Speeches, etc.

Margaret Thatcher

General Election Press Conference (health)

Document type: Speeches, interviews, etc.
Venue: Conservative Central Office, Smith Square, Westminster
Source: Conservative Party Archive: transcript
Editorial comments: 0930-1000. Tebbit, Fowler, Newton, and Lord Young shared the platform with MT.
Importance ranking: Major
Word count: 4445
Themes: Defence (general), Defence (arms control), Employment, General Elections, Public spending & borrowing, Foreign policy (USA), Foreign policy (USSR & successor states), Health policy, Labour Party & socialism

PRESS CONFERENCE—HEALTH—28 MAY 1987

Mr Tebbit

… on the trade figures when they are announced each month at the Department of Trade and Industry. It is not appropriate, of course, for him to use those premises for a Press Conference during an Election period, so we have given him the facility here to call his normal conference on the trade figures. It will take place at 11.40 am. The figures are released at 11.30 am, so there is the usual 10 minutes in which to see them before the Conference starts.

The Prime Minister

Thank you very much. I will ask the Secretary of State to make his statement and we will aim, as usual, to finish at 10 o'clock. I think that you might have had quite an interesting morning and, therefore, would be quite grateful if we did finish at 10 o'clock. We shall try and oblige.

Mr Norman Fowler

For the second Election running, Labour's tactics on the Health Service is simply to run any old scare story they can dream up. Last time we were told that a Conservative Government would scrap the Health Service altogether, dismember and dismantle it. Those are the sort of words that they use. This time it is basically the same, but with knobs on—discriminating against elderly people, privatising the ambulance service and paying the managers extra to close wards in hospitals.

There is not a word of truth in any of those allegations. Labour is desperately putting up hares in all directions and none of them are basically running. I shall set out briefly some of the real facts about the Health Service we inherited from the Labour Government, and what we are doing to develop the Service. We inherited a budget of under £8 billion from the Labour Government. We have increased that budget to £21 billion—a real increase over and above inflation of 31 per cent. We inherited a record waiting list of 750,000 from Labour. We have reduced Labour's waiting list by 70,000 and we would have reduced it by even more had it not been for the industrial action in 1982 which Labour supported. Over [end p1] the next 12 months we have a special waiting list drive, which will give treatment to a further 100,000 people waiting for operations. We aim to treat an extra 100,000 people in the 12 months after that.

The fact is that the Health Service is now treating over 1 million more in-patients, nearly half a million more day cases, and 4.25 million more out-patients than when we came to power. At the same time, we will be building up other services like the new national breast cancer screening service. Breast cancer is the commonest form of cancer among women in this country, and I can say today that we have agreed with the regions concerned the location of the four centres, which will provide training for the staff involved in breast cancer screening programmes throughout the country. The centres will be in Manchester in the north-west region, Nottingham in the Trent region, Guildford in the south-west and Camberwell in south-east Thames. In addition, because of their special expertise, we are discussing with the Royal Marsden Hospital the possibility of their providing some training as well.

But I think that the comparison which makes the point most sharply is the comparison of hospital building. We inherited a hospital building programme which has been the victim of the Healey cuts under the last Labour Government. Labour cut hospital building by 30 per cent. This Conservative Government have increased the hospital building programme to an all-time record. A massive £3 billion programme is now under way—the biggest in the history of the Health Service.

The position is basically this: we have started and completed over 200 major hospital building projects. We have a further 150 now under construction and over 350 at various stages of planning and design. Perhaps I can show you what this means around the country—(diagrams). We have divided the map into London, Scotland and England and Wales. The map will show you the schemes that have been started and completed since 1979—about 200. Secondly, the map will show you the schemes that are under construction. Thirdly, the map will show you the schemes at their planning and design stage of which there are 350. The charts give you some idea of the extent of the hospital building programme in all parts of the country. [end p2]

I remind you that we inherited a hospital building programme which had been cut by the last Labour Government by 30 per cent. We have restored that hospital building programme and the result is that, today, new hospital building is taking place all over the country. It is a record hospital building programme in this country.

