I beg to move,

That this House
has considered the matter of NHS staffing.

This July, we celebrate the 60th anniversary of the national health service. As the Prime Minister said in a recent speech, it is not only a great institution but a great, unique and very British expression of an ideal. Health care is not a privilege to be purchased but a moral right secured for all.

Over the past six decades, the NHS has cared for tens of millions of people and saved many hundreds of thousands of lives. It has been at the forefront of innovation in health care, pioneering advances in medical treatment, such as triple therapy for TB; in surgery, such as artificial hip replacements; and in imaging, with the development of MRI scanning. With its unique offer of health care free for all at the point of need, it has liberated us all from the fears of unaffordable treatment and untreated illness.

As we begin to celebrate the achievements of the NHS over the past 60 years, it is right that as new technologies emerge, as expectations rise and as health care needs change we look ahead and continue to reform and renew the NHS for the future. Indeed, the birth of the NHS was not easy. Aneurin Bevan had not only to persuade his colleagues in Cabinet that all hospitals should come under the umbrella of the new national health service but to fight to establish the NHS in the face of concerted Opposition in Parliament from the Conservatives, who voted against its establishment at each turn, and outside from the British Medical Association, I am afraid, which was equally opposed to the idea.

Is it not the case that the NHS came about as a result of the Beveridge report in 1942 and was supported by the glorious leader of Parliament at the time, Winston Churchill, who was a Conservative MP?

The hon. Gentleman should check the facts. The Bill that set up the NHS was voted against on Second and Third Reading. That was very sad.

Babies born into the NHS in 1948 have had the opportunity of 60 years of the NHS. The NHS is one of the biggest employers in Europe and now employs more than 1.3 million staff. That level of staffing is required to provide the standard of health care that people demand and the significant improvement in health care provision that we have seen over the past 10 years.

When we launched the NHS plan in 2000, the public made it clear that their top priority was to have more staff working in the NHS. More staff are working in the NHS in England now than in 1997. There are almost 11,500 more consultants, more than 35,000 more doctors and nearly 80,000 more nurses in the NHS than there were in 1997.

The hon. Lady is explaining things very clearly. Is there a problem at the moment with the highly skilled migrant workers scheme, particularly at a time when a number of locally and fully trained doctors are having a great deal of difficulty finding jobs?

As has been stated—I think the announcement came out today—migrant doctors are always welcome to work in the NHS, as they have been for the past 60 years. Without them, the NHS would not have reached the strength that it has today. However, the scheme involves training places, and that has been decided in a court of law.

In addition, as I said, the investment has helped improve the delivery of treatment and care across the NHS and has driven down waiting times. The health budget has nearly trebled from £35 billion in 1997 to £90.4 billion. That investment in resources and staffing has had a dramatic effect on the health of the nation. Our reduction in the amount of time that people have to wait—

I thank the Minister for giving way; she is being very generous. On the issue of staffing, will she not accept that the Department of Health's figures have recently shown that the number of managers and bureaucrats has grown at a faster rate than the number of doctors, nurses or consultants during the past 10 years? Does that not reveal a problem with bureaucracy in the NHS?

The hon. Gentleman's point is not relevant to the management of a service that is very complex. Health care is not easy to deliver. It requires excellent management and excellent leadership. The managers are not there to be bureaucrats, but to manage a complex system. They manage it professionally and in the best way.

The average in-patient wait for treatment has been slashed from more than 13 weeks in 1997 to around 4.5 weeks now. That is possible only with good management. More than 98 per cent. of patients now wait less than four hours in accident and emergency. That is an amazing, genuine and much-needed improvement. Over 1 million more operations a year are carried out now than in 1997, and 99.9 per cent. of people with suspected cancer are seen within two weeks of being referred. The number of heart operations has more than doubled since 1997.

That has been achieved by investing in staff in the NHS. The service employs many more talented people, and they have shown consistently that they are capable of rising to whatever challenge the future holds. The Government are enormously grateful for the work that they do and want to support delivery with the appropriate resources.

There are, of course, problems that still need to be dealt with, and many challenges to overcome. The Government are looking to continue to improve the NHS at all times. Our assessment is that we are around two thirds of the way through the reform programme that we set out in the NHS plan in 2000.

Do the Government know how many whole-time equivalent dentists there are in the NHS?

I cannot answer the hon. Gentleman now. I shall try to get an answer for him during the debate and, failing that, I shall write to him. However, I can tell him that the health of the nation's teeth and the state of our children's oral health are among the best in Europe. I praise the work being done by dental practitioners in the NHS.

The challenge facing us now is to complete the job of reform. My noble Friend Professor Lord Darzi of Denham is leading an in-depth review throughout England. For the first time, we are including clinicians and staff at every level, as well as patients, charities, organisations in the third sector and all the bodies that help everyone in the NHS in developing work force planning. I have the privilege of chairing the work force group, and I am grateful for all the time that has been made available to ensure that the work force of the present and the future—who will take the NHS through the next 60 years—reflect the changing needs and demands of health care in the 21st century.

The interim report from the Lords lays out a vision of a world-class NHS that is fair, personalised, effective and safe. The final report is due later this year, and will set out how we can deliver that vision and secure the NHS for the future.

I want to pay tribute to the staff of the NHS. In particular, I want to praise the work of all those volunteers who are not classified as staff but who are very much part of the work force, as they have been since the inception of the NHS in 1948. Those volunteers give of their time so that patients get that extra bit of care that professionals are sometimes unable to deliver.

In the US, for example, there is no national health provision, and the result is that more than 40 million families there worry every day about how to get the care that they need. We do not have that problem, thanks to the work done by Beveridge and the Attlee Government in 1948. We in this House have a duty to protect the NHS, and to make sure that it has the right work force. The care that it delivers must be safe, progressive and personalised, and that is our goal for the future.

I warmly welcome this opportunity to debate this broad topic, although I am not sure what we have learned about NHS staffing from the speech that the Minister has just completed. It made no reference to the real problems experienced by NHS staff.

The Government seem to have a paradoxical approach to their stewardship of the NHS. No one doubts their commitment to trying to make it work better, and it is factually correct that investment has increased. However, their management of the NHS is not delivering the necessary return on that investment, or delivering the real, positive change that the Government themselves recognise as necessary.

At the heart of that paradox is the fact that this Government seek to control everything from Whitehall. Too often, they employ a one-size-fits-all approach, yet at the same time they seem to have something of a feudal, divide-and-rule attitude to NHS staff. Their running battles and regular and increasingly bloody skirmishes with different sectors of the NHS are causing resentment, disillusionment and anger among the people on whom we rely for the delivery of health services in this country.

