Commons Sitting of 19 December 1979

Preamble
The House met at half-past Two o'clock
PRAYERS
[Mr. SPEAKER in the Chair]
ORAL ANSWERS TO QUESTIONS
ORAL ANSWERS TO QUESTIONS
  SCOTLAND

    Scottish Fishermen's Federation
    Mr. Mylesasked the Secretary of State for Scotland when he will meet next the chairman of the Scottish Fishermen's Federation.
    The Secretary of State for Scotland (Mr. George Younger): I met representatives of the fishing industry, including the president of the Scottish Fishermen's Federation, on 29 November to discuss progress towards a settlement of the common fisheries policy and again during the Council of Ministers on 3 December. Arrangements will be made to meet the industry again before the next Council takes place.
    Mr. Myles: If the hoped-for discussions with the chairman of the Scottish Fishermen's Federation take place soon, will my right hon. Friend consider declaring a moratorium on interest on White Fish Authority loans? Will he bear in mind the ever-increasing costs that are borne by the fishermen and that the money that those fishermen get decreases with the ever-decreasing quotas and the effect of imports?
    Mr. Speaker: Order. If that was a brief question, I congratulate the hon. Gentleman.
    Mr. Younger: That is not a proposal that we have considered so far. There would be difficulties in making an exception for interest rates on such a matter. I am conscious of the difficulties that the
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    fishing industry faces because of rising costs, and we shall certainly take all these points into account.
    Mr. Strang: Is the Secretary of State aware that at a time when the ban on herring fishing in the North Sea costs the industry thousands of pounds—albeit rightly—there is deep anxiety and anger at the evidence that French fishermen are landing herring caught in the North Sea, in French ports? Do the Government accept that that is happening, and, if so, will they do something about it?
    Mr. Younger: We do all that we can to investigate every case that is reported to us. As I have said before at Question Time, prosecution has been brought on at least one occasion. The hon. Gentleman can rest assured that we shall investigate very seriously every example that we hear of.
    Mr. Grimond: Can the Secretary of State tell us something about the limitations on mackerel fishing and whether they were agreed with the fishermen's associations?
    Mr. Younger: The announcement made this week was a warning that we shall have to do something, because the catching capacity of the fleet is increasing while stocks are depleting. I assure the right hon. Gentleman that we shall not make any detailed arrangements without first consulting the fishing industry.
    Mr. McQuarrie: I had intended to ask the question posed by the right hon. Member for Orkney and Shetland (Mr. Grimond). [HON. MEMBERS: "Question."] My question would have been the same as that asked by the right hon. Gentleman.
    Mr. Speaker: I am much obliged. There was a detailed debate on the subject last night, and it will come up again.

    Health Boards
    Mr. Robert Hughesasked the Secretary of State for Scotland when he expects next to meet chairmen of health boards in Scotland.
    The Under-Secretary of State for Scotland (Mr. Russell Fairgrieve): I met the chairmen of health boards in Scotland on 13 November. No arrangements have been made for a further meeting. The

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    next regular meeting between chairmen and officers of my Department will take place on 11 March 1980.
    Mr. Hughes: Will the hon. Gentleman have an urgent meeting with the chairman of the Grampian health board in order to investigate the report that the health board has had to stop open-heart surgery? Otherwise, many emergency patients will have to go to Glasgow or to London to have their operations. Is it not totally unfair that the board should bear the opprobrium of having to stop that kind of surgery, since that responsibility belongs to his Department? If anyone dies, it will be the hon. Gentleman's responsibility.
    Mr. Fairgrieve: I am aware of that problem, and it has many ramifications. If the hon. Gentleman will let me have further details, I shall be delighted to give him a detailed reply.
    Mr. Pollock: When my hon. Friend next meets the chairman of the Grampian health board, will he impress upon him the need to ensure that there is adequate provision at local level for maternity cases and for the mentally handicapped? The present policy of the board seems designed to concentrate such help in large centres of population.
    Mr. Fairgrieve: As my hon. Friend knows, I was in Duff town last weekend to discuss this problem. In the light of those discussions I shall be considering the matter further.
    Mr. Maxton: When the Minister met the chairmen of the health boards, did he discuss with them the mean and nasty little cuts that he has made in the ambulance services in Scotland, whereby out-patients at physiotherapy departments will not be carried if they can walk, walking-out patients will not be carried and limitations have been placed on hours of attendance? Does he agree that despite constant denials that there will be no cuts, there have been those cuts in the Health Service in Scotland?
    Mr. Fairgrieve: I assure the hon. Gentleman that there have been no cuts in the ambulance service, and certainly no mean and nasty cuts. However, in the interests of public expenditure we have asked that where people can easily get to hospital without an ambulance—and
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    their doctors say that they can get to hospital without an ambulance—they should do so.
    Mr. McQuarrie: Is my hon. Friend aware that 17 part-time chairmen of health boards and two full-time members of the Scottish Health and Welfare Commission are costing approximately £69,000 per annum? Will he investigate that high cost with a view to reducing it and thus helping to reduce public expenditure?
    Mr. Fairgrieve: Naturally, I wish to help to reduce public expenditure. However, if my hon. Friend takes the figure that he has mentioned and divides it by the number of people concerned he will see that we are getting a good service. I greatly value the work that these health board chairmen do. They are called part-time, but some of them work almost full-time.
    Mr. Hughes: On a point of order, Mr. Speaker. In view of the appalling ignorance on the part of the Minister of what is happening in his constituency—
    Mr. Speaker: Order. There is a formula that hon. Members use when giving notice of their intention to raise a matter on the Adjournment.

    National Health Service (Reorganisation)
    Mr. Adamsasked the Secretary of State for Scotland if he is satisfied with the structure of the National Health Service in Scotland.
    Mr. Fairgrieve: My right hon. Friend's proposals for changes were set out in a consultative paper "Structure and Management of the NHS in Scotland" published on 11 December.
    Mr. Adams: Against the background of the Minister's recent public statement as reported in The Scotsman, will he tell the House precisely with what he intends to replace the structure of the National Health Service in Scotland and when? Does he agree that his utterances as reported in The Scotsman do nothing for the confidence of the health boards or the people working in the Health Service? Does he further agree that the only solution to the problems of the Health Service in Scotland is a massive increase in public expenditure?
    Mr. Fairgrieve: My right hon. Friend's consultative document, which was reported in The Scotsman, asks for replies by 30 April. It is clearly a consultative document, and we are asking for opinions from all concerned. I am sure that we shall get sensible opinions and achieve a more efficient Health Service at the end of the day.
    Mr. Ancram: Does my hon. Friend agree that there are too many administrators and paper-pushers in the National Health Service in Scotland? Will he confirm that he is taking steps to restore the balance between administrators and medically qualified staff, to the benefit of the patients, for whom the Service is there?
    Mr. Fairgrieve: I hope that that fact will come out in the observations that I receive. Our intention is to get the effort to the sharp end of the Service, and that is why we have suggested, for example, that those concerned look at the role of districts and health councils.
    Mr. John Home Robertson: Can the Minister recall who was responsible for the reorganisation of the Health Service which is coming in for so much criticism?
    Mr. Fairgrieve: I must inform the hon. Gentleman that there was no reorganisation in Scotland of the type that he is suggesting.
    Mr. Peter Fraser: Is the Minister aware that the waiting list for orthopaedic patients in Scotland, which dramatically increased during the industrial troubles of last winter, has not yet been seriously reduced? In any reorganisation of the National Health Service in Scotland, will he do all that he can to ensure that the effort is directed to making sure that people with painful conditions get the treatment that they need?
    Mr. Fairgrieve: Regrettably, I accept that that is the position, and we shall do everything that we can to prevent its occurring again.
    Mr. George Robertson: Is the Minister aware that although his consultative document was published last Tuesday the first sight that hon. Members had of it was when 25 copies were placed in the Library last Friday afternoon? The
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    Vote Office still has no supplies of that document available for hon. Members, and I checked on that before I came into the Chamber. Does the hon. Gentleman agree that that is scandalous? When will the Government decide to run the country through Parliament and not through press releases in Edinburgh?
    Mr. Fairgrieve: The adjective "scandalous" should be applied to more serious matters. My Department regrets very much that these 25 copies were not in the Library sooner, and I shall take steps to see that that sort of thing does not happen again. However, there is no question of a consultative document of that nature being put in the Vote Office.

    Fishing Industry
    Mr. Sproatasked the Secretary of State for Scotland if he will make a statement on the current situation in the fishing industry.
    Mr. Younger: I am aware that the fishing industry faces many problems as a result of rising costs and the decline in many of the more important fish stocks. The current uncertainties in the industry can best be removed by a satisfactory settlement of the common fisheries policy and the Government are working urgently to that end.
    Mr. Sproat: Does my right hon. Friend accept that Aberdeen should be treated in the same way as Hull, Grimsby and Fleetwood, which last year were given £l·2 million? Will he confirm that those three ports have now put in for further aid and that it would be monstrous if they received two grants of aid and Aberdeen received none?
    Mr. Younger: I shall certainly look into the matter. As my hon. Friend knows, the district council and the Aberdeen Fishing Vessel Owners Association have made a preliminary request for aid, and I understand that they are following that up with a memorandum. I assure my hon. Friend that I shall consider that memorandum most urgently when I receive it.
    Mr. Robert Hughes: When did the right hon. Gentleman abandon the Government's policy that industries must sustain themselves without subsidy?
    Mr. Younger: I am not certain what the hon. Gentleman is referring to, but the Government have abandoned no policies.
    Mr. John MacKay: Does my right hon. Friend realise that fishermen on the Clyde have conserved their fish stocks, especially herring, very well over the years, and that any policy for the future must protect them against non-local fishermen, whether they be foreigners or fishermen from elsewhere in the United Kingdom?
    Mr. Younger: My hon. Friend will not be surprised to hear that I share his admiration for the way in which the Clyde fishermen have controlled a difficult situation over recent years. I assure him that any common fisheries policy will take into account their interests and those of other Scottish fishermen.

    Rates
    Mr. Dempseyasked the Secretary of State for Scotland whether he proposes to seek powers to negotiate the levels of local rates levied by local authorities; and if he will make a statement.
    The Under-Secretary of State for Scotland (Mr. Malcolm Rifkind): My right hon. Friend does not propose to seek new powers of this kind, but I shall be consulting the Convention of Scottish Local Authorities about certain aspects of the present rate support system. My right hon. Friend will then reach a view on the need for change in his powers relating to grants to local authorities.
    Mr. Dempsey: Is the Minister aware that I hope that when he consults the local authorities he will bear in mind that the Conservative Party issued a manifesto pledging the implementation of certain policies? As the Government are responsible for the prudent handling of finances, is he further aware that I hope that there will be no interference with local authorities in the performance of their traditional function?
    Mr. Rifkind: The hon. Gentleman is correct in that local authorities have their obligations, but in Scotland the Government provide over 68 per cent. of their expenditure and therefore have a prime obligation to ensure a proper level of support for those authorities.
    Mr. Bill Walker: Will my right hon. Friend bear in mind that one difficulty is that local authorities that were well behaved under the previous Labour Administration and adhered to the guidelines are now facing the greatest difficulties?
    Mr. Rifkind: The Government have kept that in mind for the rate support grant for next year in order to assist prudent authorities and to discourage those who might otherwise be profligate. The ratio of needs to resources in the rate support grant has been changed to assist those authorities which are prudent and which intend to continue to be prudent.
    Mr. Ron Brown: Will the hon. Gentleman explain why he is trying to govern Scotland by press handouts? Under the powers of local government, could not he have made a statement to the House? Will he confirm that concurrent functions and not the boundaries are under review?
    Mr. Rifkind: My right hon. Friend the Secretary of State has made clear that the review of local government in Scotland is not a comprehensive one. Any recommendations of the review committee have to be consistent with the viability of existing regional and district councils. After several years of experience of the new system there is widespread agreement among the local authorities that it will be useful to consider the detailed changes that might be appropriate at this time.
    Mr. Allan Stewart: Does my hon. Friend agree that the previous Government fixed the rate of industrial rating in Scotland at 15 per cent. on the then reasonable assumption that there would be revaluations on both sides of the border? As there has been a revaluation only in Scotland, which has moved the burden of rates towards industry, does he agree that the figure should now be reconsidered?
    Mr. Rifkind: I am happy to assure my hon. Friend that the provision for industrial derating, which was originally a temporary measure, will, as a result of the provisions of the recently published Local Government Finance Bill, be permanently established. That will be of assistance to industry in Scotland and it will ensure that its rate burden is not significantly different from that south of the border.
    Mr. Milian: Is it not clear that, with the present accelerating rate of inflation, and with the Government cheating on the cash limits by refusing to pay their fair share of the costs of that inflation, rents next year in Scotland will go through the roof?
    Mr. Rifkind: I am astonished that the right hon. Gentleman, of all people, should complain about the cash limits that have been set for next year. He was responsible for suggesting to local authorities that wage increases this year would be a mere 5 per cent. That figure was greeted with derision by the local authorities, and rightly so. The figures set by this Government are far more realistic. If local authorities are prepared to accept the advice of the Government about the level of expenditure, there is no need for rates to soar through the roof, as the right hon. Gentleman suggests.
    Mr. Milian: Why does not the hon. Gentleman answer my question? Is it not absolutely clear from what the local authorities have said that the cash limit is quite inadequate and that most local authorities in Scotland will have great difficulty in keeping rate increases next year to below 30 per cent? Is it not the case that many of them will go beyond that figure?
    Mr. Rifkind: Any local authority that reduces its expenditure on the basis that the Government have indicated will not face the problem referred to by the right hon. Gentleman. He is correct that local authorities would have liked higher cash limits, but I have not heard representations from any local authority that the cash limits are not enormously more realistic than those set by the right hon. Gentleman in the previous Administration.

    Scottish Development Agency
    Mr. Norman Hoggasked the Secretary of State for Scotland if he will define the responsibilities of the Under-Secretary of State for Scotland, the hon. Member for Edinburgh, North (Mr. Fletcher) in relation to the Scottish Development Agency.
    Mr. Younger: The responsibilities of my hon. Friend the Under-Secretary of State concern the exercise by the Agency
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    of those statutory functions which require ministerial approval under the Scottish Development Agency Act and the guidelines.
    Mr. Hogg: The new guidelines require the SDA to refer certain investment proposals to the Under-Secretary of State. Will the right hon. Gentleman explain in what way the wisdom of his hon. Friend is greater than that of the collective wisdom of the board?
    Mr. Younger: It is not a question of greater wisdom. It is more a question of both parties playing a specific role. My hon. Friend and I have the role of checking investment above a certain level by the Agency. That is to the mutual benefit of the Agency and the Government.
    Mr. Gordon Wilson: Does the right hon. Gentleman accept that one real problem facing the Agency is the low level of regional incentives compared with those in the Republic of Ireland? In view of the fact that, so far, the Agency has displayed all the dynamism of a tortoise in relation to industrial investment in my constituency, does the right hon. Gentleman agree that urgent action is vital in view of the rising trend in unemployment?
    Mr. Younger: I am always anxious to hear suggestions on this matter from all hon. Members. Regional incentives in the areas where they are concentrated—particularly in West Central Scotland—are as high as any in Western Europe. As far as a comparison with Ireland is concerned, we have to make a careful comparison of all facets of investment. When that is done, little difference can be found.
    Mr. Sproat: Does my right hon. Friend appreciate that all sensible people in Scotland warmly welcome the firm new guidelines that have been put forward? Until he and the Government took a grip on the SDA, it showed a net return on investment of minus 14·3 per cent. under the previous Administration.
    Mr. Younger: I am grateful to my hon. Friend for his remarks. The Agency has welcomed the guidelines and believes that they will lead to an improvement.
    Mr. Harry Ewing: Is the Secretary of State aware that there is grave public concern about the way in which his hon. Friend the Under-Secretary of State has

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    interfered in the Agency's work? That public concern has been expressed in the national press by a host of bodies. Will the right hon. Gentleman give the Agency an assurance that his hon. Friend will stop interfering? Economics taught at Greenock high school are no better than those taught at any other school in Scotland.
    Mr. Younger: The hon. Gentleman is wrong in the implication of the last part of his question. Apart from the Labour Party in Scotland, nobody has suggested that my hon. Friend has done other than carry out his duties in an excellent manner. It is interesting to note that what he has done so far has been under the guidelines set by the previous Administration.

    Sir William Gray
    Mr. James Whiteasked the Secretary of State for Scotland if he will make a statement on the findings of his investigation into the source of the press leak from his office regarding his decision not to reappoint Sir William Gray as chairman of the Scottish Development Agency.
    Mr. McKelveyasked the Secretary of State for Scotland if he will make a statement on the findings of his investigation into the source of the press leak from his office regarding his decision not to reappoint Sir William Gray as chairman of the Scottish Development Agency.
    Mr. Younger: I have already made clear that there is no evidence to suggest how the decision not to reappoint Sir William Gray as chairman of the Scottish Development Agency became known to the press in advance of my announcement on Monday 3 December. I am, however, satisfied that my office was not involved.
    Mr. White: Will the Secretary of State tell the House whether he is really satisfied with that answer? It was a distasteful position for Sir William Gray to find himself in and I hope that the Secretary of State has written a letter of apology to him.
    Mr. Younger: I have written to Sir William to thank him for the work that he has done for the SDA. I am satisfied that my office was not involved in the leak. I was interested to see that the press report made that fact clear.
    Mr. McKelvey—
    Mr. Lang: Does my right hon. Friend accept that the appointment of Sir William Gray's successor, Mr. Robin Duthie, will be widely welcomed throughout Scotland, and beyond? Not only is he an extremely successful businessman operating in Scotland, but he is a man without political affiliations.
    Mr. Younger: I am grateful to my hon. Friend. I have no doubt that the general welcome for the appointment of Mr. Duthie will assist the SDA in carrying out an excellent job in the future.
    Mr. McKelvey—
    Mr.. Speaker: I should have called the hon. Member for Kilmarnock (Mr. McKelvey), and I do so now.
    Mr. McKelvey: I find the Secretary of State's answer most disappointing, and I feel that he should have discovered where the leak came from. Nevertheless, will he assure the House that he is not contemplating any more politically motivated dismissals or redundancies in Scotland? If he is contemplating such matters, will he name the people involved?
    Mr. Younger: There was no political motivation in the change. I am enjoined by the Act to make an appointment to the chairmanship of the SDA. The previous chairman's appointment had run out and I appointed the best man that I could find for the job. I am convinced that I achieved that.
    Mr. John MacKay: Despite the gnashing of teeth on the Labour Benches, does my right hon. Friend remember that the Labour Party would not find a seat for Sir William Gray on Strathclyde regional council at the time of the reorganisation? Will he hazard a guess at how many rejection slips Sir William has received from his so-called Labour Party friends?
    Mr. Foulkes: Not as many as Teddy Taylor!
    Mr. Younger: I am glad that my responsibilities do not extend to investigating the reasons why the Labour Party withdraws its support from certain Labour members. No doubt Labour members are able to answer that point better than I.
    Mr. Millan: While I have every respect for the abilities of Mr. Duthie and wish

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    him well in his new appointment, I feel that the way in which Sir William was dismissed at short notice, in conjunction with the press leak, has left a nasty taste. Will the right hon. Gentleman at least apologise for that?
    Mr. Younger: I am grateful to the right hon. Gentleman for his welcome to Mr. Duthie. It is unfortunate that the leak took place, because it gives the impression that Sir William had not done a satisfactory job. Let me state clearly that I am most grateful to him for doing an excellent job in that position for the four years that he was in office. His term of office came to an end and it was up to me to make an appointment, and I did so.
    Mr. Russell Johnston: Knowing that all this has absolutely nothing to do with politics, will the right hon. Gentleman recall his remark of a few moments ago to the effect that the Scottish Development Agency welcomed the new guidelines and, indeed, thought that they were an improvement? What would he have done if the SDA had not welcomed those guidelines?
    Mr. Younger: I should have told the House. I am glad to see that the hon. Gentleman thought that this was nothing to do with politics. At times I thought that he thought that he had nothing to do with politics either.

