NHS Expenditure (Hansard, 18 December 2003)

§ 9. Rob Marris (Wolverhampton, South-West) (Lab)
If he will make a statement on his policy for public expenditure to 2008 in relation to the NHS. [144724]

§ The Chief Secretary to the Treasury (Mr. Paul Boateng)
The Government are committed, as we announced last year, to raising health service funding by £41 billion over the five years to 2008—the biggest ever sustained increase in NHS funding.

§ Rob Marris
I thank my right hon. Friend for that helpful and encouraging answer. I am pleased to hear his confirmation that the NHS will continue to receive the Government money it needs. May I seek his assurance that the Government will not seek to fund health care through devices such as vouchers, tax reliefs or any extension of co-payment?

§ Mr. Boateng
I am happy to give my hon. Friend that assurance. He describes the policy of the Conservative party, which in office failed to invest sufficiently in the health service and ran it down, so that in 1997—[Interruption.] Conservative Members groan and moan but, if one compares health spending with what it was in 1997, one finds that by 2008 it will be 90 per cent. higher in real terms than when their party had stewardship of the economy.

§ Mr. Oliver Letwin (West Dorset) (Con)
The Chief Secretary congratulates the Government on raising NHS spending by £35 billion a year until 2008, but does he accept that the people of this country expect to get value for such vast amounts of money?

§ Mr. Boateng
People are getting value. Let us examine what that money has bought. There are 25,000 more doctors, 80,000 more nurses and 100 new hospitals. Compare that with what was achieved under the stewardship of Conservative Members. When we came to power in 1997, not one new hospital had been built under the private finance initiative. That is their record: this is ours.

§ Mr. Letwin
I am delighted that the Chief Secretary is able to name some things that the money has so far bought, but how does he explain the fact that a 37 per cent. increase in spending has led to only a 5 per cent. increase in the number of operations, and no increased improvement in waiting times?

§ Mr. Boateng
Just look at the facts. Out-patient attendances in 1997–98 were 11.53 million, whereas in 2003 they were 13.03 million. Elective admissions were 4.46 million, and in 2003 were 5.32 million. [Interruption.]

§ Mr. Speaker
Order. The hon. Member for North-West Norfolk (Mr. Bellingham) is using a camera.

§ Mr. Bellingham
It is a mobile phone.

§ Mr. Speaker
The hon. Member should not he using a mobile phone. I ask him to leave the Chamber.

§ Mr. Boateng
On waiting times, 186,000 fewer patients are waiting for treatment now than when the Conservatives were in office. Out-patient waits of more than 26 weeks have been virtually eliminated, and 98.5 per cent. of suspected cancer patients are seen by a specialist within two weeks. We are proud of that 1710 record. The right hon. Member for West Dorset (Mr. Letwin) should be ashamed of himself for denigrating and running down the NHS, as he does time and again.

§ Mr. Letwin
I am sorry that the Chief Secretary is unable to explain the official figures. Can he do any better at explaining why, when there has been only a 5 per cent. increase in the number of operations, there has been a 45 per cent. increase in the number of managers? Does that accord with the Labour manifesto pledge to rebuild the NHS and to reduce spending on administration?

§ Mr. Boateng
That is an old canard. It is no use the shadow Chancellor looking pained. He ought to look at the facts. The fact of the matter is that his definition of administrators and bureaucrats includes painters, gardeners, doctors' secretaries, electricians, cleaners and thousands of valuable support and ancillary workers, all of whom contribute to the success of the NHS. Why does not he give them and—yes, it is Christmas—us some credit for that achievement?

§ Mr. James Plaskitt (Warwick and Leamington) (Lab)
I can tell my right hon. Friend what increased investment has already delivered to the NHS at Warwick hospital. There are 150 more nurses, 20 more consultants, and a 40 per cent. increase in activity levels. We want to go further and get booked appointments and even shorter waiting times. Will the additional investment be forthcoming to deliver that?

§ Mr. Boateng
That is indeed the Government's policy—resources firmly linked to reform. That is why we have devolved power to front-line organisations, and why we are giving new financial incentives to improve performance. We are reforming the NHS. Given half a chance, the Conservatives would ruin it with charges, cuts and unfair, inequitable subsidies for private health insurance.

§ Mr. Mark Field (Cities of London and Westminster) (Con)
The Chief Secretary will be glad to know that I shall not raise an old canard, but I may have a new canard in mind. I appreciate what he has to say about public funding for the health service, but equally he will appreciate that there need to be financial incentives for private health care. Does he believe that that is ideologically wrong, even if financial incentives for private health care ensure that there is a bigger pot for health care on which all our citizens can rely?

§ Mr. Boateng
No, I do not. This has nothing whatever to do with ideology, but everything to do with how best to help people and how best to deliver an NHS that is fair and free at the point of use. We need to stand back for a moment and reflect on what health care would be like if we were to provide the subsidy for people with private medical insurance that some Opposition Members propose—including, I suspect, the hon. Gentleman. The Opposition's patient passport would increase deadweight costs by up to £1 billion. That would be the price the taxpayer would have to pay for something that was enjoyed only by the very richest in our society. That simply is not fair.

§ Dr. Brian Iddon (Bolton, South-East) (Lab)
The Government have a policy of closing the gap between target expenditure and that of NHS trusts covering constituencies such as mine which, in 1997, were far from the target. The gap is closing extremely slowly, however. Will my right hon. Friend look again at the formula that delivers extra expenditure to deprived communities like mine, and try to close the gap a little more rapidly?

§ Mr. Boateng
My right hon. Friend the Secretary of State for Health is devoting considerable attention to that very question, and to the best way of ensuring that we continue to reduce inequity in health care and provision.

§ Mr. Andrew Turner (Isle of Wight) (Con)
Will the right hon. Gentleman put on record the Treasury definition of public expenditure, and also the Treasury definition of public sector investment, so that next time the Prime Minister is asked that question—as he was yesterday—he does not through ignorance lamentably and inadvertently mislead the House?

§ Mr. Boateng
The Prime Minister did no such thing. This is a definition that has ensured that we are now delivering 450,000 more operations than in 1997–98. It is a definition that has ensured that we are now involved in providing 860,000 more elective admissions each year. It is a definition that has worked for this country, and for the NHS.