the hon. Gentleman announced this morning: he does not care about NHS patients.