Our record and our plans are basically set out in this booklet (Health into the Nineties). We are committed to a Health Service that provides the best possible modern care.

Prime Minister

Questions on health please.

Q

Secretary of State, can you give any assurance that prescription charges will not go up again if you were in a third term?

Mr Fowler

No. The important aspect on prescription charges is that about 75 per cent. of them are prescribed free. That is the important and crucial thing. Obviously, we will review prescription charges each year as they come along. But the important thing is that the exemption policy means that those people who cannot afford prescription charges are prevented from the cost of them.

Q

Do you see a large role for the private sector in the next term of Conservative Government? Do you welcome the scheme at Guy's Hospital which was decided last week to contract-out its private pay beds to private management? Would you encourage further schemes like that?

Mr Fowler

It is very much a matter for the health authorities themselves. The Guy's scheme is one of those schemes which has been decided by the health authority. That seems a sensible course to have taken as far as Guy's were concerned. It maximises the income as far as the hospital is concerned. With regard to the future, we want to see basically partnership between the private sector and the National Health Service. We do not want a return to the position of the 1970s, which is basically what Michael Meacher is promising at the moment, and that is a battle between the private sector and the public sector. We stand for sensible co-operation and partnership, and you can see that taking place. [end p3]

Q

On that point, Mr Fowler, can you just explain in a little more detail what sort of projects you might see in terms of that partnership between the private sector and the public sector?

Mr Fowler

That is very much a matter for the individual health authorities themselves. We do not set down a directive from the centre on that. It is a matter for the health authorities themselves. We are concerned with developing the National Health Service and developing patient care. But when there can be sensible co-operation between the two, that is in everyone's interests. One example has been the way that waiting lists have been tackled under the £25 million initiative in which we are treating something like 100,000 patients over the next 12 months. The position there is that, in one or two cases, the private hospitals are seeking to help health authorities by treating those patients. That is a sensible use of that discretion.

Q

What do you say to Mr Meacher 's statement yesterday that, if you look at the actual spending on patients rather than on wages and the costs of buildings, the Conservative record shows a 3.5 per cent. decrease. He backed that up with a Parliamentary Question.

Mr Fowler

Only Mr Meacher could actually work his arithmetic out that way. Mr Meacher is promising precisely what the Conservative Government have achieved. Over the past eight years, we have increased spending by 31 per cent. in real terms over and above inflation. His pledge is only that he will go some part of the way to achieving that, so he is not even going to achieve what we have achieved already. That is provided, of course, that you believe in his economic policy. The heart of this Election campaign is economic policy—the financial strength of the country itself. It was when the economy collapsed and ran into the sand, and the IMF came in, that Denis Healey had to make his devastating cuts in the hospital building programme.

Mr Tebbit

The logic of Mr Meacher 's argument is that if we were paying the staff less and had less of them, the patients would be getting a better deal. That is not a particularly clear logical position to take. [end p4]

Q

Spending on the NHS is going to go up by 2.2 per cent. this year in real terms. But I think that it is bound to go down to 1.1 per cent. in real terms. Can you tell me why the increase in real terms is going down?

Mr Fowler

No, because that is simply the planning assumptions that take place in future years, and, obviously, we assess that year by year as we have in the past. The best indication of the Conservative's commitment as far as spending is concerned is to look at our record over the past eight years, and you can see the 31 per cent. increase in real terms.

Q

Your diagram included projects that are in the planning stage. Over what time-scale are you talking about? Is it into the 1990s?

Mr Fowler

Yes, that is what you do with a capital programme. You take it into the 1990s. That is why we have talked about health going into the 90s, but the fact is that we have given you three categories. We have given you the hospitals that we have started and completed—started under our Government, not just inherited from the Labour Party, although there was not much to inherit when it came to the hospital building programme—those which are under construction, and those which are being planned forward. It is very interesting that during this whole Election campaign our hospital building programme has never been challenged by the Labour Party or the Alliance.

Q

How are you going to cope with the nursing shortages brought out in figures by the RCN which are affecting operations?

