The hon. Member for Waveney (Mr. Porter) made a rather strange speech. He said that he was going home to tell his constituents the good news about what the Government have done, and he then spent the rest of his speech complaining about things that were going wrong for which he wanted help, to which many of the answers lie with the Government. I certainly agree with him that his constituency, as all others, needs things from the Government, and I hope that the Leader of the House will be able to deliver.
I also agree that not many hon. Members will vote against the motion. After a spell of Committees sitting late into the night, I could defend having a week off—five working days—to even the most determinedly aggressive constituents. It will do us and the country good to have a few days with our families or friends in the fresh air and to come back renewed in about 10 days.
The debate a year ago on the Easter Adjournment motion was started by the former right hon. Member for Lewisham, Deptford, the late John Silkin. I believe that it was his last speech in the House before he died and that it is therefore appropriate now to pay tribute to him for all his services to the House. Until the very end in the equivalent debate a year ago he was arguing for constituency and wider matters of particular interest to him.
I support many of the arguments already made by hon. Members, such as the hon. Member for Bradford, South (Mr. Cryer) who spoke in favour of the Settle to Carlisle railway, and the hon. Member for Altrincham and Sale (Sir F. Montgomery) who spoke in support of Manchester airport and the diversion of air traffic to the north. As someone born in Cheshire and who lived for the first decade of my life next to a Cheshire airfield, although not Manchester Ringway — it was the AV Roe Woodford airfield — I have considerable sympathy with the hon. Gentleman's decent and proper regional argument. The hon. Member for Belfast, North (Mr. Walker) rightly argued for more money for his constituents and for Northern Ireland housing in general. It is unfair that that has been cut.
I wish to speak about the crisis in the Health Service in inner London, a subject which formed part of my speech in the equivalent debate last year. I spoke then about the crisis in nursing. It is no better, but today I wish to go slightly wider and I hope that the Leader of the House will give us some fundamental assurances.
Since I spoke from these Benches on health matters last year, I have been dogging the Secretary of State for Social Services with questions about hospital and community services cuts in London. Eventually, after much obfuscation, I obtained the figures. In an oral answer on 12 January the Secretary of State confirmed that between 1981–82 and 1986–87 expenditure in the four Thames regions had dropped in real terms by 2·8 per cent. That was a bigger reduction than even I had expected. The Secretary of State justified those cuts by saying that they were
more than offset by increased efficiency." —[Official Report, 12 January 1988, Vol. 125. c. 132.]
That gives rise to three questions which I hope the Leader of the House will take away with him. First, what is the basis for that efficiency claim? How do the Government measure increased efficiency for the purpose of that claim? Have they made specific calculations of increased efficiency, or is it a general statement? Are their claims of increased efficiency accepted as valid by anyone but themselves? When the Government's figures confirm real cuts, as they do in London, we need more than a general statement that they have been offset by efficiency.
Secondly, and confirming the worry, the Government say that taking into account efficiency savings, purchasing power in the Thames regions increased by 2 per cent. during those five years. That contrasts enormously with the 2 per cent. increase in services needed annually to keep pace with greater numbers' of elderly people, existing policy commitments such as community care, and medical advances. The Government have accepted that a 2 per cent. increase in services is needed annually. Even taking on board their claims about efficiency, if they acknowledge that there has been only a 2 per cent. increase over five years—not each year—in purchasing power, they must also acknowledge that services have not increased by anywhere near enough to meet the growing demands of people in inner London and the south-east.
By the Government's own admission that a 2 per cent. increase in services is needed annually, their admission in January that purchasing power has increased by only 2 per cent. in total over five years makes it clear that the NHS in London has not had enough money even to stand still. It has been slipping back and services have been declining. Will not the Government at last admit that, I hope as a preface to doing something about it? They will have another opportunity to do something in the next few weeks.
Thirdly, must not the Government acknowledge that because the resource allocation working party formula does not take sufficient account of indicators of social deprivation and therefore, tends particularly to shift resources away from urban areas in the south-east, the cut in London, as opposed to the four Thames regions, which go outside London, will be even bigger than the 2·8 per cent. cut that the Government have acknowledged in the Thames regions as a whole—and that in an area that desperately needs more health resources?