Public Expenditure

Part of Bill Presented – in the House of Commons at 9:11 pm on 15th May 1991.

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Photo of Mr Tony Marlow Mr Tony Marlow , Northampton North 9:11 pm, 15th May 1991

As is quite often said these days, public expenditurre is good in many respects. Obviously one has to be careful how one spends the money. There are two purposes to public expenditure. The first is to care for and to help those who are unable temporarily or, sadly, permanently, to care for themselves. That area of public expenditure is one that this Government have built up. We have managed to refresh the parts that previous Governments have not reached.

The second is to ensure the provision of effective and adequate public services. That is not done by public expenditure alone. Today, I visited the channel tunnel. That service, facility and infrastructure will be made available, but it has not been paid for by the public. That is a totally refreshing change from previous Governments, who felt that everything of that kind should come out of the taxpayers' pocket.

Another area of public services is the water authorities. They are now in the private sector. The public—the people of this country—paid to buy them. So the taxpayer has had the money for those services, and now that those services are generating profits, they are providing the taxpayer with money yet again.

The Opposition go on about public expenditure—about spending more money, and about more plans for spending public money. They are going to buy the water authorities back. They are going to find more taxpayers' money to pay for that, and then they will lose the taxation on the profits in the future. So it is not what you do—it is how you do it.

One of the most important areas of public expenditure, recognised by both sides of the House—it is just the philosophy with which we approach it that is different—is the health service. Our approach is that we want to get more care for the cash. However much money we can make available—and we on this side of the House have made more money available than Labour did in the past or could in future—we want to make sure that it generates as much care as possible.

That is the reason we are going for hospital management trusts. A trust hospital will have control over its own destiny. It will run itself. It will manage itself, which will give it an incentive to be more effective and efficient. Not only that, but it will have a far greater awareness of the costs of what it does. By having that awareness of the costs, trust hospitals will be able to do more treatment for any given amount of money. They will want to have more people to come to them. They will want more business—more work, more care, more patients, more treatments and more effective use of our money. They will give more care for the cash.

The Opposition have talked ad infinitum about cuts and closures, but they do not tell us about the wards and the new hospitals that we open or about the additional treatments. Since the Government took office, they have increased the resources to the health service by more than a half. Is that a cut? Since the Government took office, the number of doctors and nurses has increased—8,000 more doctors and 53,000 more nurses. Is that a cut? Since the Government took office, treatments, operations and in-patient treatments have increased by a third. Is that a cut?

We have plans to increase the effectiveness and efficiency of the health service. The Opposition tell scare stories and take matters out of context. They tell us that they will not proceed with our reforms, so they will not achieve improvements in efficiency. Where will they get the resources from? We have been told that they will not increase taxation, apart from the 10 per cent. and 9 per cent. increases, and that they will obtain the money from growth. The money that will come from growth is already committed to old-age pensions and child benefit. Therefore, there will be no extra money for the health service and no improvement in that service.

We would return to the days of the previous Labour Government, when the International Monetary Fund was involved. Then there were cuts in the health service and in the amount of money spent. It was a question not of priorities and decisions about who should be treated, or of doctors and hospital management, but of the National Union of Public Employees and the Confederation of Health Service Employees, who were the Opposition's paymasters. The career of the Leader of the Opposition depends on the unions. He is more concerned about receiving the approval of NUPE or COHSE than about providing an effective and efficient health service. They decide his destiny and his position as Leader of the Opposition.

The Government have rightly given more resources to the health service and the public sector. We have rightly encouraged the private sector to provide facilities that would not otherwise be provided. We have rightly managed to boost the amount of money to the taxpayer rather than reduce it.

By contrast, if the Opposition took office they would do what they did before: they would try to improve services, but they would not have the systems to do so. They would not make the reforms that we have made. They would either borrow money, as my hon. Friends have said, or, once again, mug every taxpayer and take money out of their wallets and handbags. We must avoid that.