My Lords, this has been an immensely stimulating debate. I particularly appreciated the maiden speech of the noble Baroness, Lady Jowell. As one who was a Cabinet Minister at the other end and who retired at the election last year, she, as well as anyone I have heard, illustrated how one can give up elected office but not give up the vision of public service and what can be achieved in this Parliament. I look forward to her further contributions.
I also appreciated listening to the valedictory speech of my noble friend Lady Perry, who I will be very sad not to see in this House so frequently in future. I look forward to seeing her in Cambridge, where she will continue to be one of our brightest stars, not least in the education world. We very much look forward to her leadership in Cambridge in the years ahead.
I will make three quick points, as time does not permit much else. Domestically, the gracious Speech reaffirmed the Government’s commitment to the National Health Service. Of course, the Bill for non-EEA migrants or visitors to this country to pay a proper contribution to the health service is welcome, but your Lordships have agreed today to investigate the sustainability of the NHS in future. One aspect of that is its financial sustainability. Frankly, in the last Parliament—as my noble friend responding to the debate will remember well—we set out to deliver substantial savings in the NHS, and did so. The so-called Nicholson savings of some £15 billion were achieved. The £5.5 billion of administrative savings were achieved, at considerable political cost. However, we never expected at the beginning of the last Parliament that in this one we would have to do not only that again but more.
To be realistic about that, we must recognise that in circumstances where the NHS employs more staff, the population is rising and the demography demonstrates increasing frailty and need, some of our underlying hopes that by this stage we would be looking after many more patients in the community are not being fulfilled to the extent that we expected. We need more innovation, preventative healthcare and digitalisation of healthcare, but, frankly, we also need the resources to transform community services, social care and the NHS. We will not be able to do that in the short run with the resources currently available. As a proportion of GDP, the NHS budget is falling. To be sustainable, we could easily set ourselves the objective that it should not fall any further. In a world where we can commit ourselves to 2% of GDP going to defence and 0.7% to international development aid, I am sure we could make a similar commitment of 7% or something of that order to the NHS as a floor for its future funding. That would be consistent with what was realistically included in the five-year forward view by the NHS for its own resources.
Secondly, happily I do not need to say much of what I might otherwise have done because the noble Lord, Lord Bilimoria, spoke for me as a Eurosceptic who believes we should remain in the European Union. In 1999, when I ran the Conservatives’ European parliamentary election campaign—very successfully, thank you—we fought on the principle of “in Europe but not run by Europe”. I still believe in that. With the Prime Minister’s most recent negotiation plus all that went before it, we are not in the euro, Schengen or a common asylum policy. We are in the things we want and chose to be in, on the environment, trade and the European arrest warrant. We are now in a situation that we never imagined we could get to, where we can be in a single market which, as the noble Lord, Lord Hannay, rightly said, still has more to offer us. This week we will probably hear more about e-commerce and the ability to create a single market in online trading. That is really important. We can do all this but do not have to sign up to a united states of Europe. That will not happen and we will not be in the euro. We will retain our essential sovereignty. That is what we always wanted in this Conservative Party for 30 years. Now, when we have that in our grasp, it seems utterly perverse to let it go.
Finally, today is the World Humanitarian Summit. I understand why the Prime Minister felt he had to fight the referendum campaign and could not be in Istanbul, but that is a pity. We have so much leadership to offer and there is so much that needs to be done. The noble Lord, Lord Purvis of Tweed, spoke very well on this subject. It is important that we do not let the World Humanitarian Summit happen and people walk away saying, “Well, that wasn’t enough”. We must do more coming out of the summit in creating a much stronger professional and staffing infrastructure to handle not only immediate crises but follow-up on seeing how basic education and healthcare can be instrumental to handling such crises. Not least, we must recognise that we in Britain did more than our bit in trying to look after the refugees around Syria. As I saw for myself 18 months ago in Jordan, at that tipping point when they despaired of their ability to go back to Syria, there should have been a ramping up of international effort to give them the education, healthcare and commercial opportunities that would have ensured that they stayed in safe havens outside Syria rather than become so desperate that they started travelling across borders. It is a great pity that we did not invest, and that others did not invest like us, at that time.