We are also still reaping the results of botched contract negotiations and inadequate work force planning. Taken together, those problems are holding back the NHS, at a time when it should be allowed to prosper and flourish.

The 2006 Health Select Committee report branded work force planning in NHS a "disastrous failure". More recently, Lord Darzi's report outlined the need for an overhaul of work force planning and the commissioning of education and training. So far, however, it seems that very little has changed.

There is an overall equation that at the moment simply does not balance. Staff have been taken on with no long-term thinking but simply to achieve centrally imposed targets. People have been laid off or denied training places so that NHS trusts can balance their books. Like MPs all over the country, I have had junior doctors, nurses and physiotherapists visiting my surgery or writing me letters because, after all the hard work that they have done—and all the training that they have received at great cost to the taxpayer—they simply cannot find a job.

Yet huge amounts of money—some £1.18 billion in 2005-06—are being spent on agency nurses. They are hired at huge cost to the taxpayer, but better planning would mean that a great proportion of that money could be spent on health care and on areas where there are real gaps in NHS staffing.

Of course, the Department of Health has increased the number of training places and encouraged more people to apply for them, but it did not ensure that sufficient jobs would be available down the line for newly qualified professionals. On the one hand, there are real concerns over staffing levels—especially in maternity and other areas—and about the overuse of agency staff but, on the other hand, we have disillusioned young people unable to pursue their chosen careers. The careers that those people want to pursue are needed and valued by society, yet nurses are currently leaving the country in their thousands.

I am listening to the hon. Gentleman with interest, and I agree with much of what he has said. Does he agree that so many people leaving medical school are not getting jobs because medical professionals from Europe and elsewhere have been encouraged to come into the NHS? Is not that part of the mixture that is causing the problem?

That is an interesting question, but the overall approach to staffing in all sorts of areas simply does not add up. I mentioned maternity services: we all know that there has been a failure to recruit enough midwives to provide the one-to-one care that the Government have promised. Birth rates are rising, many midwives have retired, and the problem can only get worse. If it continues, the chronic shortage of midwives could also force the closure of small childbirth centres across the country—just when the Government, quite rightly, are pushing forward with trying to give women real choice about where and how they have their babies.

I turn now to the increasingly damaging row between the Government and GPs, in particular over extended hours. The Government are trying to paint that row as one between them and the "unrepresentative" British Medical Association, not doctors. The Government are trying to suggest that the BMA is not willing to offer more extended opening hours, but all the doctors to whom I have spoken say that they support some form of appropriate extended hours. As a result, they feel that they are being ignored and dictated to.

Everyone agrees that extended hours are a good thing and, crucially, doctors agree with that too. The doctors in my Constituency—indeed, all the GPs and their representatives to whom I have spoken—have made it clear that they would be more than happy to offer extended opening hours to their patients. However, they also have a very good idea of their own practice and their patients' lifestyles and needs, so they have different suggestions as to how extended opening hours could be offered to fit both their practices and, crucially, their patients' demands.

The so-called dispute with the BMA is about a 10-minute difference between what we want patients to receive and what the BMA is proposing. That is in the context of an investment of £158 million. We believe that GPs will support the interests of their patients.

That is exactly the kind of approach that is doing so much damage. It is about dictating, not listening. The row must be resolved by working together with doctors, and in partnership with GPs. The experience with dental contracts has shown that an imposed solution that is not acceptable to the medical profession will not work. Members may be slightly surprised to see me waving the flag for conflict resolution and peace, but it is vital for the future of primary care that a solution be reached with doctors. I hope that the Government and doctors sit down together to work through the issue, and that a flexible, sensible solution is found that works to the benefit of all.

We need partnership, a much more flexible approach and much more local decision making, including on NHS staffing. We need real, long-term, strategic work force planning across the NHS. Instead of top-down solutions from Whitehall, we need solutions that are tailored and adapted to different needs and situations across the country.

rose—

I will give way, but I am not sure whether I get any more time for doing so.

Lord Ara Darzi's review does exactly what the hon. Gentleman wants: it involves clinicians and patients. My question to the hon. Gentleman is: does he support the Ara Darzi review?

I support the review of the current situation, but the Government have been in power for almost 11 years, and it seems a bit late for a complete overhaul of the way in which we run our NHS.

The Government should stop trying to look tough all the time, stop alienating staff and stop alarming patients. They should come up with workable solutions that meet local health care needs. For now, the skirmishes carry on. They are draining and distracting for all sides, and are not conducive to the provision of health care, which clearly requires Government, local health care organisations and the professionals to work together. The Government are ignoring the cause of our nurses, have lost the trust of our junior doctors, and are now at war with GPs. They are trying to control instead of guide, dictate instead of empower, and micro-manage instead of devolve. That is not the way for the NHS to achieve its potential, and it is time for a change of approach. It is time, at last, for the Government to listen.

On behalf of everybody present, and indeed on your behalf, Madam Deputy Speaker, and the behalf of every Member, may I pay tribute to the wonderful work done by doctors, consultants and nurses, and the ancillary workers who are often the unsung heroes of the NHS? As Greg Mulholland says, there are tensions within the NHS. It is therefore simply beyond belief that not one Labour Member of Parliament intends to speak in this debate on NHS staffing. I hope that when the Minister makes her final comments, she will apologise for that, as it sends out a curious message to all those in the NHS who are under considerable stress.

In recent years, the NHS has faced a number of problems, not least in Suffolk. The county has been hit by cash crises, service cuts, closures and redundancies. Our hospitals are continually on black alert. In the past 10 years, the number of available beds has been cut from 1,501 in 1996-97 to 1,194 in 2006-07. What is really sad is that community nurses and doctors have told me that the local hospital, the West Suffolk hospital, is being forced to discharge patients prematurely. Of course, the hospital is doing everything in its power to mitigate those unfortunate circumstances, but the situation has arisen because of very tight finances. The problem is that there are insufficient numbers of intermediate care beds, ever-increasing pressures on staff, and a top-down, centralised, target-driven culture that continues to drive front-line clinicians in our NHS to despair. That is well known.

I often hear the argument that there is too centralised a system in the health service, and many of us would sympathise with it, but there is a corollary: everybody also complains about the postcode lottery. There is a contradiction in many people's arguments. How does the hon. Gentleman resolve that contradiction?

