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Volume 124: debated on Thursday 10 December 1987

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To ask the Prime Minister if she will list her official engagements for Thursday 10 December.

This morning I presided at a meeting of the Cabinet and had meetings with ministerial colleagues and others. In addition to my duties in the House I shall be having further meetings later today.

Are we to have a statement before the Christmas recess on what action, if any, is to be undertaken to deal with the present acute crisis in the National Health Service? When beds are not available for young children, as at the Children's hospital in Birmingham, and when at the Queen Elizabeth hospital cancer and kidney patients continue to wait for beds, what evidence is there, if any, that the NHS is safe in the right hon. Lady's hands?

If the hon. Gentleman had been here when I last answered questions, he would have heard of the enormous number of operations that are now taking place—about 2,360,000 a year; of the 6·5 million inpatients a year in hospital; and of something like 38 million out-patient attendance in hospitals. He would also have heard of our excellent record on perinatal mortality, which means that some 3,000 babies are now surviving who would not have survived some 10 years ago.

Has my right hon. Friend, during her busy schedule, observed that, for the first time, the miners have now produced 4 tonnes per manshift, and that is double the production during the time of Lord Robens? Is that not partially attributable to the wise policies conducted by Her Majesty's Government?

It is very good news from the viewpoint of the miners and it shows how ridiculous is the overtime ban. It also shows the Government's wisdom in their excellent investment in mining equipment.

In an unprecedented statement this week, the presidents of the Royal Colleges of Physicians, Surgeons, and Obstetricians and Gynaecologists said—I shall use their word — that there is a deep financial "crisis" in the National Health Service. Does the Prime Minister agree with them?

No, Mr. Speaker. As the right hon. Gentleman is aware, spending has gone up enormously on the National Health Service. Spending on the family practitioner services has gone up by 43 per cent in real terms since the last Labour Government. It has gone up by 26 per cent. in real terms on hospital and community services. Capital spending on hospital and community services has gone up by 42 per cent. Indeed, the Government's record on health services far exceeds that of any other. As I have indicated to the right hon. Gentleman, expenditure on health services will continue to increase further.

The House and the country will note that the Prime Minister rejects the advice of the presidents of the royal colleges. Is that not further evidence that she is suffering from incurable complacency as well as untreatable arrogance in these matters as in many others? Following her litany of figures, may I say, in the words of Sir Raymond Hoffenberg, the president of the Royal College of Physicians:

"We know we will be hit by all the statistics … but the basic fact is that we are spending less on our health service than any other developed European country. The bottom line is that we had a service which was the envy of the world which we ran very cheaply. We are now trying to run it too cheaply."
The statement says:
"In spite of the efforts of doctors, nurses and other hospital staff, patient care is deteriorating."[Interruption.]
The House and the country are listening to those boos, when the Presidents of the royal colleges, are saying:
"Patient care is deteriorating. Acute hospital services have almost reached breaking point. Morale is depressingly low."
Does the Prime Minister not think that that is a crisis?

No, Mr. Speaker. Had the right hon. Gentleman listened to the figures, I would have thought that he would commend the Health Service on the excellent work that it is doing. I gave the annual figures for in-patients, for out-patients, and for operations. May I also point out that the Government have increased the proportion of the GNP spent on the National Health Service from 4·8 per cent. under the last Labour Government to 5·5 per cent. Not only has the GNP gone up, but the proportion spent has also gone up in real terms. Other countries are able to devote more to health care services because more is contributed privately, both from private insurance and from families' pockets. If the doctors think what they have written, they must be very thankful that there is not a Labour Government in power.

In the 40-year history of the National Health Service the presidents of the royal colleges have never found if necessary to speak to any Government in the terms that they have spoken to the Prime Minister's Government. Can she not learn from that, or from the evidence of patients, nurses and other professions in the National Health Service? When Mr. Ian Todd, the president of the Royal College of Surgeons says:

"Managers are telling surgeons to do less work to balance the books."
does she not recognise that she is responsible for setting lives against sums? What will she do about it?

Order. How can the Prime Minister possibly answer with all this noise going on?

In the 40 years of the NHS there have never been more patients treated, whether as inpatients or out-patients. There have never been more accident and emergency cases treated. There have never been more heart bypass operations or hip replacements —[Interruption.] Of course hon. Gentlemen will interrupt, because they cannot bear to hear the facts.

