NHS (60th Anniversary)

I begin by congratulating my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) on tabling the motion and on the tone in which he introduced it. The key point that he wanted to draw out—I wholeheartedly agree with him—is that the political fact in 2008, as opposed to 1946, is that the national health service is built on a political consensus that includes every single Member of this House from every party. A key element of the background to my hon. Friend's initiative in introducing the debate is that it is a relatively unusual experience over the 60 years of the NHS for a Conservative spokesman to be able to point to opinion polls saying that the Conservative party is the most trusted party on health policy issues. I congratulate him on achieving that as our health spokesman; I certainly never achieved it when I held that post some years ago. The important point is not to luxuriate in the fact that we are more trusted than the Government on health care, but to draw a political conclusion about the fact that Labour spokesmen go round the country saying that because the Conservative party voted against the national health service in 1946, it is somehow not committed to the principles of the health service—despite the fact that we have been responsible for it over 35 of its 60 years of history and have never taken action that undermined the principles of the health service. I say to my hon. Friend the Member for South Cambridgeshire that the more often he can create opportunities for that argument to be developed, the more it suits our purpose, because it demonstrates that the arguments used by our political opponents cut no ice with the voters. The voters regard us as the more trusted party because they accept that there is no point of difference on the matter in the House of Commons. There is an all-party consensus on the principles of the national health service, and the true debate in politics is not who is committed to it and who is not, but who can deliver. On the 60th anniversary of the NHS, we should focus on that argument. The charge against the Government is the one I mentioned during a brief intervention on my hon. Friend. The Government have hugely increased the budget of the national health service over the past 11 years. I applaud them for that—it is the right thing to have done—but they have not brought about the improvements in the delivery of health outcomes and health care that we should have expected for that scale of resource increase. One or two of our more partisan supporters say that all that money has been spent, but that there has been no improvement. That is not true. Of course there has been an improvement in the delivery of health care in Britain over the past 11 years, just as there was during the previous 49 years. A year-by-year improvement in the delivery of health care is the consistent story of the NHS since 1948. If we are to be reflective on the 60th anniversary of the health service, what should disappoint us is that over the past 11 years there has been a huge increase in resources, but no improvement of performance commensurate with that increase. The question is, why is that true? Ironically, some analysis of the reasons for that failure is implicitly shared by those on the Opposition Front Bench and those on the Government Front Bench. If we look at what happened to health policy during the past 11 years, we see that the truth is that, in some important respects, it has gone round in a huge circle. The neatest way of encapsulating that is to refer to a speech I heard made in the summer of 2006 by Paul Corrigan, the health adviser to the former Prime Minister, Tony Blair. He explained that as a result of the insights of Mr. Blair, a new idea had been introduced into the health service—commissioning. By empowering commissioners, we would introduce conditionality about the use of resources, and we would ensure better value in terms of efficiencies and health outcomes for the money provided by the taxpayer. I am afraid that when I heard that speech, I could not resist observing that its sentiments were precisely the same as those in the comments made by Professor Sir Donald Acheson, who was the chief medical officer when I first became a Health Minister in 1990 and my right hon. and learned Friend the Member for Rushcliffe (Mr. Clarke) was Secretary of State for Health. The truth is that we introduced what we called purchasing and it has now been relabelled commissioning. We introduced trusts; the hon. Member for Wirral, West (Stephen Hesford) referred to the importance of local decision making and trusts and I entirely agree. We introduced what we called GP fundholding, and the Government introduced practice-based commissioning. A gigantic circle has been drawn and the health service's institutional framework today bears a sharp resemblance to the one that we left in 1997. The regret is that it has taken so much money and such a long time—wasted time and money—to get back to the point that we had reached in 1997, not in resources, for which I give the Government credit, but in their use and the management of health service institutions.