Mr Fowler

On the general position of nurses, one of the most significant steps forward that there has been is the fact that we have set up the Independent Pay Review Body. That was something that the RCN, as you know, wanted for a very long time. This Government have set it up and the result of that has been that the real pay of nurses has increased. Obviously, we are consulting on Project 2000 and we will want to improve the training and the whole position as far as nurses are concerned. [end p5]

Q

At the Conservative Party Conference in Brighton, Mr Tebbit made a splendid speech on the idea of private enterprise taking over the management of NHS hospitals provided that the service remained free of charge to the patient. What initiatives in the third term are you likely to take following up Mr Tebbit 's suggestion, because nothing has actually happened in this way, and it strikes me that it would fit in well with your efficiency proposals?

Mr Fowler

I think that you might have missed what I said earlier. Co-operation between the Health Service and the private sector is a matter for the health authorities themselves. We have no general policy of the kind you have just described.

Mr Newton

I wish to add a small point on the question of the nursing shortages which is well-known and the background to the Project 2000 proposals on which we are consulting at the moment—a demographic trend which is reducing, over the next few years, the number of people who, as it were, form the normal catchment for nurse recruitment. So there is an important problem there to be tackled in a variety of ways, and it is one of the reasons why we are actively encouraging health authorities, for example, to look to back-to-nursing campaigns to attract former nurses and mature people to nursing, and to provide appropriate training facilities. It is quite clear that that is something that we shall want to go on encouraging in the future.

Prime Minister

Just before a considerable number of you arrived, we had an excellent demonstration of the hospitals that we took over and built, the hospitals that were built in our time completely, and of the plans that we are making now for building in the future. A lot of you did not see that. It actually invoked applause by those of you who did see it. We would very much like another round of applause. If you missed it, we should give a repeat performance.

Mr Fowler

(showing diagrams) … To use England and Wales as an example, you can see the extent of the hospital building programme of this Government. I emphasise again that we inherited a hospital building programme, which had been cut [end p6] by 30 per cent. by the last Labour Government. We have restored that programme, and the hospital building programme is now at an all-time record level. As you can see, graphically, we are building new hospitals literally all round the country.

Q

Secretary of State, will the hospital building programme result in a net increase in hospital facilities? How does it match up against any hospitals that are being closed down?

Mr Fowler

Yes. You will find in the booklet that we have given to you some of the things that it is providing in terms of x-ray rooms, operating theatres, accident and emergency departments. We are trying to provide modern facilities as far as the patients are concerned, and also modern facilities as far as the staff are concerned. Over the past few days, I have been to a number of the new hospital projects and you only have to talk to the staff about those new hospitals to understand just how important it is for patient care. It is vastly important.

Q

Can I just clarify your answer? Will it result in a net increase in hospital beds—this hospital building programme?

Mr Fowler

It will result in more patient care. It will result in more patients being treated than previously in better conditions. If you want to compare the hospital bed position with the position at the last Government, I am happy to do that. But the basic thing that the Health Service is doing is providing better treatment for patients. We are treating patients and that is what new hospitals enable you to do.

Mr Newton

It is very important that this should be understood. Yesterday, at a smaller press conference I referred to the fact that cataract surgery is increasingly being done on a day-case basis, whereas people used to stay in hospital for a long time. In America, it has been done on a day-case basis for quite a long time. If you invest in the right facilities to do day-case cataract surgery, you may not have the same number of beds, but you are performing a whole lot more cataract operations and the net result is that your patient care and the quality of your Health Service has improved. [end p7]

Prime Minister

Any other questions on the Health Service or on the Departmental work of the DHSS? Right, we will go to open questions.

Q

Prime Minister, do you approve of the United States President intervening on the Election of this country?

Prime Minister

I do not accept that the United States President has intervened. We are free to say what we wish. We must extend the same freedom to other people.

Q

Mr Kinnock has cited Lord Carrington in his support this morning—Lord Carrington having said that he saw no great prospect of a Soviet threat of invasion. Do you agree that there is no great Soviet threat?