Of course the hon. Gentleman is right to say that there are difficulties. Naturally, the problem that it is possible to obtain a certain form of treatment in one part of the country but not another has to be resolved, but I am not really talking about that. I am talking about a culture that has caused people to be pushed out of beds prematurely—that is the view of community nurses and doctors—simply because of the pressures of centralised targets and control. That is quite different from the dilemma that he rightly mentions. There is a great sense of despair among many of those who work in the NHS. The result is that our GPs are forced to pick up the pieces, which is difficult. I was talking to a GP in my Constituency about that only yesterday.

Having targets for capacity in our hospitals raises the risk of superbugs such as clostridium difficile and MRSA. There have already been worrying increases in the number of superbug cases in some of the hospitals in the eastern region. Both West Suffolk and Ipswich hospitals have experienced increases in C. diff infections among patients over 65; in contrast, nationally there is improvement to the problem. Vomiting and diarrhoea bugs are commonplace. It is truly horrific that some elderly constituents of mine are now scared to go into hospital because of those bugs.

I reiterate that our doctors, nurses and ancillary workers do a wonderful job, but they are struggling to cope. Job cuts have simply not helped the situation. I acknowledge that, as the Minister said, since 1997 the number of staff employed in the NHS has grown, but since September 2005, some 38,000 jobs have been cut from the NHS. Last year, almost 7,000 nursing jobs were lost. The total number of qualified nursing, midwifery and health visiting staff employed by West Suffolk Hospital NHS Trust has decreased by 9 per cent. since 2004. The number of professionally qualified clinical staff has decreased by 8 per cent. since 2003.

The vacancy rate for nurses is 0.5 per cent., which is the lowest level for six years. The nursing work force are to be congratulated on that.

It's the number of nurses.

The hon. Lady mentions nurses; they are an important part of the work force. In fact, they are the largest part of it. It is important that we get our facts right.

I note that the Minister does not contradict the fact that I mentioned about the diminution in numbers. It is based on information that is beyond dispute; the figures are official statistics.

I am sure that the Minister knows what I am about to ask my hon. Friend. There is a shortage of midwives in the national health service—a fact that is widely publicised by the Royal College of Midwives itself. There is also a shortage of student midwives. If the Government are to meet the guarantees in the Midwifery Matters strategy, the midwifery profession in the health service must be provided with more money, so that it can ensure safety in birth and the delivery of post-natal work.

I am most grateful to my hon. Friend for making that point. He is entirely correct; the UK birth rate is increasing appreciably, so not only has there been a shortage of midwives but with the rising pattern of births the situation can only get worse.

The statistics I gave are not in dispute, but in various parts of the country accident and emergency attendances put huge pressures on the staffing resources of hospitals. At West Suffolk Hospital NHS Trust, A and E attendances have soared by 34 per cent. since 2001-02, at the very time when there have been staffing cuts at the hospitals and a reduction in the number of beds.

There has already been an allusion to the recruitment of doctors. It is a growing problem in Suffolk, so I welcome the Government's announcement today that they are attempting to preserve health service jobs for British graduates. However, budgetary constraints are another reason why junior doctors struggle to find employment; GP practices are unable to fund extra posts. I have had many conversations about that point with GPs in my Constituency.

I am constantly told by constituents and people who work in our hospitals that rather than cuts we desperately need more doctors and nurses in the local NHS, reversing the pattern of the past few years, yet instead the number of NHS managers is increasing three times as fast as the number of nurses. Between 2005 and 2006, twice as many nursing jobs were lost as managerial jobs. In the east of England, there has been a 4.9 per cent. increase since 1997 in the number of manager and senior manager positions—from 2,027 to 3,126—yet there has been only a 2.8 per cent. increase in the number of nurses, from 29,424 to 37,377.

It is important to get the facts right. Our training levels for doctors have never been higher. The recruitment and retention rates for junior doctors, and for GPs in particular, have never been higher. It was right that we looked at their contracts some time ago, which has helped considerably in recruitment and retention, but I do not recognise the claim that there is a shortage. There are areas with inequalities and it may be more difficult to recruit GPs to them, but training in our medical schools, in particular for GPs, has never been at a higher level.

I agree that the level of training for doctors is of high quality, but over the last few years, because of the appalling mismatch between the training and production of junior doctors and the lack of opportunities, many of them have been unable to find jobs, so they have emigrated. I am pleased about the Government's announcement, but I hope the Minister will not resile from the fact that over the last few years the morale of junior doctors has been severely tested by considerable confusion on the part of the Government, the results of which are clear to see.

My hon. Friend is making a powerful speech. Does he agree that one of the problems is not the number of doctors trained but the number of vacancies? In some cases, up to 20 qualified doctors apply for one post; on average three times as many people apply as there are posts.

My hon. Friend is entirely correct. In close memory, we saw junior doctors walking through the streets of London in protest against what had happened—an unprecedented situation in the history of the NHS.

Management costs in the Suffolk primary care trust increased by 22 per cent. in the last financial year. Amazingly, there are now more people managing and organising the NHS than there are beds. I hope that some justification can be given for the astonishing payments to officials in our strategic health authorities, where massive salaries are paid. My dealings with the East of England SHA have not inspired me with confidence that the organisation is on top of the role it is meant to play.

We all accept that there is a role for good management in any organisation, including the NHS. Does my hon. Friend feel that sometimes when we talk about bureaucracy the Government misrepresent the argument to make it seem as though we are attacking management, whereas in effect we are saying that there is room for good management but we must look at the costs of bureaucracy in the NHS for the benefit of all patients and staff?

I entirely agree. Of course, good management is important but I do not think my hon. Friend will disagree that the extent and volume of management, especially in our SHAs, has not been particularly productive and is extremely expensive. Considering the ever-greater pressures on the NHS, because of demographic and other factors, there is a mismatch, which is exactly the point he was making.

At West Suffolk hospital, there has been an increase of 184 per cent. over the past six years in the amount spent on salaries and wages for managers and senior managers. There has also been an 82 per cent. increase in the amount spent on salaries and wages for administrative and clerical staff. The figure has nearly doubled, yet there has been only a 73 per cent. increase in the amount spent on salaries and wages for nursing, midwifery and health visiting staff—from £16.6 million to £28.7 million.

The Prime Minister's own independent reviewer of NHS finances, Sir Derek Wanless, said that little benefit has been gained from the huge pay deals that were a consequence of "Agenda for Change". The Select Committee on Health criticised the Government's poor financial planning:

"The Government's estimates of the cost of Agenda for Change and the new GP and consultant contracts proved to be hopelessly unrealistic".

