National Health Service

Part of the debate – in the House of Commons at 8:38 pm on 20th October 1982.

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Photo of Michael Meacher Michael Meacher , Oldham West 8:38 pm, 20th October 1982

If the hon. and learned Gentleman is referring to the fact that I am sponsored by COHSE, I apologise to the House for not saying so, but that is widely known and in no way influences the accuracy of my remarks.

A 1 per cent. to 2 per cent. increase in real terms in NHS expenditure is necessary because of the increasing proportion of NHS patients over 75 years of age who have to be cared for and whose medical and nursing needs are the most expensive of all. When that trend is taken into account, as it has to be by any Government, it becomes clear that, despite the increased expenditure, there has been no improvement in standards. Indeed, the reverse is true.

Another fact that the Secretary of State did not find it convenient to mention is that health expenditure today as a proportion of total public expenditure is no greater than it was in 1950. So much for all those expansive claims about greater resources. The record tells a different story' that we must consider when discussing the crisis in the Health Service.

In July 1979, the Chancellor of the Exchequer acknowledged that the refusal to increase cash limits in the National Health Service meant a cut in real terms in the NHS of at least £100 million. Then, in the March 1980 Budget, cash limits were set at 14 per cent. when inflation was 19 per cent. The Government were effectively enforcing a real cut in pay for NHS staff—or a reduction in staff—and a cut in services.

In November 1980, the Chancellor announced further spending cuts of £11 million, including a requirement for the National Health Service to find a 0·25 per cent. saving in total expenditure by increasing what the Chancellor liked to call efficiency measures, which is a nice euphemism for further cuts.

In March 1981, strict cash limits were again imposed on the NHS, allowing for 6 per cent. increases in pay and 11 per cent. in prices when inflation was 12 per cent. This inevitably meant a further reduction in employment or further cuts in services.

Again, in the latest Budget in March 1982, the Chancellor imposed strict cash limits on the NHS, and the expenditure increase was expected to be kept at 5 per cent.—half the projected rate of inflation. Additionally, a saving of up to 0·5 per cent. was expected from increased efficiency—in reality, another cut. It has been a constant story of cut and cut and cut again under this Government. What those cuts meant in practice was not spelt out by the Secretary of State. I have used the Government's figures.

In the Government's first two-and-a-half years—which is as far as the figures go—182 hospitals were completely closed. A further 345 hospitals were partly closed, had wards or departments closed or their uses changed. Therefore, up to a year ago, no fewer than 7,500 hospital beds were lost or redistributed.—[Interruption.] It is up to hon. Members if they want to make a virtue of that, but the facilities have not been replaced. We are talking of a net loss.

It is estimated that as much as £4 billion is needed to bring our hospitals up to standard. The Secretary of State said that he has not the money for that purpose or to make National Health Service workers a better offer. We say that if Britain can afford £2 billion to regain by war some tiny islands in the South Atlantic and apparently an additional £½ billion to rehabilitate those islands, we can certainly afford to spend less than half that to pay National Health Service workers a reasonable wage. The Government should at least agree to the wide call by the House tonight to take the issue to arbitration.

The Secretary of State spoke of further moves to promote private health care and to achieve a better balance between the private sector and the NHS. I do not doubt the Secretary of State's sincerity, but, whatever he may think, it is clear from the Think Tank leak and the constant insistence by Treasury Ministers that, if the Tory Party wins the next election, the Prime Minister and the Chancellor of the Exchequer will abolish the National Health Service and replace it with a private health care system in addition to de-indexing pensions and benefits and, no doubt, dismantling other parts of the Welfare State.

If the Secretary of State or the Minister of State deny that, may the House have a guarantee that no such proposals, nor anything resembling them, will be introduced by a future Conservative Government under the present Prime Minister's leadership? Until we have such a guarantee, millions of people will suspect that that will be the result of a Tory victory at the general election.

The real crisis in the National Health Service is not just that it is under-financed, rather than over-spent, but that it is the greatest post-war monument to a civilised community—an optimal service, free at the point of service and universally available—which is increasingly put at risk by the death of a thousand cuts. That is the story of the past three years. The service is also the greatest single symbol of compassion. Its threatened elimination by the Prime Minister and her hard-nosed colleagues will be one of the major causes of the Conservative Party's election defeat.