Public Spending (Hansard, 12 December 2002)

§ 1. Ann Winterton (Congleton)
What representations he received in advance of the pre-Budget report on the targets he has set for outputs from public spending. [85247]

§ The Chief Secretary to the Treasury (Mr. Paul Boateng)
Numerous representations are received in advance of the pre-Budget report on a range of matters, including individual targets. Departments are responsible for delivering, and reporting progress on, their own public service agreements.

§ Ann Winterton
The Chief Secretary will be aware that concern about the Government's high rate of tax and spending growth featured in the International Monetary Fund report published this week, which highlights the need for effective and efficient delivery for taxpayers' money. Is he aware of the national health service data published today which show that up to April this year NHS funding was up by 21.5 per cent, but that hospital treatment outcomes are up by only 1.6 per cent. and hospital admissions are down by 0.5 per cent? When will we see real reform for real public service improvements—or will it be the same old story of missed targets, more tax and spend, and more failure?

§ Mr. Boateng
The hon. Lady's strictures are misconceived. I am well aware of the IMF report. It states that the economic achievements of the Government are due in no small part to our sound macro-economic policies. That was not something that could ever have been said about the achievements of the hon. Lady's party when it was in office.
In fact, the NHS figures reveal that there has been an 11 per cent. increase in the number of patients admitted to hospital against the comparable figure for 1997–98. The number of medical procedures taking place has 376 increased by almost 1 million. That is a record to be proud of—resources accompanied by reform delivering results.

§ Caroline Flint (Don Valley)
The three primary care trusts in Doncaster will see an increase in their funding of more than 30 per cent. over the next three years. When I was elected in 1997, there were huge health inequalities in the area and we have been trying to put that right. Although much has been done, we still need to focus on primary care to ensure that people do not develop diseases that may kill them later on in life.

§ Mr. Boateng
My hon. Friend makes a good point about the importance of ensuring that we address inequalities—hence the appointment of a Minister for Public Health, as well as our continuing drive to reduce inequalities, using targets, and the announcements made by my right hon. and learned Friend the Secretary of State for Health yesterday. Again, that amounts to resource, reform, results.

§ Mr. Michael Howard (Folkestone and Hythe)
As the Chief Secretary knows, the Prime Minister and the Secretary of State for Health think that an important contribution to greater outputs from public spending on the health service can be made by foundation hospitals. The First Minister for Wales and the Secretary of State for Wales disagree. What is the Treasury view?

§ Mr. Boateng
The Treasury view was made clear by my right hon. Friend the Chancellor of the Exchequer when, in the course of the pre-Budget report to the House and subsequently, he made repeated reference to the benefits—actual and potential—of foundation hospitals, in terms of delivering resource with reform and meeting local needs according to the concerns of local people. That is something that Opposition Members should welcome.

§ Mr. Howard
We know why the Chancellor did not answer the question: because he told The Guardian less than a month ago that he was opposed to foundation hospitals. He thinks that they give NHS bosses too much power, so why will the Chancellor not tell the House what he told The Guardian?

§ Mr. Boateng
Not that Guardian breakfast again—how many times is that meal going to be regurgitated by the right hon. and learned Gentleman? He has the facts. My right hon. Friend the Chancellor supports foundation hospitals and so should the shadow Chancellor.

§ Dr. Nick Palmer (Broxtowe)
Does my right hon. Friend agree that even those of us who take a special interest in Treasury affairs may be in danger of valuing improvement only by measurable output? For instance, the replacement of tricyclic drugs by modern drugs that has taken place in the NHS has transformed the lives of many patients, yet it is not measurable at all. Does my right hon. Friend also agree that the Conservative policy of not increasing funding is inherently implausible—

§ Mr. Speaker
Order.

§ Mr. Boateng
I agree with my hon. Friend on both counts—especially the latter. My hon. Friend's first 377 point was extremely important: we need to get targets right. We need to ensure that they are not seen as an end in themselves but as a drive—a goad—to improve performance. That is what we are doing and I should have thought that it would be welcomed by hon. Members on both sides of the House, including the hon. Member for Congleton (Ann Winterton), who shares with me real concern about adoption policy. She would be the first to admit that the target of a 40 per cent. increase in adoption has helped to drive improvements in that area.