    CBI and TUC
    Mr. Allan Stewartasked the Secretary of state for Scotland when he plans next to meet the Scottish Confederation of British Industry and the Scottish Trades Union Congress.
    The Under-Secretary of State for Scotland (Mr. Alexander Fletcher): My right hon. Friend and I have met representatives of both bodies several times since taking office and have made it clear that we are prepared to meet both bodies at any time they wish.
    Mr. Stewart: When my hon. Friend next meets both sides of Scottish industry will he point out to them that there have been no adverse effects whatever on industry and employment in Scotland following the Chancellor of the Exchequer's courageous and correct decision to abolish exchange controls, despite the
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    hysterical, economically illiterate scare-mongering from the Opposition?
    Mr. Fletcher: Yes, Sir. I am most grateful to my hon. Friend. The decision to abolish exchange controls is likely to benefit the United Kingdom and Scottish economies, as my right hon. and learned Friend the Chancellor of the Exchequer told the House last month.
    Mr. Foulkes: Will the Minister, when he meets either of those bodies, explain why unemployment has risen by 500 in Scotland in the last month and why the underlying trend is clearly upwards? Will he also say where this trend will end? In other words, what is his high target for the unemployment that will follow from the public expenditure cuts that Scotland is experiencing?
    Mr. Fletcher: That is one point that I do not have to explain to either body. The STUC and the CBI in Scotland are fully aware that unemployment doubled under the previous Labour Government.
    Mr. Bill Walker: When he next meets the STUC will my right hon. Friend remind it that the problem in Scotland has been not the lack of investment capital but the lack of areas for that investment capital to produce profit and jobs for the future?
    Mr. Fletcher: My hon. Friend is right. There is no shortage of investment funds in Scotland, but there is a shortage of investment opportunities. Until the economy operates on a more sound basis we cannot expect opportunities to present themselves quickly.
    Mr. Harry Ewing: Is the Minister aware that his hon. Friend the Member for Renfrewshire, East (Mr. Stewart) has displayed his knowledge of the Scottish economy from A to B? When the Minister next meets the Confederation of British Industry in Scotland, will he discuss with it the statement yesterday by his hon. Friend's successor at the CBI that unemployment in Scotland next year will rise to 250,000 as a result of the Government's policies?
    Mr. Fletcher: I have not seen the statement to which the hon. Gentleman refers, but I would not disagree with the fact that next year unemployment is likely to rise throughout the United Kingdom, including Scotland. However. I am not in

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    a position to say what the figure might be.

    Council Houses (Sale)
    Mr. Dewarasked the Secretary of State for Scotland what representations he has received from community groups, tenants' associations and other bodies supporting the sale of council houses.
    Mr. Rifkind: We have received large numbers of letters from individuals who support sales and who wish to buy their own homes. Very few representations have been received from organisations expressing views, whether favourable or otherwise, on the sale of council houses.
    Mr. Dewar: Will the Minister accept that very few of those letters will come from areas such as Glasgow, Garscadden, where there is widespread fear and dismay about the effects of the sale of council houses? Is the Minister aware that most of my constituents expect that any sales will be in the more popular areas of Glasgow, which will reduce social mobility by ensuring that those who do not already live in those areas will have no chance of moving there to a house of their choice? In view of that, will the Minister look again at the inflexible and dogmatic way in which he approaches this problem?
    Mr. Rifkind: The letters that have been received from individuals have included approximately 200 in favour and 10 to 15 against the Government's policy. I would also say to the hon. Gentleman that all tenants in Scotland will have the right to buy their homes. I am convinced that tenants in the hon. Gentleman's constituency, when they realise the generous discounts available, will take the opportunity to buy their own homes, in the same way as tenants are doing throughout Scotland.
    Mr. David Steel: Will the Minister confirm that he has had representations from the housing authorities in Tweed-dale, and Ettrick and Lauderdale district councils, and presumably elsewhere in Scotland, pointing out that his inflexible formula will be disastrous in the rural areas? Does he agree that these representations are more to the point than letters from individuals?
    Mr. Rifkind: The Government do not accept that any of the proposals in the
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    Tenant's Rights Etc. (Scotland) Bill will be disastrous in the rural areas. There is no reason why council tenants living in rural areas should not have the same rights as those in urban areas. We believe that we should ensure that this fundamental freedom is available to all Scottish tenants.
    Mr. Peter Fraser: Can my hon. Friend indicate, from the sales of council houses that have already been achieved since his order went out to local authorities, what finance has been required by those tenants buying their houses from local authorities and what proportion has been self-financed?
    Mr. Rifkind: It is already clear that this year more council houses will have been sold to tenants than in any other year in Scottish history. We are pleased to see that a substantial proportion of tenants have been able to finance the purchase of their own homes other than through local authority mortgages. My hon. Friend may be interested to know that the building societies have informed us that 25 per cent. of their depositors are council tenants. The building societies are therefore clearly able to help council tenants as well as other owner-occupiers.
    Mr. George Robertson: On a previous occasion the Minister said that the purpose of the Government's legislation on the sale of council houses was to extend a new human right to council house tenants. What does he say to families living in high rise flats who will see their chances of ever getting out of those flats and moving into other areas compromised by the Government's proposals? What sorts of human rights will those people have in future?
    Mr. Rifkind: The hon. Gentleman must accept that the very tenants to whom he refers have found that even without this right to buy they have been unable to move to an area of their choice for many years. What we are saying to these tenants is that they will now have the right to buy and at least have something to show for the many years during which they pay rent.

    Scottish Development Agency
    Mr. James Hamiltonasked the Secretary of State for Scotland when next

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    he will meet the chairman of the Scottish Development Agency.
    Mr. Younger: My hon. Friend with responsibility for industry and education and I have already had preliminary meetings with Mr. Duthie and expect to meet him regularly in the future.
    Mr. Hamilton: Many of us on the Opposition Benches congratulate the new chairman and wish him well in his difficult task. Will the right hon. Gentleman tell the new chairman that the visit to America of the Under-Secretary of State was a disaster, according to reports in the press? The hon. Gentleman played down the work of the Scottish Development Agency, which did not do it a service. In view of the new Government guidelines, will the right hon. Gentleman give us an assurance that the Under-Secretary will not be breathing down the neck of the chairman and the board, and will allow the Agency to get on with the work of rejuvenating Scottish industry?
    Mr. Younger: I am grateful to the hon. Gentleman for his good wishes to Mr. Duthie. My hon. Friend's visit to America was an outstanding success. He met a number of important firms with investment opportunities in Scotland. I assure the hon. Gentleman that my hon. Friend will, as before, carry out his duties with strict regard to what he is entitled to do by statute.
    Mr. Ancram: Can my right hon. Friend confirm with the new chairman that under the new investment guidelines the SDA will no longer be able to subsidise inefficiency or promote subsidised unfair competition as in the past?
    Mr. Younger: My hon. Friend can be assured that the new guidelines make it clear that the Agency's investment functions will be much more likely to be efficiently managed with technical skill in investment matters, which will ensure what my hon. Friend has suggested in his question.
    Mr. Campbell-Savours: Will the Secretary of State accept that the SDA has been a glorious success in its ability to attract jobs and industry to Scotland? Does he agree that Scotland now has a major advantage, as against the Northern region, in its ability to attract jobs and industry for the future? Will the right
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    hon. Gentleman try to sell the idea of a development agency for the Northern region to the Secretary of State for Industry?
    Mr. Younger: That is a matter that the hon. Gentleman must take up with my right hon. Friend the Secretary of State for Industry. I agree that the Scottish Development Agency and those who work in it are doing a good job. The functions that were inherited from several bodies that have been in business for a long time in Scotland have been carried out extremely efficiently. I and my hon. Friend will give the Agency our support to do an even better job in future.
    Mr. Knoxasked the Secretary of State for Scotland how many new factory units have been built by the Scottish Development Agency since its inception.
    Mr. Alexander Fletcher: Since it was set up in December 1975 the Scottish Development Agency has completed a total of 177 factory units providing some 2·5 million sq ft of factory space.
    Mr. Knox: Can my hon. Friend tell us how many of these units have been sold? Has he given the SDA any guidance about whether its attitude to such sales should be active or passive?
    Mr. Fletcher: I am not aware of how many units have been sold. I believe that the majority of this accommodation is rented. I agree with my hon. Friend that it would be in the public interest if more sales of these factories could be to their occupants.
    Mr. Dewar: Will the Minister impress upon the Scottish Development Agency the importance of looking at existing industrial sites for factories? Has he had any discussions with the SDA about the Singer site at Clydebank? What progress has been made with the Government's plans for some sort of rescue operation in that hard-hit area?
    Mr. Fletcher: My right hon. Friend and I have asked the Scottish Economic Planning Department, in conjunction with the SDA and the local authorities, to prepare a working plan for the Clydebank area. We hope that the findings of the group on this project will be available shortly.
    Mr. Budgen: When my hon. Friend next sees the officers of the SDA will he remind them that in all their work, whether it is building factory units or otherwise, they should stick to the tight guidelines that have properly been imposed upon them? Will he remind them that there are wider implications than the purely Scottish one, in that they are spending money from the taxpayers of the whole of the United Kingdom, and one of their objectives is to take jobs and investment away from places such as Wolverhampton, which was once prosperous?
    Mr. Fletcher: As my right hon. Friend said, the SDA has accepted the new guidelines that we have presented to it. We have every confidence that it will cooperate with us in making sure that the guidelines are carried through successfully.

    Assisted Places Scheme
    Mr. Foulkesasked the Secretary of State for Scotland what representations he has received regarding the Government's assisted places scheme as it affects Scotland.
    Mr. Alexander Fletcher: About 25 letters have been received about the proposal, mainly from parents who are interested in the scheme.
    Mr. Foulkes: Does the Minister agree that because of the distorted geographical distribution of the schools—most of them being in the East of Scotland, and nearly 40 per cent. of the places being in Edinburgh—the taxpayers of the West of Scotland, including Ayrshire, will effectively be subsidising the privileged education of the petty bourgeoisie of the city of Edinburgh? What will he do to alter this position?
    Mr. Fletcher: The hon. Member has certainly changed his coat since he had to flee from Edinburgh politics a few months ago. I take the point that traditionally the distribution of schools is not as good as it might be. We hope that as the scheme comes into being there will be further opportunities for schools in other parts of Scotland to take advantage of it and provide a better choice for parents.
    Mr. Donald Stewart: Does the Minister accept that if anyone wishes to set
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    up a private school and fund it 100 per cent. from his own resources it would be a denial of democracy to stop him from doing so? However, does he further accept that the types of schools that have been discussed are half State and half private, and therefore the State part is robbery from the public purse?
    Mr. Fletcher: I do not agree with the right hon. Gentleman's last point. I am glad that he accepts the point that, just as people should be free to set up independent schools if they wish, so parents should be free, regardless of their means, to take the opportunity to send their children to these schools if they wish to do so.
    Mr. Sproat: Does my hon. Friend agree that what we have just heard from the Opposition Benches, particularly from the hon. Member for South Ayrshire (Mr. Foulkes), is a grotesque misrepresentation of the purpose of the scheme? Is it not clear that the hon. Member has not even read the opening sentence of the document, which says quite clearly that the objective of the scheme is to provide an option for able children from lower income families?
    Mr. Fletcher: My hon. Friend is absolutely correct. So many Labour Members are annoyed by the fact that the whole object of the scheme is to help lower income families—the very people whom they always claim to look after.
    Mr. Canavan: If it is the declared intention of the Tory Government to cut out all non-essential public expenditure, what possible justification is there for taking away meals, milk and transport from the 95 per cent. of children who attend State schools in order to give an extra £60 million a year to the privileged, private fee-paying schools, which cater for a minority of the population? Will the Minister give us an assurance that before he comes to an ultimate decision on this matter it will be debated adequately on the Floor of the House?
    Mr. Fletcher: It is a great pity that the hon. Member for West Stirlingshire (Mr. Canavan) is unable to get to his feet in this House without grossly exaggerating his points. We are not taking meals and transport away from children in the State sector. We are allowing the local authorities greater discretion.
    Mr. Lang: Is it not astonishing that Labour Members, so many of whom have had privileged education, are now so anxious to kick away the ladder which children from under-privileged homes might have the opportunity to climb?
    Mr. Fletcher: My hon. Friend is absolutely right.
    Mr. Harry Ewing: Is the Minister aware that when the Labour Party returns to power we shall immediately abolish this scheme? Will he make that clear when he is having discussions on the matter? Is he further aware that his assisted places scheme has no supporters whatsoever in the educational world in Scotland? Will he give every child in Scotland the best possible Christmas present by resigning before he ruins Scottish education?
    Mr. Fletcher: The hon. Member makes abundantly clear the well-known fact that under Labour Governments the less well-off people in this country are always worse off.

    Devolution
    Mr. Grimondasked the Secretary of State for Scotland when he expects the all-party talks about the government of Scotland to conclude.
    Mr. Younger: We received only this week the last of the replies from the other parties. We hope that it will be possible to establish talks at any rate with some of the parties early in the New Year. It is too soon to forecast when they will end.
    Mr. Grimond: Does that reply mean that there is still no agreement, even about the agenda? If there is such an agreement, does it include the prospect of a directly elected Assembly?
    Mr. Younger: I understand from the replies received that most of the other parties are prepared to undertake talks, but on certain conditions. On the question of a Scottish Assembly, I made it clear in the debate on the repeal order on 20 June that as this matter had been thoroughly thrashed out over two or three years in the House, and had been put to the Scottish people in a referendum, it was not something that people would thank us for going over again and again.
    Mr. Michael Martin: Is the Secretary of State aware that local authority housing contracts have been held up by the SDD? Will he give us an assurance that the Government are not using the SDD to delay housing contracts and modernisation contracts submitted by the Scottish Special Housing Association, such as those in the Balornock and Robroyston area? Will he also give an assurance that he will investigate whether this delay has taken place?
    Mr. Younger: That is another question, but I assure the hon. Member that no such thing is taking place.
    Mr. Allan Stewart: Does my right hon. Friend agree that many people in Scotland are delighted that so-called devolution, as generally defined on the Labour Benches, is now effectively dead?
    Mr. Younger: I am grateful to my hon. Friend for his remarks, but I hope that he will agree with me that there is still scope for trying to improve the way in which Scottish business is handled in this House. I hope that we can have talks about it.
    Mr. Gordon Wilson: In view of the assurances that were given by Lord Home of the Hirsel during the debate on the referendum about the Conservative Party's proposals for devolution, will the Secretary of State comment on the contrast between the Government's policy of offering Northern Ireland full legislative and executive self-government, including industrial powers, which were not on offer previously, and the paltry talks that are now on offer for the reformation of government in Scotland?
    Mr. Younger: I am not surprised that the Scottish National Party is not prepared to take part in these talks, because its objective is the separation of Scotland from the rest of the United Kingdom. Perhaps I should remind the hon. Member that Northern Ireland is Northern Ireland and Scotland is Scotland. We want to do it our way.
    Mr. Millan: Is it not clear that now that the Government have been flushed out by being asked to provide an agenda for the all-party talks they have abandoned even their phoney commitment to devolution? Is it not a fact that there is nothing in the suggested agenda that

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    has anything to do with devolution? All that the Government want to talk about now is the management of Scottish parliamentary business. Why was yesterday's meeting postponed, and will it take place later this week?
    Mr. Younger: On the last point, I certainly hope to have a meeting as soon as it can be arranged. There have been a number of difficulties in getting all the parties concerned together. On the first point, I agree with what the right hon. Gentleman indicated, namely, that there is scope for discussing how we can improve the conduct of Scottish parliamentary business. That is a desirable end for its own sake. The right hon. Member must accept that after all we have been through in the past three years it is not on to start talking about the whole subject of devolution again.

    Council Houses (Sale)
    Mr. George Robertsonasked the Secretary of State for Scotland what are the likely sources of finance for mortgages for the sale of local authority housing, and how much will be available from each source.
    Mr. Rifkind: All prospective purchasers will be expected to seek finance for sales from private sources in the first instance. As the explanatory and financial memorandum relating to the Tenants' Rights Etc. (Scotland) Bill indicates, we have estimated that 30 per cent. of the finance will be drawn from tenants' existing resources or provided by building societies and other private lending institutions, leaving 70 per cent. to be provided through loans from housing authorities.
    Mr. Robertson: The explanatory and financial memorandum to the Bill merely deals with one of the financial aspects of the sale of council houses. Can we expect from the Scottish Office the commitment to provide a long-term assessment of the financial consequences to local authorities as well as to central Government that has been promised by the Secretary of State for the Environment? Are we likely to receive that assessment in sufficient time to enable that most important aspect of the sale of council houses to be considered on Second Reading?
    Mr. Rifkind: We intend to provide the Government's assessment of the financial consequences to assist Members when the Bill is being considered.

    SHERIFFS PRINCIPAL
    Mr. Pollockasked the Solicitor-General for Scotland whether he has any plans to meet the sheriffs principal.
    The Solicitor-General for Scotland (Mr. Nicholas Fairbairn): I do not have any plans at present to meet the sheriffs principal, but my right hon. and noble Friend the Lord Advocate and I have meetings with them from time to time.
    Mr. Pollock: When my hon. and learned Friend next has such a meeting, will he discuss with them the options at present available to children's panels for the disposal of cases coming before them? Will he especially consider the wisdom of introducing another option for disposal, namely, financial reparation from the child involved or, more importantly, from its parents?
    The Solicitor-General for Scotland: Any improvement that we can make in the effectiveness of children's panels is something that I am sure both sides of the House would wish to achieve. To that end I am visiting a children's panel hearing at 9.15 am on Friday.
    Mr. Maxton: When the Solicitor-General meets the sheriffs principal, will he discuss with them the new Criminal Justice (Scotland) Bill that has been published today? Will he inform them of the timetable that he expects for the Bill in both this House and the other place during the next few months, and when he finally expects it to become part of our statute law?
    The Solicitor-General for Scotland: Yes.

    PROCURATOR FISCAL (PERTH)
    Mr. Bill Walkerasked the Solicitor-General for Scotland when next he plans to meet the Procurator Fiscal of Perth and Kinross district.
    The Solicitor-General for Scotland: I last visited the office of the Procurator Fiscal in Perth on 11 September, and I

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    intend to do so again early in the new year.
    Mr. Walker: When my hon. and learned Friend calls on the Procurator Fiscal in Perth in the new year, will he draw his attention to the concern felt by anglers and fishing clubs in the area about illegal poaching of salmon, especially about the use of materials that are explosive and poisonous? When my hon. and learned Friend is in court, will he draw attention to the maxium penalties that are available to the courts when prosecutions are carried out?
    The Solicitor-General for Scotland: I am aware of the problem of poaching and of the inadequacy of the penalties. That is not the only fish that I would he anxious to fry.

    SCOTTISH LAW COMMISSION
    Mr. Canavanasked the Solicitor-General for Scotland when he expects to meet the Scottish Law Commission.
    The Solicitor-General for Scotland: My right hon. and noble Friend the Lord Advocate visited the Scottish Law Commission on 15 October, and further meetings will be held as and when necessary.
    Mr. Canavan: Will the Solicitor-General discuss with the Commission the enormous legal complexities created by the Tory Government's policy of treating Scottish legislation as a minor intrusion into United Kingdom Bills, such as the Education (No. 2) Bill and the Local Government Planning and Land Bill? Will he give an assurance that he will make a personal contribution at some stage in the proceedings on the Education (No. 2) Bill to explain his learned views on his Government's unlearned policy of depriving children of their legal right to school meals, milk and transport, which will affect the living standards of children in Kinross and West Perthshire as well as in the rest of Scotland?
    The Solicitor-General for Scotland: As it is Christmas I am sure that I can make a bargain with the hon. Gentleman. I am willing to make my learned views known to the Committee considering the Education (No. 2) Bill in the proportion that he is willing to restrict his ignorant views. I am
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    sure that all Members of the House would be grateful if the hon. Gentleman would make the solemn and supreme sacrifice of forgoing sustenance himself so that the rest of the population could benefit from his abstinence.
    Mr. David Steel: When the Solicitor-General next meets the Law Commission, will he ascertain from it—if he already knows will he tell us—how it is progressing in its work of giving effect to financial settlements in divorce cases, which he knows causes a great deal of unhappiness to those in Scotland? As the matter has been under consideration for a long time, when may we see the result?
    The Solicitor-General for Scotland: It is an important matter, and the Law Commission has been working on it. It is an extremely complex issue and I regret that all the difficulties attendant upon the tragedy of human separation have not yet been solved satisfactorily by any country. If anyone can make suggestions towards a solution, I am sure that that would be welcomed by both sides of the House.
    Mr. Harry Ewing: I return to the serious issue raised by my hon. Friend the Member for West Stirlingshire (Mr. Canavan). Will the Solicitor-General discuss with the Law Commission the new practice of the Government's inserting Scottish clauses—basically Scottish legislation—into United Kingdom Bills? Is the Solicitor-General in favour of such a practice? Will he give us the benefit of his views?
    The Solicitor-General for Scotland: Even at Christmas, it is nice to see a sinner come to repentance. I do not recollect many Bills for which the hon. Member was responsible that did not have the same characteristics. It is a difficult matter. It would be nice to have separate legislation, but it is not practicable, and in any circumstance in which it is contradictory it will not be done.

