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NHS Expenditure (Reduction)

I congratulate the hon. Member for Wyre Forest (Dr. Taylor) on securing this debate on what will be one of the most challenging issues for the health service over the coming decade. I understand that the Health Committee is looking at this subject, and I look forward to the evidence that it produces. As the hon. Gentleman said, over the past 12 years funding for the NHS has increased substantially and is now—as we promised—broadly on a par with the rest of Europe. The NHS has expanded and improved beyond any recognition, and as a consequence we now have a more capable and resilient service. Patient care has improved significantly, far fewer people now die from heart disease and cancer, and waiting times are the shortest they have ever been. Despite what some newspapers claim, patient satisfaction rates are extremely high. Those improvements have been recognised internationally. Last November, the Commonwealth Fund survey of primary care services ranked the UK first in almost every area. There has been a transformation in the NHS, which has moved from being pretty poor to being good, although it must still go further before it is great. If we want a great health service, we must continue to invest in it and ensure that we deliver improved care beyond that which we are delivering now. As the hon. Gentleman said, the time of rapidly increasing budgets is coming to an end. The stimulus package that we and Governments around the world have put in place has avoided a second depression, but the cost of that will mean tighter budgets in years to come. I do not for a moment accept the argument that a crisis is coming, and neither do I believe that a great storm is coming. There is, however, a demand for good management and efficiency, and a need to ensure a clear focus on the priorities. Should any manager happen to overhear the debate—saying something in the Commons is almost like trying to smuggle a message out—the message that came out in the Mid-Staffordshire inquiry and in the problems with out-of-hours doctors and a range of issues is this: the first priority for any manager in the health service is patient safety and the quality of care for patients. Managers must be aware of issues to do with finance and targets, but the priority must be to ensure patient safety and patient care.