There are more cataract operations, more bone marrow transplants, more kidney transplants, more cervical smear tests, more people treated for kidney transplants and for chronic renal failure. —[Interruption.] Opposition Members will shout because they cannot bear the fact that the Government have a far better record than they have ever had. With regard to the future, if the Leader of the the Opposition had listened to me earlier he would have heard that next year spending on the NHS will increase by £1·1 billion. I mentioned that figure because I have heard Labour Members on the radio suggesting that an extra £200 million would do the task. Next year there will be an extra £1·1 billion—five times as much.

Bearing in mind that the demands for health care are never-ending and the fact that private spending on health care in this country is among the lowest in Western Europe, does my right hon. Friend believe that the time has come to introduce tax relief for individuals who take out health care insurance?

No. It is more important to leave people to make their own decisions about what they do with their money than to increase reliefs for a particular sort of expenditure.


To ask the Prime Minister if she will list her official engagements for Thursday 10 December.

I refer the hon. Gentleman to the reply that I gave some moments ago.

Irrespective of the statistics that the Prime Minister throws out, and irrespective of the light attitude that she has adopted towards the statement from the Royal College of Surgeons, will she take notice of the National Association of Health Authorities, which reported that the hospital service is £200 million underfunded? Will she give an assurance to the House that the much needed increase in nurses' pay will not have to be found from the existing area health budgets?

The hon. Gentleman has given the figure of £200 million which I mentioned earlier. I have already told him that next year the increase going to the NHS will be £1·1 billion. I remind the hon. Gentleman that the previous Labour Government slashed the NHS programme. They cut new hospitals by one third, cut capital spending for two years running and, having supported a strike against patients, presided over an increase in waiting lists of 250,000, to record levels under Labour.

On the matter of those employed in the Health Service, nurses in particular, and the community charge, will my right hon. Friend confirm that among the options which she and her right hon. Friends considered as a replacement for the present unfair and outdated system was capital valuation, coupled with a local income tax? Does she agree that that would bring hardship and chaos to every individual and their families, and that the Labour party, whose policy it is, is discredited for having pursued it?

Capital valuation would have been infinitely worse than even the present basis of valuation. A local tax, similar to a local income tax, would put an even heavier burden on those who pay income tax and would mean that the amount they had to pay would be greatly in excess of a community charge.


To ask the Prime Minister if she will list her official engagements for Thursday 10 December.

I refer the hon. Gentleman to the reply that I gave some moments ago.

Instead of burying her head in 10-year-old NHS statistics and repeating them like a cracked record, what would the Prime Minister say to Adrian Woolford, a seven-year-old Coventry lad, who has waited two years for a heart operation? What would she say to the parents of Chintu Kumar, a one-day-old baby, who died after a 100-mile dash from Coventry to Liverpool because half of Birmingham children's hospital beds were closed? What would she say to the parents of dozens of kids in the midlands who, tomorrow night, will meet midlands Members about the crisis? She might be able to buy her health and the health of her kids, but our families cannot. Does she not care?

Let me assure the hon. Gentleman that the statistics that I give are not out of date but are updated. The number of bypass operations, cataract operations and many other operations that are now performed on children could not have been performed 10 or 15 years ago. The number of nurses on paediatric work has greatly increased over and above what it was under Labour, and the number of paediatricians is also up. Services are rapidly increasing. Under this Government, not only have we had a great increase in the gross national product, but we have devoted an increasing proportion to the National Health Service, and the amount of care far exceeds that which occurred under Labour or anything that could ever occur under Labour.


To ask the Prime Minister if she will list her official engagements for Thursday 10 December.

Will my right hon. Friend find time to consider a survey that was published by the Department of Trade and Industry? It shows that of the 300 foreign-owned companies in this country 90 per cent. said that industrial relations had improved in recent years, and that 96 per cent. said that the performance of their British subsidiaries was equal to or better than that of their foreign-owned subsidiaries. Is that not yet another endorsement of the Government's policy?

Yes, it is excellent news. The success of this Government and the response of people to their policies are being recognised the world over. That is good news for everyone in this country.

Given the Prime Minister's concern for independent companies, will she spend some time today considering the implications of British Petroleum's likely doubling of its shares in Britoil? Britoil is an independent company in Scotland. Given that that company employs so many people in Scotland and that the smell of the Guinness takeover still lingers in the nostrils of the people of Scotland, will she assure us that. first, the Government will use their golden share to protect Britoil and, secondly, that they will use every opportunity to safeguard against insider dealing?

Insider dealing is a matter of the criminal law. It is not a matter for me. With regard to I3P's purchase of shares in Britoil, I understand that it is a commercial transaction, and it is not for us to interfere.