Last year, while nearly £1.5 million was paid in bonuses to 231 "senior" civil servants in the Department of Health, a county such as Suffolk struggled to cope with an unfair funding allocation and considerable debts.

Like many other parts of the country, Suffolk has an ageing population. The number of people aged 65 or over has increased by 11 per cent. since 1997; 19 per cent. of the population of Suffolk are now aged 65 or over. Furthermore, much of my Constituency is rural, which adds to the problems. That lies at the heart of the NHS funding problem.

Our local NHS struggles to match the needs and demographics of the local population. The Minister talked about inequalities, so I shall address that point firmly. For 2007-08, the per capita spend on the NHS was £1,156 in my constituency, well below the national average of £1,388. However, in the Prime Minister's constituency in Scotland, which does not experience the health crises that people have to put up with in a constituency such as mine, the per capita health spend was £2,019, almost double the amount in Suffolk, so the service cuts and huge debts in Suffolk have not happened in his constituency.

My hon. Friend is making a most interesting speech. I am most impressed by his statistics. Has he any statistics about the problems relating to mental health, where the shortage of professionally qualified staff is creating problems for GPs?

My hon. Friend has always made an enormous contribution in the House on health matters, in which he takes a close interest. His question is about what is commonly described as the poor relation of the health services. I do not have specific statistics about the problem, but I am sure that he agrees that one of the tragedies in how mental health has been handled, from a financial and back-up point of view, is that many individuals who are tragically caught up in the vortex of mental ill health land up in the criminal justice system, where they remain for good. Nothing is more tragic in personal terms; it is also very destructive for society as a whole.

I welcome the 5.5 per cent. increase that all PCTs are receiving in 2008-09, but it does not sufficiently address the problem that I have outlined. I have met officials at the Department of Health on several occasions to discuss the funding given to Suffolk, and have spent a great deal of time examining the funding formula that distributes funding to PCTs. The strategic health authority has accepted that we get a particularly raw deal. Rural areas such as Suffolk—many of my hon. Friends will be in exactly the same position—have been adversely impacted by a funding formula that discriminates against them.

I raised the issue at a meeting with a former Secretary of State for Health, and she agreed that if the NHS structures in Suffolk and elsewhere were in financial balance by last spring, she would re-examine the problem of rurality as part of the NHS funding formula. I hope that the reason why the advisory committee on resource allocation has requested more time to finalise its review of the resource allocation formula is that it is seriously examining the rurality factor. I eagerly await the report, which we hope will finally be published this summer. I hope that the revenue allocation in my area will be considerably greater. The impact of the cuts on staffing is just one manifestation of the negative effect that the skewed funding formula has had in Suffolk and other more rural parts of the country.

At the level at which most people have contact with the NHS, I fear that we are seeing a similar discriminatory effect. Haverhill, which is the largest town in my Constituency, is being affected by the operation of the Carr-Hill formula, especially through its effect on the weighted list size of each practice. That has caused considerable distress to my constituents. I touched on the national funding formula and the fact that it has thrown up various anomalies over the years. Now we have an anomalous situation closer to home.

For most people, contact with the NHS is most frequently made through their local GP surgery. A general practitioner is invariably the first port of call for people seeking help and GPs are hugely trusted in the local community. Yet the application of the centrally determined Carr-Hill formula has resulted in the town in my constituency which is the largest and most rapidly expanding in the whole county experiencing cuts of £280,000 for the local GP practices. That has meant that those practices will have to cut back, possibly remove staff, and make additional savings.

People read the huge headline rates of supposed increases in spending in the NHS and they hear about the increased commitment by the Government, but they cannot marry that up with the fact that they see cuts in the local hospitals, beds being removed, staff given the sack, and the GPs in the biggest town in my constituency up in arms because they are faced with substantial cuts—about £280,000. The community has come together in an unprecedented way. Petitions signed by more than 10,000 people have been delivered to No. 10 Downing street and to the House.

People cherish the NHS and want it to work. They cannot understand why such situations continuously arise. Having to deal with the consequences is hugely undermining for those who so loyally work in the NHS. I read Lord Darzi's proposals with great interest. In the report published last autumn, he proposed that each PCT should have a new GP-led health centre. I am delighted that an initiative is under way in Suffolk that may bring one of those new walk-in centres that is open from 8 am to 8 pm to Haverhill in my constituency.

However, that does not offset the fact that one of the consequences of the budget cut in Haverhill, with its impact on staffing, is that some of the satellite surgeries that the GPs were able to operate in the villages surrounding the town will be cut, notably in the village of Kedington. People have got used to having a satellite surgery and they value it because public transport is limited. Because of staff pressures resulting from the cuts, the surgery there will be cut again. That undermines people's confidence in the NHS. They keep asking where all the money has gone. Such is the outrage in the village, where the GPs are held in high regard, that we are holding a public meeting. I will do everything in my power to encourage the survival of the GP surgeries, because they are held in great esteem.

During the past 10 years the whole of the NHS has suffered badly, but in Suffolk it has been hit particularly hard. As the Minister said, the NHS marks its 60th anniversary this July. It was based on the founding principle of providing health care for all citizens and it is very much cherished, yet if the Minister has listened to what I said—I have tried to cite the statistics as accurately as possible—she will accept that people question whether that principle is still upheld. They do not understand what is happening.

Our hospitals are at bursting point. There is no question but that staff morale in the NHS is very low, we do not have enough beds, patients are being discharged too early—not for clinical reasons, but because of the target-driven culture—and the obsessive bureaucracy is impacting on the lives of our doctors and nurses. When patients go into hospital, there is the danger, as a consequence of superbugs, that they will leave in worse health than when they were admitted. There is the prospect that some of my constituents will be without a local GP surgery. As the elderly population grows, the situation will become worse.

In conclusion, yes, there has been an increase in staffing overall, although recently that has not been the pattern locally. Yes, more money has gone into the NHS and technology has improved. But my constituents share the concerns of doctors, nurses, community nurses and ancillary workers about what is going on in the NHS. Despite all the good intentions that may exist, morale is probably at its lowest point in the history of the NHS. That is a terrible indictment of what the Government have done.

I associate myself with the comments of my hon. Friend Mr. Spring about staff in the NHS and I, too, pay tribute to them. Seventy per cent. of NHS funding is spent on staffing, and the effectiveness of the NHS depends on that work force. The recruitment, training, professional development and morale of the work force are crucial to the effectiveness of our NHS.

