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Health Care Prioritisation

I congratulate the hon. Member for Wyre Forest (Dr. Taylor) on securing the debate. The House benefits from his clinical expertise and long history of fine service to the NHS. He has also become gradually aware of how to be a streetwise politician, as is clear from some of his recent contributions to debates. The hon. Gentleman entered the House in the first place through an attempt to have an honest and open debate about health care in his local community. He campaigned very emotively on behalf of the local hospital and succeeded in removing the sitting MP. The hon. Gentleman will therefore understand why there might be parameters to people's willingness to be open about the need for change and transparency in the NHS. However, I will not hold that too much against him this evening. The hon. Gentleman raises several fundamental issues that we need to address now and in the future, given the changing nature of our society and of health care. It is important to contextualise the debate. This Government have put in an unprecedented level of resources over a sustained period, in terms of the history of the NHS. As a consequence, we have had a massive improvement in patient care, beyond all recognition compared with the state of the health service only 10 years ago. Between September 1997 and September 2006, nearly 36,000 more doctors and nearly 80,000 more nurses were employed in the NHS. Waiting times are now at the lowest levels since records began. Only five years ago, thousands of patients waited for anything up to 18 months for in-patient treatment; now, the vast majority are seen and treated within six months. By 2008, all patients will be treated within 18 weeks of referral from a GP in the vast majority of circumstances. More than 99 per cent. of patients with a suspected cancer are seen by a specialist within two weeks of being referred by their GP, which is a huge improvement over only 63 per cent. in 1997. More people than ever before who are diagnosed with cancer begin their treatment within a month of diagnosis. We have increased the number of cancer specialists by 45.6 per cent. since 1997, while cancer mortality in people under 75 fell by nearly 16 per cent. between 1996 and 2003. Leaving aside the statistics however, that means that 50,000 lives have been saved. We are proud of the cancer reform strategy that we announced today. It puts great emphasis on prevention, but we want to go even further in terms of the advances that have been made. In the hon. Gentleman's community, Worcestershire primary care trust will receive allocations of £617.7 million in 2006-07 and £679.3 million in 2007-08. Those allocations represent an extraordinary cash increase of £130.4 million, or 20 per cent. over two years, although it is about the national average. The hon. Gentleman quoted Lenin and Nye Bevan. I shall not be able to emulate him in that respect, but I shall mention that John Lennon wrote ““Imagine””, a song that gave an idealistic view of the world and which said that we should be optimistic and positive about the future rather than grudging, cynical and negative. At different stages in the development of the NHS there have been people who have preached doom and gloom; they said it was not doable, not possible or no longer viable. Much of the reform in the Conservative Government's agenda for health between 1979 and 1997 was underpinned by the notion that if they eroded public confidence in the national health service that Labour created, and which we believe in, over time the public would stop believing in the NHS, too, and wholesale privatisation would be the inevitable consequence. I am delighted that they were never allowed to finish their mission. In any case, the British people would have rejected it overwhelmingly. There is no doubt that we live in a changing society and the health service cannot function in isolation. People are living longer, and they suffer from more challenging conditions. There are medical and technological advances. Patients have different expectations nowadays from 10, 15 or even 20 years ago, so the hon. Gentleman is right to say that the health service has to adjust, not just to present-day realities, but to our changing society. The hon. Gentleman says that people with learning disabilities are not treated properly in the NHS and that there is a failure to respect the dignity of older people. He should talk to some of his professional colleagues and the managers in the service about why some of those things happen. It is not because there are not enough resources to fund the system properly. That cannot be used as justification for not treating older people with dignity and respect and not treating people with learning disabilities properly. We should not entirely let NHS management and professionals off the hook in terms of their responsibilities to some of the most vulnerable patients. It is important that we talk about quality, accountability and responsibility. A number of factors will influence an equitable and fair NHS in the future. The building blocks are in place. NICE is world-class by any comparable standards, and I thank the hon. Gentleman for being positive about the role of NICE, as well as for being realistic about some of the difficulties and tensions the organisation faces. NICE is consulting on its technological appraisal methodology, and I urge hon. Members and members of the public to comment on whether that methodology should be changed in any way. Whatever the system, if it comes up with popular results, an organisation will be applauded to the heavens, but when its decisions are more controversial or unpopular the organisation will inevitably attract significant flak and criticism. That is why we must be consistent in our support for the integrity and independence of NICE. The organisation is relatively young and new, but it does a very good job indeed. The other factors that will influence the long-term sustainability of the NHS, its universality and the comprehensive nature of what it offers people, include resource allocation. We are consulting on the resource allocation system in the NHS. What are the characteristics and ingredients that make up the formula that determines how resources are distributed across the system? Factors such as the nature of a local population, need within the community, poverty, the number of elderly people, sparsity and rurality are all important when looking at whether the distribution of resources across the system is as fair as possible. The hon. Gentleman rightly raised the question of where we spend the existing money. As the Minister with responsibility for social care, mental health and children's health, I think that there is an issue about significantly shifting resources in the national health service from acute NHS care to early intervention and prevention, and community-based services. That requires courage from people such as the hon. Gentleman, who is respected for his clinical judgment; such people should argue fiercely that no change is not an option in terms of best patient care and that the position of Her Majesty's official Opposition, which appears to be a moratorium on any change to services, is highly irresponsible and not in the best interests of patient care.