What discussions he has had with Trent regional health authority about a new breast cancer unit at Nottingham city hospital. [151948]

The Trent regional office and the Nottingham health authority strongly support the scheme for a new breast care unit at Nottingham city hospital. It will replace the 23-year-old prefabricated accommodation with a new purpose-built unit. The local breast team is internationally recognised as being at the forefront of clinical care and research into the diagnosis and treatment of breast cancer. The regional office expects to receive the full business case by September this year, at the latest.

Will my right hon. Friend take a personal interest in the development of the breast cancer unit at Nottingham city hospital? There has been some slippage over the past couple of years, so his intervention would be very welcome. As he said, this is an internationally renowned breast cancer unit, and many people come from abroad to see it. At the moment, it is housed in prefabricated buildings. Will my right hon. Friend take a personal interest in the matter and ensure that if September is the target date for the business plan, September is also the reality for Nottingham city hospital's breast cancer unit?

I will certainly take a personal interest in the matter, and I pay tribute to my hon. Friend for his keen interest in the success of the project. It is planned to spend more than £5.2 million on it from different sources, and it is clearly in everyone's interest to get it under way as quickly as possible.

As one of the chairmen of the all-party breast cancer group, I welcome any new facilities for the new breast cancer unit at Nottingham city hospital. However, will the Minister tell the House what role clinical need plays in the treatment of patients who present to their general practitioners with suspected cancer? What response would he give to the president of the Royal College of Surgeons, who claims that clinics are being snowed under with inappropriate referrals for breast cancer because of the Government's two-week target?

The whole point is to ensure that patients with the highest clinical need are referred urgently to a consultant. The two-week waiting time is for urgent referrals. In support of that, we have published referral guidelines for use by general practitioners that have been drawn up with leading clinicians. The whole point is to enable general practitioners to identify women in need of an urgent referral. I believe that we have a policy that is designed and aimed to give the highest priority to those with the greatest need.

What assessment his Department has made of the number of additional nurses required to meet the requirements of the NHS plan and enable private sector providers to comply with the Care Standards Act 2000 and regulations made thereunder. [151949]

The NHS plan contains a commitment for 20,000 more nurses to be provided by 2004. Private sector providers are represented on the new local organisations charged with planning the numbers of nursing staff needed in local communities.

The Secretary of State will know that about one in four nurses is due to retire in the next four to five years. The Royal College of Nursing, in its report last year, said that there would be a shortage of about 57,000 nurses over the next five years. Does the right hon. Gentleman accept, therefore, that increasing the number of posts in the NHS potentially increases the number of vacancies? Will he guarantee that in the effort to recruit more nurses, the international recruitment nursing director will not strip bare developing countries of their valued nurses? Will he also ensure that there will be a dramatic expansion of nurse training places in this country, so that we can grow our own nurses to fill the vacancies?

That is precisely what is happening. It is true that nurse training places have been cut in the past; they were certainly cut under the previous Government in the mid-1990s. The number of nurses was cut in the mid-1990s, too. The national health service is still feeling the effects of that. However, the number of nurses is now consistently rising, the number of training places is up by one third, and the number of UK-based applications for nursing and midwifery courses has increased by more than 56 per cent. in the past two years alone.

Will my right hon. Friend make it clear to the private sector that before it gets the same input of taxpayers' money that it got last year, it is essential that it complies with care standards? That is a question of the private sector having to come up to those standards not after new nurses have been trained, but before. That is a simple lesson that I would have thought would be in the interests of every patient.

My hon. Friend is right: standards should be high wherever care is provided. That is particularly the case if the resources for that care, whether it is given in the private or the public sector, are provided at NHS expense. Standards are what count, which is why the action that we are taking to raise standards and to expand the number of nurses working in the NHS and the health care system overall is so important.

The RCN survey shows that 70,000 trained nurses are staying at home, but in his evidence to the Nurses and Midwives Pay Review Body the Secretary of State said:

"The central message of the evidence from the Departments was that there was no case for a special pay response from us this year on grounds of recruitment and retention."