    VANDALISM
    Mr. Dewarasked the Solicitor-General for Scotland what is his estimate of the impact on numbers of Crown Office staff and the Procurator Fiscal Service of the introduction of a new offence of vandalism.
    The Solicitor-General for Scotland: In the event of a new offence of vandalism

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    being created, it would not be expected to affect the numbers of staff in the Crown Office or in the Procurator Fiscal Service.
    Mr. Dewar: Will the Solicitor-General accept that there will be some dismay among the many people who see the new offence of vandalism surviving as clause 75 of the Criminal Justice (Scotland) Bill that was published today? Many feel that it is a totally redundant piece of cosmetic window-dressing. Any offence that could be envisaged could be covered by existing offences such as malicious mischief and breach of the peace. Is the hon. and learned Gentleman aware that it is a nasty example of the Conservative Government trying to give the impression that they are doing something about crime when they are merely putting on the statute book a piece of useless lumber?
    The Solicitor-General for Scotland: That is one of the many matters in the Criminal Justice (Scotland) Bill that will be greatly welcomed. I wish that the hon. Member for Glasgow, Garscadden (Mr. Dewar) would not continue to purvey dismay. Resentment at all attempts to prevent the hideousness of crime is anything but desirable.
    Mr. Sproat: As it is now estimated that vandalism is costing the country about £200 million a year, and as it inspires terror and misery, especially among the elderly, will my hon. and learned Friend accept that anything that the new Bill does to reduce vandalism will be widely welcomed throughout Scotland.
    The Solicitor-General for Scotland: I am grateful to my hon. Friend. Vandalism is one of the most pernicious sores in our society, because it is so unlikely to be detected. Anything that can contribute to its eradication will, I am sure, be welcomed, even by those who vote Labour.
    Mr. Hugh D. Brown: Will the Solicitor-General apply his common sense, rather than his legal knowledge, and admit that the Government's policy of securing cutbacks in libraries, museums, leisure and recreation services will hardly reduce vandalism?
    The Solicitor-General for Scotland: Probably the worst vandalism to occur for some time was the encouragement given by Labour Members to think that we were entitled to live beyond our means with money that we did not have.
    Mr. Harry Ewing: If the Solicitor-General is so concerned about detecting crimes of vandalism—we all have that concern—will he indicate how many acts of vandalism will be detected in future merely because the offence is called vandalism, as distinct from malicious mischief?
    The Solicitor-General for Scotland: As the hon. Gentleman knows, there is more to crime than the mere detection of it. There is also the deterrence of it. If people are made conscious in public of the opprobrium that attaches to vandalism and the penalties that attach to it, they are infinitely less likely to commit it.

RHODESIA (BINGHAM REPORT)
The Attorney-General (Sir Michael Havers): With permission Mr. Speaker, I should like to make a statement.
In 1978 the then Secretary of State for Foreign and Commonwealth Affairs referred the Bingham report to the Director of Public Prosecutions to consider whether further inquiries should be undertaken with a view to possible criminal proceedings for breaches of the Southern Rhodesia sanctions order. Shortly thereafter leading and junior counsel were instructed by the Director to advise him whether, in the circumstances disclosed by the report, criminal offences appeared to have been committed and, if so, by whom. It will be appreciated that the Bingham inquiry was neither a police investigation nor a trial, and it was not, therefore, conducted within the constraints of the rules of evidence or procedure applicable in a court of law.
In February 1968, and again in February 1969, meetings took place between Her Majesty's Government and senior officers of Shell and BP. The outcome of those meetings—described extensively in the Bingham report—appeared to have been interpreted by the oil companies, rightly or wrongly, as giving them tacit, if not express, approval to operate what has become known as the "exchange" scheme, whereby oil and petroleum reached Southern Rhodesia. It was by no means clear whether and, if so, for precisely what length of time, the so-called "exchange" scheme was operated thereafter.
Against this background, the Director appreciated that much more factual information and research into the legal problems were required in order to particular rise offences, to identfy the principal persons acting on behalf of the oil companies and to collect the admissible evidence. Accordingly, a team of senior police officers was instructed to make further detailed inquiries, while counsel continued to review the material already available.
Steps were taken in April 1979 under schedule 1 to the 1968 sanctions order to require the oil companies to produce all the relevant documents in their possession or under their control.
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It seems that there are over 20,000 files, of which at least 14,000are likely to be relevant. Bearing in mind the substantial amount of time and public money likely to be involved in analysing this mass of paper and investigating the evidentiary material available overseas, counsey were asked to give the DPP further advice. By the beginning of November 1979, in an opinion running to almost 50 pages, counsel advised the DPP of the great difficulties in the way of a successful prosecution.
The Director had to consider the following matters:

(1) The material disclosed by the Bingham investigation was wholly insufficient for the purposes of a criminal trial. Direct evidence by witnesses or from proved documents would be needed.

(2) There was abundant material in the report which showed that, in the period following the meetings in 1968 and 1969, oil and petroleum products had been supplied direct by railway wagon to Southern Rhodesia. The question which arose in an acute form, however, was whether it could be proved by the strict rules of evidence applied in the criminal courts of this country:

(a) which companies had in fact made these supplies;

(b) who, if any, among the officers, agents or employees of the companies during the relevant period were knowing parties to such supply.

It was also necessary to seek to determine whether these supplies had been made in contravention of the alleged "understanding" with Her Majesty's Government.
(3) Furthermore, it was material to have regard to the fact—emphasised in the Bingham report—that many of the companies and their officials were subject to the laws of States deeply hostile to the sanctions policy and were liable to penalties for any refusal or failure to supply oil on demand. There is no power to compel the attendance of witnesses from abroad.
The available material disclosed—and, indeed, the Bingham report investigation found—that many of the principal officials concerned in the contraventions of

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the sanctions orders were not amenable to our jurisdiction. Some who appear to have been at the very centre of the operations had since died and others had retired. It was likely to prove difficult in the extreme to establish the complicity and knowledge of their successors.
Whilst the prosecution might confine criminal charges to the years 1971–77,the defence would investigate the entire history of events from 1966 onwards. Those events would cast their shadow over the whole case and this important factor would have a serious bearing on its outcome. Counsel were of the opinion that a jury might well be reluctant to convict if there appeared to be substance in the defence that those charged had acted in the belief that their conduct had the express or ostensible consent of the authorities.
Finally, it was apparent that as complex and prolonged an investigation as this would probably not reach the stage of a jury's trial in less than four years from now, particularly as the defence would be entitled to require full committal for trial proceedings and strict proof of the essential ingredients of the offences. Also, the trial itself might occupy a jury for as long as 12 months, with all the risks that attend such an extended hearing.
The Director has therefore reached the conclusion that further investigation and public expenditure would not be justified and the matter should proceed no further. I agree.
Mr. Russell Kerr: You want to pack it in, Michael.
Mr. John Morris: I am sure that the whole House, and the Opposition especially, will want to study with great care the important statement made by the Attorney-General. The right hon. and learned Gentleman is dealing with a matter of grave concern not only to the United Kingdom but to countries abroad, and to all those who have been concerned with clear breaches of law in this country. It is a matter of grave importance for those who are concerned with the rule of law—be it in our domestic matters or in international matters, and in the matters contained in the statement especially—that on the advice tendered to the Attorney-General it appears that we cannot now deal with these matters in the
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proper way, which is in the courts. That is a matter of regret. Against that background we shall want further time to consider the issue.
How many companies and individuals have been prosecuted so far for breaches of sanctions, and what have been the penalties imposed? It there not a danger, as is manifest in the conclusions to which the right hon. and learned Gentleman has come, that the minnows have been dealt with and that it is not possible, for whatever reason, to deal with the big fish? Will the right hon. and learned Gentleman recall that the House resolved that there should be an inquiry into the whole affair and that a contrary view was taken by another place? What is the Government's view about a further inquiry?
The Attorney-General: I hope that the right hon. and learned Gentleman will forgive me when I say that I do not have with me the details of the other prosecutions. However, details have been given in a number of written answers in response to questions put to me by some of his hon. Friends. An inquiry is a matter for my right hon. Friends. I am unable to give the House any information.
Mr. David Steel: Is the Attorney-General aware that he has made an extraordinary statement? Surely the impression that he is leaving with the House is that justice and truth are commodities that we can no longer afford. That is not good enough. The Government have had months to consider this matter. That consideration has not been confined to the right hon. and learned Gentleman's ministerial responsibility. There was a debate and a free vote in the House in February. The other place disagreed with this place, but that is not an excuse for dropping the matter.
Is the right hon. and learned Gentleman aware that the whole table reflects sadly on the political and business ethics of this country? The matter cannot be allowed to drop because of legal technicalities. If the Government have come to the conclusion that they should close the book on the whole sorry subject, let that be proclaimed as their political decision, and let it not be clouded by legal technicalities.
The Attorney-General: The right hon. Gentleman has failed to appreciate the distinction. This is not a Government

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decision; it is a decision of the Director of Public Prosecutions, acting within his proper duties. An inquiry, as I have said, is a matter for my right hon. Friends. The right hon. Gentleman says that the Government have had months to consider the matter. That is not so. Counsel's opinion was delivered to the Director of Public Prosecutions only at the beginning, or in the first week or so, of last month. Thereafter, he, in discussions with me, reached his conclusion. It is not fair to say that the Government should be in a position today, when I have just made this statement, to give a firm commitment, one way or the other, about an inquiry.
Mr. Maxwell-Hyslop: If I heard my right hon. and learned Friend aright, the Director of Public Prosecutions has enunciated what I understand to be an entirely new principle, namely, that if a malefactor has retired he is now to be immune from prosecution. The Attorney-General referred to people who "had died or retired".
I understand that people who are dead cannot be prosecuted, but is the same doctrine to apply to burglars if they have retired? This is a serious point. If retirement confers immunity from prosecution, is this to be a precedent across the whole field of criminal law?
The Attorney-General: I regret that my hon. Friend should treat what I consider a very serious matter in such a light-hearted manner. [HON. MEMBERS: "Oh." When he reads my statement, I think that he will understand that the major problem is that many individuals are simply not within the jurisdiction and some of the others have died.
Mr. Jeffrey Thomas: I join forces, for once, with the hon. Member for Tiverton (Mr. Maxwell-Hyslop), whose remarks go to the root of the problem and to the root of our fears on the Opposition side of the House. The rule of law is indivisible. The rule of law applies as much in this country as it does overseas. It is wrong for the Government party to be seen to be paying mere lip service to the rule of law.
Will the Attorney-General tell the House, for instance, what are the extraordinary factors that mean that this trial
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could not be reached for something like four years? Will he also now publish the names of those persons listed in the Bingham report and the schedules thereto who, in the opinion of the authors, were vulnerable to criminal prosecution—both persons and companies?
The Attorney-General: The hon. and learned Gentleman asks why the matter would take four years. A huge amount of investigation would be necessary. Let us take, for example, Shell Mocambique. If one were to try to prove the movement of particular wagons of oil from Mozambique to Rhodesia it would be necessary to have the freight tickets and perhaps necessary to call some of the railwaymen. There is no power to enforce either the production of those documents or the attendance of those witnesses. I did tell the House in my statement that as a result of a request of the Director in April this year 14,000 files were obtained from the two oil companies. We are told that the number of documents in those files probably exceed a quarter of a million papers. All would have to be looked at.
Any lawyer in this House knows that the prosecution could not possibly go into court without having to consider, with a large team of lawyers and police officers, every one of those quarter of a million documents. It would simply not be right not to do that. That is only one of the grounds. I remind the House that the reasons that prompted the Director to come to the conclusion that he reached were the well known and recognised procedures involving the public interest aspect in prosecutions.
Mr. Gordon Wilson: Coming on the heels of the Blunt affair, many people in the House now believe that had President Nixon been Head of State in the United Kingdom and shielded by the establishment here, he would have got off scot-free. Bearing in mind the honourable role played by the courts in that affair, will the Attorney-General say whether he has consulted the Lord Advocate on the subject?
If the Attorney-General is not prepared to accept responsibility in England for offences committed against the United Kingdom as a whole, will he ask the Lord Advocate in Scotland, where court proceedings are generally shorter, if he will undertake this investigation?
The Attorney-General: These matters were referred by the then Foreign and Commonwealth Secretary to the Director of Public Prosecutions. It is, therefore, a decision for the Director to take. He has taken it and, as I have told the House, I agree with him.
Mr. Stokes: Cannot there be a sense of realism in this matter? Is this report not out of date and superseded by events? Is not criticism of those concerned, who acted on political direction, futile humbug?
The Attorney-General: There is no doubt that one of the matters that the Director would have to consider, as in every prosecution, is how old the offences, if they can be proved, are. There is no doubt here that some of the matters that might be the subject of prosecution go back more than 10 years.
Dr. Bray: In considering the need for further inquiry, will the Attorney-General and his right hon. Friends bear in mind the need to give civil servants and retired civil servants, who are named in the Bingham report and in the subsequent debate, an opportunity to clarify their own roles in the breach of sanctions? Is the right hon. and learned Gentleman aware, in particular, of the statement that I made in the debate that Mr. Angus Beckett, under-secretary of the petroleum division at the time of the breach of sanctions, was offered jobs by major oil companies on his retirement, that he was refused permission to accept them by the head of the Civil Service and that he subsequently accepted appointment to a consulting firm employed by those major oil companies from which he now enjoys a very large income? Is that an appropriate state of affairs that should be allowed to continue without explanation?
The Attorney-General: This cannot arise out of the matters referred to the Director of Public Prosecutions. Any other matter that might be relevant to the question whether an inquiry is set up will certainly be considered.
Mr. Jay: The right hon. and learned Gentleman said that the decision was that of the Director of Public Prosecutions. Surely, by saying that he agreed with that decision, the right hon. and learned Gentleman shares responsibility for it—
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or is he disclaiming any responsibility for the decision?
The Attorney-General: I hoped that I had made absolutely clear by the last two words of my statement, having said that it was the decision of the Director and adding "I agree", that I was accepting the responsibility, equally with him, and accepting my responsibility to answer in this House for his decision.
Mr. Ronald Bell: Is there to be any reward to, or recognition of, those patriotic men who, through those difficult years, sustained the true British cause, all too often against British Governments.
Mr. Russell Kerr: Honorary traitors.
Mr. Alexander W. Lyon: May I remind the Attorney-General that Bingham was a lawyer, that he mounted in his report a very considerable case of conspiracy, not only by individuals but by companies, and that he based that report on his access to the records then available? Does it not happen that in many fraud cases one cannot prosecute the full compass of the fraud but selects specific ingredients that can be proved? On that basis, the judge is able to give an appropriate sentence.
The Attorney-General: Every case depends on its own effects. Having read Bingham with care, the hon. Gentleman, as a lawyer, will recognise that it was not a report based on evidence that one could produce in a court. In the end, what happens in every case is that, with the assistance of very experienced counsel who have spent a great deal of time on the matter, one has to examine the likely availability of evidence from overseas as well as domestically. I remind the hon. Gentleman of the difficulties that Bingham said that he found in trying to get any documentation from Mozambique.
Mr. Latham: On a point of order, Mr. Speaker. I distinctly heard an Opposition Member below the Gangway call my right hon. and learned Friend the Member for Beaconsfield (Mr. Bell) an honorary traitor. Surely that cannot be in order.
Mr. Speaker: Order. If that expression was used, the hon. Gentleman concerned will no doubt rise and agree that he said it.
Mr. Latham: It was the hon. Member for Feltham and Heston (Mr. Kerr) to whom I was referring.
Mr. Russell Kerr: I am afraid that there was some confusion. There was a general suggestion that people who had furthered the cause of Rhodesia in the recent squabble should get recognition in the House. I made what I hope was the helpful suggestion that they should have the title of honorary traitors.
Mr. Speaker: Order. It is clear that the remark was not addressed to the hon. and learned Member for Beaconsfield (Mr. Bell).
Mr. Robert Hughes: Has the Attorney-General not now made it clear that under British law the bigger the crime the more chance there is of getting off? Is this not a shameful end to a shabby episode in British history? What credit does one now give to the Prime Minister's call for an economic boycott of Iran?
The Attorney-General: I am afraid that I missed the last question posed by the hon. Gentleman.
Mr. Robert Hughes: I shall repeat it. However, I should be glad if the right hon. and learned Gentleman would answer the first two questions. What credit can the world now give to the Prime Minister's call for an economic boycott of Iran?
The Attorney-General: Dealing with the last question, it must be made clear to the hon. Gentleman that this decision is remote and divorced from any decision of the Government. It is a decision by the Director of Public Prosecutions. Any comment to the contrary is a direct and totally unjustified attack upon the integrity both of counsel and of the Director, who is totally impartial in these matters.
Mr. Dobson: Will the Attorney-General, in his new role as the Santa Claus of the Establishment, cast his mind back to the time when he was talking about the Clay Cross councillors and, as reported in The Times, said that no democracy could survive when people decided to obey only laws that suited them? Does he agree that the decision at which he and the Director of Public Prosecutions have arrived is a disgrace to our system of government, to our judicial system, and to himself?
The Attorney-General: The only consequence of that comment can be that the Director of Public Prosecutions and I have acted in a political rather than an impartial way. I totally reject it.
Several Hon. Members Several Hon. Members rose—
Mr. Speaker: Order. I propose to call five more hon. Members.
Mr. S. C. Silkin: Now that the decision has been taken by the Director of Public Prosecutions, and the Attorney-General agrees with it, is it possible for the chapter in the Bingham report that was withheld from publication whilst the matter was being considered by the Director to be made available for publication?
The Attorney-General: That is a matter for my right hon. and noble Friend, to whom the report was made.
Mr. Cryer: Does the Attorney-General accept that this is a totally disgraceful episode in the Government's history? Does he further accept that people outside will now believe that there are two standards, one for ordinary folk—the Conservative Government lose no opportunity legally to attack the trade unions when it suits their book—and another for people in high places? Will he confirm the clear fact from his statement that if the crime is big enough and complicated enough, and has sufficient documents, people in very high places and well connected either by marriage or relationship can get away with it?
The Attorney-General: Every case has to be approached by the Director, or any prosecuting authority, on the following bases: first, are the prospects for conviction more than 50–50? If not, it is rare for such a prosecution to be brought.
Secondly, in every case involving complexity, another matter to be considered is the huge expenditure of further public money with the strong likelihood, based on counsel's advice, that the end result would be an acquittal. In those circumstances, it is right that the expenditure involved should be a matter to which the Director should pay attention.
Mr. Rooker: Does the Attorney-General appreciate that the only reason given to the House for non-publication of the third appendix was that criminal

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charges may follow? It is not good enough now, after his decision and that of the DPP, announced today, to say that publication of that third appendix is a matter for the Foreign Office. It should come automatically.
Will the right hon. and learned Gentleman confirm that following his statement it is abundantly clear that the instructions given to the DPP by my right hon. Friend the then Foreign Secretary about the matters referred in the preface to the Bingham report regarding Castrol Limited were never followed through and that, therefore, those instructions were totally ignored by the civil servants?
The Attorney-General: As is obvious to the House, since the reference was made by the then Foreign and Commonwealth Secretary, the attention of the Director, counsel and the police officers engaged in the investigation was concentrated on the main matters in the Bingham report. Only at the conclusion of that investigation could any further considertion be given to other matters, such as the passing reference to Castrol at the beginning of the report. In view of the difficulties that I have explained to the House there will be no further investigation of the matters involved and referred to in the report.
Mr. Whitehead: Does the Attorney-General understand that the lesson drawn by the public from what has been said will be that anyone accused of conspiracy stands to be all right provided that he has 20,000 files and can be guaranteed to occupy a jury for a year? What cost can be too high for asserting the principle of respect for the rule of law and the elected Government of the day?
The Attorney-General: The hon. Gentleman simply refuses to listen to what has been said. I have now three times said that one of the matters that has to be considered by any prosecuting authority is the likelihood of conviction. On the advice of counsel and the Director, particularly bearing in mind the events of 1968 and 1969 and the shadow that they cast over what happened afterwards, it was decided that the likelihood of conviction was not such as to justify going on.
Mr. Dalyell: Has not the Attorney-General had his middle stump knocked
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out by his hon. Friend the Member for Tiverton (Mr. Maxwell-Hyslop) who asked how it was that retirement in some way grants immunity? Will the right hon. and learned Gentleman explain to us laymen why it is necessary for 14,000 documents to be examined? Is he saying that each of those 14,000 documents must be examined? Is he also, by way of example, saying that we would not get co-operation from Shell Mocambique if the Shell headquarters here and in the Netherlands did not ask for its co-operation? Is that the argument?
The Attorney-General: It is a matter not only of getting co-operation from Shell Mocambique but of getting the documents and the strict proof that I assume would be required of the actual movement of the vehicles from Mozambique into Rhodesia.
As for the 14,000 documents, if prosecuting counsel and his team did not go through all those documents, and if certain documents that were favourable to the defence were brought out for the first time by the defence in the middle of the trial—after six months—when they had been in the possession of the prosecution all the time, and such documents provided an entirely different aspect to the matter, just think how stupid the Crown would look.
Mr. Shore: Neither the House nor the country can accept the Attorney-General's statement as a fitting end to what has been a disgraceful and, indeed, damaging affair to the reputation of this country. Does the Attorney-General's statement mean that other cases now in the pipeline relating to sanctions are to be dropped? If they are not, how does the Attorney-General distinguish between those cases that will be prosecuted and those major offenders whom, apparently, it is too difficult to pursue further? Will he not agree that irrespective of the difficulties with prosecutions the situation enormously reinforces the case for the establishment of a joint special Committee of this House—such as was passed and voted upon on 1 February this year? Will the Attorney-General take this matter up with his right hon. Friend and make an early statement?
The Attorney-General: I made inquiries earlier this week to see how many other prosecutions were in the pipeline.

