Engagements (Hansard, 28 November 2001)

§ Q1. David Burnside (South Antrim)
If he will list his official engagements for Wednesday 28 November.

§ The Prime Minister (Mr. Tony Blair)
This morning, I had meetings with ministerial colleagues and others. In addition to my duties in the House, I shall have further such meetings later today.

§ David Burnside
Recently in Ulster, Her Majesty's Government have removed the royal title and the Crown insignia from the Royal Ulster Constabulary and prohibited the flying of the Union flag from police stations, and they plan to remove the royal coat of arms in courtrooms. Does the Prime Minister believe that those changes symbolise a deep-seated republican tendency at the heart of his Government? Do the Government intend to apply similar changes to police forces and the judiciary in England and Wales?

§ The Prime Minister
Let me make two points. First, the principle of consent—that Northern Ireland remains part of the United Kingdom as long as the majority of people there wish it—is absolute; it is the founding principle of the Belfast agreement. Secondly, the proposals are for consultation. It is important to ensure that we get the broadest possible support for a police service and criminal justice system that command support right across the communities. I hope very much that the hon. Gentleman will play his part in that effort, because it is an essential part of the new dispensation in Northern Ireland that we have both a police service—I pay tribute to the work that the RUC has done over many years—and a criminal justice system that command support and can be part of the new Northern Ireland that is being built.

§ Mr. Brian Jenkins (Tamworth)
Will my right hon. Friend take this opportunity to update the House on the position of the 12 British tourists held in jail in Spain—[HON. MEMBERS: "Greece."]—sorry, Greece for plane-spotting, especially Wayne Groves, a resident of Tamworth? Will he pass on to the British consulate the thanks of the family for the work its staff have done? Will he also take this opportunity to assure the many British tourists who are considering booking holidays in Greece that it is a safe place to visit?

§ The Prime Minister
I have spoken to the Greek Prime Minister about the issue and my right hon. Friend the Foreign Secretary spoke to his Greek counterpart today. I hope that the case can be resolved. Whatever the difficulties, most people understand that those people are indeed tourists. I hope that the issue can be resolved as swiftly and satisfactorily as possible.

§ Mr. Iain Duncan Smith (Chingford and Woodford Green)
Has the number of patients waiting more than an hour in casualty gone up or down since the right hon. Gentleman became Prime Minister?

§ The Prime Minister
The number of patients waiting more than an hour in casualty has gone up—that is 961 correct. However, the overall number of patients waiting has fallen by more than 100,000. In particular, the number of patients waiting more than six months has fallen.

§ Mr. Duncan Smith
In that case, will the Prime Minister tell us in what areas the health service has gone backwards under his Government, as his party chairman says?

§ The Prime Minister
I have just mentioned one, but perhaps I should read the entire quote from the chairman of the Labour party. He said: The fact is there have been massive improvements in some parts of the NHS but other areas where we've…gone backwards". If the right hon. Gentleman wants to look at both sides of the equation, let me give him one example of an area in which treatment has improved. In 1997, 63 per cent. of patients urgently referred with suspected cancer were seen within two weeks. Today, the figure is 93 per cent. By the end of the year, there will be 13 new anti-cancer drugs made available to NHS patients. By the end of next month, we shall have successfully introduced the maximum one-month wait from GP referral to treatment for children and for testicular cancer and leukaemia. By the end of this year, there will be a maximum of a one-month wait from diagnosis to treatment for breast cancer patients. In this year alone, we are putting into the NHS over 100 new cancer scanners.
Yes, in some areas there is still a very great deal to do, but in other areas where the extra investment has gone in, there have been improvements. The difference is that we on the Government Benches believe in a national health service system that is funded out of general taxation and is free at the point of use. The purpose of the Conservatives is to ensure that people are forced to pay for the treatment that they have.

§ Mr. Duncan Smith
I remind the Prime Minister that his chairman said that they had "gone backwards". The right hon. Gentleman does not want to answer that part of the question. Let me tell him that the number of people waiting over a year for their operations is up; the number of people waiting over three months to see a consultant is up; the number of people waiting more than an hour in casualty is up; and the number of unfilled GP posts is up.
The Prime Minister used to tell everybody that he had 24 hours to save the health service. Yesterday, his Chancellor said that he needed another 20 years. When did it go from 24 hours to 24 years?