The difference between this Government and the previous one is that we are paying nurses' pay awards in full, not staging them. Indeed, there is extra pay to address shortages in particular areas, so where need is highest, but where the cost of living is also the highest, we are paying extra money to nurses—up to £1,000 a year extra. There is more money for ward sisters. Last year, there was more money for staff nurses. The year before, there was more money for newly qualified nurses. All the investment that we are making is contributing to the expansion in NHS nursing numbers.

What progress is being made in improving services which will cut the incidence of cancer and improve cancer survival rates. [151950]

National health service cancer services are receiving more investment and greater priority than ever before. Waiting times are falling, the number of cancer specialists is rising and I can tell the House today that the NHS has the fastest-improving cancer services in Europe.

I thank my right hon. Friend for the investment that he has so far made in cancer services in Milton Keynes. My constituents welcome the priority that has been given to improving cancer services, but if he had a further half a million pounds to invest in Milton Keynes, would he rather spend it on further improving cancer services or subsidising private health insurance?

For a moment or two, I thought that that question would cost me money, so I approach the answer with trepidation. It is right that we invest in our cancer services. Cancer kills well over 100,000 people a year and we know that many of the deaths could have been prevented had earlier action been taken. Although the focus will inevitably and rightly be on improvements in treatment services to get waiting times down, to ensure that more operations are carried out and to provide more scanners and more equipment, the biggest gains in improving cancer care will come from improved prevention.

Will the Secretary of State consider for a moment prostate cancer? The excellent service that I have received from the national health service at Charing Cross hospital only goes to prove what can be done if such services are carried through properly. How much extension work is being done to provide radiotherapy at more hospitals to deal with the problem of prostate cancer?

I am grateful to the right hon. Gentleman; his comments about improvements in prostate cancer services will provide reassurance to many men. Inevitably, when people read newspaper reports about the state of cancer services, they do not always get the most accurate picture. As he knows fine well, by and large NHS cancer care is of a very high standard. We need to expand the range of services available and, most importantly of all, we need to ensure that those services are timely and of the highest possible standard.

When a patient with suspected cancer visits a GP, often the GP's first question is, "Do you smoke?" That is an important question, but patients are seldom asked where they work or used to work, and in what conditions. The ex-vinatex workers group in my constituency feels that GPs and consultants should ask those questions, so that the position can be checked and action can be taken to ensure that workplaces are safe environments. Does my right hon. Friend agree?

My hon. Friend makes an important point, although there is a direct correlation between smoking and cancer—and, indeed, between smoking and heart disease. If we succeed in doing what we want to do—improving heart-disease and cancer services, especially on the prevention side, and cutting tobacco consumption—we shall save an awful lot of lives in our country. Finding out where people have worked provides an important clue to the cause of problems, and we are certainly prepared to think about that.

I am sure the Secretary of State agrees that a key part of the Government's strategy is the pledge in the NHS cancer plan that there will be nearly 1,000 extra non-surgical cancer consultants by 2006. Does he deny that that figure is acknowledged in his own Department to be unachievable, that Ministers at the highest level—including the Prime Minister—were advised at the time that it was unachievable, and that it was included in the cancer plan only on the Prime Minister's specific insistence?

I would be amazed if that were the case, but if the hon. Gentleman hands me his briefing I shall gladly look into it for him.

What steps he plans to take to improve the retention of experienced general practitioners within the NHS. [151951]

GPs do a vital job exceptionally well, so the retention of experienced and skilled GPs is crucial to the successful delivery of the NHS plan and a modernised NHS.

I thank the Minister for his answer. Three quarters of general practitioners consulted in a recent survey in my constituency said that they were less satisfied with their conditions in the NHS than they had been two years earlier, and 60 per cent. said that they were considering leaving. Does the Minister accept that there has been a catastrophic drop in morale among GPs? Does he agree that it is vital for us to plug the gap and to restore confidence in their work and in the NHS?