Prime Minister

I think that Lord Carrington would be somewhat astonished if he heard himself being cited on that matter. Of course, the Soviet Union is still in Afghanistan. The Soviet Union still dominates the satellite country. The Soviet Union puts Cuban troops, by proxy, in many other countries in the world. The Soviet Union tries to extend influence across the world by every means possible. We have the 750th anniversary of Berlin. There is still a wall separating East Berlin from West Berlin. Of course, there is—and will continue to be—a Soviet threat. I find it absolutely astonishing that anyone should suggest that there is not, particularly when you look at the Soviet military might. If you are a responsible person, you do not rely on hopes for the defence of your country.

Q

The Leader of the Opposition has also just said that he suspects that the British Government may have sought to mobilise the President in expressing his views last night. What do you think about that?

Prime Minister

It is totally and utterly untrue, as you would expect it to be untrue.

May I just add that sometimes in the House of Commons we have an answer pursuant to a previous answer. May I say that the nuclear deterrent greatly diminishes and, indeed, has stopped either nuclear war or conventional war from starting in Europe [end p8] in the past 40 years. That is why its future is crucial to the peace of our country.

Q

In your Manifesto, you talk about the Community programme being re-vamped, and there being a premium top-up rate on top of supplementary benefit. Can you tell us what the rate is? Is it going to be the same as Sir Geoffrey Howe suggested in 1982, which was £15 a week?

Prime Minister

You are actually solely on the Community Programme.

Lord Young

Could I say that this is all part of a much larger package. What we actually have at the moment is a Community Programme which is only helping, in the main, young people as about 60 per cent. of people on the Community Programme are under 25. In the new arrangement in which all between 18 and 25 will be guaranteed a place on the job training scheme as soon as they have been six months out of work, we will, therefore, have to re-model the Community Programme to help people who are older and have family commitments. Therefore, we are proposing that the new Community Programme will operate at a premium of about £15 a week over benefit payments. This, if you are married with two children over the age of 11, for example, approximates to a gross salary of about £150 a week and certainly will provide facilities for many older people—family people—to receive work experience and training.

Q

Since the Conservative Campaign began in earnest at the weekend, we have had a fairly rough-and-tumble between the main parties over the past 48/72 hours. I wonder if the Prime Minister and the Chairman of the Party would like to tell us how they see the campaign now. Where have you got to?

Prime Minister

We have got to where we are, and we tend to go ahead. And we do not intend, like any good General, to reveal our plans. Accepted?

Q

How well do you think you are doing?

Prime Minister

If we go on steadily like this, we hope and believe—the words that I usually use—that we shall be [end p9] returned with a good majority. I am sure that you would like to add something very pithy. (Aside to Mr Tebbit).

Mr Tebbit

I am sure that I would like to add something very polite to Mr Cole.

Prime Minister

We do not have these rough-and-tumbles.

Mr Tebbit

We would like to maintain so far as is possible an Election campaign, which is about the policies that we are putting forward and, to some extent, our critique of the policies that others are putting forward. The latter issue is rather more difficult since, by the time we get to polling day, it looks as though all that will be left of the Alliance Manifesto are the covers; the rest of it seems to be changing as you look at it. Of course, we think that we will uncover a little more of what lies behind the covers of the Labour Manifesto—as you know, they have got into a muddle on rates as well as defence; they have got into a muddle on the political control of the police. We will continue to do that. We also found that, since the Labour Party felt it necessary to package, spray and cosset its Leader and make his personality very very much an issue of the campaign, we would have to say something about the policies of other members of the Labour Party, and you have seen us do that.

Q

Talking about the abandonment of nuclear weapons, Mr Kinnock said several times this morning that the occupation of Europe is not a feasible military operation.