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Many of them in the past have come through customs and excise, but there are no more from that source. There is one prosecution awaiting appeal and two others in the pipeline. What I said today covers only and exclusively the matters referred to in the Bingham report. Should an inquiry be necessary I shall make certain that what the right hon. Gentleman said is considered by my right hon. Friend.

MEMBERS OF THE EUROPEAN PARLIAMENT
Mr. Jim Marshall: I beg to ask leave to move the Adjournment of the House, under Standing Order No. 9, for the purpose of discussing a specific and important matter that should have urgent consideration, namely.
"the provision of facilities for Euro-Members of Parliament in the Palace of Westminster."
I think that you, Mr. Speaker, and the House will agree that this application is specific, since it concerns the 81 individual British Members of the European Parliament.
On the question of urgency, I draw two matters to your attention. The first one is that the European Members are likely to have to leave their present premises across the road from the House in a few weeks. The second issue of urgency relates to the other place. As you are probably aware, Mr. Speaker, the other place has been giving this matter consideration for the past two years, and I understand that there is to be a debate on the third report of the House of Lords Offices Select Committee this afternoon. It is alleged that the report concludes that there should be urgent consultations between the other place and this place with a view to getting concerted action on the question of facilities for Euro-Members of Parliament in the Palace of Westminster.
I believe that the matter is important for two reasons. Access to facilities in the House of Commons by Euro-Assemblymen raises big questions about the rights and privileges both of Parliament itself and British Members of Parliament. As the House knows, and you as the guardian of the privileges and rights of Euro-Members know only too
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well, Mr. Speaker, the only people who have access at the moment are the people who serve Parliament, whether they be Officers of the House or secretaries. I believe that this positon could be usurped if Euro-Assemblymen have a right of access to the Palace of Westminster.
On the question of importance, my view is quite clear. If the Euro-Assemblymen wish to have facilities in London they should be provided by the European Commission or by the European Parliament. To underline that point, I believe that we are already paying enough to the Common Market and if further expenditure is required for European Members of Parliament it should be provided either by the Commission or by the Parliament.
I hope, Mr. Speaker, that you are convinced of the urgency, the importance and the specific nature of my request and that you will be able to accede to it.
Mr. Speaker: The hon. Member for Leicester, South (Mr. Marshall) gave me notice before 12 o'clock today that he would seek leave to move the Adjournment of the House for the purpose of discussing a specific and important matter that he thinks should have urgent consideration, namely,
"the provision of facilities for Euro-Members of Parliament in the Palace of Westminster."
As the House knows, under Standing Order No. 9 I am directed to take account of the several factors set out in the Order but to give no reasons for my decision. I have given careful consideration to the representations that the hon. Gentleman has made but I have to rule that they do not fall within the provisions of the Standing Order and, therefore, I cannot submit his application to the House.
Later—
Mr. Winnick: On a point of order, Mr. Speaker. I apologise for not giving you notice earlier of my point of order, but that was not possible under the circumstances. I refer to the facilities at Westminster for Members of the European Parliament. May we have an assurance that no decision will be taken during the recess and that no decision will be taken without a full debate in the House? Not only is accommodation of importance; an important constitutional question is involved. It would be unfortunate

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if a decision were taken by the Services Committee during the recess without a full debate in the House.
Mr. Skinner: Further to that point of order, Mr. Speaker. Will you take into consideration that in the past two years hon. Members have experienced growing difficulties when trying to book rooms for various parliamentary activities? Last week, for instance, the important Labour Party trade union group tried to arrange a meeting with a leader in the trade union movement. Normally the trade union group can guarantee finding a room somewhere. However, such is the pressure on all the rooms, despite there being one or two more available, that the group had to cancel its meeting at the last minute.
In the past few months, in particular, the use of many rooms and other facilities have been cancelled because of the pressure of activities by hon. Members. We are talking not only of the 81 Members of the European Parliament who will want to come here but of the many others who will be associated with them. After the thin end of the wedge we must think in terms of several hundred people requiring facilities on some occasions in premises in and around the House.
This is a big issue. I hope that no hurried decision will be taken. You, Mr. Speaker, carry considerable weight. During your long career as Speaker this may be one of the most important decisions that you will have to take. I hope that you will think carefully about any decision that you have to make with a view to ensuring that the already overloaded facilities in the House of Commons are not further overloaded by the Members of the European Parliament and their associates.
Mr. Speaker: I am obliged to the hon. Members for Walsall, North (Mr. Winnick) and for Bolsover (Mr. Skinner) for the way in which they expressed their point of view. I can give the House an assurance. The Services Committee do not decide this matter. No decision will be taken during the recess. Of that I can give the House an assurance, so far as I am concerned.
I do not decide on the subjects for debates; that is a matter for somebody else. The House of Commons Commission has considerable responsibility. I feel cure that since we are to rise the
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day after tomorrow—I hope—no decision on such an important matter will be taken during the recess. The hon. Member for Bolsover was kind enough to refer to my long career. It is half-way through.

BROADMOOR SPECIAL HOSPITAL
Mr. Race: I beg to ask leave to move the Adjournment of the House, under Standing Order No. 9, for the purpose of discussing a specific and important matter that should have urgent consideration, namely,
"the very serious allegations which have been made today concerning the treatement of patients at Broadmoor special hospital."
These allegations have been made by nurses who until recently were employed at Broadmoor. They are specific because they relate to individual cases. They are important because they relate to a number of recent incidents at Broadmoor. The importance of them to the House, Mr. Speaker, can be judged by the nature of some of the allegations. They are that patients have been kicked and beaten unconscious by staff at the hospital on a number of occasions; that patients have been soaked alternately with very hot and very cold douches of water by staff in order to get compliance; that electro-convulsive treatment has been given to patients without their approval and without anaesthetics; that drugs, including major transqullisers, have been used by doctors to control patients without a therapeutic reason for doing so; and that solitary confinement has been used in order to ensure compliance with the regime at the hospital.
Lastly—the issue that I beleive is extremely important for this House—I believe that the nurses in question have been threatened with prosecution under the Official Secrets Act by the Thames Valley police if they make these allegations public. These are all serious matters, which I believe that the House should debate as quickly as possible. That is why I referred these questions to you, Mr. Speaker. I hope that you will consider them—I am sure that you have done so—in a reasonable and fair fashion.
Mr. Speaker: The hon. Member for Wood Green (Mr. Race) gave me notice this morning before 12 o'clock that he would seek leave to move the Adjourn-

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ment of the House for the purpose of discussing a specific and important matter that he believes should have urgent consideration, namely,
"the very serious allegations which have been made today cocerning the treatment of patients at Broadmoor special hospital."
The hon. Gentleman was also good enough to outline for me the camplaints that he has brought to the notice of the House this afternoon. Of the importance of the matter there can be no doubt, in view of what the hon. Gentleman said. However, my choice is strictly limited. I do not decide whether the House discusses this matter; I merely decide whether it should be debated tonight or tomorrow night.
I have given very careful thought to the letter sent to me by the hon. Gentleman and to his application this afternoon. As the House knows, under Standing Order No. 9 I am directed to take account of the several factors set out in the Order but to give no reasons for my decision. I have to rule that the hon. Gentleman's application does not fall within the provisions of the Standing Order, and therefore I cannot submit his application to the House.

RHODESIA (BINGHAM REPORT)
Mr. English: I beg to ask leave to move the Adjournment of the House, under Standing Order No. 9, for the purpose of discussing a specific and important matter that should have urgent consideration, namely,
"the statement this afternoon by Mr. Attorney-General."
The practice of giving traitors immunity is spreading. The House should discuss it, because the Attorney-General is the only Minister whose actions cannot be discussed before a Select Committee. His actions can be discussed only on the Floor of the House. I do not ask for a ruling today, Mr. Speaker. However, I ask you to consider this matter.
The real matter of importance is not that of immunity. It has just been said, in effect, that our processes of criminal investigation are so weak that we cannot do what the Americans can do in relation to a Head of State with 2 million employees, but we can for a multinational company with 200,000 em-
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ployees. There is a need for an inquiry into our processes of criminal investigation. The matter is so important that it cannot wait.
Mr. Speaker: The hon. Member for Nottingham, West (Mr. English) seeks leave to move the Adjournment of the House for the purpose of discussing a specific and important matter that he believes should have urgent consideration, namely,
"the statement this afternoon by Mr. Attorney-General."
I listened carefully to the exchanges this afternoon and to the hon. Gentleman's arguments. As I said earlier, I do not decide whether this matter should be debated by the House. I have only to decide whether there should be an emergency debate tonight or tomorrow.
After careful consideration of the hon. Gentleman's representations I have to rule that they do not fall within the provisons of the Standing Order and therefore I cannot submit his application to the House.

BALLOT FOR NOTICES OF MOTIONS
FRIDAY 25 JANUARY
Members successful in the ballot were:

Mr. Jim Callaghan.

Mr. Ioan Evans.

Mr. Iain Mills.

BILL PRESENTED
  HOUSING
  Mr. Secretary Heseltine, supported by the Prime Minister, Mr. Secretary Younger, Mr. Secretary Edwards, Mr. John Biffen, Mr. John Stanley and Mr. Geoffrey Finsberg, presented a Bill to give security of tenure, and the right to buy their homes, to tenants of local authorities and other bodies; to make other provision with respect to those and other tenants; to amend the law about housing finance in the public sector; to make other provision with respect to housing; to restrict the discretion of the court in making orders for possession of land; and for connected purposes; And the same was read the First time; and ordered to be read a Second time upon tomorrow and to be printed. [Bill 109.]

  DUMPING OF WASTE (CONTROL)
  4.6 pm
  Mr. Raymond Ellis: I beg to move,
  That leave be given to bring in a Bill to require local authorities to consult parish councils prior to the dumping of toxic and/or hazardous waste.
  Is it not strange that when it is proposed to establish a gipsy site the parish council involved has the right to object? Is it not strange that when it is intended to sink a coal mine at Belvoir the parish council concerned has a right to object? Likewise, is it not strange that local councils have a right to object to the starting of a quarry or open-cast mining, the building of airports, motorways, and such simple measures as housing development, but that when it comes to the infinitely more dangerous practice of dumping toxic waste, local authorities not only do not have the right to object but do not even have the right to know?
  I cite as an example the experiences in North-East Derbyshire, in and around the small village of Morton. This was once a thriving coal mining area. The mine was worked out and permission was granted to mine the remaining coal by open-cast methods. Instructions were given with the planning permission that within a certain period the ground should be sealed and restored to agriculture. Only a certain amount of the ground could be open at any time.
  The conditions of that planning permission were broken time and again. Eventually there was a hole in the ground that would have held the entire Houses of Parliament 10 times over—and they would have been lost without trace. On top of that indignity we discovered that licence had been granted to dump toxic poisons without anybody in the local authorities being given any information. The shroud of M15 secrecy that surrounds that operation makes my constituents alarmed, anxious and angry.
  Almost daily at Morton one can see dead wildlife, dead herons and dead household pets, such as cats and dogs. Hon. Members will understand the feelings of my constituents.
  In an attempt to clarify the situation and to placate fears, last week I tabled a dozen or so questions to the Minister so that a reply could be given to the
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  questions of my constituents. However, the answers to the questions did not help. For instance, I asked whether any toxic waste or hazardous poisons were being imported, to be dumped in my constituency. The Minister replied that there was no restriction on the origin—only on the type.
  In recent months I monitored entry to the site of laden lorries that travelled from as far a field as Swansea, Preston, Port Talbot and Humberside, which are all located in or near coastal areas. My constituents tell me that North-East Derbyshire has become the toxic dustbin for the entire world. The Minister does not know—but somebody knows.
  That is why I now seek to put on the statute book legislation that will at least clear the air for future occasions. It is too late for Morton to be saved, because by the time the measure is on the statute book the devil's cauldron there will be brimming over.
  I am worried, because there were six clear-water streams and extensive coal mines in the area. When we try to seal off the area we shall discover a Pandora's box. It is my intention to assist other areas and to give parish councils the right to know what is going on at the bottom of their gardens.
  At the moment county authorities can fill any hole in the ground without prior leave or consultation. Although the Merseyside area is level ground, permission was given to store toxic waste there.
  In seeking permission to present a Bill to give parish councils the right to consultation prior to the dumping of toxic poisons within their areas, I refer to another answer that I received from the Minister to a question about a factory explosion that occurred a few years ago. It took place at a chemical factory in a constituency close to mine. Hon. Members may have heard of a recent similar occurence in Italy, when a poisonous gas cloud led to the evacuation of the affected area. Fortunately, on this occasion at the Coalite works at Bolsover there was no escape of poison gas into the outside air stream. However, there were fatal accidents. The explosion created dioxin poison similar to that in Italy. The entire factory walls and structures were so impregnated with the poison that the factory had to be demolished,

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  dismantled and dumped. I asked the Minister whether that factory poison had been dumped at Morton. He said that he did not know.
  I seek a small exercise in open government. I hope to obtain permission from the House to present a Bill to give parish councils the right to consultation prior to the dumping of toxic poisons. I am convinced that I am making a real and unambiguous attempt to return the powers of consultation to the parish councils at the grass roots.
  Question put and agreed to.
  Bill ordered to be brought in by Mr. Raymond Ellis.

  DUMPING OF WASTE (CONTROL)
  Mr. Raymond Ellis accordingly presented a Bill to require local authorities to consult parish councils prior to the dumping of toxic and/or hazardous waste: And the same was read the First time; and ordered to be read a Second time upon Friday 25 January and to be printed [Bill 111].
ORDERS OF THE DAY

  HEALTH SERVICSES BILL
  Order for Second Reading read.
  Mr. Deputy Speaker (Mr. Bryant Godman Irvine): Mr. Speaker's intention is that from 7 o'clock the 10-minute rule will apply in this debate.
  4.26 pm
  The Secretary of State for Social Services (Mr. Patrick Jenkin): I beg to move, That the Bill be now read a Second time.
  I am sure that the House will be sorry to hear that my hon. Friend the Minister for Health is unwell and that he will be unable to reply to the debate tonight. If my hon. Friend the Under-Secretary of State catches your eye, Mr. Deputy-Speaker, he hopes to wind up the debate and, of course, we shall deal with any questions that arise in the debate.
  The Second Reading of a Bill, by the custom of the House, need not be confined to the substance of the Bill itself, and I have no doubt that today's debate will be no exception. However, I think that it would be right for me at the outset of the debate to say that, although I cannot forecast the business of the House, my right hon. Friend the Chancellor of the Duchy of Lancaster told me that he would give favourable consideration to providing time soon after Christmas for a general debate on the report of the Royal Commission on the National Health Service and on the consultative paper recently issued by my Department and the Welsh Office. I make this clear so that hon. Members in all parts of the House, though of course entirely free to raise any points that are in order, may know that we may reasonably forecast that there will be this further opportunity to deal with more general matters covering the National Health Service than are comprehended within the clauses and schedules of the Bill.
  Of course, the first two clauses are not wholly unrelated to the proposals in the consultative paper. I therefore cannot possibly argue, nor indeed would I wish to argue, that this is not an appropriate occasion for putting forward views

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  on that paper. Nevertheless, I should like to make one point as clearly and unequivocally as I can. It is that nothing in the first two clauses of the Bill is intended to prejudge or prejudice in any way the outcome of the consultation son the consultative document. In our foreword my right hon. Friend the Secretary of State for Wales and I said this:
  "We believe that Ministers must now give a firm lead and this is what we are doing. We do however want the views of those concerned and we look forward to receiving these by the end of next April so that we can take final decisions and get the necessary changes moving from the middle of the year."
  We mean exactly what we have said.
  What, then, is the purpose of these two clauses? It is simply to give a permissive power to the Secretary of State to appoint district health authorities. They also allow a family practitioner committee to cover a different territorial area from that of a district or area health authority. In other words, these two clauses do no more than confer greater flexibility on Ministers in determining the most appropriate structure of the Health Service to suit the needs of the Service in different parts of the country. They do not commit anyone to any particular structure.
  It will be for right hon. and hon. Members in all parts of the House to decide what line to take in their own speeches. I hope that the House will understand if I say that I intend to reserve my comments on the report of the Royal Commission, and on the substance of the consultative paper, for a future occasion. I have said that my hon. Friend the Under-Secretary will be very happy to deal with any points which right hon. or hon. Members may raise. I stress again that nothing in this Bill prejudges either any debates we may have or our consultations on the consultative paper, or the decisions which we may finally reach in the light of those consultations.
  I come to the part of the Bill which I imagine will prove to give rise to most argument, namely, part II, dealing with private practice. Those of us who took part in the debates on the subject of private practice during the last Parliament have no need to be reminded of the passions that were aroused, both inside and outside the House. I certainly do not want to rehearse in detail the events of those unhappy days, except to make the
  650
  point—which I do without rancour—that I believe some Members of the Labour Party, and in particular the then Secretary of State, Mrs. Barbara Castle, bear a heavy responsibility for fanning the flames of controversy. I also believe, however, that there are many on both sides of the House who will agree with the sentence in The Guardian leader of Monday 10 December in commenting on the Bill:
  "Compared to five years ago the mood is quite different."
  Our views on this side of the House can be briefly stated. We believe that it is a part of a free society that patients who wish to seek private medical treatment should be free to do so. We believe that doctors who wish to practise privately should have the right to do so. These views are shared by the overwhelming majority of the people.
  Mr. Stanley Orme: Justify it.
  Mr. Jenkin: The right hon. Gentleman says "Justify it".
  Mrs. Elaine Kellett-Bowman: The electricians.
  Mr. Jenkin: I will come to the electricians in a moment.
  A national opinion poll taken earlier this year showed that 6 out of 10 employees would be interested in having private medical cover as part of their terms of employment, and that included 63 per cent. of male manual workers. In the light of this, I come to the point made by my hon. Friend the Member for Lancaster (Mrs. Kellett-Bowman). It is hardly surprising that some unions are now beginning to include such cover in their negotiations with employers, and this must be welcomed.
  The poll showed two further things. Nearly three-quarters of the trade union members polled, including nearly 70 per cent. of National Health Service union members, believed either that their unions should support private medicine or that they should take a wholly neutral stance. Only 11 per cent. said that it was the job of their unions to oppose it. [Interruption.] Perhaps hon. Members opposite will listen to this one: the poll showed that even among Labour supporters nearly twice as many people believed that private prac-

