Health and Social Security

Part of the debate – in the House of Commons at 6:34 pm on 27 November 1989.

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Photo of Sir Ray Whitney Sir Ray Whitney , Wycombe 6:34, 27 November 1989

I do not have the benefit of knowing the constituency of the hon. Member for Pontypridd (Dr. Howells), but I am certain that the Welsh health authority—in my experience an extremely good one —has shared in the increase in funding that all regional health authorities have enjoyed. That increase has led to more nurses and more doctors. If the picture that the hon. Gentleman painted of his constituency is the truth, he should go to the Welsh health authority to demand better treatment. I suspect that he will find that his constituency has also shared in the increase in funding, nurses and doctors. We all agree that we have not reached Utopia, and that is why we need to take a new look at the National Health Service.

Sadly, the hon. Member for Pontypridd, in common with the Opposition Front Bench spokesman, the hon. Member for Livingston (Mr. Cook), provided the same old litany and not a single new idea. Regrettably, that was the contribution, or should I say lack of contribution, from the spokesman for the Liberal Democratic party, the hon. Member for Roxburgh and Berwickshire (Mr. Kirkwood). All we hear about is the need for more funding. I should like to consider the question of resources and to go back to the situation that prevailed in the spring of 1979.

The House will recall that, in 1979, we were coming to the end of a period of Labour government. That period saw an actual cut of 20 per cent. in real terms in nurses' pay and a 30 per cent. cut in the hospital building programme. It was the time of the winter of discontent, and spending on the NHS stood at £8,000 million.

Imagine if my party, the Conservatives, had stood on a platform during the 1979 election campaign and promised that, within 11 years, spending on the Health Service would have increased by 45 per cent. Imagine if we had run on a campaign that claimed that, in the forthcoming decade, there would be 67,000 more nurses, whose pay would, on average, be 43 per cent. higher in real terms than it was in 1979. Imagine if we had told the electorate in 1979 that there would, in 10 years, be 14,000 more doctors and 20 per cent. more general practitioners, that the average list size of GPs would decline by 300 and that those doctors would be paid, on average, 37 per cent. more in real terms than they were in 1979. If we had said that spending on health would increase by 1 per cent. of gross domestic product—our GDP is much higher than it was under the Labour Government—what would have been the reaction of the Opposition parties? They would have scoffed and scorned as they are doing now.

What would have been the reaction of the media? We can imagine the editorials of the Daily Mirror and we might even imagine the editorials of some of the more moderate and balanced papers advising us not to be so ambitious or so boastful. What would have been the reaction of the British Medical Association or some of the royal colleges? They, too, would have scoffed, and they would not have believed our claim. If we had been able to convince the BMA that we were speaking the truth arid that we could make the economy so strong that we could deliver that increase in funding and staffing, what would the BMA then have said? It could have said nothing but that its troubles were, to a significant extent, over, and that we would have a Health Service that satisfied all our demands.

We all know the reality, and we know that demands are far from satisfied—no Conservative Member would dream of suggesting that those demands have been met. We should all understand the pressures that have caused that shortfall. We have the pressure of an aging population —I am happy that that is so—and the huge expense in medical care required as one moves into one's later years. There is also the pressure of medical advance, which we all welcome, which is tremendously expensive and demanding on resources. The Health Service also faces the pressure of rising aspirations. As a number of my hon. Friends have already said, Opposition Members mention the failures and the problems, but they never mention the great successes and advances that have taken place in prenatal care, old-age care and whatever else.

Great advances have been made, but great challenges still lie before us. If people were to look at this subject objectively, they would say that we have had 40 years of a basic structure, endless commissions and royal commissions, inquiries, surveys and reports, but that fundamentally the structure that was put in place in 1948, and opposed by the British Medical Association, is no longer able to stand up.

Opposition Members should remember that the Conservative party was fully behind the then Minister for Health who, in 1944, introduced the White Paper which first established the principle of a National Health Service in this country which was available for all and free at the point of delivery. That is the principle to which we have adhered and on which the present proposals are founded. With the experience of the past 10 years and with the huge —in 1979, literally unbelievable—increase in resources, we have reached a point where it must be clear to all but the most closed minds that simply providing more money is not the answer and will not possibly produce the answer.

We have come to expect closed minds among the Opposition and listen in vain for any new idea from the Labour party and what remains of the centre parties. However, we are deeply dismayed that the minds of those in the medical profession so often seem to be closed. Fortunately, there is now a sign that their minds are being opened. Contrary to what the hon. Member for Livingston said, there are signs that good sense is at last breaking out among a number of those in the medical profession. The 2,700-strong Hospital Consultants and Specialists Association rightly condemned the British Medical Association's appalling propaganda campaign and welcomed intelligent debate about the proposals which the Government have sensibly put forward.

People who are worried that so many doctors and the British Medical Association are against the proposals and believe that therefore those proposals must be wrong, must take account of the British Medical Association's record. In an otherwise excellent speech, my hon. Friend the Member for Birmingham, Edgbaston (Dame J. Knight) was wrong about one point. She said that the BMA had opposed medical advance for 40 years. It has actually opposed it at least from 1911, from the time of Lloyd George's National Insurance Act 1911. Once the Act had been in operation for two years and was seen to work, the BMA supported it wholeheartedly. Once our proposals are in operation and seen to work, the BMA and the rest of the medical profession will support them.

I lament the fact that the Opposition have not proposed a single new idea. I applaud the deep commitment which the Government have shown to the National Health Service by the huge increase of resources that they have committed, and continue to commit, to it. I call upon the House to reject the amendment.