§ The Parliamentary Under-Secretary of State for Health (Mr. Paul Boateng)
The range of services provided by the NHS, whether in hospitals, in the community or in GP practices, and the variety of means of 747 measurement, are such that it has not historically proved possible to arrive at a single figure for the number of patients to be treated.
§ Dr. Fox
Notwithstanding that somewhat disappointing answer, it is obvious that the number treated will depend on the budgets available to the NHS. In response to the hon. Member for Crewe and Nantwich (Mrs. Dunwoody), the Minister of State indicated that he would like wages in the NHS to rise. If a settlement similar to the £4 minimum wage now given to local authority workers in Scotland is reached in the NHS, what additional costs does the Minister estimate the NHS will have to bear?
§ Mr. Boateng
The disappointment, such as it is, arises from the appalling legacy left by the Conservative Government's stewardship of the Department of Health over some 18 years. This year's Budget settlement was very good; it will seek real growth of some 2.35 per cent. as opposed to the growth anticipated by the previous Government of some 1.2 per cent. That is progress under Labour, delivered in a way that is about patient care, not about bureaucracy.
§ Mr. Stevenson
Does my hon. Friend agree that the ability of the NHS to treat and discharge patients depends on multi-agency assessments and the provision of care in the community? In that regard, the additional resources for the NHS are most welcome, but does he share my concern that, if they are not matched by additional resources for social services, we shall be in danger of riding a tandem with the risk of one wheel dropping off?
§ Mr. Boateng
We need to make sure and we will make sure—my hon. Friend is right to say that we must make sure—that local authorities and the NHS work well together. That means making sure that resources are used as effectively as possible. We have already begun a dialogue with the Local Government Association and the NHS executive to make sure that that happens.
§ Mr. Jack
The Minister will be aware that, last week, there was an announcement about waiting lists. That will have a crucial effect on the number of patients who can be treated in the NHS. Can the Minister clear up some confusion caused by the announcement in respect of hospital trusts? What will happen in the case of a hospital trust that has negotiated contracts with more than one health authority? In the case of a trust that has a contract with, say, four authorities, three of which have specified a higher level of service than the fourth, can he confirm that the new arrangements will require—without the Secretary of State's prompting—that all those patients face a levelling down of service as a result of the creation of a common waiting list?
§ Mr. Boateng
The right hon. Gentleman really ought not to believe that a Labour Government work on the same basis as the previous, discredited, Tory Government. We are concerned to level up patient care, but he thinks in terms of levelling down. The assumption he makes is totally without foundation: we will aim for the best practice and we will encourage trusts and authorities to work together to make sure that that happens.