  651
  tice helped the National Health Service as thought that it was a burden on it.
  Mr. David Ennals: I am not certain what the question was that was put, but, if the policy of any Government is to be determined by what opinion polls show, opinion polls show at present that the Government are extremely unpopular and the Labour Party should be in office. So opinion polls are not the way in which we should take sensible decisions.
  Mr. Jenkin: I am not asking the House to take decisions on the basis of the opinion polls. I was seeking to answer the question of the right hon. Member for Salford, West (Mr. Orme), who, when I said the overwhelming number of people supported our policy, said I should prove it. I believe that I have proved it.
  Mr. Reg Race: Will the Minister tell the House how the opinion poll which he has quoted differs from the many opinion polls which have been reported in newspapers over many years which show great opposition among the public both to private practice within National Health Service Hospitals and to the idea of private practice as a whole?
  Mr. Jenkin: I am bound to tell the hon. Gentleman, having asked for evidence of all the recent opinion polls that have covered this subject, that my Department was unable to find one which did not bear out what I have said.
  Let us take another matter. The presence of pay beds in National Health Service hospitals generates considerable revenue for the NHS. Private patients in those hospitals are expected to bring in over £35 million next year, and when National Health Service spending is under constraint it is folly to throw good money away. Perhaps I could ask the Opposition where else they think in these days that many of that kind is to come from.
  The poll showed that 60 per cent. of trade unionists believed that it would be wrong to give up this revenue, and I believe that they are right. So a clear majority favour retaining both private medicine and NHS pay beds.
  There is a practical argument to this, too. We need the geographical whole-time consultant. It must be possible for
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  a doctor to see his private and NHS patients in the same hospital. That was a point that was made by Mr. Bevan in a debate over 30 years ago, and it is as true today as it was when he said it.
  I recognise that there are many on the Opposition Benches who believe that there should be no independent medical practice at all or, if there has to be, that it should be totally separated. The right hon. Member for Norwich North (Mr. Ennals) shakes his head. He knows of the resolutions that have been passed at his party conferences, and he knows that they are represented on the Opposition Benches. But there are others who believe that there should be private practice but that it should be totally separate from the NHS. That is their view and they are entitled to express it. Nothing that I say will persuade them on the principle of the matter, but many I ask them to consider these further points?
  Whatever hon. Members opposite may have said, whatever they may have thought they voted for in the last Parliament, it is a fact that even without this Bill pay beds and private patients would have remained in much of the National Health Service indefinitely.
  Mr. Orme: That is the trouble.
  Mr. Jenkin: The right hon. Gentleman may say that that is the trouble, but he does not deny that it is the fact. When it comes to legislating for real events involving real people in the real world, the gulf that divides the two sides on the issue of principle tends to narrow down to differences of emphasis, to changes in procedure and changes in timing. I ask the House to look at part II of the Bill very much in that light.
  Under the legislation passed by the Labour Government, there was apparently a commitment, first, to phase out pay beds entirely from the NHS and, secondly, to exercise a rigorous control over the development of the private sector. In practice, however, as the right hon. Gentleman acknowledged, with relatively few exceptions the pay beds that have disappeared in the last few years were beds of a very low usage, and, moreover, the so-called Goodman compromise tacitly recognised that in many parts of the country, particularly in small towns and remote areas, pay beds would remain indefinitely in NHS hospitals.

  653
  It goes further than that. The Labour Government included in their legislation a clause which gave the Secretary of State power to authorise private practice in National Health Service hospitals for highly specialised treatment unlikely to be available in the private sector. No time limit was imposed on that clause and, indeed, the right hon. Member for Norwich, North was at the time of the election actively engaged in consultations with the medical profession on how that clause might best be implemented. That clause envisages a permanent availability of private practice in National Health Service hospitals for the treatments covered by it. That is the fact, and that is the point from which we start.
  If one looks to the private sector outside the NHS, it is widely acknowledged that the last five years have seen the biggest expansion of the private sector since the war. Whether or not hon. Members opposite thought that that was what they were voting for, there can be no doubt whatever that that is what has happened. It is equally clear that even if existing legislation had remained in force this expension would continue. The trend is perhaps important because it points the way to the future. The trend in acute private practice has been for the more minor elective procedures to take place in the private sector outside the NHS while urgent or more specialised procedures remain in NHS hospitals. I believe that this trend is likely to continue, though it will not be universal. It seems to me, therefore, that it is right to set the provisions of the Bill not against the passionate denunciations of Labour politicians or against the uncompromising resolutions of Labour conferences but against the background of what was happening and would have happened under their legislation.
  In the chapter on private medicine in the report of the Royal Commission, it was said that private practice, both in and outside the NHS, was very small compared with the NHS, too small to have a significant impact on the National Health Service, except perhaps locally and temporarily. The Commission did not consider the presence or absence of pay beds in NHS hospitals to be significant at present from the point of view of the efficient functioning of the National Health Service.
  654
  It may be asked, therefore, perhaps by some of my right hon. and hon. Friends, why the Government think it necessary to legislate at all. There are good reasons—quite apart from the issues of principle to which I referred.
  In the first place, it is rather silly, if pay beds are to remain indefinitely in the Health Service, that Parliament and the public should be invited to pretend otherwise. The Bill, therefore, repeals those provisions which would require—and I stress the word "require"—further progress towards phasing out. If there is no demand, the beds will go anyway. If there is demand, it should be met.
  Secondly, if it was right that a good many pay beds would have remained indefinitely, there seems no sense or logic to allow them only where they happened to be located at the time of the 1976 Act. It really is not sensible to preclude anyone from authorising pay beds in new hospitals or expanded hospitals, however great the demand might be. Our Bill, therefore, puts this right.
  Thirdly, the Labour Party's Bill placed the decision on whether pay beds should continue or be revoked on a body which was in no way answerable to this House. The Health Services Board had a duty to make proposals which neither my predecessor nor I could do anything about except to implement. I am sure that I am not alone in finding such a provision constitutionally offensive. As Secretary of State, I am answerable to this House for the National Health Service, and that includes the availability of pay beds. Yet, on that issue, the Act passed in the previous Parliament effectively stops the House having any say at all. The Bill, therefore, provides for the transfer from the Health Services Board to the Secretary of State of the power to authorise or revoke authorisations for pay beds, and it abolishes the board.
  In my view, the board carried out the duties imposed on it with scrupulous care. It was given a difficult task, and it has performed it admirably. I would like to express my thanks to Lord Wigoder and his colleagues, and to the Scottish and Welsh committees, for all the time and consideration that they devoted to their task.
  Those, then, are the changes we propose, and I suggest that they are modest.

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  At the same time, we are keeping and, indeed, improving the safeguards for the NHS. I share fully the concern of those who want to make sure that private practice in no way harms the interests of NHS patients. My overriding concern must always be for the NHS patient.
  The most important safeguard is that contained in section 62 of the 1977 Act, that the powers may be exercised only if I am satisfied that anything which I propose to do or allow under those powers
  "will not to a significant extent interfere with the performance
  of my duty to the National Health Service and National Health Service patients, and
  "will not to a significant extent operate to the disadvantage of"
  National Health Service patients. This is a clear legislative safeguard. It remains unchanged both in intent and language.
  When my hon. Friend the Minister for Health issued a consultative paper last June about our proposals, he made it quite clear that arrangements for private practice in National Health Service hospitals should operate, and be seen to operate, fairly. We are, therefore, going further than our predecessors ever did in seeking to make this effective.
  Mr. Frank Haynes: If the right hon. Gentleman is saying that this is a question of fairness, does he agree that queue-jumping is unfair? That is how I have found the pay bed system to be in my area.
  Mr. Jenkin: No doubt the hon. Gentleman will seek to catch the eye of the Chair, but I am about to deal with that point because I share his concern about that issue.
  The House will remember that the 1976 Act imposed a duty on the Health Services Board to make proposals about common waiting lists. This reflected the concern that was then felt, and is still felt, that private practice can lead to queue-jumping. The report published in May 1977 recommended that there should be common waiting lists for every category of patient, though it made the very important statement that complete responsibility for admitting patients from waiting lists should remain with the consultants.
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  In the event, my predecessor, the right hon. Member for Norwich, North, was unable to go the whole way with the Health Services Board. He introduced common waiting lists only for urgent cases and the seriously ill. It is true that he asked health authorities to enter into discussions about extending common waiting lists to all patients, but, so far as I can ascertain, little progress was ever made in those discussions. The position, therefore, when we came into office remained as the right hon. Member for Norwich, North left it—that common waiting lists existed only for urgent cases and the seriously ill.
  Mr. Laurie Pavitt Mr. Laurie Pavitt(Brent, South) rose—
  Mr. Jenkin: Perhaps I can develop my argument, and then I shall give way.
  It did not seem to us that that went far enough to implement our pledge that private practice in the Health Service should not prejudice the interests of National Health Service patients. We, therefore, approached the medical profession with a number of more far-reaching proposals, and I am happy to say that we have reached agreement with it on six "principles of private practice", which have been endorsed publicly by the BMA and which it will, at the appropriate time, draw to the attention of all consultants practising in the National Health Service.
  The first principle restates the under taking that private practice should not significantly prejudice non-paying patients. That is in the Bill. It will be in the Act.
  Secondly, subject to clinical considerations, earlier private consultation should not lead to earlier National Health Service admission or to earlier access to NHS diagnostic procedures. What this means is that it is now clearly recognised by the profession as an abuse of the system to use a private consultation as a device to gain earlier admission to hospital as an NHS patient. That. I believe, by itself will remove one of the major grounds for complaint that has existed in the past.
  Thirdly, common waiting lists should be used, as at present, for all urgent and seriously ill cases, but they should be extended to cover highly specialised diagnosis and treatment. The principle adds that

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  the same criteria should be used for categorising paying and non-paying patients.
  Fourthly, after admission, access by all patients to diagnostic and treatment facilities should be governed by clinical considerations. This principle is qualified only to the extent that it does not exclude earlier access by private patients to facilities specially arranged for them if these are provided without prejudice to National Health Service patients and without extra expense to the NHS.
  Fifthly, standards of clinical care and services provided by the hospital should be the same for all patients. Again, this principle does not affect the provision, on separate payment, of extra amenities, nor the practice of the day-to-day care of private patients usually being undertaken by the consultant engaged by them.
  Together, the fourth and fifth principles in effect mean that clinical considerations alone will govern the availability of treatment and care after admission to hospital for NHS and private patients alike.
  Mrs. Gwyneth Dunwoody: Will the right hon. Gentleman give way?
  Mr. Jenkin: Perhaps the hon. Lady will allow me to state the sixth principle, and then I shall give way. The last principle says that single rooms should not be held vacant for potential private use longer than the usual time between NHS patient admissions.
  Mrs. Dunwoody: I hope that the right hon. Gentleman will forgive me if I point out that that is supposed to be the set of principles under which the consultants in the NHS have been operating since the inception of the Service. Indeed, is it not a measure of the disgraceful stage that we have reached that the Secretary of State needs to spell out those principles?
  Mr. Jenkin: All I can say is that we have gone further on this and have got a clear statement of the principles as well as a clearer commitment from the medical profession than any previous Secretaries of State. I think that that is something that the House should welcome.
  Mr. Orme: We shall obviously want to look at the proposals in some detail in Committee. However, what about social conditions? What about the woman with a large number of children who needs to be admitted urgently? What about ortho-
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  paedic cases, such as the one of the elderly lady in my constituency? Will they be admitted on an equal basis?
  Mr. Jenkin: I hope that this point will be examined in Committee, because it is very important. But what the right hon. Gentleman has said, particularly in his first example with regard to social conditions, makes it abundantly clear that in the management of waiting lists—this point is clearly brought out in the report of the Health Services Board—one simply cannot automatically arrange people in orders of clinical importance. There are many other factors that must be taken into account. I am glad to note the support of my predecessor, the right hon. Member for Norwich, North. That is why the board and the right hon. Member for Norwich, North rightly decided that those matters must rest in the hands of the consultants. There is no alternative.
  Mrs. Kellett-Bowman: That is the point that I wish to make. My right hon. Friend said that payment should not lead to earlier admission. Do not people who pay for private medicine often wish to delay treatment until their other commitments enable them to go into hospital? It is not that they try to jump the queue; they often go back down the queue.
  Mr. Jenkin: My hon. Friend is quite right. Payment gives a measure of flexibility. It does not necessarily operate to the detriment of National Health Service patients.
  Mr. Michael Meacher Mr. Michael Meacher(Oldham, West) rose—
  Mr. Jenkin: I must go on; I have given way a lot.
  There are good arguments, to which I have frequently referred, for treating private patients separately from NHS patients in the same hospital, where that is practicable. However, it can, and sometimes does, give rise to avoidable difficulties because the same nurses and the same ward staff are concerned with private and National Health Service patients. Many hospital authorities recognise those difficulties and do their best to provide for private patients in order to avoid difficulties and embarrassment on that score. However, that is not always possible. The advice that I shall give the health authorities will press that point further.

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  I believe that these principles will go a very long way indeed to reassuring the public and staff in hospitals that there will be fairness between private and National Health Service patients. But this must work both ways. I hope that staff for their part will realise that all patients in National Health Service hospitals, private or NHS, must be treated in the same way and that there should be no reverse discrimination against private patients. I believe that the overwhelming majority of staff, including union members, will want to take a sensible line on that.
  I turn to the provisions of the Bill dealing with the private sector outside the National Health Service.
  First, clause 14 and schedule 4 propose certain amendments to the nursing homes and mental nursing homes legislation under which private homes and hospitals have to register with the Secretary of State. In practice, they register with the area health authority. These controls are concerned with standards of accommodation and non-clinical care. The Bill proposes to relax the residency requirement for the person in charge and also to bring private day care within the scope of the Act. I believe these are sensible measures which will be welcomed by everyone.
  More important are provisions in the Bill covering controls over the development of the private sector. Here I will be frank with the House. I had hoped that we might have found it possible substantially to modify the existing controls. Some people would see no reason why anyone who wants to build and run a hospital should be in any different position from someone who wants to build and run, say, a hotel. But we all recognise that it is not as easy as that. It is a fact that, although on the Continent there are a number of different health care systems, there is not one country that allows a completely free rein to hospital development.
  Although the private sector rightly offers a measure of choice to the people of this country, it cannot be said to do so under normal competitive conditions. In particular, the National Health Ser-
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  vice is inevitably constrained in what it can provide by the availability of clinical manpower. In these circumstances, it is not difficult to envisage private sector developments which could—although not necessarily—locally operate to the detriment of a National Health Service hospital. I believe we are right, therefore, to retain a measure of control. However, the Bill significantly simplifies procedures of control and makes some substantive changes. Clauses 10 and 11 make three amendments.
  The threshold for authorisation is raised to 120 beds across the country, rather than the present 100 in Greater London and 75 elsewhere. There will also be an exemption for increases in the number of beds over this level, where the increase is less that 20 per cent. in a three-year period. Those two changes relax the controls modestly. The third change tightens control. There will be a new reserve power whereby the Secretary of State would be enabled to designate by regulation areas or parts of areas where all private hospital developments would have to be authorised. This is to meet the point raised by the Royal Commission, which argued that an aggregate of small hospitals could in some places be just as detrimental to NHS interests as a single large one. I see this control very much as a long-stop. The Bill provides that such a control should apply only if a health authority specifically requests it and only for a specified period.
  However, with the private sector outside the NHS, just as in the case of pay beds in the NHS, we are anxious to remove any legitimate cause for criticism due to abuse of the system, so with the private sector we are anxious to meet the criticism that has been made that, although it is called independent, it is not truly independent because it depends on the National Health Service for its trained staff. In one sense, of course, the argument is bogus. The public sector education system trains a great many professions, many of them expressly for service in the private sector—one thinks of accountants, lawyers, even clergymen. There is nothing sacrosanct. One does not have to work in the public sector because one was trained in it.
  Mr. Orme: Why do they not?
  Mr. Jenkin: I am coming to that. The right hon. Gentleman really must contain his impatience. I shall get to that point in a moment.
  However, why should it be different for doctors and nurses?
  In another sense, the argument may have some force. If the main reason for putting a quantitative control on private hospital development is that it could threaten shortages of skilled clinical manpower for adjacent NHS hospitals, should not the private sector itself do more to contribute to the pool of trained people? I believe that it should and that it could, and I am greatly encouraged to find that this is a view widely held in the private sector itself. Of course, some private hospitals have for years contributed to nurse training. I mention the arrangements which the Royal Masonic hospital has had with Queen Mary's hospital, Roehampton. I have now initiated talks with a number of other private hospitals with a view to their making a contribution to nurse training.
  Of course, any such arrangements would have to secure the approval of the appropriate authorities, particularly the General Nursing Council. I am sure there is scope for training nurses and perhaps other professions in the private sector, and it is excellent that the private sector has accepted my challenge to do more.
  Clause 4 gives health authorities a power to raise money from voluntary sources to supplement their funds. I am bound to say that I am surprised and a little saddened by the reaction of the Opposition Front Bench to this proposal. Health authorities have always been free to accept voluntary contributions and to hold and administer trust funds, but they have been precluded from being involved directly in fund raising.
  Mr. J. W. Rooker: Turning people out on to the streets.
  Mr. Jenkin: I have always understood that the reason for this was that, when the National Health Service was set up, Mr. Bevan wanted, quite reasonably perhaps, to break down the demarcation between the old voluntary hospitals and the municipal hospitals. Therefore, he intro-
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  duced the rule that no hospital should appeal for funds.
  I believe that today the restriction is unnecessary and unreasonable. We all recognise that the Health Service is unable to meet all the demands made upon it. All Governments in recent years have found and every Secretary of State has had to make speeches explaining that there are waiting lists and that important projects must wait and why there is not enough money available. The right hon. Member for Norwich, North had to do that and I must do it. At the same time, there is undoubtedly great public concern about the well-being of local hospital services, and there are welcome signs that more people want to do something about it. Of course, leagues of friends and other similar bodies can raise substantial sums and channel them into the Health Service. But it really seems absurd that health authorities themselves should not have power to appeal for funds to supplement what they get from my Department.
  The proposals in the Bill are modest and scarcely justify the hysterical reaction of the right hon. Member for Salford, West. He talked about running casinos and implied that the clause spelt the end of a Health Service free at the point of use. With great respect to the right hon. Gentleman, that is absolute rubbish. Clause 4 does not give any power to run casinos, which he would have discovered had he devoted time to reading it before delivering his outburst. Moreover, there is a reserve power to forbid any activity that the Secretary of State thinks unsuitable. The power to raise funds no more undermines the principle of a National Health Service free at the point of use than does its present powers to accept voluntary gifts.
  What are we looking for here? If a small local hospital is threatened with closure because resources are needed to finance the commissioning of a modern new hospital—and I am sure that we can all think of examples of that—is it unreasonable that the health authority could indicate that, if voluntary funds were forthcoming to meet the whole or part of the cost of keeping that small hospital open, it would be happy to make an arrangement to do just that?
  Is it really obscene—to use the right hon. Gentleman's word—that if a health authority ands that it does not have the

