This is the text of Sir George’s speech on the Lords Amendment to the Governments Health and Social Care Bill.
Sir George Young (North-West Hampshire): The hon. Member for Vauxhall (Kate Hoey) and the right hon. Member for Birkenhead (Mr. Field) have just had the courage to articulate reservations which we all know are widely shared by Labour Members. I hope that, even at this late stage in our debate, Labour Members will reflect on what those two Members have said. The first time we voted on this issue, the Government majority was 35; the second time, it was 17. At that rate of progress, the vote later on could be quite tight.
I say to the Minister of State, Department of Health, the right hon. Member for Barrow and Furness (Mr. Hutton), who opened the debate, the issue is not whether the Bill reaches the statute book, as he implied; the issue before the House now is whether the Bill reaches the statute book with part 1, or without it. All the other beneficial measures in the Bill will go on to the statute book if, in a few minutes' time, the House agrees with the Lords in their amendments.
Two issues that have run through the debate this afternoon and evening remain wholly unanswered by the Government. The first relates to funding. If a foundation trust successfully raises money privately and uses those resources to construct a building that would not otherwise have been built, the consequence will be that another hospital does not get a building that was in the Government's plans, because the overall public expenditure ceiling cannot be breached. Every single addition, every single success scored by a foundation hospital, will be compensated for by a failure by another hospital. It is no good the Secretary of State pointing at his head. He and the Minister of State have had debates this afternoon and this evening to answer that point, and neither has done so.
Hon. Members: Answer him!
The Secretary of State for Health (Dr. John Reid): I shall speak slowly, because even after three explanations, hon. Members obviously do not get it. It is quite easy for those who can do arithmetic. The envelope for capital expenditure is sufficiently big to contain all of the demands because, unlike the Conservatives, Labour is building up investment, not cutting it.
Sir George Young: With the greatest respect for the Secretary of State, I have to say that that does not answer the point that has been made time and again, for the following reason: he will never be able to get from the Treasury the totality of the money that he would like to spend on the NHS. If foundation hospitals were to be allowed to spend in addition to the provision made, there would be some advantage in their creation, but I repeat what I said a few moments ago: every success by a foundation trust will be matched by another building for a hospital that is not a foundation trust having to be dropped from the plans. That is the charge that the right hon. Gentleman has failed to answer throughout the debate.
The second point was touched upon by the hon. Member for Vauxhall. The Secretary of State wants to make services more responsive to the needs of patients. We agree with that. However, he has democratised the wrong body. It is not hospitals that determine the shape or the volume of services that are consumed. It is the primary care trust that commissions the services from the hospitals. If the right hon. Gentleman wanted to make the NHS more responsive to local needs, he should have applied his corporate government measures to the primary care trust, not to the hospitals.
Some Labour Members are cautious about voting with the Opposition. I have voted with Oppositions in previous Parliaments when there were Conservative Governments. If a Government Member thinks that it is right to vote with the Opposition because he or she believes that the amendment under question is right, he or she should do so. It seems to be perverse to rebel if it is thought that there is no chance of success, but to pull back on the one occasion when there is a real prospect of making a change. I understand that Labour Members have cover from their party conference if they want to vote in favour of the Lords amendment.
If Labour Members want a satisfactory resolution — if they want all the measures in the Bill to reach the statute book but not part 1 — they should vote with the Opposition. They know in their hearts that that is the right thing to do, and they should not listen to the bullying from the Secretary of State.