I feel that the House would appreciate it if, before I deal with the detail of the statement, the Secretary of State explained how yet another of his Department's statements was leaked to the media before being delivered to the House.
Those of us who were up at the time will know that the 6 am news on Radio 5 Live contained a detailed report on the setting up of admissions wards in hospitals, which could have resulted only from a detailed knowledge of the contents of the statement. It also appeared on BBC teletext. The nurses' pay award statement was leaked to the press two weeks before publication. The Ashworth hospital statement was leaked to The Daily Telegraph one day before it was made to the House. The mental health statement was leaked to The Sunday Telegraph two days before publication. The social services statement appeared in The Independent and The Guardian on the morning of publication. The children's safeguards statement appeared in the Evening Standard on the morning of publication. The health spending statement, made in March 1998, appeared in The Times on the morning of its delivery to the House.
Is it not high time that the Secretary of State lived up to the undertaking that he gave the House in November 1998 to find the person responsible for that brazen contempt of Parliament, and to have that person dismissed? Perhaps he could tell us what progress he has made on that one.
In the course of the right hon. Gentleman's statement, he kept referring to the "new" Government. I should say that, after listening to the statement, the "new" Government are looking pretty old: old money recycled as new announcements, and old announcements reannounced. There was very little that was new in the whole statement. Will the right hon. Gentleman therefore tell us how much money has been taken from the so-called modernisation fund to fund the nurses' pay award? Did not the Government's own statement on the modernisation fund, in July 1998, say that the fund was intended for waiting lists, capital investment, education, staff training, primary care and mental health? Why, therefore, is it being used to fund regular expenditure on pay? If he plans on saying that the fund was always designed to do that, will he give the House a simple guarantee—that no project will be delayed that was to be funded from modernisation money in order to pay the nurses' pay award? Will he give us that simple guarantee?
Does the right hon. Gentleman also remember the Labour party's pledge in 1996 to establish a task force on trolleys and to monitor the number of patients forced to wait for treatment in that manner? Why has he broken that pledge? Is he not now essentially telling doctors how to manage their hospitals by requisitioning wards for use as a temporary stopping place for patients? Is he really satisfied that that is the best use of such space, given the strain that our hospitals are under?
Would not a better solution to the problem of patients waiting on trolleys be to abandon the right hon. Gentleman's damaging waiting lists initiative, which has resulted in hospitals continuing to admit routine waiting list cases even though accident and emergency wards had patients stacked up on trolleys this winter? Does he agree with the view of Dr. Simon Fradd, deputy chairman of the British Medical Association GPs committee? He said:
These well-intentioned but ill-informed initiatives put huge pressure on hospitals … there is a downward spiral of reduced resources and increased waiting times"?
Would the right hon. Gentleman care to calculate how many times now he has re-announced the modernisation fund and NHS Direct? Does he agree that he has been forced to do so again because, despite the huge tax take of the past three years, all he has to announce to the House today is an extra £100 million? Is that why we are not getting a proper Budget debate on health?
How many patients were left lying on trolleys because of this winter's health service crisis? Will the right hon. Gentleman guarantee that the dedicated wards that he has announced today will not reduce capacity elsewhere in hospitals? I should like a very clear answer to that question: in setting up those wards, will he be reducing capacity elsewhere?
On 9 November 1998, after the pre-Budget announcement, the Secretary of State announced £200 million expenditure. The NHS Confederation, however, said:
This is really only next year's money paid early so that we can implement schemes that will save money".
Was it correct? Is the money that is being announced today really new money?
Has the right hon. Gentleman come to any conclusions on how NHS Direct—he has not told us today—will be organised nationally? National centres are likely to be more efficient and lead to more uniform standards, but may reduce co-ordination with local GPs, whereas local centres based in practices may lead to a lack of uniformity in standards. Will he take this opportunity to reassure GPs that the pilot scheme in Northumberland, which routed all out-of-hours calls to NHS Direct, will not be extended—as has recently been speculated—to cover in-hours calls, too? Given that today is, by my calculation, the third time on which he has made a statement on NHS Direct, surely he has now had the chance to form more detailed opinions on how the scheme will work in practice, rather than merely giving us vague words and principles.
Will the right hon. Gentleman confirm that any measures that he intends to put in place—including those announced today—to prevent a repeat of this winter's chaotic scenes of patients on trolleys will not, this time, be left until the last moment? Has he finally learned this winter's lesson—that money and schemes announced at the last minute, to grab topical headlines, do not produce much for the NHS? The winter, after all, is predictable.
Does the Secretary of State agree that next winter, trusts will be under greater pressure than ever as they struggle to adapt to his upheaval in primary care? What allowances is he making for that? Will he put money in place to ensure that the burden of extra bureaucracy imposed on the health service by his reforms does not reduce levels of patient care, as his waiting lists initiatives have done?
The right hon. Gentleman referred again today to £21 billion of extra money. Will he answer this simple question—so simple that I am sure that he has the answer at his fingertips? What was the total level of spending on the national health service for the financial year 1998–99 and what is the planned level for the financial year 2000–01? What is the difference—I can supply an abacus if he cannot manage the sum—between the two?
The Secretary of State concentrated heavily on the provision of new equipment to combat cancer. Does he agree that one of the main problems is the shortage of radiographers? Why is he concentrating on equipment? What plans does he have to address the shortage of radiographers?
The Secretary of State says that he is drawing his expertise from the Norfolk and Norwich hospital. I seem to recall that that hospital's imaginative solution to the winter crisis was freezer vans in which to stack the dead. He will note that the Portsmouth example that he gave will cost £1 million, yet he claims that the £70 million to £80 million that he has budgeted for will cover all accident and emergency adaptations. Is he saying that there are relatively few such adaptations left to make? If not, how will he afford them from that sum?
Finally, what progress have the Government made towards realising the Secretary of State's target of a maximum two-week wait to see a specialist after an urgent written referral for suspected breast cancer?
Lastly—[HoN. MEMBERS: "Oh!"] Well, finally and in conclusion rather than just finally. As the Secretary of State has mentioned the NHS in shopping malls, will he acknowledge his debt to the private sector, which pioneered that practice?