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  money to modernise a nursing home, as is the case in my constituency at present, upgrade an old ward or install a sophisticated piece of equipment it should make such projects known to the public and appeal for funds?
  I believe that the right hon. Gentleman and his hon. Friends do themselves no credit at all by their absurd reaction to this clause. I believe that the public will fully understand its purpose, and I hope that they will respond generously when appeals are made. I am convinced that a hospital will best serve the community if it can be persuaded to look outwards towards the community rather than for ever upwards to the hand that feeds it.
  Mr. A. J. Beith: I agree with what the right hon. Gentleman is saying, but what kind of undertaking can he give to health authorities that allocations made to them will not be subsequently reduced because of voluntary cntributions that have been received?
  Mr. Jenkin: That matter is dealt with in the Bill and can, no doubt, be examined and elaborated in Committee. Between £10 million and £15 million is currently paid voluntarily to the Health Service, and that contribution makes no difference to the allocation to the authorities. Those sums are additions, and that is what people want. I am sure that our hospital services will thrive to the extent that they look outward to the community and the community responds. They should not constantly have to appeal to me for more and more money.
  Mr. David Mellor: Does my right hon. Friend agree that in any case every major London hospital has a substantial capital fund yielding substantial income, which is used for the benefit of all patients? The proposal is only the extension of a long-established practice.
  Mr. Jenkin: My hon. Friend is absolutely right, but that point applies not only to London but to hospitals all over the country which have trust funds. We want to seek to increase that sort of finance.
  Clause 5 brings up to date the provisions for the financial control of health authorities. Under existing procedures, I am under a duty to advance sums to meet whatever a given approval of ex-
  664
  penditure might require. The House will recognise that that duty, as worded, is now totally incompatible with the system of cash limits instituted by the Labour Government. It is necessary to change that duty to give health authorities advances not exceeding a predetermined sum which is compatible with the Department's cash limits. Secretaries of State, as my predecessor, the hon. Member for Norwich, North, will recognise, cannot be in the position of having a duty to advance more money than is available.
  Clause 5 also places a duty on health authorities to contain their expenditure within the cash limit allotted to them, together with any other sums that they receive—for instance, by way of pay bed revenue. It was, I think, the absence of any such clear statutory duty that contributed to the unfortunate events in the Lambeth, Southwark and Lewisham area health authority in recent years. In view of pending litigation, I cannot say more about that today. I believe that this clause is necessary to put beyond doubt a duty that successive Governments—and I have read all the correspondence of my predecessor—have certainly expected health authorities to fulfil.
  The Bill contains a sensible, moderate package of reform, which should attract support from all sensible, moderate opinion. I have no doubt that right hon. and hon. Members on both sides of the House will wish to scrutinise the details carefully in Committee, and that is as it should be.
  At the last election, the Conservative Party undertook to simplify and decentralise the National Health Service and cut back bureaucracy. Clauses 1 and 2 of the Bill give us the power to do just that, if the consultations on "Patients First" endorse our proposals. The right of health authorities to appeal for funds will once again enable local communities to demonstrate practical support for their hospital.
  In our manifesto we also undertook to allow pay beds to be provided where there is a demand for them and to end Labour's vendetta against the private health sector. Part II of the Bill implements that pledge in a reasonable and balanced way. The undertakings given by the medical profession demonstrate

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  its commitment to the belief that the right to practise privately carries with it corresponding responsibilities. The six principles to which it has agreed go further in that direction than ever before and meet all the real objections to private practice in the National Health Service.
  These are all commonsense measures, and as such I commend them to the House.
  5.5 pm
  Mr. Stanley Orme: I welcome what the Secretary of State has said about a debate on the report of the Royal Commission, and I assume that it will be early in the new year. There are wider aspects than those covered in the Bill that we want to discuss.
  This Bill will not help the National Health Service. We recognise that there are problems in the Service. The developments that have taken place in its 31 years of existence—increased technology, improved conditions and earnings for those working in the Health Service, the demographic change for the elderly—will create problems that as a nation we shall have to face, and we need a National Health Service that can cope with them. We should therefore look at the Bill to see whether it takes us along that road.
  The Secretary of State talked of Conservative philosophy and the question of principle. We agree that the Bill is not so much about technology but about philosophy and general approach. The right hon. Gentleman should not be under any illusion. We disagree vehemently with the general direction of the Bill.
  This is the first step by this Government down the road towards a two-tier Health Service, and it amounts to a private patients' charter. It is an important step away from local democracy, accountability, and the principles of health care free at the point of use. We have already seen the Government's emphasis on charging and the increased prescription charges. It is also an important step along the road to financing the National Health Service—and I want to say more about clause 5, which is extremely important—through raffles, bazaars, and so forth. I repeat that it is obscene that people's health should depend on such practices.
  The right hon. Gentleman has the effrontery to quote Aneurin Bevan on the National Health Service. When the
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  National Health Service was created, it was intended to be free at the time of use to everybody and to be financed through direct taxation of the community as a whole. We do not deviate from that basic principle.
  Mr. Patrick Jenkin: In that case, why, under the previous Labour Government and, indeed, under every Labour Government since the war, have voluntary funds been cheerfully accepted? The right hon. Member for Norwich, North (Mr. Ennals), my predecessor, praised the giving of voluntary funds whenever the matter was referred to. What is so different about accepting voluntary funds in addition and appealing for voluntary funds? The right hon. Gentleman is being foolish on this point.
  Mr. Orme: There is a world of difference between the friends of a hospital raising money to provide a television set, chairs or amenities and nurses on the street with collecting boxes.
  I should like to deal with four main points in relation to the Bill: the Health Service reorganisation, the powers of the health authorities to engage in voluntary fund raising, financial matters and private medicine, both within and outside the National Health Service.
  We are all in favour of better service and getting rid of bureaucracy. On the question of reorganisation, we should look in some detail at the proposals to get rid of the third tier within the NHS. I remind the House that the present Secretary of State for Industry put in that third tier. His reorganisation—the 1973 Bill—was based on the Kinsey report that was commissioned by the Government of the day—
  Mr. Patrick Jenkin: McKinsey report.
  Mr. Orme: Not Saatchi and Saatchi, of course.
  The question of reorganisation raises some basic principles about democracy. In the Bill, the regional and area health authorities are greatly strengthened. They are given more powers, including the right to determine boundaries. Alongside those powers, the consultative document, which, for a document of its sort, contains many firm proposals, states in paragraph 23—on the subject of the membership of the new boards and whether the present one-third local

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  authority membership is necessary—that there should be four local authority representatives on district health authorities. That is a reduction of local health representatives on all bodies. At the moment, bodies with 20 such members will have that membership reduced to six or seven, while a membership of 30 will be reduced to 10.
  That input of local authority representation is the only indirect democratic link, as opposed to appointment within the area health authorities. If hon. Members or local councillors in their wards went on to the street and took a poll, they would find out how many people knew who their representatives were on district or area health authorities—very few. It is a fundamental matter which we should like to examine in detail.
  I notice that the Royal Commission report referred to the question of local authority representation and whether the NHS should be devolved to local government. In paragraph 20.61, the report states:
  "We concluded in Chapter 16 that the NHS should not be transferred to local government at the present time but that the question should be looked at again if regional government became a possibility in England."
  It rightly posed the possibility that there is something wrong in the democratic structure of the NHS. We should take account of that fact.
  My right hon. Friend the Member for Norwich, North (Mr. Ennals), when he was Secretary of State, put forward proposals for industrial democracy and trade union representation of those working in the NHS. Those proposals have now been dropped and there has been no reference to them by the Secretary of State. If we take into account that the right hon. Gentleman does not accept the Royal Commission recommendation that family practitioner committees should be brought within the district or area health authorities, that is another block against the extension of democracy.
  The problem of the community health councils cannot be excluded. I found it strange that the consultative document called "Patients First" should refer in paragraph 26 to community health councils—themselves representative bodies—representing patients. The latter part of paragraph 26 states:
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  "The need for separate consumer representation in these circumstances is less clear; next year the councils will cost over £4 million. The Government will welcome views on whether community health councils should be retained when the new district health authority structure has been implemented."
  I see that as the death knell for the CHCs, which have played an important role and which have often been a thorn in the flesh of the AHAs and RHAs.
  Mr. Ennals: That is why the right hon. Gentleman is doing it.
  Mr. Orme: The CHCs did a good job. The report on the difficulties experienced at Normansfield mental hospital commended the CHCs. I am glad to see that the Secretary of State concurs with that commendation. They did not give up, like others did, in the attempt to get the scandals publicised, recognised and dealt with.
  Mr. Patrick Jenkin: The right hon. Gentleman said that paragraph 26 sounded the death knell of the CHCs. I should like to state publicly that the Government's mind on this point is absolutely open. Paragraph 26 makes that clear. Whether or not the CHCs will stay depends greatly on representations that may be made to us between now and next April. I should like that fact to be understood. I have made no decision on the matter.
  Mr. Orme: The Secretary of State's words are rather different from those used in the consultative document.
  Mr. David Atkinson: Is it not reasonable to suggest that, once the new district health authorities have been established, including, as they will, local councillors, there may not be a case for community health councils to continue in existence? The local view will already be represented on the district health authorities.
  Mr. Orme: The CHCs will still represent large numbers of people. There is insufficient democracy in the NHS, and I believe that we must explore ways of trying to achieve sufficient democracy. I have no easy answer to that—it is a difficult question. Many of my hon. Friends would like to keep open the question of putting the NHS into the local authority ambit. However, there are difficulties for the regional health authorities and I recognise that fact. If education and other

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  services can be carried out on a local basis, why not health services?
  Mr. Race: Does my right hon. Friend agree that one of the most important functions that the community health councils have—and one of the powers that they have—is an ability to refer to the Minister any hospital closure decision made by an area health authority? Does he agree, therefore, that if a proposal to abolish the CHCs was accepted by the Government it would be fair to ask who, if anybody, would then exercise the power to object to closures by area health authorities? Does not this reflect on the essential nature of moving away from democratic accountability by CHCs?
  Mr. Orme: My hon. Friend the Member for Wood Green (Mr. Race), who has great experience of the National Health Service, has gone straight to the point. Without wearying the House, I shall refer to the speech by the Secretary of State in March 1973, when the new structure was proposed, in which he said:
  "the consumer's voice is clearly taken into account via the new community health councils."—[Official Report, 26 March 1973; Vol. 853, c. 925.]
  I listened carefully to what the Secretary of State had to say, and I shall weigh his words and watch his actions during the coming months. The Royal Commission recommended the strengthening of the CHCs. We support that and will probably say more about it when we debate the Royal Commission report.
  Mr. J. D. Concannon: I should like my right hon. Friend to agree that we, as public representatives, have found the CHCs helpful when dealing with all National Health Service problems. This is the one point at which public representatives come into play. I have an excellent CHC in my area. That CHC owes some gratitude to my hon. Friend the Member for Ashfield (Mr. Haynes), who used to be its chairman. My hon. Friend ran that CHC well, and it is the kind of organisation we should maintain.
  Mr. Orme: I thank my right hon. Friend. My right hon and hon. Friends have underlined the importance of the CHCs. When one is a Minister, CHCs can often be a nuisance; they can be
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  critical and raise questions. But that is what CHCs are for in a democracy. Ministers should be accountable. It appears that the Government—there is a further example in the Bill—are placing all the power in the hands of the Secretary of State, and we are opposed to that.
  Mr. David Crouch: There are only two members of regional health authorities in the House, and I am one. We should not confuse the function of the CHCs as representing public opinion—which is important and which should continue—with participation in the management of the National Health Service. There seems to have been some confusion during the last five minutes about where CHCs fit in. The role of CHCs is to represent the public concern about health care through the NHS.
  Mr. Orme: I thank the hon. Member for Canterbury (Mr. Crouch) for his constructive point. I believe in strengthening the CHCs. They are often the poor relation in the Health Service structure. From what has been said to me by area and regional health administrators, I understand that they would like to see the back of the CHCs, and for that reason I want to maintain them.
  I turn now to private practice, which the right hon. Gentleman made a central point of his contribution.
  Mrs. Jill Knight: The right hon. Gentleman has made a strong case for the CHCs. Does he believe that there should be no deletion of any tier?
  Mr. Orme: No. I am sorry if the hon. Member for Birmingham, Edgbaston (Mrs. Knight) misunderstood me. I said that we were in favour of improving the Health Service. If this measure will improve the Health Service, we will not oppose it. But we believe that three tiers are too many. What we are concerned about is what happens to democracy and representation. I am not opposed to looking at the basic structure as such.
  The second major proposal in the Bill deals with private practice, both within and outside the Health Service. As the right hon. Gentleman said, the Bill recommends the abolition of the Health Services Board, the reversal of the phasing out of pay beds and an increase in the number of private hospitals before

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  Government clearance to go ahead is obtained. The number of private beds authorised will be 120 throughout the country as opposed to the present 75 in the provinces and 100 in London.
  I recognise that the Bill contains a small measure of tightening up in the private sector. As I read the Bill, that will affect the abortion clinics. We believe that these three provisons amount to a positive step by the Government to encourage the private sector and allow it to flourish and develop.
  There is a fundamental difference between the Opposition and the Government. In principle, we should like to see a National Health Service with no private sector. However, we accept that a private sector exists, and no doubt we shall have a private sector in one form or another for some time. But the basic principle from which we start, and upon which the Health Service was founded, is to provide a service for the whole community. As with education, once people are allowed to buy themselves out, the pressure to improve the service is weakened.
  Mr. F. A. Burden Mr. F. A. Burden(Gillingham) rose—
  Mr. Orme: I must develop this point.
  I find it odd that we have to argue about the issue of common waiting lists. If a person needs to go into hospital—not necessarily urgently—he should not have to compete with the private sector. I raised this point with the right hon. Gentleman, and he did not answer. I pointed out the problems that would flow from having to compete with the private sector. Often the consultants are not prepared to take non-urgent cases into account. In many instances the consultant makes only a clinical judgment. We feel extremely strongly about this proposition.
  Mr. Burden: The right hon. Gentleman stated that the private sector, because of its advantages, would depress the public sector. Surely the opposite is true. If we have something that is better than that which is generally available for everyone, there is a pressure from those below, who do not receive those advantages, for higher standards. That happens in every walk of life.
  Mr. Orme: Health should not be dependent on payment. That is the moral point from which I start.
  The House knows that it was the desire of Aneurin Bevan to bring the whole medical profession into the National Health Service on a salary basis. That was unacceptable at that time to the medical profession. To launch the National Health Service, he had to concede that point. He recognised that he could not persuade the medical profession to accept what he was advocating. Thirty-one years later, I still think that that basic argument is right and I re-emphasise it.
  The Government are to abolish the Health Services Board. This is an independent body, yet the Tories still cannot trust it so they abolish it. The Secretary of State takes powers unto himself—and tomorrow in the Social Security Bill he will take more powers unto himself—and abolishes independent bodies which are appointed to perform a service for the community. Their abolition is all tied up with this word "quango" Apparently, because they are called quangos, they must be wrong. We do not accept that attitude. In fairness to the Secretary of State, he paid tribute to the people who have worked on the Health Services Board, and, of course, he has just reappointed them—
  Mr. Patrick Jenkin: That is an example of what I was referring to. The board is in no way answerable to this House, and therefore I have no option under the existing Act but to reappoint the members until this Bill becomes law. I should have thought that accountability to the House of Commons was something that the right hon. Member, as a House of Commons man, would appreciate. Surely there is some merit in accountability—a merit which he has not recognised.
  Mr. Orme: I do not accept that interpretation of accountability. Everything cannot be accountable. Personal cases cannot be accountable. Of course, the Secretary of State has given us an incentive. The longer we keep this Bill in Committee and elsewhere, the longer he will have to wait for the abolition of the Health Services Board.
  I come to the serious point that the Secretary of State made about industrial

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  relations in relation to the phasing back in of pay beds and the abolition of the Health Services Board. He keeps on about industrial relations. He keeps referring to last winter and the problems that arose then. In abolishing the independent board and phasing pay beds back into the NHS, the right hon. Gentleman will do more harm to Health Service industrial relations than he could have done by any other single measure. We shall see a return to queue-jumping at the taxpayers' expense. I have never understood how this could be justified. The green light to private hospitals will further undermine the National Health Service. It is already difficult to attract staff at all levels, and now more personnel will be siphoned off. Nowhere is there a duty laid down to assess private sector development in the interests of NHS patients, who form the vast majority.
  How long will it be before the Secretary of State's much-vaunted insurance proposals, which would take us further down the road to the destruction of the NHS, see the light of day? What views does the Secretary of State have on the effect of these on the size of the administration? He often speaks of the insurance principle. Perhaps he has seen the recent lecture of Professor Brian Abel-Smith, who made this point:
  "The only problem which a switch to health insurance could help to resolve would be that of unemployment. If we followed the French or German examples it would mean creating some 150,000 to 200,000 extra bureaucratic jobs to collect…contributions and bills.…The elimination of separate billing is one of the largest economies from having a National Health Service."
  That is a central point. When the Royal Commission examined overseas health services, it came to the view that the administration costs of the NHS were possibly the lowest in any modern developed society.
  I turn to the question of voluntary fund-raising, which is not unconnected with the previous point. I do not take back one word that I have said on this issue. Earlier I quoted what Aneurin Bevan said in 1948 when he was appointed Minister of Health. If there was one thing that he wanted, it was to stop the practice whereby nurses had to go around with collecting boxes two or three times a year to subsidise or help finance their local hospital. This is absolutely
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  different from the question of raising money to improve a room or buy a chair or television set.
  In principle, there are objections to voluntary fund-raising. It favours the popular hospitals. It favours richer districts where money is easy to raise and this increases inequality between the rich and the disadvantaged. No doubt the Secretary of State has seen what the Royal Commission said about the under-privileged areas in the inner cities. This is one aspect on which I criticise the Royal Commission because, while it refers to this matter, it does not take on board the seriousness of the situation. I represent an inner city area, and I know the problems. Fund-raising also leads to unhelpful annual variations in revenue and may encourage last-minute cuts. It favours popular specialities, such as cancer, at the expense of the mentally ill or geriatrics.
  Let us take the example of the "Blue Peter" campaign on Kampuchea. The voluntary organisations have complained that this campaign has sucked away from them the moneys which would otherwise have come to them. We have the classic example of the fund-raising case in the North-West. I believe that this is a bizarre way to apportion money.
  Clause 4(3) says:
  "The activities authorised by this section include public appeals or collections and competitions, entertainments, bazaars, sales of produce or other goods and other similar activities, and the activities may involve the use of land, premises or other property held by or for the benefit of the health authority or the Board exercising the power."
  The Secretary of State said that he was taking powers of control. He said that there would not be casinos. But I wonder whether he will allow nurses to raise collections. Will he issue a code of guidance on this matter to area or regional health authorities?
  Mrs. Kellett-Bowman: The right hon. Gentleman really cannot have it both ways. First, he says that fund-raising provides chairs and television sets and then he goes on indirectly to attack the Pat Seed cancer campaign in the North-West which has raised money for specialised equipment in dealing with cancer. Fund-raising goes far beyond that. It provides kidney machines and, in my own hospital, it has provided apparatus in the Intensive care unit. This equipment would not have

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  been provided with the money supplied by the previous Government.
  Mr. Orme: I give credit to the magnificent work done by Mrs. Pat Seed, but, quite frankly, it should not have been her responsibility to raise £1,750,000. That is a question of financing, and if equipment is so essential and needed so badly it should be provided by the State. The right hon. Gentleman told the House that he could stop certain things and allow certain things. We are entitled to know what they are.
  Mr. Patrick Jenkin: The words "casinos" and "lotteries", as I understand it, do not come within the clause. They would be the subject of legislation from another Department. My control would be exercised through the opening words of clause 4(3):
  "Subject to any directions of the Secretary of State excluding specified descriptions of activity".
  Mr. Orme: It becomes more confusing. We shall examine the clause in Committee and consider any further proposals put forward by the Home Office.
  In the financial provisions in clause 5, the sections on financial duties are ridiculously rigid. They confer vast powers on the DHSS and the regional health authorities to order around district authorities, and make it a legal duty to remain within cash limits. At a time of unexpected changes in inflation rates, it seems unfair and impracticable to set out that sort of duty, especially as the Government are creating the inflation. It only increases the pressure to make large panic cuts, leading to gross under spending. Funding would be reduced by the Treasury.
  We shall wish to examine that clause in great detail. It provides powers to remove authorities which do not carry out the Secretary of State's wishes or which he feels have failed to carry out their statutory obligations as laid down in the Bill. In Lambeth and Southwark he has suspended the authorities, but he cannot remove them. It is important to note that in the Bill he takes powers to sack authorities if he so desires.
  I shall put many questions to the right hon. Gentleman. If he is unable to answer them, we shall await consideration of them in Committee. Would the
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  money that the Government expect to save from the reorganisation be added to the Health Service Vote or would it go into the Treasury coffers? How much would be saved?
  I regret that the Minister for Health is not present. I hope that he soon recovers from his indisposition. He is on record as saying that the reorganisation would save £30 million. I have never known any reorganisation that has saved money. There has been local government reorganisation and Health Service reorganisation, and both have cost money. Will the Secretary of State spell out from where the £30 million would come? It could come only from salaries and job losses, because those are the real changes that are to be made.
  What powers of direction does the Secretary of State intend to take over the health authorities which spend over their cash limits? Would health authorities continue to be allowed the opportunity that we gave them to carry over to the next financial year 1 per cent. of underspending? Is that flexibility to remain?
  Does the Secretary of State agree that the interests of National Health Service patients must be the major criterion in deciding whether to allow further expansion of private medicine? The right hon. Gentleman has acknowledged that he has reappointed the Health Services Board. Would it be able to carry on phasing out pay beds? It is a statutorily legally appointed board.
  Clause 15 amends section 2 of the National Health Service Act 1966, which
  "enables the General Practice Finance Corporation to make loans to medical practitioners providing general medical services for the provision of premises and to acquire and lease to such practitioners sites required for such services".
  Will the right hon. Gentleman spell out whether that means that there will be basic changes?
  Dr. Alan Glyn: I am sure that the right hon. Gentleman understands how difficult, indeed almost impossible, it is for general practitioners to find premises in view of the high cost of property in London and other central areas. I believe that that is the reasoning behind the clause.
  Mr. Orme: I note that point, but we wish to know the intentions of the Secretary of State.