What is important is that we underline our commitment to putting general practice at the heart of our NHS reforms. We are already doing that with the creation of primary care groups and, now, primary care trusts. Measures that we are taking today to encourage further GP recruitment will help to bring into general practice the extra numbers that we have promised. We are also taking measures to reduce GPs work loads by cutting bureaucracy, and we wish to develop extended roles for other members of the primary care team staff so that GPs can concentrate on the patients who need their support most.

I welcome my right hon. Friend's statement on the provision of additional support for GPs, which is obviously an urgent matter. However, will he also take into consideration current patient waiting times to see GPs? I have problems in my constituency with that matter, and it would be helpful if he would examine it with some urgency with a view to reducing waiting times for patients.

My hon. Friend makes a very important point. We have said that by 2004 we want patients to be able to see a GP within 48 hours. We are already showing, in the work done by the primary care development team, how practices can reorganise themselves to meet that access target without—this is very important—increasing the work load and burden on GPs. Additionally, we have allocated funds from the record investment that we are making this year in the NHS to enable primary care practices to extend and improve patient access.

Does the right hon. Gentleman agree that one of the best ways of retaining GPs and cutting surgery waiting times is to make greater use of complementary and alternative therapies? Is he also aware that many doctors refer to a proportion of their cases as heart-sink patients whom they cannot help, whereas 70 per cent. of those patients get relief if they are referred to acupuncturists, herbal medicine practitioners or homeopaths? Does he not think that now that 30 per cent. of the United Kingdom population have tried herbal medicines, it is time that the Government responded positively to the Lords report on complementary medicine and made such medicine more widely available on the national health service at the point of delivery?

I congratulate the hon. Gentleman—whom I always think of as the hon. Member for Holland and Barrett—on his consistent contribution to our debates. Clearly, there is a level of interest among GPs in making use of complementary medicines. The British Medical Association has produced guidance which has been circulated to all primary care groups and primary care trusts on the prescribing of and referral to complementary medicine. Additionally, as the hon. Gentleman has said, the House of Lords has produced an important report on the issue, which the Government are considering.

Does my right hon. Friend accept that Burnley and east Lancashire are areas of deprivation where there are health problems because of some of their traditional industries? Does he also accept that they are also the very areas where it is difficult to retain GPs and to attract new GPs? Will he ensure that money is targeted towards attracting and retaining the GPs whom we need to provide services in such areas?

One of the measures that my right hon. Friend has announced today is a £5,000 payment to newly qualified GPs finishing their period as a GP registrar and entering general practice. The payment will be £10,000 in deprived and under-doctored areas. We have taken that action not only to increase the proportion of doctors entering general practice, but particularly to encourage them to work in areas that are currently short of doctors or facing high deprivation levels. I hope that my hon. Friend will feel that we have tried to design the scheme that we have announced today around the types of needs that he has described.

We welcome the attempts being made to reimburse GPs. However, as the father of a GP—I declare an interest—may I ask what research has been done into why 40 per cent. of GP trainees do not enter general practice? Is the Minister convinced that it is simply a matter of money, or does he think that other action is needed to reform the system, so that we can not only attract GPs but retain them?

That is a very good question. There is no doubt that the financial incentive that we announced today, which has been welcomed by the BMA, will help. However, there are other barriers. One is that it can seem to be a fairly daunting step to move from the fairly structured environment of training to taking on the full responsibilities of a GP principal. Therefore, one of the additional measures accompanying the financial package which we have announced today is 20 days of additional training in the first year of practice as a GP principal—something that has been argued for by the BMA. By doing that, we hope to provide greater support for doctors who want to go into general practice. We want to ensure that they can maintain their professional skills and overcome the inevitable challenges of their first year in practice.

According to this week's edition of the Doctor newspaper, 70 per cent. of GPs surveyed supported some form of action to highlight their "anger and disillusionment" with the Government. The Government have been in office for four years, so how does the Minister account for that finding?