There has been an absence of planning for and with staff to ensure that they can deliver the care and services that people need. My hon. Friend the Member for West Suffolk spoke about morale. The Health Committee report in 2007 stated that there has been a disastrous failure of work force planning. Although I always enjoy a history lesson on the inception of the NHS, I was disappointed that the Minister did not address work force planning, which is central to today's debate.

What are our NHS staff doing? A survey of nurses last year found that 66 per cent.—two thirds—spent more than a third of their time on paperwork. Eighty-one per cent. said that less than half the forms were important for patient care. The nurse of the year last year said that some days she did not see a patient, and that was not good. She said that she was a nurse and she wanted to nurse—that was her profession. She cited "constant pressures with bureaucracy" as her primary reason for leaving.

What about the money? In 2006, the NHS paid out £192 million in severance and redundancy payments. We have heard about the scandal of the pay-offs that the chief executive of Maidstone and Tunbridge Wells NHS Trust might receive. The Health Committee mentioned the huge growth in funds, and nobody would doubt that the Government have made considerable investment in the NHS. The question is about what they have done with the money.

The Health Committee also talked about the demanding targets that are now set and the staff increases that far exceeded the NHS plan. The NHS was spending too much, and boom quickly turned to bust. The nurse of the year said:

"Sitting in meetings we are constantly being told: 'We're going for this cheaper option with this bandage; we're going for that cheaper option with that dressing; we need to be mindful of resources; we need to watch what we are spending'. I'm absolutely fine with that—I run my household like that—but what I see as a waste of resources is when I'm sitting in a big meeting, and as a clinician I am the cheapest person there at £35,000 a year, and decisions are still being put off to another meeting."

My hon. Friend is making an excellent speech; we are listening with great interest. Is she aware that in my area, the accident and emergency units and maternity units are threatened with closure? That is disillusioning staff—hard-working nurses and midwives. They fear that the closures are due to financial pressures, not clinical need.

My hon. Friend makes an excellent point —[Interruption.] The Minister is smiling, but she would be wise not to. The problem is that the Government have put huge resources into the NHS—more than three times as much in 10 years. However, what is happening to that money? The Health Committee stated:

"There has been a disastrous failure of workforce planning."

It went on to say that there is

"constant re-organisation including the establishment and abolition of Workforce Development Confederations within 3 years. The planning system remains poorly integrated and there is an appalling lack of coordination between workforce and financial planning. The health service, including the Department of Health, Strategic Health Authorities (SHAs), acute trusts and Primary Care Trusts (PCTs), has not made workforce planning a priority."

In other words, the Government have not made NHS staff—70 per cent. of what the money is spent on—a priority.

Where is the evidence that the NHS does not make work force planning a priority? I chair a group under the Lord Darzi review—the first ever that involves all aspects of health care workers and those from the voluntary sector. Does the hon. Lady accept that that is good practice?

I accept that the report from which I was quoting was produced by a Committee with a dominance of Labour Back Benchers, and was chaired by a Labour Member. I am simply quoting a report that has come from the Minister's own party's Back Benches.

The Audit Commission is reviewing the SHAs' work force planning but that is to be kept a secret. There is fury in the press about that. Reference has been made to NHS managers. It is not that we do not need managers; one of my hon. Friends made the very good point that the NHS is enormous and needs management. However, there has been a 73 per cent. increase in the number of managers since 1996 and only a 31 per cent. increase in clinical staff.

rose—

I shall not give way because I am short of time and the clock is not stopping.

Some £1.8 billion has been spent on agency staff. My hon. Friend Sir Nicholas Winterton has a particular interest in midwives; the Royal College of Midwives is extremely concerned about the rising birth rate. It is up by 16 per cent. in London; there are 72,000 more babies. The number of deliveries per midwife has gone up. The NHS maternity services budget is shrinking, as is the NHS midwifery work force. We need more student midwives. There have been fewer training places in the years 2002-03, 2003-04, 2004-05 and 2005-06. Although there has been a significant increase in the number of nurses, there are now cuts in the number of specialist nurses and posts are being frozen. Some 180,000 nurses are due to retire in the next 10 years, and more than half rated their morale as very poor or considerably poor in a recent survey.

The Department of Health itself has predicted a shortfall of 14,000 nurses by 2010. Independent research shows that the mortality rate in hospitals with the lowest registered-nurse-to-patient ratio is 12 per cent. The number of nurses per patient is literally crucial to the survival of patients. I could go on about physiotherapists. More than 2,000 physiotherapy students graduated in 2007, but only 25 per cent. have a permanent job. Some 49 per cent. have not been able to find one.

We cannot walk down the street without a cardiologist pulling us away and inserting a stent. Yet the 66,000 people newly diagnosed with heart failure and the 345,000 people newly diagnosed with angina are not getting the cardiac rehab for which they are desperate.

Will the hon. Lady give way?

I would love to, but sadly time does not allow me.

You have had 10 years of government, Madam Deputy Speaker—

Order. I remind all hon. Members that that does not involve me personally. Perhaps the hon. Lady would like to rephrase her comment.

I apologise, Madam Deputy Speaker. The Government have had 10 years to get a grip on the situation, yet there has been an abject failure of planning for our NHS work force. The Government thought that all would be well if they chucked money at the NHS. In fairness, they have done that, but they have not considered what has happened to the money. One could consider it quite a feat that a Government who have given large pay rises to staff—particularly GPs and consultants—should also have managed to be so disliked and to drive morale down.

We have mentioned targets. I recently had a conversation with an A and E physician who is unable to keep his patients who are waiting for an intensive care bed on at A and E simply because the manager wants them up in the medical ward, where they are less well looked after, so that he can meet his targets. The Royal College of Nursing states that there are serious deficiencies in work force planning and that they need to be addressed. There is an all-time low of health visitors, despite the fact that health inequalities are rising. The Secretary of State himself said last year:

"The reality on the ground is that there is a gloomy mood. There has been an awful lot of change in a short period and staff feel overwhelmed by it."

The verdict on the Government's work force planning is definitely D-minus— [Interruption.] The Minister is smiling again, but I do not think that NHS staff will share her joy. "Could do better"—it is a disgrace and appalling. I urge the Minister to stop listening to her officials at the Department who reassure her, and instead face up to the truth. In many areas, the NHS work force is in freefall. The incompetence shown by the Government is outstanding—

Order. The hon. Lady's time is up.

I congratulate my hon. Friend Anne Milton on a powerful exposure of the situation. I know that she would have liked to give way to the Minister, but she could not because of the time limit. The Minister can intervene on me as much as she likes. We are lucky that she is here today; she has detailed knowledge not only from her previous and current roles, but from her intermediate role with the former Chancellor.