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  This is a thoroughly bad Bill that attacks the fundamentals of the Health Service. We oppose it and we shall fight it. I restate the Royal Commission's endorsement that the National Health Service should be free at the point of use for all and paid for by the community through direct taxation. I re-emphasise that, and I shall continue to do so.
  The National Health Service, with all its problems, is a credit to the nation, yet it is under central attack. We regard it as an outstanding post-war achievement. I assure the Government that they will have a major fight on their hands. We are defending something which we created and in which we believe. We shall continue to fight for it.
  5.48 pm
  Mr. Charles Morrison: Much of the speech of the right hon. Member for Salford, West (Mr. Orme) was taken up with fears that have been based on myth and his imagination. He sought skeletons in cupboards that do not exist. During the course of my remarks I shall refer to some of the issues that he raised.
  I say at the outset, especially as I shall be making some fairly critical comments on the reorganisation, that I am in complete agreement with the objectives of the Bill. Undoubtedly there is a need for changes in the administration of the National Health Service. From the beginning, some of us feared that the present structure would be too bureaucratic. Regrettably, our fears have proved well founded.
  The previous Government's Health Services Act 1976 was based on dogma and not on common sense. It did not have any regard to the growing public demand for private medicine, not least from the trade unions, to which my right hon. Friend the Secretary of State has already referred.
  Phasing out pay beds is contrary to public demand. It removes from the National Health Service a source of income. It divides private and public medicine and unnecessarily complicates the lives of doctors and consultants, some of whom have been tempted to opt out of the National Health Service altogether.
  Providing health authorities with the powers to raise money by appeals and collections is good not only in that it
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  provides a small source of extra funds but because it should have the effect of stimulating community involvement and interest in local Health Service provisions. Thus, money-raising could be one more way of keeping the Health Service authorities in touch with, and making them responsive to, public opinion. The right hon. Member for Salford, West utters ridiculous nonsense when he says that it is a bizarre way of allocating money. Such remarks demonstrate the opposition of Labour Members to any form of personal choice.
  I shall address most of my remarks to the method of rationalising the structure of the NHS administration. I was especially glad when my right hon. Friend the Secretary of State said that no conclusions have yet been drawn about the future organisation of the Health Service. It may not be popular to say so, but the simple truth is that the bulk of part I of the Bill is before us because we made nonsense of reorganisation in 1974. I suspect that the reason was much too much theory and not enough practical thought given to reorganisation. I have a nasty feeling that unless we are careful the same may prove true again.
  My first plea to the Secretary of State is that he should bear in mind constantly the emphasis in the Royal Commission's report on variety and flexibility of organisation. Every time that my right hon. Friend draws a conclusion about the Health Service organisation in one area, he should turn to page 324 of the report and remind himself of the contents of paragraph 20.48, which states:
  "The NHS is not a tidy construction and it still bears the marks of the haphazard growth of health services before 1948."
  The sentence that I wish to emphasise reads:
  "Arrangements which suit one part of the United Kingdom well will be wholly unsuited to another."
  I hope that my right hon. Friend will keep that paragraph before him throughout his consideration of the future Health Service organisation. That is one of many paragraphs that stress the need for variety. Again and again, the Royal Commission stresses the need for flexibility.
  That stated, I shall produce a little theory of my own. I ask the House to consider the pyramid of Health Service administration. At the top is the Depart-

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  ment. Underneath are the regional health authorities, the area health authorities, the existing district health authorities, and the community health councils. My right hon. Friend correctly wishes to remove one tier. It seems clear that the nearer the base of the pyramid from which the tier is removed, the greater the size of the bureaucracy which may be involved and the greater potential, therefore, for saving administration costs. However, that is not what my right hon. Friend seems to be proposing in the lead that he has given in his consultative paper.
  The consultative paper tells us that my right hon. Friend would like to get rid of area health authorities and build up district health authorities. That seems rather odd. First, it means that for most area health authority quangos now in existence there will be several district health authority quangos in future. I know that there is a view that there are not enough quangos to go round to meet the demand for places on them, but I understand that that is a view that is repudiated by the Conservative Party and by the Government.
  Secondly, every quango generates its own bureaucracy and costs. Quangos have done so in the past, whatever responsibilities they have had. Miracles happen, but not very often. I fear that, if district health councils are established, the expected saving of £30 million on bureaucracy will prove meaningless. I shall give two small examples to illustrate my argument. There are currently 17 members of the Wiltshire area health authority. If each of the three districts within that authority becomes an authority in itself, there could be a total of 60 appointed members. The consultative paper suggests that there could be up to 20 members of each district health authority. If there are 60 in total in Wiltshire, the cost of travel and of servicing the 60 will not be inconsiderable.
  At present the Wiltshire county council deals with one area health authority. In future its actions may have to be tripled. The extra time that may be taken by officers will not be inexpensive. The Association of County Councils is much exercised on that score. It believes that area health authorities should be coterminous with county councils.
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  My third argument refers to the natural evolution of the Health Service since it has been reorganised. In his speech to the Conservative conference at Black pool this year, my hon. Friend the Minister for Health praised the Somerset area health authority for saving over £200,000 by simplifying its administration. It did so by abolishing two health districts and centralising on the area, not by doing the reverse. Furthermore, I believe that 39 of the 90 area health authorities are now single district areas. On the tenth page of the consultative paper, which is entitled "Patients First", it is suggested that single district area authorities should not be changed unless there are substantial advantages. Thus, in that context it seems that my right hon. Friend recognises the value of centralising at area level.
  That value can be proved in a number of ways. I shall take one example from my own experience. The Wiltshire area health authority has decided to centralise its stores. That will save £100,000 a year. However, that decision has been made in the teeth of opposition from districts. I think that my right hon. Friend or my hon. Friend the Minister for Health will know of that opposition because representations were made to one or other of them from one or more of the districts.
  Fourthly, I put a question to the Minister who is to reply. In calculating the saving of £30 million, has account been taken of the fact that, under the currently prevailing Whitley council regulations, if a district management team becomes a district health authority all chief officers and some of their staff will be upgraded and, as a consequence, salary costs will rise?
  Fifthly, the implication of what has been said about the reorganisation—this is the implication of the consultative document as I read it—is that all area health authority responsibilities will go to district health authorities. Is that really so? I have no doubt that many duties which are above district level will go to regional health authorities. If I am right, decision-making will be taken further away from the community. At present, Chippenham, which is the headquarters of the Wiltshire area healthauthority—an area represented so ably here by my hon. Friend the Member for Chippenham (Mr. Needham)—has

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  liaison with the districts of Bath, Swindon and Salisbury. In future, distant Winchester, the headquarters of the regional health authority, could be telling those districts what to do.
  The Government are looking to the regional health authorities to review the structure of the National Health Service. If they continue to look in that direction, they can be certain of the conclusions before they are reached and forwarded back to the Government. It is a matter of human nature. People like power. By getting rid of area health authorities, the regional health authorities will increase their own power and will be in the position of being able to divide and rule the districts. I have no doubt whatever about that.
  The Association of County Councils has advocated the abolition of the regional health authorities. It makes the point—not an unfair one—that education is adequately dealt with at county level. Counties are directly responsible to the Department of Education and Science. Why, therefore, could not the Health Service be organised on similar lines?
  I refer again to the consultative paper entitled "Patients First". We all applaud that sentiment, but we must remember also that prevention is better than cure. I fear that that will be forgotten at the district level, where opinion is likely to be more subjective than at area level at present.
  Those are only some of the reasons why I doubt the wisdom of a wholesale slaughter of area health authorities. I should like reassurance—which I fear will not be forthcoming—before I am convinced otherwise.
  It is a not uninteresting fact that in their short existence every health district within the Wiltshire area health authority has overspent its budget in one year or another. Who has to get the district back on the rails? Who, in effect, has to discipline the district authorities? It is the area health authority. In doing so, it has incurred, not surprisingly, some unpopularity with districts and doctors. That is one reason why many doctors support the abolition of the area health authority. Should district health authorities be established, will their budgeting be any better, particularly in the face of the highly articulate advocacy of doctors and
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  consultants, whose voices will be even stronger at district level than at area level?
  The Secretary of State, rightly, has attached great importance to good mangement, particularly in hospitals. I fear that much of the best hospital management was dissipated by the 1974 reorganisation. Good management must be attracted back to hospitals. There is a shortage of good management in hospitals, as in many other spheres in the United Kingdom. Is it wise to spread the available management talent even more thinly than it is spread today by increasing the number of health authorities?
  Many existing area staff are worried that if areas are abolished they will not be offered service with district health authorities, which will make automatic appointments from among existing district staff. I hope that the Minister will be able to reassure current employees of area health authorities on that point. Clearly, the best management must be employed, but that may not always be from among those currently holding the jobs.
  I have long held the view that advisory committees, of whatever variety, have a limited useful life. If district health authorities are established, I believe that community health councils can be abolished. If there is centralisation at area level, it may be worth retaining community health councils, but only on the basis of the appointment of a representative from each community health council to the authority at area level. The longer the community health councils are left standing shouting on the sidelines, the less attention the players—the medical staff and administrators—will pay to them. At present, community health councils have no real power or responsibility. If they are to continue to exist, they must be given a small measure of both. If they are abolished and district health authorities are formed, the knowledge of many existing community health council members can be put to good use on district health authorities.
  Some of my remarks may have sounded a little harsh. I realise that in any Health Service organisation the Secretary of State deals with many matters on which the conclusions are often contradictory. Nevertheless, I hope that during the passage of the Bill through the House, and as he sets about the subse-

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  quent reorganisation of the Health Service, he will not forget my comments. Should he forget, above all, the need for flexibility and variety of organisation, the taxpayer and the user of the Health Service—not the Secretary of State, because he will have moved on by then—will live to regret it.
  6.9 pm
  Mr. David Ennals: I am sorry that the Secretary of State has left the Chamber. When I was Secretary of State for Social Services, he made some harsh remarks about me. I did not object to that. I start with a harsh remark about the right hon. Gentleman, and I am sorry that he is not in the Chamber to hear it. In the seven months during which he has been Secretary of State, he has done his job as if he were still a Treasury Minister. He has not shown the compassion which must inspire anyone with responsibility for a Department which is concerned with the sick, the disabled, the infirm and the weak in our society. He fulfils his function as if he were still a Treasury Minister.
  The right hon. Gentleman proved that in a letter he wrote to the director of MIND, in which he said that
  "where we differ from previous governments is not in our policies for the mentally ill and for the mentally handicapped but in our overriding determination to secure substantial retrenchment in public expenditure…I…accept that this retrenchment will have an adverse effect on progress towards the new patterns of services which we would all like to see."
  I emphasise the phrase
  "overriding determination to secure substantial retrenchment in public expenditure."
  That is the objective set by the Secretary of State, and I believe that it is an unworthy objective. He shows an excessive concern—as he did when he was on the Opposition Benches—for the private sector of medicine at the expense of the National Health Service.
  I have three main points to make. I want first to speak about the private sector and the pay beds issue; secondly, about local democracy; and, thirdly, about the financing of health authorities.
  In looking, first, at the private sector, it is important for us to realise what a very small sector we are talking about. It can be seen from the Royal Com-
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  mission's report, page 289, paragraph 18.22, that
  "The overall scale of private practice in relation to the NHS is small. In England about 2 per cent. of all acute hospital beds and 6 per cent. of all hospital beds are in private hospitals and nursing homes"
  As the report states,
  "The private sector accounted for about 3 per cent. of total expenditure on health care in the United Kingdom in that year.".
  That was 1976. So we are talking of a very small sector of health provision. Of course there are advantages in a private sector. Those who can afford it, and think it ethical, can jump the queue.
  I was very interested to hear the assurances that have been given by the medical profession to the Secretary of State. I should like to analyse them and to look at one or two of the qualifying terms, to see whether the assurances really mean anything at all. I hope that they do. I hope that they are built on the foundations that I tried to lay for common waiting lists. The private sector provides a supplementary income to those consultants who work in the NHS and also in private practice. On average, as the Royal Commission reports, there is about £6,000 per year in additional income for those who work in the NHS and who are also in private practice.
  On the other hand, the private sector acts as a drain on the NHS in many ways. First, it lives off the NHS. My right hon. Friend the Member for Salford, West (Mr. Orme) mentioned earlier that the private sector does not incur the expense of training its own doctors, nurses or other staff, and the Secretary of State quite rightly recognised this.
  Secondly, in some areas the private sector can suck into its orbit doctors and nurses who are needed by the NHS. This is why we established the Health Services Board. The Secretary of State has decided to expand the private sector, and I believe that this will take away doctors and nurses who are needed to run our National Health Service, which, of course, services the health needs of 98 per cent. of the nation.
  Thirdly, there is a degree of subsidy, because the capital element is not always adequately covered. That is a criticism of myself, perhaps—that we did not set the figure for pay beds high enough.

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  When we look at what the Royal Commission recommended, we see that the Secretary of State is straying very far away from it. He drew upon the Royal Commission's report in a number of cases. The Royal Commission concludes on page 298, paragraph 18.43(b), that
  "the capital element of pay beds charges should cover both the interest and depreciation costs of the capital investment in pay beds."
  More important still, it states that
  "the Health Services Board should be given power"—
  that men as additional power—
  "to control, and a responsibility to consider, the aggregate of beds in private hospitals and nursing homes when any new private development is considered in a locality".
  The Royal Commission's report mentions the strong emotion that is created by the pay beds issue among those who work within the National Health Service. As it states on page 294, in paragraph 18.40,
  "Pay beds arouse strong emotions…health service workers, including some junior doctors, resent both the additional work they claim is imposed by private patients and what they see as the purchase of privilege by a small minority within a public service. When the controversy is raging, patients suffer."
  Not "Patients First", but "patients suffer".
  Paragraph 18.42 states:
  "From the point of view of the NHS the main importance of pay beds lies in the passions aroused and the consequential dislocation of work which then occurs. The establishment of the Health Services Board led to a welcome respite from discussion of this emotional subject."
  Why stir the trouble up again? That is the question I want to put to the Government. Why should they now, at a time when they and all people who care about the National Health Service want to see an improvement in industrial relations, hit the NHS on an issue which they know is wounding to so many who work within it?
  I was involved in putting on the statute book the measure that the Bill seeks virtually to repeal. My aim was to try to cool troubled waters. Of course, the waters were not always cool, but in this sense they were. The great issue of private practice and pay beds was, in a sense, put before an independent board instead of being made the decision of the Secretary of State. The Secretary of State
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  has decided to take it back to himself. I believe that he is very wise in doing so.
  The Health Services Board is to be abolished eventually. The phasing out of pay beds is to be put into reverse, and the control of private hospital development is to be decreased. This is quite wrong at a time when more and more doctors are needed in the NHS and when an increasing proportion of the doctors are opting to work full-time with the NHS. We ought to be encouraging that trend, not discouraging it.
  We are not today discussing the details of "Patients First", although the hon. Member for Devizes (Mr. Morrison) referred to it in his speech. But the Bill gives powers to the Government to implement proposals contained in "Patients First". As has been recognised, at least the document acknowledges the mess that was made by the right hon. Member for Leeds, North-East (Sir K. Joseph) when he was Secretary of State. It broadly accepts the management recommendations of the Royal Commission and it gives the stamp of approval to my own work to create single district authorities.
  It happened to be my decision, taken by me as Secretary of State, which led to the creation of a single district area. I hope that the Minister, when he replies, will give some details. Is it to be assumed that over five years £30 million has been wasted each year, making an accumulation of £150 million? Where does this figure come from? Was it just plucked from the air? Our experience was that the creation of a single district area produced a saving of about £100,000. I hope that we shall get some answers.
  What about the consumers' interest? What is all this about "Patients First"? I said last week that it was a little cheeky of the Government to call the document "Patients First" when they were cutting down patients' services as a result of public expenditure cuts, and when they were putting up patients' charges as a result of their absolute determination—using the Secretary of State's own words—to reduce public expenditure.
  Will the Government's proposal for more local health authorities lessen the bureaucracy? That question was also asked by the hon. Member for Devizes. I cannot see that it will. I agree with my right hon. Friend the Member for Salford, West. I believe that paragraph

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  26 of the consultation document spells out the death knell of the community health councils. Certainly it must have done when the Secretary of State approved it. It may be that he is now changing his opinion. It may be that pressure is being brought to bear upon him, that perhaps £4 million is not everything, and that perhaps the views of the public on the running of the National Health Service matter a little.
  Community health councils took a few months—and in some cases a few years—to get under way, but they spoke up for the patient and for the community. It would be a tragedy if they were to be lost.
  I agree also with my right hon. Friend's criticism of the reduction in the number of representatives of local authorities. I very much doubt whether, in the sort of structure that we have here, we shall find our new health authorities being more responsive to the consumer. There will be fewer local authority representatives. There will be no elected representatives of staff interests, to which the previous Government were committed and which play a vitally important part in industrial democracy. As my right hon. Friend has said, regional health authorities are given greatly increased powers. The watchdog role of the community health councils is in danger of being seriously stifled by the Government. The Government have abolished bodies that criticise them. They may want to abolish the community health councils because the councils sometimes speak out critically. The job of the councils is to be critical and to speak up for the people.
  The Government have abolished the personal social services council largely, in my view, because it was critical of what is happening to the social services as a result of decisions taken by the Government.
  Clause 4 would give powers to the new health authorities to raise their own money by appeals and collections. We have run through the list. The Secretary of State has given an assurance that the list will not include casinos. I do not know the reason for his decision. Are there to be regulations stipulating that no casinos will be allowed? The right hon. Gentleman has decided against lotteries. Why should lotteries be excluded? Lot-
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  teries are one of the best methods of raising money. My local Labour Party is doing marvellously in every way, but especially in raising money through lotteries.
  What about jumble sales? Every time we put these suggestions to the right hon. Gentleman—it is a pity he is not present—he leaps up and says "We are not going to do that." The right hon. Gentleman is telling health authorities to raise their own money but not to raise it in ways that he, as Secretary of State, does not like. That seems to be arrogating to himself powers that no Secretary of State should seek to take.
  Mrs. Kellett-Bowman Mrs. Kellett-Bowman rose—
  Mr. Ennals: I have not given way. I may give way in a moment. I believe that the hon. Lady will try hard to catch Mr. Speaker's eye. I would not like to miss a word that she has to say.
  I am not opposed to leagues of friends and efforts to raise money for television sets, curtains and other items for hospitals. I am fully in favour of the voluntary effort that goes into hospitals. As Secretary of State, I did more probably than any other Secretary of State to put money, resources and encouragement into the voluntary spirit. One aspect was the "Good neighbour" campaign which the Secretary of State decided to abolish by merely signing a letter without hearing the views of the advisory committee.
  The work that can be done by leagues of friends is good. I am not opposed to local mayors setting up an appeal for a kidney machine or some equipment that the health authority does not possess. There are all sorts of voluntary activity. I believe that local people should be proud of their hospitals and should feel that they want to give. Some people, who know that their lives have been saved by the treatment they received in hospital, may want to make a donation.
  The Secretary of State said that over £10 million was contributed to health authorities last year simply through the good will of people who said that they wanted to put something back personally. That is fine. But it is a different matter to make health authorities dependent, or even partly dependent, upon public fundraising. As my right hon. Friend said, that is wrong in principle in a service that, for a long time, has been, and, I