One of the things that GPs know is that for the past three years this Government have paid pay review body awards in full and without staging. In contrast, the Conservative Government regularly failed to implement those awards in full and without staging. GPs therefore know the difference between this Government and the previous Conservative Government.

The real causes of GPs anger and disillusionment have been four years of non-stop reorganisation and change, increased centralisation by the Secretary of State, the scapegoating of the profession by Ministers in this House, increased paperwork and form-filling, and less time for patients. All of that has led to the lowest morale that anyone can remember.

the findings were very encouraging, pointing to the continuing improvement in recruitment indicators".

The number of people leaving general practice is at its lowest level for five years. That is a fact. We are addressing the real problems that we inherited from the previous Government, who failed to train enough GPs and nurses or to invest enough in primary care. We have shown our commitment to putting primary care at the front line of the new NHS by saying that we will devolve £25 billion of NHS resources to primary care, to be controlled by primary care groups and primary care trusts. Those resources will give GPs and other practice staff a say in and an influence over the shape of the NHS that they have not had previously.

If he will make a statement on hospital waiting times in the south-west. [151952]

At the end of January 2001, the number of south-west residents waiting for in-patient treatment in the region was 98,579—a drop of 10,422, or 9.6 per cent., on the position that we inherited in June 1997. As waiting lists have come down, the number of long waits is also falling.

I asked about waiting times. Does the Minister accept that the money given to acute hospital trusts under the Budget will often be soaked up by the financial deficits that the trusts have accumulated over recent years? Constituents of mine who need routine operations, such as hip operations, do not want to pay for private treatment, which is what the Conservative party advocates. However, neither do they want to wait for 18 months for the operation, which is the current waiting time at the Royal United hospital in Bath. When are things going to get better?

I have to tell the hon. Gentleman that the NHS in the south-west is treating more patients than ever, and is carrying out more hip operations than ever. I think that the trust in his area, along with the trust in my area and those right across the country, will strongly welcome the extra money that they have been allocated in the Budget, on top of the boost to their resources that they have had from this Government, who are doubling the real increase that they have had over the past 20 years.

Will my hon. Friend congratulate staff at Swindon's Princess Margaret hospital who have worked extremely hard to reduce waiting times in ophthalmology and audiology? The dedication of staff teams and the Government's investment in resources have led to massive reductions in audiology and cataract waiting times. Will my hon. Friend assure my constituents that this investment will continue and that we will see further reductions in waiting times, increases in the quality of services and less pressure on our very hard-working NHS staff?

I assure my hon. Friend that the increase in investment in the NHS of more than 6 per cent. in real terms each year will continue for the next few years. I congratulate staff across the NHS who are working to bring down waiting times, often through new innovative programmes, including the cancer collaboratives. It is not simply about extra resources—it is about modernisation as well.

Does the Minister understand the deep-seated resentment of the droves of people in the south-west who languish indefinitely on the waiting list to get on the waiting list? Does she recognise that it is unacceptable that in many cases cheap, simple and non-urgent operations are leapfrogging expensive, complicated but urgent operations simply to satisfy the Government's ludicrous waiting list initiative? In answering that question, will she bear it in mind that her response is of the keenest possible interest throughout the south-west, not least to the excellent prospective Conservative parliamentary candidate for the Somerton and Frome constituency, Mr. Jonathan Marland, who will shortly be replacing the hon. Member for Somerton and Frome (Mr. Heath) as that constituency's representative in this House?

I am reluctant to intrude on this private argument. The extra investment in the NHS is about bringing down waiting times across the board. Perhaps the hon. Gentleman should consider the fact that his party's policy to cut £340 million from resources for tackling waiting lists would push up waiting times. Patients would have to wait longer, apart, of course, from people needing hip, hernia and cataract operations—they would not have to wait at all, because Conservative party policy would deny them any treatment on the NHS.

