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The Opposition are merely attempting to disrupt my speech, Mr. Deputy Speaker. Their actions are childish, given that there is an agreement between the Whips that we should all try to limit our remarks so as to get as many people in as possible. I certainly intend to observe that request.
Where possible, I want the amount of competition and patient choice to be increased substantially, but there can never be redundancy, duplication or competition in disciplines such as neurosurgery, intensive care or ophthalmic surgery, for example. We have a choice with them, and one option would be to leave the producers to deliver what they want when and how they want, but that is never acceptable. If health producers are subject to no discipline or no counterbalance to their own inclinations, it is tantamount to our saying that we cannot influence the monopoly, which must be left to deliver whatever it wants to deliver. To say that would be an abdication of the responsibility that Parliament assumed when the National Health Service Act 1946 came into force in 1948. It is a hopeless way forward, and I am very sorry that my former hon. Friends in the Opposition have gone down that road, possibly for totally the wrong reasons.
I want to give the House another example. The Medical Training Application Service was a debacle because there was too much producer orientation. Ministers set up a quango and then declined to second-guess its results. I understand that it is difficult for a Minister to second-guess senior consultants and the people running the royal colleges, but it is clear in retrospect that that is what should have happened. Unfortunately, however, the senior doctors were influenced by their own interests: they thought that spending so much time interviewing junior doctors was boring, and that it would be a thoroughly good thing to allow a computer to do all that. That is an example of how producer orientation and monopoly power can go wrong—in medicine, as in other areas of human activity.
We set up the health service, and we in this House are proud if it. We have the responsibility to make sure that it produces the outcomes and outputs that the public demand and require, which means that rules and targets must continue to be imposed from the centre.