Prime Minister

I seem to remember that in 1940 it was. When we are dealing with these defence matters, I am constantly saying to everyone, “Just look at the map” . It is Europe that is liable to a conventional occupation. There will never be a convention occupation; no one will ever attack the Soviet Union in the same way as she has been attacked previously. They have learnt too much from the past. The United States will never be subject to conventional attack. It is Western Europe that is subject to conventional attack and what deters that is the nuclear weapon. It is no earthly good anyone saying, “Well, Europe will not be conventionally attacked or conventionally occupied” . All experience indicates otherwise, and all experience [end p10] indicates, too, that it was not the Resistance Movement that made those countries free. It was the United States, the United Kingdom and the Armed Forces which, after bloody battles, released—liberated—those countries once again. I think that that is an excellent point on which to end this Conference.

Q

If there are cuts in Geneva on intermediate weapons, I wonder what justification you can give for NATO installing compensatory weapons around the British Isles?

Prime Minister

We are still consulting with our allies on precisely what measures should be negotiated along with the intermediate cuts and the short-range cuts. We are all very much aware that there seems to a process of a kind of salami tactic of taking one set of nuclear weapons out and then taking another out, and you simply cannot look at defence only on that basis. It is the duty of any Government to safeguard the defence of the country. That means that you have to look way, way, way beyond the immediate negotiations on two particular groups of nuclear weapons, and we are doing just that. We are constantly in touch with our allies on the precise stance that we should take. Let us have it absolutely clear. Our task, as a Government—and we hope and believe that we shall continue to be a Government—is to secure the defence of liberty and justice in these islands and throughout Europe, and to play a full part in NATO.

May I quote what was said by Lord Stewart in a very good debate in the House of Lords on defence options and the nuclear question. He said:

“If we hope to have any influence in that field” —the nuclear field and defence options—
“it is no good beginning by telling the United States to take all its nuclear weapons out of this country, and not to expect any co-operation from us in nuclear matters in the future … We can say that if we like” ——

Michael Stewart went on—

“but we cannot expect, after that, to have any effect at all on United States policy” .
[end p11] He went on to address the question that the country should be non-nuclear, but still part of NATO with nuclear weapons. He said;
“First, that would put British troops in Europe in great danger. Secondly, that would deeply upset the whole organisation and the set-up of nuclear power and weapons in NATO. If we became non-nuclear and refused to give nuclear facilities to the United States, it would inflict a fearful twist on the whole structure of NATO's defences.”

—(House of Lords, 25 February 1987, Hansard, cols.213–214). That puts it in a nutshell.

Q

President Reagan would like to see a nuclear-free world. Would I be right in assuming that you, on the other hand, would continue to see nuclear weapons as necessary for the West as long as the Soviet Union retains its present political system?

Prime Minister

President Reagan knows, and has said many times, that there must continue to be a nuclear deterrent. There must continue to be a nuclear deterrent for the foreseeable future. You cannot, in my view, act as if nuclear weapons have not been invented. If a conventional war were ever to start—just supposing you thought that nuclear weapons had all been destroyed—we know that conventional weapons, alone, do not prevent war. We know that from two world wars which started in Europe. If as a consequence of there being no nuclear weapons and no nuclear deterrent, a conventional war were started, the race would be on, as it was in the last war, as to who got the nuclear weapons first; who, in fact, had stowed a few away just in case. That person, in fact, would undoubtedly be the victor if it were one side and not the other. The nuclear deterrent is your only real defence of peace. We know that, and I cannot over-emphasise that too much. Defence is the most serious of all subjects. If you make a mistake, there is not time to put it right. You know that we had to make provision for the follow-on to Polaris, because it goes out in 1995. We had to make provision as far back as 1980. The more sophisticated your weapons get, the longer forward you have to plan, and you simply cannot [end p12] ever take any risk either with your forces in the front line or with the total defence of your country, or take any risk really in offending your allies. Because do not forget that it was really Britain standing alone and the United States coming into the war that both defeated the forces of evil in Europe, and rescued and liberated the other countries.

I remember Winston saying at one time, “If the United States and the United Kingdom always stand together, then the world will always be free” . That might have been a slight exaggeration—we cannot, in fact, do without the rest of NATO—but that is the fundamental basis on which not merely the defences, but our freedom and justice, is maintained.