If he will make a statement on the proposed timetable for establishing the new community hospital in Gravesend. [151953]

The public consultation on the proposal to develop integrated health and social care facilities on the Gravesend and North Kent hospital site is due to begin this month.

I thank my hon. Friend not only for that reply but for the considerable support that she has given to our efforts to rebuild the health service in Dartford and Gravesham and for the extra resources to open the new ward at the Gravesend and North Kent hospital and to keep it open. In addition, there are plans for a community hospital of more than 100 beds with the full range of out-patient services.

Under the private finance initiative, my hon. Friend's constituents have benefited from a £94 million new hospital. In due course—I share his impatience, and certainly want it to happen on time—they will benefit not only from a new community hospital with about 100 beds and 200 day care places per week, but from extended new community facilities. The hospital is in addition to the new facilities—a new, innovative project with social services. People will benefit from extra investment and see in reality what modernisation means—bringing health and social care together under one roof.

What measures he has taken to promote a strategy of health care for older people that is based on keeping them in the community. [151955]

The Government are committed to promoting older people's independence and ensuring that they are helped to remain in their own homes for as long as possible. The NHS plan announced a range of measures to promote independence and improved quality of care for older people, including additional intermediate care beds and places, extra rapid response teams, additional home care and other support services, improved community equipment services, and carers respite services. In 1999–2000 an estimated 15,000 to 20,000 more older people were being helped to live at home than in 1998–99.

I thank my hon. Friend for that reply. Does he agree that for many disabled elderly people the provision of aids and equipment can make the difference between enjoying living in their own homes and being forced into residential care? Does he agree that tackling that approach and ensuring that there is proper funding lie at the heart of modern care in the community?

I certainly agree with my right hon. Friend, and I pay tribute to his work in the House and outside to support people with disabilities. He is right about the importance of community equipment services. That is why in the NHS plan we announced a further £100 million of NHS expenditure in the next three years to support new types of equipment and ensure that they reach older people more quickly. That is the key to improving the independence of older people. By the same token, it is a matter of real regret that the Conservative party has not yet been able to match our commitment to making those investments in community equipment services. The Conservatives have refused to match our spending on social services, which lies at the heart of the new investments that we are making. Until they do so, their promises to older people will be treated with utter and total contempt.

Is my hon. Friend aware that the report that, thankfully, he commissioned in Rochdale on the care of older people looks as if it will show that there has not been enough investment in intermediate and intensive home care for the elderly? Will he do everything he can to ensure that the investment is there to help our council to prioritise that much-needed home care, rather than there being an over-average reliance on putting people into residential homes?

I agree with my hon. Friend. Most Members, and most of our constituents, would certainly prefer to be looked after at home whenever possible—it is certainly where I would want to be, and I am sure that every right hon. and hon. Member would want that option too. For far too many older people that option has not been available because the necessary health and social care services have not been available. We are putting that right. Nearly £900 million in new investment is going into health and local authorities in the next three years. I repeat that the Conservative party will not match that expenditure, and that would compromise the health and well-being of millions of older people—I am sure that my hon. Friend will want to take advantage of that fact in the next few weeks.

Whatever the Minister's plans for home care for elderly people, may I urge him not to allow the Nunnery Fields geriatric and stroke hospital to be closed until alternative provision is genuinely available? It is now only a few weeks since 97-year-old Connie Jones died after a two-day wait in a corridor for a proper medical bed. Yet again, over the weekend all three of our accident and emergency units were completely overloaded, leaving many elderly people waiting; one unit was closed to new entrants. Will the Minister ensure that we have enough bed provision for elderly people before that hospital closes?

I hope that the hon. Gentleman will understand that I am not familiar with the facility that he describes—but I will certainly write to him about the issue that he has raised. I am sure that he will be the first to acknowledge that the Government are making significant additional resources available both for the NHS in Kent, and for Kent county council to improve the range of services for older people. I know that it is the common practice of the hon. Gentleman and his hon. Friends to bemoan rates of expenditure, but until he can persuade his right hon. and hon. Friends on the Front Bench to match the expenditure to which we are committed, his words will sound rather hollow.

