HL Deb 27 June 2000 vol 614 cc759-61

2.42 p.m.

Lord Renton of Mount Harry asked Her Majesty's Government:

What measures they intend to introduce to encourage the take-up of private health insurance.

Lord McIntosh of Haringey

My Lords, the Government have no plans to introduce any measures to encourage the take-up of private health insurance. We believe that the best way to provide for the healthcare needs of all British residents is to use the available resources to fund the NHS directly rather than to subsidise those who, for whatever reason, choose to make alternative arrangements.

Lord Renton of Mount Harry

Oh dear! My Lords, following the historic announcement yesterday about the decoding of the human genome, I was hoping for an Answer from the Minister that was a little more forward looking—given that that marvellous achievement was made by a coming together of private sector and public sector research, which is bound to continue. Does the Minister agree that there are now some 7 million people in Britain who have taken out private health insurance, but that we are still well below the EU average for the percentage of private healthcare as a percentage of total healthcare? Can the noble Lord try to persuade his colleagues that those 7 million people should be allowed to pay their insurance premiums without taxation? Every penny that goes into BUPA or PPP gives the NHS more scope to help others. If, as President Clinton said yesterday, we are all to live for another 25 years, will the NHS be able to cope with that alone? I doubt it.

Lord McIntosh of Haringey

My Lords, I admire the noble Lord for looking forward. However, he should also look a little backwards. The Conservative government introduced tax relief on private medical insurance in 1990, which we removed after the 1997 election. Experience shows that, over that period of time, the number of people over 60 covered by private health insurance increased from 500,000 to 550,000 only; in other words, the tax relief went almost entirely to those who were already taking out private medical insurance, not to the health service.

Lord Winston

My Lords, is my noble friend the Minister aware that the National Health Service undoubtedly benefits most considerably from the admission of private patients into its hospitals? Are the Government aware that one of the problems with some of the big private insurance companies is that, at present, they offer a monopolistic practice that actually prevents their insured patients going into teaching hospitals? I should declare an interest here, as I am an honorary consultant within the NHS.

Lord McIntosh of Haringey

My Lords, nothing in my answers has indicated a decision on the part of this Government to set up barriers between private healthcare and the NHS. Indeed, that was not the purport of the original Question. My noble friend must not draw the conclusion that we are proposing any further changes in private provision or in its funding.

Lord Clement-Jones

My Lords, the original Question seemed to assume that more private health insurance would have benefits for our national health services. Is the Minister aware of any evidence which shows that subsidising private health insurance in this way would bring such benefits?

Lord McIntosh of Haringey

My Lords, I believe that my response to the supplementary question of the noble Lord, Lord Renton of Mount Harry, made it clear that I agree with what the noble Lord, Lord Clement-Jones, has just said.

Lord Marsh

My Lords, does the noble Lord accept that many people will find what he says both deeply depressing and quite extraordinary? On virtually every count—whether it be fatalities in certain diseases, numbers of doctors or the proportion of GDP spent on healthcare—this country's health provision, regardless of which party is in power, is behind that of other countries; indeed, France is a classic example. Will the Minister agree that there is a benefit to be gained in trying to get more money spent on the National Health Service, and that the best way to do so is to encourage more people to contribute?

Lord McIntosh of Haringey

My Lords, I am glad to note that the noble Lord, Lord Marsh, is referring to the recent report of the World Health Organisation. However, the noble Lord should read that report with a little more care. Although it found that this country spends less of its GDP on health services in total, we stand at 18th in the world list, though that is not an ideal position to be in. We fall down badly—everyone agrees that this is right—on the responsiveness of our National Health Service to patients. That is a problem that we must certainly address. But it does not follow that the best way to improve our health services is to help to fund private medical services through our tax system. The real growth in NHS expenditure has been significant under this Government. We believe that that is the right way to move forward.

Lord Peyton of Yeovil

My Lords, I am searching for some crumb of comfort in the noble Lord's answers. I believe he said that it was no part of this Government's intention to create barriers between the public and the private sectors of the health service. I hope that the noble Lord will learn from that answer and practise it. The immense inhibitions from which the health service suffers as a result of the sort of proprietary, defensive attitudes of the Government cannot be exaggerated.

Lord McIntosh of Haringey

My Lords, that sounded to me like an assertion, not a question.

Lord Renton

My Lords, would it help the Government to reach a decision in this matter if I mentioned that the only reason why I am still alive is that, last year, BUPA spent 10 times more on my medical attention than I had paid for my premium?

Lord McIntosh of Haringey

My Lords, the noble Lord, Lord Renton, got good value and we continue to get good value from his continued presence.

Lord Walton of Detchant

My Lords, at a time when the National Health Service is gravely understaffed in terms of doctors, nurses and medical laboratory scientific officers, and is having to turn to the private sector for assistance in carrying out operations, is it not now possible that pragmatism can overcome idealism?

Lord McIntosh of Haringey

My Lords, the impact of what the noble Lord, Lord Renton of Mount Harry, proposes, and of what we understand the Conservative Member Dr Liam Fox proposes, would be a continued brain drain from the National Health Service to the private sector, which would benefit no one.

Lord Saatchi

My Lords, the Minister not only insists on taking responsibility for the fact that 97 per cent of the amount of money spent on health is spent by the Government—the world record for a government share—but is actually proud of that. However, is he also proud of the conclusions of the detailed report, to which the noble Lord, Lord Marsh, referred, which shows that we are in 18th position in terms of standards of healthcare? Does he take responsibility for the fact that we are lower in the world table than such countries as San Marino, Andorra, Malta, Greece and Iceland?

Lord McIntosh of Haringey

My Lords, I am delighted that the noble Lord, Lord Saatchi, has read the report rather more carefully than the noble Lord, Lord Marsh. I take pride in the fact that 97 per cent of our health expenditure is public health expenditure. If we move towards insurance funding of health services—the United States is the classic example of this—we shall have poorer health services at considerably higher cost.