Orders of the Day — Budget Resolutions and Economic Situation

Part of the debate – in the House of Commons at 4:41 pm on 7th July 1997.

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Photo of Frank Dobson Frank Dobson The Secretary of State for Health 4:41 pm, 7th July 1997

There was a touch of "All Our Yesterdays" in the former Secretary of State's intervention. I can certainly confirm that, last year, the Government gave the impression that they had found more money for local education authorities, but, while they may have increased the SSA, they did not increase the funds. Consequently, money was moved out of social services into education, following pressure from local people who were under the impression that the Government had given their local council extra money.

We emphasise that—as my hon. Friend the Member for Stoke-on-Trent, South (Mr. Stevenson) pointed out—all our aims depend on more co-operation. We want to promote co-operation at all levels and in every part of the national health service. The internal market introduced by the previous Government set different parts of the health service at one another's throats. A health service manager in my area described it to me a few years ago as "dog eat dog". That must stop: stupid, petty and ridiculous competition must end. Co-operation must be the order of the day from now on, with different units helping each other out, because patients suffer when they do not.

That is happening already, in that many common-sense people in the health service have been trying to work together, but they have been obstructed by the system and the messages from Tory Ministers. Here is a good example. Last year in Birmingham, the various parts of the NHS got together with the council to make contingency plans to cope with the winter pressures. As a result, they coped well last winter. That approach must be applied right across the NHS.

At the general election, we promised that we would make sure that the boards of health authorities and trusts would be more representative of the local communities that they serve. Some 900 appointments to trusts are due in November and December this year. The appointments process was set in train before the general election, but I am nevertheless trying to live up to our manifesto commitments, even in the limited time available. The sort of people whom I want to appoint are the sort of people whom I would like to stick up for me and my family and for local services on my local health authority and my local trusts.

I have opened up the appointments exercise. I have invited local councils to put names forward and invited every Member of Parliament in England with a local trust board vacancy—regardless of party—to do the same. I emphasise, however, that no one will receive special treatment: all the appointments will be made on merit and will be subject to Nolan procedures. I have also made it clear that I expect trust boards to meet in public in future and I propose to change the law to require them to do so.

Those measures are not window dressing; they are a serious contribution to improving the services that the health service provides. They will increase public involvement, public knowledge and public commitment—and commitment counts for a lot when it comes to providing local services and improving cost-effectiveness.

Most of the debate on the Budget has been about money. That is only natural, but money is not the only thing that counts in the NHS. The health service certainly needs money. Its staff need decent pay and conditions, and access to modern medicines and up-to-date equipment. They need good data systems and top-quality management. All that is, at least in part, to do with money, but something else that the staff want is not connected with money. Above all else, the staff need to feel that they are treated with the respect that they deserve—respect for their commitment, respect for their professional skills and experience, respect for their dedication. With this Government, they will get the respect that they deserve.

The changes that we make will be carefully thought out and carefully discussed in advance with the people involved, and they will be tested. Unlike the previous Government, who thought that they knew it all and forced repeated changes on the NHS against the advice of the people who have to do the work, this Government will involve the staff, listen to their ideas and respond to their concerns. We will not always agree with any particular group, but we will listen, because we recognise that the future of the NHS depends on the people who work in it.

We want to see a genuine national health service, providing top-quality services close to home—top-quality services ranging from the health visitor, local pharmacist, local GP or district nurse to community hospitals, district hospitals and centres providing specialist care, but all part of the same national health service and accessible to all. We want them to work together, helping each other to help the patients. That is what we promised in our election manifesto. We also promised, "If you are ill or injured, there will be an NHS there to help. Access to it will be based on need and need alone, not on your ability to pay, who your GP happens to be or where you live." We will keep that promise to safeguard the basic principles of the health service.

Unlike the Conservative party, we take our election promises seriously. We do not make promises that we cannot keep; we do keep the promises that we make. We promised to raise NHS funding in real terms year on year, and we have. We promised to cut bureaucracy and shift more funds to patient care, and we have. We promised to overcome the problems that plagued the private finance initiative, and we have. We promised to replace the wasteful competition of the internal market, and we have. We promised to give priority to the NHS, and we have.

That is because we treasure the NHS, which was founded by the Labour party. It has served the people well for 49 years, and it is the most popular institution in our country. That is partly because it works well in practice and partly because it is based on the principle that the best health services should be available to all—the best for all: quality and equality.

The health service appeals to the British people because it demonstrates the benefits that flow from working together for a common purpose. The NHS is practical and it is also a symbol. It does not merely bind the nation's wounds; it helps to bind our nation together. That is why it is precious, that is why we are keeping our promises and that is why we shall never let the NHS down.