I welcome the objective of treating more people in their own homes. However, is the Minister not alarmed that social services budgets throughout the country are expected to finish the financial year more than £200 million overspent? Although he has announced rises in the standard spending assessment for next year, social services directors expect next year to be even tougher. What hope is there that the services the Government talk about can be provided for people in their own homes, if social services departments struggle to meet even their existing commitments out of their existing resources?

I am aware of the concerns to which the hon. Gentleman rightly draws attention—as are most right hon. and hon. Members. However, during the past three years we have provided 12 per cent. real-terms growth in social services spending. More real-terms growth is coming. It is worth comparing like with like: during the previous Parliament, real-terms growth in social services spending was 0.1 per cent. During this Parliament and over the comprehensive spending review period, it will be 3.4 per cent. in real terms.

Most Labour Members support the sentiments in the main question. However, when I addressed the Caretalk conference for care home proprietors and managers at Leicestershire county cricket club last Friday, I heard that far too many elderly people, when they are eventually admitted to care, are poorly nourished, lonely, depressed, frail and more ill than they might otherwise have been, because of the failure of home care services. Is the Minister confident that we can improve those services so that it really is worth while to encourage elderly people to stay at home?

If more older people are to be looked after properly at home, there is no doubt at all that we shall have to provide not only more but better quality services to support them in that environment. Last year, through much hard work and sensible use of resources, local authorities were able to provide a significant number of additional care packages to support more older people so that they could remain independent at home for longer. We intend to build on and develop that, but it is important—and fundamental to our plans—that if we are to encourage more older people to stay at home, which is the right thing to do, we provide better and more easily accessible services that are better supported and resourced. That is precisely what we are trying to do.

The Minister knows, however, that from time to time older people have to go into respite care. Is he aware that in my constituency, South Staffordshire health authority now plans to close Hammerwich hospital and to halve the number of beds in the Victoria hospital in Lichfield? Is he further aware that Staffordshire MPs held a meeting with the health authority, and were told that the Government had uplifted prescribing costs by 9 per cent? That is good, except for the fact that the full cost of prescriptions is likely to be 12 per cent.—bad—and that, as a result of the National Institute for Clinical Excellence, the Government have made an extra commitment of £500,000 for South Staffordshire health authority—good—except that the result of the cost will be an extra £2 million—bad. We currently suffer a £4.7 million rolling deficit. Come on, let us have adequate funding.

I am probably not the only hon. Member in the House who did not follow the hon. Gentleman's question. Perhaps there is a chance that when I read it in Hansard it might make better sense. The hon. Gentleman ended his question—[Interruption.]

Order. The hon. Member for Lichfield (Mr. Fabricant) has asked a question. The Minister must be allowed to reply.

I am grateful to you, Mr. Speaker. The only point that I understood in the question put by the hon. Gentleman was the request that the Government should spend more on the national health service. No one in the House could regard that as a serious question or a serious proposition. The official Opposition have not even committed themselves to matching the expenditure that we have provided for. [HON. MEMBERS: "Yes, we have."] No they have not. Of course Opposition Members want to claim that, but it is complete and utter nonsense.

What progress is being made in improving services which will cut the incidence of coronary heart disease. [151956]

Two of the biggest causes of heart disease are smoking and lack of access to fruit and vegetables. That is why the action to cut the incidence of heart disease includes comprehensive support for smokers who want to give up, and rolling out free fruit in infants schools.

I thank my hon. Friend for that response. Is she aware that this Friday, a new chest pain clinic is opening at Northampton general hospital, and does she agree that such measures will not only help to cure heart disease but will help people to monitor their own condition and get it under control?

I agree with my hon. Friend, and I certainly welcome the arrival of the new rapid-access chest pain clinic in Northampton. In the national service framework we have set out plans for rapid-access chest pain clinics throughout the country. Those are being opened as we speak, and are starting to provide services throughout the country, because it is important that when people are suspected of suffering from heart disease they can be seen very swiftly and properly diagnosed.

