§ 7. Mr. Harry Cohen (Leyton and Wanstead)
If he will make a statement on the number of knee replacement operations carried out in the NHS in 1998–99. 
§ The Secretary of State for Health (Mr. Alan Milburn)
According to provisional data for 1998–99, 28,876 primary knee replacement operations were carried out in national health service hospitals in England.
§ Mr. Cohen
I have had a letter from my constituent, Mr. Bracewell, which describes as "great news" and "a miracle" his successful knee operation. He said:as a Godfearing man, you will be rewarded for helping in due course.Although such knee operations are not high profile, is it not vital to keep the elderly mobile and the young up and running? Is my right hon. Friend aware that in my health area, Redbridge and Waltham Forest, there have been 193 such operations over the past year and 500 over the past three years? That is a rising trend. When I praise the NHS for that, I am sure that the House will appreciate that it is not a knee-jerk reaction.
§ Mr. Milburn
It was going so well until then. I am sure that my hon. Friend will receive his due reward.
I can only agree with my hon. Friend. Indeed, I cannot do anything other than agree with the Conservative central office briefing for today's Health questions, which makes very impressive reading.
§ Mr. Milburn
Indeed I must be if I am reading that. The briefing states:Knee replacements are important to enable patients to retain mobility and, therefore, independence. They should be available according to clinical need.That is right; they should be available according to clinical need. However, the hon. Member for Woodspring (Dr. Fox), the shadow Secretary of State, told The Sunday Times, on 16 January, thatconditions…like hip and knee replacements, hernia and cataract operationsshould be covered by private medical insurance. Why did he say that? His hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond) told Sky News on 31 January that, under Conservative plans, people would look to the NHSwhen they had serious, life-threatening conditions and would look to their private insurance to help them with the rest.Why did the hon. Gentleman say that?
The Conservative central office briefing is right. That treatment should be provided according to clinical need, not ability to pay. Why does Conservative central office say one thing while those on the Conservative Front Bench say another? I know that Conservative central 149 office spends half its time briefing against those on the Front Bench, but I did not realise that it had taken to doing so in writing.
§ Mr. Graham Brady (Altrincham and Sale, West)
My constituent, Mr. James Hickson, agrees with the Secretary of State that such treatments should be provided according to clinical need. Yet six months ago, after an interminable wait under this Government to have a seriously diseased hip replaced, he was forced to go the private sector for an operation. He is without private health insurance and I have at least one other constituent who has been forced, under the Labour Government, to resort to private treatment without having insurance to pay for it.
Will the Secretary of State now recognise what is happening under his stewardship of the Department of Health and reimburse my constituents who have to pay but who have not got private health insurance?
§ Mr. Milburn
The hon. Gentleman rails against private treatment for hip and knee replacements. People talk about joined-up government, but what about a bit of joined-up opposition between Conservative Back Benchers and Front Benchers? Once again, Front Benchers say one thing and Back Benchers say another, and the Conservatives' health policy is in tatters.
§ Mr. Barry Gardiner (Brent, North)
Will my right hon. Friend assure the House not only that the Government will eschew any suggestion that we go down the route of postcode health care provision, but that they will eschew what Conservative Members would suggest—bank sort code health care provision?
§ Mr. Milburn
My hon. Friend is right. It is about time those on the Conservative Front Bench came clean. They give interviews to newspapers and to television companies, and it is the Conservatives' policy in which people are interested. Overwhelmingly, cataract, hip and knee operations are operations of old age. Older people will therefore literally pay the price of Conservative health policy. They will pay the price in a new tax on old age if the Conservatives have their way.
Conservative Members are now threatening to take a host of procedures out of the public sector, where they are free in the NHS, and instead force people to go private. That policy will not work and the people will not vote for it, either.