NHS (Government Spending)

Caroline Lucas Excerpts

Wednesday 28th January 2015 Commons Chamber

[Chris Leslie]

If my hon. Friends will allow me, I will give way in a moment. I want to pick up the point made by the hon. Member for Stourbridge (Margot James), when she implied that the Conservative party somehow has plans to support additional investment in the NHS. The Chancellor of the Exchequer alluded to the fact that the Government might be able to cobble together £2 billion of additional funding. According to page 65 of the Treasury Green Book—“Autumn Statement 2014”— £1.2 billion was supposed to come from reserves or underspends for the NHS, but there is absolutely no commitment for any additional money beyond 2015-16. I will give way to the Minister if he will explain where his party has identified resources to meet that commitment beyond 2015-16. Will he spell that out? [Interruption.] I do not think that he wants to. My hon. Friends will ensure that he explains later, as he has just promised, because the public need to know where the money will come from to meet the pressures we face.

The Conservatives also wanted to switch £750 million out of Public Health England and Health Education England as some kind of sticking plaster for the NHS. However, we must think about the impact switching money away from preventive systems such as inoculations and vaccinations would have. [Interruption.] The Liberal Democrat Minister of State thinks that that is a good idea, but it is not a sustainable way to provide funding for our NHS. He has to do his sums again, make tough decisions and find the additional resources. Of course, the Liberal Democrats have said that growth will somehow magic up the money for the NHS, which shows their lack of credibility.

It is no wonder that the Institute for Fiscal Studies has said that Labour is the most cautious party in ensuring that it fully funds its pledges. It is no wonder that the Government parties do not want the Office for Budget Responsibility to go anywhere near the costings for the promises of political parties.

[Caroline Lucas (Brighton, Pavilion) (Green)]

Does the hon. Gentleman agree that when Government Members ask us to congratulate NHS staff, which we do, it seems a bit hollow when they will not even pay nurses a decent wage? Does he further agree that privatisation is fragmenting the NHS, making it much harder to deliver a good service for patients?

[Chris Leslie]

We have to do far more to create a joined-up health service and social care system. That is very much part of the 10-year plan for the NHS that we announced yesterday. Yes, this is a debate about resources and getting the investment in, but we have to do more than that.

I question why the Conservatives are not putting their plans for funding the NHS on the record. Is it that they do not have any plans to pay for it or, which is more likely, that they are committed to shrinking public service investment in this country? The Conservatives and the Liberal Democrats have signed off on projections that would shrink public services to just 35% of GDP by the end of the coming Parliament. [Interruption.] I say to the hon. Member for Daventry (Chris Heaton-Harris) that there was nothing in the charter for budget responsibility about shrinking the state to 35% of GDP. That is his plan. Public services have not been at that level since the late 1930s—before the NHS even existed.

That is the Conservatives’ vision, but what would it mean for the NHS? We are fortunate in this country that charging makes up just 10% of a patient’s out-of-pocket expenses. That includes prescriptions, optical services and dental services. Let us just look at how it works in those countries where public services form just 35% or less of GDP. There are four such countries across the OECD. In Switzerland, where public services make up 32.8% of GDP, more than a quarter of a patient’s income goes towards the cost of treatments. It has an insurance system in which the patient effectively pays an excess: as with a car insurance system, the patient has to pay the first amount and it is deducted from the total bill. Patients in Switzerland typically pay £1,800 out of their own pockets. In Mexico, charging makes up 44% of out-of-pocket expenses, in Chile it is 32% and in Korea it is 36%. Korea has a co-payment system, which means that up to half the hospital costs have to be borne by the patient.

Such things happen in every country where less than 35% of GDP goes towards public services. The Conservatives want to head us in the direction of such pressures. An NHS free at the point of use is not sustainable under the Conservative plans, and the risk that charges will be introduced is great.

The Conservatives have form on this issue, because their 2005 manifesto, which the Prime Minister and the Chancellor authored, encouraged people to go private. They wanted a patient passport that would have introduced charges for people who wanted to jump the queue. I wonder whether my hon. Friends recall that. The Prime Minister and the Chancellor wanted such charges for basic medical treatments. I have another question for the Minister and, again, I will give way to him. Would the Conservative party still introduce those plans in the dreadful event that they won the next general election? I will give way to the Minister if he wants to say that that is categorically not part of his party’s plans.

--- Later in debate ---

[Dr Poulter]

Such drivel, frankly, is beneath the hon. Lady. We have made considerable additional investment in the NHS. Comparisons between an NHS run by a coalition Government in England and the NHS in Wales bear up very well for the NHS in England.

[Caroline Lucas]

Just before I came into this debate I met a 10-year-old constituent, Margot, and her mother, who works for the NHS. She works all hours and still struggles to put enough food on the table. Can the Minister explain why the Prime Minister does not care about NHS workers? That is what Margot wants to know and that is what the rest of the country want to know.

[Dr Poulter]

I am familiar with the hon. Lady’s constituency, having worked as a doctor at a hospital in the area. Her question is very disingenuous when we have increased the number of front-line clinical staff working in our NHS, investing in more staff to treat patients. We have also recently agreed with the unions a pay deal that will see the majority of NHS staff receiving a substantial increase in pay, thanks largely to their increments. Other staff will receive 1%.