National Health Service

Part of Opposition Day – in the House of Commons at 9:19 pm on 19th January 1988.

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Photo of Harriet Harman Harriet Harman Shadow Spokesperson (Health) 9:19 pm, 19th January 1988

This year is the 40th anniversary of the Health Service. I understand that a staff member in the Department of Health and Social Security has been appointed to arrange celebrations, but in the 40th year of the Health Service there is great fear for its future and growing recognition that there is a crisis caused by lack of resources. People know from their own experience and the experience of their friends and relatives that there is a crisis in the Health Service. Nothing that the Prime Minister or Health Ministers say and no amount of figures they reel out can change that, because people know that it takes longer to get the treatment they need, and they wait in pain with their condition deteriorating. They know that when they finally get into hospital they are treated by nurses and doctors who are hard pressed and do not have enough time, and they are discharged from hospital very quickly—often before they are well enough to return home.

Not only patients recognise the crisis in the Health Service. The recognition has spread to doctors, among whom there has been an unprecedented outcry. Doctors have taken out advertisements in local newspapers in Oxford and west Berkshire. The British Medical Association has said that the National Health Service is in terminal decline and the presidents of the three royal colleges have talked about patient care deteriorating and services reaching breaking point. There have been petitions from doctors to Downing street and resolutions of regional and district health authorities.

Nurses have been warning the Government, particularly the 30,000 nurses who vote with their feet against the Health Service every year by leaving. Recruitment of nurses is dangerously low. For the first time, nurses have gone on strike in Manchester and Edinburgh. They are relatively demoralised because they cannot provide the care that they joined the Health Service to provide. To make matters worse, district health authorities are imposing recruitment freezes because they cannot pay the nurses they have.

Health Service organisations are unanimous about the developing crisis. The National Association of Health Authorities has said that the work of the Health Service is being jeopardised and community health councils have said that they are on the brink of collapse. National and local newspapers are overflowing with tragic cases of people dying before they get their operations and of mothers condemned to watch young children gasping for breath as they wait and wait for heart operations.

The Government are now slowly and reluctantly beginning to acknowledge that there is a crisis only in order to join the Right wing of the Conservative party in urging us to ditch the Health Service and start looking for alternatives. They say that we should look for an alternative system because the National Health Service is too expensive, but alternative systems are more expensive than ours. We spend £364 per head on health care, whereas in America £1,300 per head is spent on health care. The Institute of Actuaries has said that if our health system were run like that in America, we would overnight spend 10 per cent. more on health without getting any improvement in the service.

The Government try to make out that, whereas in the rest of Europe the percentage of GDP spent on health care is higher, the contribution from the public purse is lower in those countries than here. That is not the case. Our public sector contributes 5 per cent. of GDP on health, which is less than the public sector contribution in France, Belgium and Ireland. It is therefore a travesty to label the Health Service as greedy and out of control, when it is already substantially underfunded compared with health care systems abroad.

The Health Service treats patients more cost-effectively than the private sector. In the west midlands it costs the private sector £450 more to do a hysterectomy than a National Health Service hospital, and it costs the private sector £700 more to do a hip replacement operation than the National Health Service.

I expect that the right hon. Member for Chingford (Mr. Tebbit) would say that no account is taken of capital, but no account is taken in the private sector of the training of staff by the National Health Service, who then leave for the private sector.

We are told that we must have an alternative system because we cannot control Health Service costs, which are somehow spiralling out of control. It is true that costs are increasing, but that is partly because of the large number of elderly people. We should welcome that as an advance. I welcome the fact that my parents have been able to live to a ripe old age. I want to live to a ripe old age, and I want my children to do so. That should be welcomed as an advance in health and well-being, and should not be complained about by Conservative Members as being a problem. Costs have increased because of medical advance. We should be welcoming that rather than complaining and wishing to return to a system in which we cannot treat people and send them home without hope.

No lessons can be learnt from abroad about curtailing cost increases. The free-market or insurance-based system has a far greater rate of increase in costs. Last year, in the United States—in one year alone—costs rose by seven times more than the rate of inflation. Germany, which was given as an example by the right hon. Member for Chingford, has similar problems with runaway costs.

Alternative foreign systems are more expensive and less subject to cost control. If the Government are looking for alternatives to control costs, they are barking up the wrong tree.