§ The Prime Minister
If the right hon. Gentleman wants to look at areas where the NHS has improved, we find that the number of people waiting over six months has improved. The number of people waiting for cancer treatment has improved. The number of people waiting for cardiac treatment for over a year has improved. The number of doctors is up. The number of nurses is up. The number of beds in hospitals this year is up. The number of new hospital buildings is up.
Yes, it is true that the process will take substantial extra resources. The issue is whether those resources come from general taxation or from social insurance, which is specific taxation on employers or employees, or from forcing people to pay for private medical care. The fact is—I challenge the right hon. Gentleman directly on 962 this—that it is the policy of the Conservative party to say that those who can should pay for some of their medical services.

§ Mr. Duncan Smith
The policy of the Conservative party is to improve the health service, not make excuses for it. [Interruption.] Oh yes, that is right.
As for the Chancellor, he gave us a long lecture yesterday about consensus. The consensus that the people outside the House know about concerns why they should have to wait in pain for routine operations or die sooner than their counterparts in Europe, and the fact that the fourth largest economy should be able to offer decent treatment to its people. Those are the consensus issues for the public.
The only consensus for the right hon. Gentleman, his Chancellor and his Government is that between him and the trade unions—[Interruption.] to make sure that there will be no change that threatens their vested interests. Why does the right hon. Gentleman always put favours to friends ahead of the interests of patients?

§ The Prime Minister
The right hon. Gentleman denied specifically that it was the policy of the Conservative party to say that people should pay for some of their treatment. Perhaps he would like to comment on the memorandum from the shadow Treasury spokesman to the shadow Chancellor dated 12 November—just two weeks ago—in which he said: As you are aware, we remain vulnerable to the irritating attack that we are the party who will be cutting back on health care expenditure to reduce taxation. He then goes on to say: The only propositions which make sense are… (iii) the reforms which we will be proposing will end the NHS monopoly and will entail those who can afford it making some payment for their health care services. In the interests of debate, perhaps the right hon. Gentleman will explain what was meant by that.

§ Mr. Duncan Smith
Perhaps I ought to remind the Prime Minister that all taxpayers in this country pay for their health service. He said only a couple of months ago that reforming the NHS was a vital test for the modern Labour party". He also said, it's not reform that is the enemy of public services it's the status quo". Does not the Chancellor's statement yesterday prove that he has flunked that test and that there is no further reform—none at all? He has handcuffed the Government to the whole status quo and the state monopoly. He has condemned patients to wait longer, suffer more and die earlier than our neighbours in Europe. The Prime Minister does not have a clue and does not have a cure for the health service.

§ The Prime Minister
There is a perfectly simple distinction between a national health service that should indeed be reformed, as the Chancellor said yesterday and as I say today, and the right hon. Gentleman's proposals to force people out of the health service to pay for their treatment—[Interruption.] There can be no other explanation of the words that he used. There are two 963 issues in the debate. First, do we need more resources for health care in this country? Answer, yes. Secondly, do we get those extra resources from general taxation payments, from specific payments like social insurance in France and Germany, which is also a form of taxation, or by making people pay directly for their health care? We believe in the first. What on earth does the right hon. Gentleman believe in?

§ Mr. Robert N. Wareing (Liverpool, West Derby)
Does my right hon. Friend agree that the time has come for a much more rational airports policy? Is it not ludicrous that congestion is being increased by the building of a fifth terminal at Heathrow, when many people, business men and tourists who live in the north of England have to traipse down to London before they can start their journey abroad? Is it not time to expand airports such as Liverpool, Leeds-Bradford and Newcastle? Is that not the rational approach to airports policy?

§ The Prime Minister
If my hon. Friend will allow me, I hope that he will add Teesside, in which I have a particular interest, to that list. We have to do two things. Because of the greater demands on air travel by a range of different sources, we will have to develop Heathrow, but we will have to develop our regional airports as well. That is one reason why the recent developments in Manchester are welcome. We therefore need to do both things, but I entirely agree that additional pressures on air travellers will mean that we need increased capacity.