I should like to start by praising NHS staff, who are extraordinary people. I am not thinking only of doctors and nurses, but I will single them out for praise. It is no secret in the House that five years ago my wife was diagnosed with liver and bowel cancer. A local GP had the skill to find a little lump that gave the alert. She was immediately sent to the local hospital, which is not in Wellingborough but a considerable distance away. I am grateful that the Minister has agreed to come to north Northamptonshire to look at that problem.

The trick was to phone up in the morning to say that we were on our way. I did that, and was told that no beds were available. I said, "Blow this—I am coming anyway." By the time we got there, they had found a bed in a different part of the ward and she had the emergency operation. The skill of the 20 people who were involved in that operation and the recovery period was second to none. The same was the case when she had the emergency liver operation and, again, her life was saved by the NHS. I am pleased to say, touch wood, that she is fully recovered. Sitting in NHS hospitals for long periods at her bedside and observing NHS staff gave me an unusual insight into what goes on. There is no question but that the nurses in those hospitals are absolute angels. However, one of the problems that I noted was that on many occasions they were so short of staff that the nurses on duty stayed on for extra hours to cover and help out. They would also put off holidays to come in to look after their patients. That is a testimony to NHS staff based on my personal observations.

I do not think for one minute that this is an evil, nasty Government who want to destroy our NHS—quite the reverse. They came to power in 1997 after my side had been kicked out, partly on the basis that there were 24 hours to save the NHS because those evil, terrible Tories had made a complete mess of it. I do not agree with that analysis, but that is what they thought. The Prime Minister, in his role as Chancellor, believed that throwing money at the NHS would solve the problem, and that is what he did. The amount of money going into the NHS in real terms has doubled since 1997, and it is now topping about £100 billion a year. That is equivalent to the amount that we will pay the European Union over the next few years, but that is another issue, which we have been debating in this Chamber for some time. While I am on the subject of the EU—

Order. I hope that the hon. Gentleman's remarks will be relevant to NHS staffing.

Yes, they will. Having sat through the hours of debate on the EU, I was surprised to hear yesterday that the new treaty would give the EU some control over our national health service, the implication being that because ours is not a competitive system like those in the rest of the EU it can interfere with our staffing levels. There was not enough time for the Minister to answer that question, but it is an issue that we need to be concerned about; perhaps we can discuss it in another debate.

The Minister kindly mentioned the volunteers in our health service, who do a tremendous amount of work, obviously unpaid, and are an integral part of it. Let me single out one group—Crazy Hats, which is based in my Constituency and works to support breast cancer victims. It is a small charity that started from nowhere and has done exceptionally well. It has supported Kettering, Northampton and Leicester hospitals and raised an enormous amount of money. One of its methods is the annual walk round Wicksteed park, which my hon. Friend Mr. Hollobone and I will do in the next couple of weeks. The volunteers in our NHS, as well as the paid staff, do an enormously important job, and they have the gratitude of the whole country.

Let me talk about something that I do in my constituency that has a bearing on this subject. My party is very keen on keeping in touch with what people think—it is always having opinion polls and focus groups—so I thought, "If it's good enough for my party, it's good enough for me and my constituency." We run a so-called tracking poll by putting out our "Listening to Wellingborough and Rushden" survey all the time in different parts of the constituency. Among other questions, we ask local people what are the issues that really concern them, and the NHS consistently comes up as the second most important issue in the area. When one analyses the sub-questions, one sees that the main issue is the lack of availability of health care and the lack of staff.

I want to relate a very distressing story that is worth repeating—I have mentioned it before in the Chamber. It concerns a constituent of mine whose husband was in Northampton general hospital, which is one of the two hospitals that serves my area. He was elderly and quite ill, and unfortunately he was not being fed. Food was being placed at the end of his bed, but he was somewhat blind—that is not very good wording but I think that the Minister will take the point—and had a slight mental problem. In any case, he was a person who needed treatment. The food was put at the end of the bed, but then people came round two hours later and took it away because he was unaware that it was there. When his relatives put a sign above the bed saying, "My father cannot see the food—could you feed him?" the answer came back from the poor nurse, "I'm afraid we do not have time to feed the patients." That poor man begged to go home to die at home. He said that it was like being in a hellhole. Unfortunately, he got two hospital-acquired infections, and he did die at home. There is something wrong with a system that allows that to happen. I know that the Government would not want it to happen, but the Minister will know that I am not making it up.

The Minister will not be surprised to learn that my area, north Northamptonshire, is the worst funded part of the NHS in the whole country, and the knock-on effects on staffing will be clear to everyone. The Government rightly work out, with considerable time and expense, a national capitation formula to work out how much each primary care trust should have each year to deal with its needs. Unfortunately, that is based on retrospective information, which does not help my constituents in an expanding area. Nevertheless, it would be okay if we received the national capitation formula. As the Minister knows, in each and every year since that formula was brought in, we have not received the full amount. Over the past four years, £120 million has not been provided to my local PCT because, we are told, other areas are overfunded. However, if there is a national capitation formula and that is the minimum amount that should be available in an area, why is my area not getting it? If we had £120 million more in north Northamptonshire, the hospitals there would have more nurses and we would have fewer problems.

Staffing levels also have a direct effect on some of the treatments that are allowed in my area—for instance, IVF is not done, or is given a very low priority. I am much more concerned about the condition of wet-eye age-related macular degeneration.

In parts of the country, hospitals can treat that condition very easily with injections. A patient would probably need three injections a year, for two or three years. The cost is a mere few thousand pounds. If we had a real national health service, my patients would not have to worry because there would be enough staff to provide those injections. I know that the Minister has been helpful on this matter, and so has the Prime Minister. As far as they possibly can, they have urged the PCT to give those injections. The situation is nonsensical because if people do not have the injections in a short period of time, the staff are not available to give them—

Order. I understand the hon. Gentleman's point, but the debate we are having this afternoon is on NHS staffing levels.

I am grateful, Madam Deputy Speaker, and I think that I have made my point on the lack of staff for the treatment of wet AMD.

I should have declared an interest at the beginning: I am a member of the Select Committee on Health. In the excellent speeches so far, we have heard that there are not enough staff in certain areas, while there are too many people applying for jobs in others. We have investigated this matter in the Health Committee and taken evidence, and we have heard that the Government recognise that there are not enough people available, that the staffing levels are wrong, and that there are dentist shortages. The fact that many dentists have left the NHS to go private has reduced the number of staff doing NHS dentistry. The Government ought to know, so that they can deal with the problem, how many whole-time equivalent NHS dentists there are. Unfortunately, I understand that they do not collate that figure. This wonderful national service is planning the provision of NHS dentistry, but it does not know how many dentists it has. It knows how many it has trained, but if it does not know how many it has got or how many it needs, it may end up providing too little training, or too much.

