National Health Service

Part of the debate – in the House of Lords at 4:31 pm on 2nd February 2000.

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Photo of Lord Forsyth of Drumlean Lord Forsyth of Drumlean Conservative 4:31 pm, 2nd February 2000

My Lords, in listening to the debate, I find myself in an extraordinary position. I congratulate my noble friend Lady Cumberlege for initiating it because not only has she given us an opportunity to discuss this matter at a topical time--she delivered a splendid speech, if I may say so, summarising the position and drawing on her considerable experience--but I believe she may have given the Minister and the Government a window of opportunity. Listening to the debate and the speeches, it is quite clear that the view, certainly in this House, as in the country, is that the game is up. The days of pretending that it is possible to have the kind of health service that our people are entitled to and, at the same time, pledging no tax increases, are at an end unless other sources of funding to meet the needs of the health service are being suggested.

The Government, through the discussions which take place in the Budget, are effectively setting a ceiling on the quality and quantity of healthcare that people may have in this country, and are also preventing alternative providers from providing competition to the health service and thereby improving quality. At the end of the debate the Minister should say that two things have changed. He should say, "We are going to stop claiming that we can have the health service that we all believe that we need and to which our people are entitled without finding additional resources"; and he should say also, "We shall stop going around saying that we have the best health service in the world".

If we are talking about the people in the health service--the doctors, the nurses and all the others--I am prepared to accept that we may very well have the best health service in the world. But if we are talking about the resources and the range of treatments available to patients, it is no longer the case. A number of suggestions have been made in the debate for additional sources of revenue.

Can we please end this partisan, political point scoring of whose statistics on the health service were better; who spent more money; who did what. The truth is that we all tried to do what we could for the health service--we have all seen the budget increasing--but we have all shied away from ideas such as hypothecation and insurance. If the Tories stand up and say, "Insurance", the Labour Party stands up and says, "Private insurance is privatisation. They want to destroy the health service", whereas the truth is that you can have mutually funded insurance schemes and privately funded health insurance schemes. As my noble friend Lord Crickhowell indicated, such schemes need to be looked at.

I have been surprised by some of the figures I have seen in articles in the press--mainly driven by the excellent work carried out by Dr. David Green of the Institute of Economic Affairs--on comparisons with other countries in Europe. For example, he has estimated that if we were to match the percentage of the GDP spent on health by Germany, we would have to spend an extra £30 billion. That would mean--assuming no reduction in yield--an increase in the basic rate of tax of nearly 12 pence. Not even the Prime Minister, Mr. Blair, can deliver that kind of additional resource without contemplating that kind of increase in tax.

My noble friend Lord Biffen said that it may not be necessary to increase spending by that amount, but, as the noble Baroness, Lady Sharp, pointed out, we need to look at the outcomes in these countries and compare them with the outcomes in this country to see the extent to which our people are being cheated. A British person is twice as likely to die from heart disease as his neighbours across the Channel. That is not all down to diet. Lung cancer patients in Germany have twice the five-year survival rate as patients in Britain. Women with ovarian cancer have a 30 per cent chance of surviving for five years in the United Kingdom; in Sweden it is 45 per cent. Other countries in Europe, such as France and Germany--and some of them have pretty socialist governments--do not find it necessary to have the state running the hospitals, employing all the nurses, employing all the doctors and funding all their healthcare out of taxes. Is it just possible that we might be out of step with the others and that we might learn from their experience?

The Government will claim that they are spending more--as indeed they are--but they are also introducing rationing. For the first time the drugs budget in the NHS is cash limited. I have a brief from Central Office but I am not going to read out any of the examples. We all read the newspapers; we know that people are not getting the cancer drugs they need; we know that there is postcode rationing. I do the Minister the courtesy of acknowledging that he would not wish it to be the case, but it is the case that we have rationing and it is the case that the Government's organisation--paradoxically called NICE--has a brief to take that forward on an institutionalised basis.

One of the things that I miss about being in this House rather than in the other place is the constituency post. I made some enquiries about the constituency post of someone I trust implicitly--my wife. She has been a House of Commons secretary for 20 years; 14 years with me. She tells me that she has never seen a constituency post on the health service such as is coming in now: tales of people on trolleys; tales of people in difficulty. I know that every January is the same: there is always a crisis in the health service. It was the same under the previous government; it is the same under this Government. The reason for the crisis is that we are not able to staff for the peaks of demand. Whatever speeches are made, whatever inquiries are made, whatever initiatives are taken by the Government, I can guarantee that next January there will be another crisis in the health service. There is a crisis of manpower and funding which needs to be urgently addressed.

Insurance schemes could add resources. The withdrawal of the tax relief on private insurance has resulted in a quarter of a million people cancelling their policies. That is a quarter of a million people--whose medical care will have to be funded out of an over-stretched budget--who would otherwise have added to the resources of the health service as a whole. There is a philosophical question here. Surely as people get wealthier they should be asked to make more of a contribution towards their health care. They certainly should not be prevented from doing so, which appears to be the prevalent view in certain quarters.

We do not have to have a service which depends on staff being overstretched and overworked. In this day and age, it is ridiculous that we rely on doctors who work 60 and 70 hours a week to carry out their tasks.

Finally, I do not know how he does it, but the Prime Minister seems to lead a charmed life. He is standing high in the opinion polls; he is respected in the country; and he was elected on a platform to do something about the health service. He is uniquely placed now to take action on the funding of the service, to set up a commission to look at the funding and to try to proceed on an all-party basis. His administration will then be remembered as one that did something of real worth for our country.