§ Mr. Charles Kennedy (Ross, Skye and Inverness, West)
In January last year, the Prime Minister gave a specific personal commitment on national television that his Administration would raise spending on health provision in this country to the European Union average by 2005. What significance should we all read into the Chancellor's statement yesterday afternoon which made no mention of that whatsoever?

§ The Prime Minister
Only the Liberal Democrats could read the Chancellor's statement as being ungenerous in funding the national health service. The fact is, we need to increase substantially the resources going into the health service. The benefit of what the Chancellor said in the report that he launched yesterday is that, for the first time, we can have a serious and proper debate about where that money comes from. The one thing that is ludicrous to suppose, although there are parts of the media that did so this morning, is that the choice is between, on the one hand, a health care system funded by general taxation and, on the other, a better funded health care system that somehow comes for free. The issue in all cases will be how to fund that health care properly, given that we need a substantial increase in resources. We have made it clear that along with that increase in resources must come substantial reforms in the national health service to make it work efficiently.

§ Mr. Kennedy
Methinks the Prime Minister does protest too much. I just want a straight answer to a straight question—[Interruption.] I am trying to be generous. 964 The Prime Minister committed himself to raising health expenditure in our country to the European Union average by 2005. Is that still the policy of his Government?

§ The Prime Minister
Of course it is. That is precisely the point of the Chancellor's announcement yesterday. With respect to the right hon. Gentleman, he is not being generous—we are. Whatever system we have, the money must come in the end from general taxation, from social insurance, or from people paying—[Interruption.]

§ Mr. Speaker
Order. Let the Prime Minister answer.

§ The Prime Minister
The purpose of what the Chancellor is saying is to get additional money into our health care system. After yesterday's statement, only the Liberal Democrats could still be saying that it is riot enough.

§ Mr. Tony Banks (West Ham)
We all share concern for the people of Afghanistan, but will my right hon. Friend show compassion for the animals of Afghanistan? Has he seen the pictures of the animals in Kabul zoo such as Marjan the lion and that poor black bear that had its nose sliced off by some barbarian? Will my right hon. Friend call to Downing street the concerned animal welfare organisations so that a relief operation could be mounted to save the animals in Kabul zoo and in Afghanistan? If he is prepared to do that, I know that millions of animal lovers throughout the country will be eternally grateful to him.

§ The Prime Minister
I understand the point that my hon. Friend raises; it has been raised by many people in the past few weeks. I cannot undertake to arrange the specific meeting for which he asks, but I will consider carefully what he said, and make sure both that the issue is taken up by Government and that he is given a satisfactory reply.

§ Q2. Sir Michael Spicer (West Worcestershire)
Why cannot we have a proper public inquiry into the foot and mouth disaster? What does the Prime Minister have to hide?

§ The Prime Minister
There are inquiries into the foot and mouth outbreak, which will indeed be public. On any basis, those inquiries must look at all the various aspects of the matter. I do not believe that a full-dress statutory tribunal costing millions of pounds and probably lasting two or three years would be helpful to the farming industry or the future of farming production.

§ Q3. Dr. Brian Iddon (Bolton, South-East)
Some health authorities are spending well below their target funding levels—about £13 million, in the case of Wigan and Bolton. Does my right hon. Friend agree that yesterday's announcement of extra money for the national health service, along with the fact that we are setting up new primary care trusts next year, provide an excellent opportunity to tackle that problem? That, in turn, would allow the Royal Bolton hospital to increase its capacity in order to meet an ever-increasing demand for its services?

§ The Prime Minister
My hon. Friend is right. It is not just the additional resources that are needed in the health 965 service; we also need to carry out the reforms, in particular so that by 2004, 75 per cent. of the money in the health service will be spent through primary care trusts. That is a huge reform in itself. A series of negotiations is under way that will change the contracts of doctors, consultants and nurses to provide greater flexibility and better incentives. The national service frameworks in each main disease area will give us national minimum standards right across the piece. My hon. Friend is right. We must make sure that the money is properly spent to deliver better health care. The reform and the investment go together.