To ask the Secretary of State for Health what was the level of capital expenditure in the national health service in 1978–79; and what is the figure for 1991–92.

NHS capital expenditure is planned to be £1·9 billion in 1991–92 compared with £0·4 billion in 1978–79, an increase in real terms of 68 per cent.

I thank my hon. Friend for those excellent figures. He will have laid emphasis on the fact that in 1979 the last Labour Government —to balance their financial books, at the behest of the International Monetary Fund—cut and cut again capital expenditure in the NHS. Those cuts impeded the development of the service in the Birmingham area, which under the present Government is launching the "Building a Healthy Birmingham" campaign, along with hundreds of millions of pounds of investment. Does my hon. Friend agree that only under a Conservative Government is that possible?

The track record squares absolutely with my hon. Friend's version. Between 1974 and 1979 the Labour party cut the NHS capital programme by 16 per cent. in real terms, compared with the increase of 68 per cent. that I have just announced. My hon. Friend will be pleased to hear that in Birmingham we currently have in progress a programme costing £15·9 million at the Queen Elizabeth hospital, £23·4 million at the East Birmingham hospital, £5·6 million at the Good Hope hospital, and £2·5 million at the Dudley Road hospital. That represents a total of schemes in progress of £47·4 million, without taking account of the £310 million which we are committed to spend on the "Building a Healthy Birmingham" programme.

Before the Minister and other members of the Government try to score too many party political points in relation to figures such as those, may I ask him to find time to read the letter in The Independent today, which is an account by a patient in a leading London hospital casualty department which is filthy, hot and overcrowded? Is the Minister aware that that is the reality facing many patients in Britain today?

The question that that patient or anyone else wishing to compare the records of the parties on capital expenditure must ask is which of the rival management teams available offers the best prospect of solving the problem—a team which, when it last had the opportunity, cut capital expenditure by 16 per cent., or a team which, since 1979, has seen capital expenditure increase by 68 per cent.