HL Deb 19 June 1997 vol 580 cc1344-7

3.25 p.m.

Baroness Cumberlege asked Her Majesty's Government:

What is their policy on charging for National Health Service services in view of the recent announcements of the Secretary of State for Health that charges for visiting a National Health Service doctor or staying in a National Health Service hospital are not to be ruled out.

Baroness Jay of Paddington

My Lords, I am very grateful to the noble Baroness for giving me the opportunity to repeat the Government's manifesto commitments on the National Health Service. Access to the NHS will be based on need, not ability to pay. The manifesto also promised that we would raise spending on the NHS in real terms every year and put the money towards patient care. Every aspect of the Department of Health's comprehensive spending review, which is part of the Government's comprehensive spending review announced last week, will naturally be judged against that commitment.

Baroness Cumberlege

My Lords, I am grateful to the noble Baroness for her reply. Will the new Labour Government honour their manifesto pledge? As I understand it, the Secretary of State for Health has said that no charges are to be ruled out. Bearing in mind that yesterday the noble Baroness told us about cancer services, can she now give a commitment that no one who is dying of cancer or who has a terminal condition will have to pay for a hospital stay or a visit from his or her GP?

Baroness Jay of Paddington

My Lords, I can confirm that no one will have to pay for cancer treatment. Without wishing to be discourteous, I am rather surprised that after several years as a Minister in the previous government the noble Baroness accepts the truth of media speculation. The rather frenzied speculation about NHS charges for this, that and the other is just that—unfounded speculation.

Lord Stoddart of Swindon

My Lords, can my noble friend confirm that the spending review will not simply take into account charges but will deal with the whole administration of the National Health Service, its priorities, how it is run, those treatments that should be given priority and those that should not and, above all, whether real progress will be made in phasing out mixed sex wards, a matter about which I, and indeed the House, which passed a Bill to outlaw such wards in the National Health Service, are concerned?

Baroness Jay of Paddington

My Lords, my noble friend Lord Stoddart is aware of my genuine concern about, and attention to, the question of mixed sex wards. It is part of the responsibilities we shall be looking at in the comprehensive spending review. The review is about setting priorities in the medium and long term—not just the next two years—and it will consider the matters the noble Lord has raised. Its purpose is to channel resources of the public sector towards the achievement of the manifesto promises and so advance the key principles of fairness, opportunity, employment and investment that we hope the National Health Service will always represent.

Baroness Seccombe

My Lords, I should first declare an interest as a pensioner. Does the Minister agree that such charges as are referred to in the Question would be a tax on pensioners, because it is the elderly who use the services of the National Health Service?

Baroness Jay of Paddington

My Lords, I understand the concerns of the noble Baroness. I can only repeat what I said earlier. All speculation about individual charges is just that—speculation.

Earl Russell

My Lords, is the Minister aware of opinion poll evidence that 56 per cent. of those who voted Labour at the election did so expecting that increases in taxation would result, presumably agreeing with the mistaken view of Polly Toynbee: trust them, they are liars? Under those circumstances, since the Government must inevitably disappoint nearly half their voters whatever they do about taxation, do they accept the view, which I would commend to any government, that they will not rule out prudent increases in taxation when they appear to be in the national interest?

Baroness Jay of Paddington

My Lords, the noble Earl, I think, is trying to take advantage of the fact that I am a newly appointed Minister, and, as in the debate on the Queen's Speech, is inviting me to speculate about the Budget and future tax arrangements, which I am sure he will understand that even someone as green as I am is unlikely to do.

Lord Ashley of Stoke

My Lords, on how many occasions were prescription charges raised by the previous government?

Baroness Jay of Paddington

My Lords, prescription charges today are 28 times more expensive than they were in 1979. Even after allowing for inflation, they are 10 times more expensive than they were in 1979.

Baroness Cumberlege

My Lords, would the Minister like to confirm that it was a Labour Government who first introduced the principle of prescription charges? And is it not the case that today 80 per cent. of people are exempt from paying prescription charges and only 20 per cent. have to pay, which is a reversal of the situation before the Conservative Government came in? The Minister talked also about press speculation. Will she comment on what Mr. Dobson was quoted as saying in The Times of 14th June 1997: We are ruling nothing out. We are looking at every aspect so that we can get the health service on an even keel and get through the pressures of this coming winter. We are going to look at charges"?

Baroness Jay of Paddington

My Lords, there is nothing inconsistent with what I have said and the press speculation to which the noble Baroness referred. As she raised the subject of the situation when her government took over and our government came in, what is true is the appalling state of NHS finances today. We have inherited a service which is £300 million in debt. A record number of health authorities and health trusts are in deficit; waiting lists are at record levels; and, as was

revealed today, prescription fraud, which was totally unchecked under the previous government, is losing the NHS over £85 million a year.