Is the Minister not concerned about the lack of fitness among our young people, and does she not consider that that is due to a lack of sporting facilities and sports education in our schools? We may accept that that is largely due to the selling of school playing fields and the requirements of the national curriculum, but what talks is the Minister having with her counterparts in the Department for Education and Employment to ensure that sport is made compulsory in our schools?

We have had considerable discussions with the DFEE and the Department for Culture, Media and Sport about promoting sport in schools. The hon. Lady will be aware that considerable work has been done to promote sport in schools, and to create school sports co-ordinators to increase access to exercise among young people. However, this issue is not just about sports; it is about exercise and access to exercise across the board. The creation of safe routes to school for many of our young people is another important way of increasing their access to exercise.

I am not sure whether Ministers, particularly my right hon. Friend himself, are aware of the deep affection in which the Secretary of State is held by my constituents, following his recent announcement of a state-of-the-art £44 million coronary care unit for Wolverhampton and the black country. My right hon. Friend is aware, as all our Ministers are, that we have the highest incidence of heart disease in the whole west midlands region, but the lowest access to such important life-saving facilities. Thank you very much, Ministers.

I join my hon. Friend in welcoming the new state-of-the-art cardiac surgery centre in Wolverhampton, and pay tribute to his very persistent lobbying on behalf of his constituents for the cardiac centre these past many months. He is right that it is important to increase access to heart operations and to increase the number of heart operations taking place in this country. He is also right that it is important to target those services exactly where we need them, in order to tackle the health inequalities as well, because the blunt fact is that a person on a low income is three times more likely to suffer from heart disease than a person on a high income. That health inequality is morally wrong.

What representations he has received on the negotiations for new consultants contracts. [151957]

If he will make a statement on the recruitment and retention of consultants. [151961]

The Government's proposals for a new consultants contract were published last month. We are now in negotiation with the British Medical Association on our proposals and its own. In the meantime, the number of consultants in the NHS has increased by almost 3,000 since 1997. We are committed to further significant increases as part of the NHS plan. By 2004, there will be 7,500 more consultants working in the NHS.

I take all that with a pinch of salt. Surely the Secretary of State realises that, even by the standards of this deeply sinister, incompetent—[HON. MEMBERS: "Rotten Government"]—rotten Government, his policy on consultants contracts is wrong. Will he now undertake to look carefully at the evidence given to the Select Committee on Health, which showed that morale in our health service will plummet as a result of that policy? Will he undertake to stop his wicked attack on our hard-working consultants and realise that although we need more hospital consultants, we certainly do not need a Labour Secretary of State for Health?

I know that the hon. Gentleman is parliamentary adviser to the Caravan Club—which probably explains why he is undertaking his political tour of Essex constituencies at the moment—but not everyone has the luxury of having two jobs at once. It is right that we correct this historic anomaly, and our proposals are designed to do something very simple indeed. The consultants contract has remained unreformed since 1948; it is about time it was changed. I want to put the NHS in a better position to compete for consultants valuable time, expertise and skills, for the benefit of NHS patients.

Does the Secretary of State's policy not show that he thinks he knows a lot better than the founding fathers of the NHS, who recognised the problems that would be caused if consultants were forced into the NHS and not allowed to engage in private practice? What makes him think that he has a better solution to the problem, which is fundamentally the same now as it was when Aneurin Bevan and other Labour Ministers, who knew what they were doing, decided that the course that he proposes to adopt was totally wrong, counter-productive and would result in consultants being lost from the NHS?

The hon. Gentleman is the oddest looking Bevanite that I have ever seen in my life; poor old Nye would be turning in his grave at the prospect of the hon. Gentleman supporting him. The contract has remained unreformed since 1948. It has remained as it was then for the past 53 years, and it has to change. The whole assumption behind the consultant contract has been that the best way for NHS consultants to get on is by opting out of NHS work. We must turn that on its head. There is a fair deal on offer for NHS consultants. We will pay them more for doing more NHS work, in exchange for which we expect them to do less private practice. We have proposed the deal, and we shall negotiate it.