I thank the hon. Gentleman for giving way; he said that he would not mind if I asked him to do so. I believe that I can now inform him that the total head count numbers are healthy. In March 2007, there were 21,041 dentists on NHS lists, an increase of more than 4,000 since 1997.

I am grateful for the Minister's Intervention because she makes my point. The Government know how many dentists there are, but they do not know how many whole-time equivalent dentists there are. They do not know how many of those dentists are working for only a fraction of the time. They may be counting my dentist, who requires me to go private because he has come out of the service. He treats children on the NHS, so he would be counted as an NHS dentist, but he is not what we would call an NHS dentist. I do not want to be awkward about this, but the Government really need to look at the issue. I know that they want to improve the situation, but they need to know the figures.

My hon. Friend touches on an important issue. All too often, the Government talk about head-count numbers but not full-time equivalents. In response to a point raised earlier by my hon. Friend Sir Nicholas Winterton about midwives, the Government have suggested that there has been a massive increase in the head-count numbers, but if one looks at the number of full-time equivalent midwives, one finds that the situation has hardly changed at all. That would account for a lot of the shortages.

I am grateful to my hon. Friend for his Intervention; he describes the situation exactly.

We experience crises. The Government believe their figures—and why should they not?—but they have not asked the right question, which is how many whole-time equivalents there are. [ Interruption. ]

I am sorry, but I did not catch what Chris Bryant said. Does he want to intervene, or is he just chuntering? [ Interruption. ] I see he does not want to intervene. Oh, he does.

How many Conservatives MPs are there? Some of them are not full time either.

Order. I think that the hon. Gentleman knows to keep to the motion under debate.

I am sorry, Madam Deputy Speaker. I made a great mistake by letting the hon. Gentleman intervene.

I know that the Government do not want what is happening, but it is happening none the less. Yesterday I was told that for the first time ever the hospital had to cancel a cardiac rehabilitation session because of the lack of staff. The Government would say that there are enough staff, but in reality that is not the case. The senior nurse to whom I spoke was dismayed at having to cancel the session. I know that the money is there and I guess that the former Chancellor lies down in a darkened room at night, and the Under-Secretary has probably seen him banging his head against a wall, saying, "Look, we've put all this money in—why hasn't it worked?" Everybody knows that that is the case and everybody is concerned about it.

The results on heart disease are impressive. We have achieved our targets on improvements for all coronary artery disease, even though Anne Milton does not appear to believe that that is a priority.

I am grateful for the Intervention. I know that the Government are in favour of targets, but the fact that we have doubled the amount of money that goes into the NHS but increased outputs by a maximum of only 25 per cent. is a problem, and I think we all accept that. I do not know where the black hole is. I do not believe that the money has gone into staffing, but it may have gone into reorganisation. When we reorganised Northamptonshire's PCT—I cannot understand why—from three PCTs to one, the cost of that, with hiring and firing people and so on, appeared to be a complete waste of money.

I am sure my hon. Friend agrees that treating heart disease is crucial but that the Government are failing to put the resources into cardiac rehabilitation, which is just about the most cost-effective, non-interventionist measure possible. Forty-nine per cent. of physiotherapists have not got jobs and could undertake that cardiac rehabilitation.

There has been no collusion between me and Front-Bench Members. That is most unlikely to be allowed in any case. However, my hon. Friend makes a fair point.

One of the knock-on effects of the funding formula is that we do not have any cardiac rehabilitation worth mentioning at Kettering hospital. People have to go to Bedfordshire to get it. They describe the problem as a postcode lottery, but I disagree. If it were a postcode lottery, my constituents would have a chance of winning now and again. However, it is not a lottery but a decision made in Whitehall to underfund the people in my area and the east midlands. We heard earlier that much more money will be spent on NHS staff in Scotland than in other parts of the country.

Spending on the NHS constitutes one of the largest parts of public expenditure. It is alleged that the NHS is the third biggest employer in the world. It was said that only the Red Army and Indian Railways employ more people. Unfortunately, that is not true. Now that Indian Railways has been privatised, the NHS has moved up to second place, and I daresay the Red Army is being cut back.

I hoped that the Under-Secretary would tell me how many times the former Chancellor had had to go into a darkened room and bang his head against a wall to try to solve the problem. She probably did not want to divulge that information.

Something about the NHS surprised me on Saturday. I visited a part of my Constituency called Great Doddington for a public meeting—it would probably be characterised as a town hall meeting—to complain about the rotten fact that the Post Office there had been closed and that that was wrong. More than 100 people attended. However, the meeting was led by a local GP and the effect of the revised GP contract negotiations on staffing came up. Out-of-hours services are affected. I appreciate that that might be a problem in other parts of the country, but in my area we still have an out-of-hours service, which works well. It is called Keydoc and if one is desperate to see a GP in the middle of the night, as I was a little while ago— [Interruption.] I thank my hon. Friend Mr. Spring for passing me a note asking me to wind up as quickly as possible because people are getting bored. [hon. Members: "No!"] Keydoc is a very good system that provides out-of-hours cover; indeed, I used it only recently for my son. We therefore do not have a problem with out-of-hours cover in our area—it may be a problem in other parts of the country—but local GPs are up in arms about the money that will be taken away from them because they are not prepared to enter into the Government's new GP contract. Some local GPs even feel that their practices will have to close if the contract comes into existence.

Finally, I appreciate that the Government are trying to do what they can to manage the NHS. The fact that we would manage it much better is neither here nor there at the moment because there will not be an election for a couple of years. However, there is one thing that I can say. There is not a single complaint about the number of NHS nurses or doctors in the hospital in my constituency or about the service that people receive. Instead, people are absolutely livid that we do not even have a hospital in my constituency. The Minister has graciously agreed to come to the area to discuss the issue—and the day that she has chosen is April fools' day.

I am pleased to follow the eloquent and passionate speech by my hon. Friend Mr. Bone, who showed considerable knowledge of the health service's advantages and shortcomings in his area.

