National Health Service

Part of the debate – in the House of Commons at 9:30 pm on 20th October 1982.

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Photo of Kenneth Clarke Kenneth Clarke Minister of State (Department of Health) 9:30 pm, 20th October 1982

I shall return to the hon. Gentleman, in favour of him, later in my speech.

My hon. Friend the Member for Portsmouth, North (Mr. Griffiths) and my hon. and learned Friend the Member for Thanet, West (Mr. Rees-Davies) referred to the crisis in the NHS. That crisis exists and people outside expect us to address ourselves to it. No one on the Government Benches has denied that there is that crisis in parts of the Health Service. As my hon. and learned Friend the Member for Thanet, West said, there has never been a debate in which there was a wider factual gap between the two sides, or a wider difference between the assertions being made by hon. Members on both sides of the House. I fear that the assertions from the Labour Benches were inaccurate and based on misunderstandings, and, in some cases, on misinterpretations of bits and pieces of documents that they have picked up from around the Health Service.

If we wish to understand the nature of the crisis of the Health Service, and if a responsible Opposition wish to address themselves to the choices that have to be made, there has to be an essential basis of fact, accepted by both sides of the House. One embarrassing stream of facts which the Opposition will not face, and which they try to disprove by sideways allusions, is the growth in resources and staff under this Government. Talk of "cuts" and "freezes" is an attempt to evade the fact that resources for the Health Service have grown in real terms by over 5 per cent. since the Government took office.

The Health Service has never had more resources at any time since 1948. There are now more doctors and dentists working in it than ever before—over 2,000 more since we took office. There are more staff than ever before—57,000 more since we took office, of whom 41,000 are nurses. We have maintained the capital programmes and provided more Health Service capital-7½ per cent. more in real terms than in the last year of the Labour Government. There are 136 hospitals under construction.

As a result of the falling inflation rate, there will be a windfall for the Health Service, because everybody has been working on price and pay assumptions which have been disproved by the Government's success in reducing inflation. That is the background to the crisis. The problem is to fit the infinite demands for more resources within the finite, though growing, level of resources that the Government can make available.

We all know that there is an infinite, growing and wholly justified demand for better services in many parts of the National Health Service. My hon. Friends the Members for Horsham and Crawley (Mr. Hordern) and for Portsmouth, North addressed themselves to that problem. I can produce a list of priorities for further development in the National Health Service. We need beter services for the elderly and greater provision for geriatrics, the mentally ill and the mentally handicapped. We need a shift of resources to community services, not just hospital services, to keep many elderly, mentally ill and mentally handicapped people in better surroundings.

We need a fairer distribution of resources throughout the country, as my hon. Friend the Member for Preston, North (Mr. Atkins) said. We need better primary care in our inner cities, and for all sorts of neglected small areas where money needs to be spent, such as drug abuse. We need to find money for the advanced thresholds of medicine—heart transplants, bone-marrow transplants, dialysis and so on—for which demand grows because of the success of our doctors. All that has to be fitted into the growth of resources that the Government have provided, but it needs a choice of priorities and planning to fit the improvements to the services within that growth.

What is the Opposition's reaction? They have gone round Wales, every region and district, and read every piece of paper they can find—in brown envelopes or wherever else they can find them—and made use of parts of documents. Every time an attempt is made to shift resources or to judge priorities—when my right hon. Friend the Secretary of State for Wales holds back money from districts for development of services in Wales, or the Thames regions hold back money for the mentally handicapped and begin to shift resources out of inner London areas, which the Labour Party agrees are over-resourced, and transfer them to Medway—the Opposition snatch at little bits of documents, quote them out of context, and say that there are cuts and freezes and other things around the country.