The Health Committee's inquiry into consultants contracts was mentioned a moment or two ago. Does my right hon. Friend remember that during that inquiry, we received evidence that, in certain parts of the country, NHS waiting lists were being artificially lengthened to stimulate a demand for private consultations and private treatment? In the negotiations with the consultants, has that matter been considered?

I understand that there are concerns about precisely those issues. Many patients find being confronted with such potential conflicts of interest extremely uncomfortable, but that is not the primary purpose of what we seek to do. Given that we have a limited number of NHS consultants—we shall have more in future—our primary purpose is to ensure that we get the maximum amount of NHS time from them. That seems reasonable; it is not a something-for-nothing deal.

I wish my right hon. Friend well in his endeavours. Do we not all know that, contrary to what Tory Members have said, Nye Bevan wanted to do exactly what my right hon. Friend is attempting to do today? The money was not there then, but we have now got an economy that enables us to achieve what we could not do in the 1940s. My right hon. Friend should not worry when the Tories talk about doctors and consultants with more than one job, because nearly every Tory MP moonlights as well.

My hon. Friend, as always, makes a very good point. I will not take much notice of what the Conservatives say, but of course we shall listen to what the consultants say. There will be a negotiation, and we have set out our position very clearly indeed. We shall negotiate on it, and I fully expect us to make progress.

Although I accept that it is normally desirable to retain experienced and dedicated consultants in the NHS, will the Secretary of State set up an inquiry into why Mr. Lennox Kane, a consultant gynaecologist at Hemel Hempstead who had been diagnosed with Parkinson's disease, was allowed to continue operating? Will the inquiry investigate the complaints of 27 of his women patients about the treatment that they received? Will the right hon. Gentleman use his good offices to ensure that the chief executive and chairman of the health authority and the trust agree to meet the members of the action group that was set up to represent those patients before such an inquiry, not after, which is all that they have agreed to at present?

The circumstances that the right hon. Gentleman describes are extremely disturbing. As I understand it, the trust is already reviewing the way in which the complaints were or were not acted upon. I promise him that I shall look into precisely the matters that he has raised with me.

On 11 June last year, the Secretary of State told BBC television:

"In most walks of life employees have got a choice haven't they about whether they work part-time or whether they work full-time … We are not going to deny that to consultants. Surely, why should we? It would be a pretty odd state of affairs if we said to highly trained consultants, some of the most expert people, professionals that we have in the Health Service, you are going to be denied a set of rights that everybody in the NHS has."

Welcome to Health questions. The hon. Gentleman should read the Government's proposals.

Answer the question.

If the hon. Gentleman will stop hollering, I will try to answer the question. If he calms down and keeps taking the pills, he will be fine.

If he will make a statement on the pace of change policy. [151958]

Each year, the Government decide how extra resources should be deployed between across-the-board increases to maintain continuity and stability in the service and to make progress nationally in priority areas, and differential distribution to bring under-target health authorities nearer to equity.

Whichever indicators are used, they show that people in my constituency are desperately in need of extra resources to improve their health. Figures in my possession show not only that in the financial year 1993–94, the Bolton part of Wigan and Bolton health authority was 6 per cent. off its target, but that the situation has not improved in the current year, and we are still 6.5 per cent.—£13 million—under target.

Four years ago, Wigan and Bolton health authority was almost 5 per cent. below target; now it is less than 3 per cent. below target. The important point is that it has received a cash increase of 9.1 per cent. for next year. My hon. Friend will know that the health authority's ability to address poverty and inequality is far greater with such an increase in resources than it would be if the Conservative party was in power, implementing its pledge to cut £16 billion from public spending—which would of course include cuts in health service spending.