I did not initially intend to contribute to this debate, but I came in at the beginning and my interest has increased as the debate has progressed. I am pleased that the Minister will be replying, and I intend to give her plenty of time to do so. She may know that what would have been an outstandingly successful parliamentary career for me floundered because of my support for the national health service and what it stood for. I chaired the Health Committee for a period. It was a wonderful Committee, with fantastic relations with all areas of the national health service, mainly through the commitment of its members, not least various Labour Members, such as the late Audrey Wise and Mrs. Mahon. They were tremendously supportive of me in undertaking critical inquiries, one of which was into maternity services.

Will my hon. Friend give way?

In just a moment.

Will the Minister give a commitment that the money that the Government have promised to maternity services in the NHS will be brought forward? Without that money, the guarantees in the Maternity Matters strategy cannot be effective and new midwives and students midwives cannot start doing the job that maternity services urgently require. I obviously speak with a little knowledge—as the House knows, for some years I have been an honorary vice-president of the Royal College of Midwives, which is an office that I am very honoured to hold.

The Minister will be aware that the midwifery profession also has a problem, in that a fairly high percentage of midwives are what I would call mature and may retire in the years that lie immediately ahead. That is why the staffing of maternity services and the coming forward of new midwives and students midwives into the NHS is so critical. It is unfortunate that so much emphasis is placed on targets, which take a lot of staff time, when much more should be devoted to, I would hope, successful outcomes.

Perhaps my right hon. Friend Mr. Knight would like to intervene now, although I hope he will be quick because I want to give the Minister plenty of time.

I am grateful to my hon. Friend for giving way. The moment has almost passed, but I just wanted to say that he should not regard his career as a failure because he has never served as a Minister. He has been a distinguished Chairman of the Health Committee and the Procedure Committee.

I am very grateful to my right hon. Friend, who is now the very distinguished Chairman of the Procedure Committee. He was also a very distinguished Minister.

The shortage of physiotherapists and speech therapists has been mentioned by at least two speakers in the debate. Those therapists are critical in the treatment of people who have suffered a stroke. If we are to give people a meaningful life after a stroke, physiotherapy and speech therapy are critical to their rehabilitation.

In an Intervention on my hon. Friend Mr. Spring, I touched on the subject of mental health. This, too, is a subject in which I take a considerable interest. During my time working on health and social security matters, we undertook an in-depth inquiry into adult mental health and mental handicap. There is a shortage of skilled professionals in mental health, which is critical because for too long this has been a Cinderella area of health care. I hope that the Minister will be able to give us an assurance that money will be available for the employment of the staff who are so essential to the success of this Cinderella area of the national health service.

I should like to thank hon. and right hon. colleagues for their contribution to this debate on NHS staffing. I cannot apologise for smiling so often throughout the debate; such is my way that I am known often to smile at many hon. Members.

Since 1997, the NHS has made significant progress in improving the level of health care in this country. The unprecedented level of investment by this Government in staffing in the NHS has been instrumental in bringing this about. I will try to refer to some of the points raised by hon. Members in the short time that I have. Mr. Bone has invited me to visit his Constituency, and I have agreed—and will continue to agree—to do so. I had the pleasure of meeting his wife when we were away on a trip together, and she had my sympathy on the issue of health care. She might possibly have my sympathy for other reasons, now that I have got to know the hon. Gentleman and the particular style that he has developed in the House. I feel that she might possibly agree with me on that.

Work force planning has always been critical to the NHS. Having worked in the NHS for more than 25 years, I know how important it is to have the right staffing levels on wards. I remember not having such levels in the '80s and '90s. I also remember training schools being closed. We were told that we were training too many nurses and doctors, and places were cut. In fact, I spoke recently to Dr. Peter Carter, the general secretary of the Royal College of Nursing, and he was happy for me to convey his views. He said:

"The last 10 years have seen substantial growth in nurse numbers. This has helped address the legacy from the 1980s and 1990s of workload issues".

At that time, we did not always plan in the way we should have done, and I am aware that officials in the Department of Health take some criticism. Let us also give them praise, however, as they are now working hard on work force planning, as they perhaps wanted to do in the '80s and '90s as well.

It is exceptionally important to have the right levels not only of doctors and nurses—they always come to the forefront when we talk about the health service—but of physiotherapists and talking therapists, who play a hugely important role, as do staff right across the section, from the cleaners who keep a complex cleaning care programme in place right through to the top docs. The work force is being planned under Lord Ara Darzi's review, under my chairmanship and, most importantly, with the membership of the clinicians themselves, in the sectors that look after our cancer care and our new stroke strategy, which has been welcomed by the all-party parliamentary stroke group as well as by the Stroke Association. Matters relating to cardiac rehabilitation need to be addressed in some areas, and I urge the managers involved to do that.

While we are discussing managers, let me say that there has been a fall in their number. The last NHS census showed the first fall in management members since the introduction of occupations codes in 1995. However, let me go on to say that managers are exceptionally important to the NHS. We know that without them it can break down, and we know the serious consequences of that. We understand the importance of learning from previous mistakes and of ensuring that all managers and health care professionals are totally committed to providing safe care.

Sir Nicholas Winterton spoke about his being the vice-president of the Royal College of Midwives. I watched his career with interest when he served on the Health Select Committee, particularly in respect of his involvement with "Changing Childbirth". He was such a progressive thinker that he was not allowed to continue to practise. The General Secretary of the Royal College of Midwives, Karlene Davis, would work closely with the hon. Gentleman. She also works diligently on work force planning and has said how difficult it is to recruit midwives at the moment. We all take that very seriously.

It is the duty of us all to praise midwifery and the safety of childbirth in this country, which is indeed one of the safest places for the delivery of babies. Our birth rate is currently increasing, and I believe it nearly always does under a Labour Government. When people are satisfied and feel confident that they will continue to be employed—either within or outside the NHS—they are always happy to increase their families. It is no coincidence when that happens.

I hope that some hon. Members will reflect further on some of the words they used, particularly regarding heart disease. Our success rate should only be praised, so I particularly ask Anne Milton to reflect more on her comments.

rose—

I have very little time left, so the hon. Lady might want to see me at some later time.

Our stroke strategy and our cancer plan have been welcomed throughout the voluntary sector—and most importantly of all, by patients themselves. Patients' satisfaction with the NHS is second to none. The work force in our NHS is also second to none. We need to do more to improve it, so we need to work together in the House. I would like to see a consensus on the point that the NHS as it stands today provides the best health care in the world. That is true only because of NHS staff. Let us all work together not to praise them only today but always. That is different from the 1980s and '90s, when I experienced marches and collection buckets for NHS equipment. No one is doing that today because we have a Labour Government looking after the NHS.

Question put and agreed to.

Resolved,

That this House has considered the matter of NHS staffing.