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  hope, will continue to be, basically a tax-financed service.
  What is to stop some crafty Chancellor of the Exchequer or some Secretary of State with experience in the Treasury, simply because of the success of fund-raising, from reducing the public funds available? The right hon. Gentleman said that a clause in the Bill made this impossible. If there is such a clause, I have not seen it. I do not understand it. I doubt whether the Secretary of State understands it. I do not think it exists.
  What happens in practice? In Southport, one can raise the money; in Stepney, one cannot. In Bournemouth, one can raise the money; in Brixton, it is much more difficult.
  Mr. David Atkinson Mr. David Atkinson rose—
  Mr. Ennals: It may be easy. If the hon. Gentleman represents Brixton, I would like to hear.
  Mr. Atkinson: Bournemouth.
  Mr. Ennals: If the hon. Gentleman says Bournemouth, I give way.
  Mr. Atkinson: I wish to dispel once and for all the myth that Bournemouth is as rich as it is often made out to be.
  Mr. Ennals: I gave way only because I knew that the hon. Gentleman would make the point for me. His right hon. Friend is saying that the new health authority responsible for Bournemouth will have the right and the opportunity to raise money itself in order to do its work without any assurance that Exchequer finance will not be reduced as a result of the generosity—or the meanness—of the population of Bournemouth. I am sure that the people of Bournemouth are generous. However, to put this responsibility on a health authority is wrong.
  Those are my reasons—delivered, I fear, at remarkable speed; for I, like you, Mr. Speaker, do not believe in long speeches, and I hope to catch your eye again tomorrow—why I shall vote against the Bill and campaign against many of its proposals with great enthusiasm.
  6.26 pm
  Mr. A. J. Beith: When I first came to this House in 1973, I made my maiden speech on the subject of the National Health Service. That speech was a plea that reorganisation should not go ahead. It was not a particularly original plea but at least it was
  690
  right. I believe that that was proved by events.
  The first clause of the Bill demonstrates that the starting point of the Bill is the failure of the reorganisation that took place in 1974. The first clause gives the Secretary of State power to make changes in the local administration of the Health Service in England and Wales. Those structures proved a disaster. They were too extensive and too numerous. The administration proliferated. Jobs were created on a massive scale on the administrative side. There were ministerial appointments galore. A great many political appointments were made of a kind that the Conservative Party now seems to be questioning.
  People felt increasingly remote from the organisations that had been created. The whole affair was a disaster. It is fascinating to see how the Conservative Party and the right hon. Member for Leeds, North-East (Sir K. Joseph) now view the matter. There is a certain honesty about their attitude. One should pay tribute to that. They admit that it was a disaster. What worries me is that when the right hon. Gentleman believes he is right, his eyes blaze and he goes into things with a clap of thunder. No one is allowed to criticise him. It is written on tablets of stone.
  When he is wrong, the right hon. Gentleman is the frankest of all people in admitting it. That has been seen in practice. How are we to view the different pronouncements that the right hon. Gentleman is making as Secretary of State for Industry? This is not a subject that hon. Members can discuss today. But one worries about the situation.
  The Government have recognised that they have to take action over what was created in 1974. I welcome their decision. There are too many tiers in many parts of the country. It is right to try to remove one of those tiers in such a way that power goes down and not up. That must be a guiding principle of a removal of a tier from the Service.
  Many areas, including the county of Northumberland, part of which I represent, are single district areas. They have experienced the full extent of what this part of the Bill is likely to achieve, although not perhaps in identical form, for most areas. Where one tier has been removed, that has not proved enough.

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  Many of the problems that arose from reorganisation still exist.
  It should not be supposed that simply by removing a tier we shall solve more than some of the problems. Many more will remain. Those trying to work in the Health Service, at local hospital level or in local general practice, however much they may favour removing one tier, will not be satisfied. The mere shuffling around of administrative responsibilities a long way up the line will not help them sufficiently in their day-to-day affairs. They want to be able to make decisions or get decisions taken within the local hospital or within the local area of general practice. They do not want to wait upon decisions made 50 miles or 200 miles away in order to get a ward painted or arrangements and facilities within a hospital altered. They want those decisions made locally. When they had the hospital management committee, they could get decisions made locally.
  Most people in the Health Service whose memories go back to the hospital management committees are unanimous in their opinion that they could get decisions taken quickly and, on the basis of their own advice, much more readily in those days than they can now. Therefore, it is important that, as well as removing a tier from the Health Service, we pull power back to the level of the local communities and hospitals. That will not be done by taking out an administrative level. It requires a rethinking of the way that the Service is conducted at district level as well.
  That brings me to the question of community health councils. There is no doubt that in the consultative document they are damned with faint praise. That is perhaps the kindest construction that one can put on that paragraph. We must keep the community health councils because they are the nearest we can get to a democratic element in the administration of the Health Service. The Health Service is severely deficient in this respect.
  I should be happy to see the community health councils go in only one set of circumstances—namely, when we have a significant elected element in the running of the Health Service. In those circumstances a purely advisory health council may be less important, but, while the Health Service is dominated by
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  appointed members and is organised in such large areas, the community health council is essential. Indeed, many community health councils have demonstrated what a good job they do.
  Although I am critical of private medicine and am in no way enthusiastic to see it grow again—it has grown under the legislation now being discussed—the Health Service could well do without another row about private medicine. I feel that the Government are making a wrong move in getting rid of the Health Services Board. The board has helped to take some of the party political steam out of the controversy. People hold genuinely different opinions about private medicine. However, I hope that we can establish agreement about the fundamental point that private medicine should not be allowed to impede the conduct of the Health Service or be used as a means of queue-jumping within it.
  When we have covered that point, we enter a different area in which we can have a much more open difference of opinion. I hope that we do not disagree on that fundamental point. But let us not get involved in another massive row about it now. It is relatively marginal to the Health Service as a whole as regards the money involved and the number of points at which it impinges on the Health Service. Let us not allow this matter to take over the attention of Ministers and democratic bodies, such as Parliament, or lead to arguments within hospitals and to the souring of relations between management and unions in the way that it has done in the past. Whatever our individual views, that should be the dominant consideration.
  The Government will arouse false expectations if they imply that many of the fundamental problems of the Health Service will be solved by the provisions in the Bill. Very few of those problems can be solved in an atmosphere of massive public expenditure cuts. Therefore, I wonder what will happen on some fronts. What can the National Health Service do about the closure of pharmacies and the lack of dental services in many areas? What will the NHS be able to do, in the atmosphere of cuts, about long waiting lists which still exist for some operations?
  What can the NHS do about the disadvantage of travel that we find in many rural areas? For people in many parts

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  of my constituency to go for a regular check-up is an expensive business unless they happen to be on supplementary benefit. If that is the case, they can take advantage of schemes that help with travel expenses. But a low wage earner in a rural area, such as Northumberland, may have to pay £3 or £4 every time he goes for a monthly or quarterly checkup if he is suffering from a recurrent complaint. The Health Service has not yet solved that problem by any adequate means-tested benefit for people who have to travel long distances to hospital. We shall not be able to do anything about that problem if cuts continue to be the dominating factor in the Health Service. These matters are worrying to many people. If we can save money by simplifying the structure of the Health Service, let us do so and put it to uses such as that.
  6.35 pm
  Dr. Brian Mawhinney: I start by declaring the fact that I have no direct interest in the Bill, although perhaps an indirect one. As a part-time employee of one of the London teaching hospitals, I am under the University Grants Committee, not the DHSS. Of course, with my office in the hospital and as I teach medical students, I obviously have considerable interest in the Bill's provisions in addition to my interest as a constituency Member.
  I welcome the first two clauses, which indicate that before long there will be a change in the structure of the NHS. As has been recognised on both sides of the House, reorganisation was not an unqualified success. The Opposition sought to lay the blame on my right hon. Friend the Member for Leeds, North-East (Sir K. Joseph), but the difference is that, while they recognised that it was not a success and did nothing about it, we are now trying to put it right.
  Mr. Roland Moyle: Will the hon. Gentleman give way?
  Dr. Mawhinney: No.
  Mr. Ennals: Will the hon. Gentleman give way?
  Dr. Mawhinney: No.
  Mr. Speaker: Order. The hon. Gentleman is apparently not giving way. Therefore, hon. Members must resume their seats.
  Dr. Mawhinney: I recognise that administration per se is not bad. There is a tendency these days to blame administrators willy-nilly. That is not right. Administration is both too much and too remote. We shall want to know from the Secretary of State that any reorganisation means a slimmed-down administration, not for financial reasons but because the decision-making processes in the NHS have become bogged down. Doctors are spending too much time on committees, to the detriment of their patients.
  The hon. Member for Berwick-upon-Tweed (Mr. Beith) said that morale in the NHS was rapidly going down because it took such a long time for decisions to be taken. They are not being taken locally. They are being referred up the system and back down the system. We simply cannot operate when decisions cannot be taken locally.
  There is a decreased commitment on the part of all who work in the NHS because of the anonymity of the system. If no decision-making is available locally in respect of industrial disputes, for example, they are inclined to get out of hand because no one has the authority to say "Yea" or "Nay" or to negotiate meaningfully.
  For all those reasons, I welcome clauses 1 and 2 and look forward to considerable advantages accruing as a result of the changes which should be made.
  The hon. Member for Berwick-upon-Tweed was right when he said that the decisions must come much closer to the ground. For that reason, I welcome any proposal that will do away with the area health authorities. There is a need for an overall structure at regional level. Equally, there is a need for decisions to be made close to the ground, and that must be at district level.
  I welcome the moves to retain private practice within the NHS. It has already been acknowledged that this right was part of the original Act. It may not have been the desire of all Opposition Members. Nevertheless, it was enshrined in the original Act, and it should remain, for a number of reasons.
  The Royal Commission stated:
  "The difference in scale of the private and public healthcare sector suggests that private practice could have at most a marginal and local effect on the National Health Service."

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  Yet it has an important effect, for the Royal Commission also noted that just under half of all NHS consultants worked part-time. It is said that the majority do so in order to have a private practice. General practitioners are free to take private practice. The numbers in group private insurance schemes have been rising. There is obviously a desire on the part of those who practice and of those who benefit that there should be a private contribution.
  There are three reasons why that should be so. First—and it is no good Labour Members pooh-poohing the idea—there is a desire for an element of freedom by both doctors and patients. That desire should not be allowed to undermine the structure of the NHS, as has been suggested from both sides of the House, but there should be an element of choice. That element is manifestly desired, and the Bill will preserve it.
  Secondly, the Royal Commission says that the strongest argument in favour of retaining private practise within the NHS is the employment of the geographical whole-time or full-time consultant. It is nonsense to have parallel systems whereby those who practice privately in the NHS have sometimes to travel considerable distances between their two practices. This is disadvantageous, wastes time and money and cuts down the time available to doctors to practice their art. I declare an interest. Such a system adversely affects medical education, and if it continues it will have an increasingly detrimental effect.
  I believe that it costs £40,000 to educate a medical student during the five years of his course, which involves exposure to the whole gamut of medicine. It is not in the interests of the student nor in the long-term interests of the patient if the student's experience is restricted because certain types of medicine are increasingly practised only in private clinics and hospitals which are not located near the teaching hospitals.
  Dr. Roger Thomas: Is it not the practice on most medical rounds that when the consultant visits his private patients the medical students are excluded from that part of the round?
  Dr. Mawhinney: The hon. Gentleman will have to ask the consultants about
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  that. There is a need for geographical full-time consultants rather than those who have to commute between two locations. The third reason why that is important—I make no apology for returning to the point—is underlined in the report of the Royal Commission in paragraph 18.27. The report says:
  "we were told that private practice contributed towards the funds available for medical research. Academic staff holding honorary NHS contracts may not normally benefit personally from any private practice they undertake. The arrangement is that such fees are paid over to the university department and used for research purposes. The amounts involved are likely to be a small proportion of the total funds available for medical research, although they may be significant for some medical schools."
  It seems silly that funds for medical research, which will eventually benefit all of us, should be denied. It is unquestionably true that the amount of money which has been paid in private practice within the NHS—primarily to consultants—has been a bone of contention. I would like to see fees made available to all those who participate in the practice of private medicine within the NHS and not simply to the doctors.
  I believe that the Royal Commission is right when it says that we should look carefully at local services in the private sector. We may well be able to learn of the deficiencies in the NHS which cause patients to turn to the private sector in those localities.
  Mr. Ennals: The hon. Gentleman has quoted the Royal Commission several times. I take it that he does not doubt that the Royal Commission, having weighed up the advantages and disadvantages, reached the conclusion, in its wisdom, that the Health Services Board should be retained and that pay beds should continue to be phased out in the NHS.
  Dr. Mawhinney: I will come to the Royal Commission's conclusion shortly. If the Opposition Front Bench spokesman was so opposed to the Secretary of State taking powers and abolishing the Health Services Board he might care to give a commitment to the House that, if and when a Labour Administration are next returned to power, they will repeal that legislation. I shall listen with interest to his views on that.

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  I remind the right hon. Member for Lewisham, East (Mr. Moyle) that private medicine within the NHS has tended to be an up-market activity; that is, it has tended to be for those who want specialist treatment. There is a genuine problem facing the National Health Service which is recognised on both sides of the House. There is a commitment to try to retain the cottage hospitals and emphasise their importance to the local communities. Nevertheless, it is also recognised that cottage hospitals are expensive to administer. Will my hon. Friend the Under-Secretary consider the possibility of introducing private beds at NHS cottage hospitals, so that these establishments can be preserved? Such a move might extend the commitment of local communities to their cottage hospitals and would be a useful and important step in safeguarding that which all of us believe to be important.
  The Conservative Medical Society issued a statement yesterday in which it welcomed the retention of private practice within the NHS. It said:
  "we call upon the Government to honour their Manifesto commitment to restore income tax relief on employer/employee medical insurance schemes."
  I shall be interested to hear the reaction of the Minister to that suggestion.
  I turn to the point made by the hon. Member for Norwich, North (Mr. Ennals) and once more quote the Royal Commission report:
  "There is no doubt that the private sector contributes to the health care of the nation, albeit on a small scale…It would be virtually impossible to establish how far health workers are diverted from employment in the NHS. We have reached no conclusions about the overall balance of advantage or disadvantage to the NHS of the existence of a private sector, therefore, but it is clear that whichever way it lies it is small as matters now stand."
  That gives the lie to the statement from the Opposition Front Bench that this is a thoroughly bad Bill. It is not. The Opposition cannot turn to the Royal Commission for support for their spurious claims. As has been said, this is a moderate, sensible and anti-doctrinaire proposal. It helps to preserve that which the majority of the people of this country would like and will benefit patients who support that view. For that reason, I am happy to support the Bill.
  6.48 pm
  Mr. Laurie Pavitt: I could not disagree more with 99.9 per cent. of what has been said by the hon. Member for Peterborough (Dr. Mawhinney). My hon. Friends and I will demolish most of his case in Committee, though I would like to take up one or two of his points. From the Conservative Benches there has been universal condemnation of the National Health Service Reorganisation Act 1973. However, no one seems to have condemned the right hon. Member for Leeds, North-East (Sir K. Joseph) for his part in it, nor for the £250,000 that was paid to American consultants for wrong advice. This Bill reflects very much the same thinking and philosophy.
  The hon. Member for Peterborough should do more research before accusing the Labour Members of doing nothing about that abominable Act. The Act came into operation on 1 April 1974 and we won the election in the February. We voted against the Bill on Second Reading, in Committee, on Report and on Third Reading. When the Bill came into operation, we immediately made changes so that more local authority councillors could sit on the area committees. We strengthened the hands of the community health councils and established a national association.
  The Bill is abominable and thoroughly bad. It is half-baked. It has come out of the wash without adequate thought. It displays an abysmal ignorance of the history and development of the National Health Service. Even more important, it is irrelevant to the real and urgent problems which the Health Service now faces. We require positive new steps, and many of us could advise the Government about what they should be. No such steps are contained in the Bill.
  The Tory Government's economic policies are reminiscent of the 1930s. They are using the same type of remedies for unemployment. In their proposals for the Health service they are going back to 1911 and the Lloyd George Act. The Bill is so antiquated in its approach that I wonder whether the Conservates have learnt anything in the last 70 years.
  The House is insulted by the way in which the Government have presented the Bill. It is a hotch-potch. We have been

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  unable to consider the Royal Commission's report, the consultative document, "Patients First", the annual reports from the Health Services Board and reports from the Health Services Council. Instead of debating those documents first and reaching conclusions from them, the Government have presented us with an enabling Bill which gives carte blanche permission for regional health authorities to do what they like. We shall oppose the Bill tooth and nail at all stages.
  The move towards local administration would be a step in the right direction had it been better thought out and if it had provided a greater democratic element. Throughout the debates on the original reorganisation Act, hon. Members argued in favour of shedding a tier. If the area authorities go, the Minister estimates that there will be savings of £30 million. I predict that when that change takes place there will be no saving whatsoever in the administrative costs of running the Health Service.
  I go further. We are talking about a Bill to alter the present provisions of the Health Service, which costs £9,000 million a year. Even if we concede the estimated saving of £30 million, this is only 0·33 per cent. of the total expenditure. That is what my right hon. Friend the Member for Huyton (Sir H. Wilson) called trying to collect the candle ends. That is typical of this Government's approach. The Government recently imposed some mean and Scrooge-like savings the like of which I have not seen in my 20 years in Parliament. In particular, the Government have increased by £5 the "season ticket" for medication needed by the chronic sick. In their attempt to cut public expenditure, the Government could not leave alone those who are permanently in need of medication, such as those who have had a coronary thrombosis.
  The structure proposed is similar to the system which existed before reorganisation. Group hospital management committees will now have a new name. As my late right hon. Friend Dick Crossman said, business men and "self-perpetuation oligarchies" will be in charge, divorced from local pressures, especially if community health councils are to be abolished, as has been hinted.
  Primary care is our main need. The switch from hospital to domiciliary care
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  is most urgent. However, the Bill consolidates the power base in the hospital service. It is nonsense not to take this opportunity to move towards a democratic structure. If the community health council watchdogs go, the Health Service will experience a period of unease, there will be problems with those employed and in sound organisation, especially at community level, and there will be problems in the relationship between the local authority social services and the Health Service.
  In the care of the elderly and in mental health, there is a divorce between what is done in the locality and what is done in the Health Service. The Bill does nothing to bridge that gap.
  I turn to the question of the dissolution of the Central Health Services Council in clause 6. Paragraph 11 of the 1978 report, headed
  "Prevention of Handicap and Perinatal Mortality",
  states:
  "One of the Council's members, Mrs. Peggy Jay, raised the subject of policies aimed at preventing handicap of perinatal origin, and referred to experience in France that financial investment in a prevention programme to reduce the number of children born with a handicap could be substantially less than the cost of providing continuing care for handicapped children."
  That is an important issue. For the sake of £127,000 the reports that we have had on this subject and, for example, on rubella and deafness will go by the board. That is an example of the Government's penny-pinching approach, for this council's work was a good source of advice and information for Back-Bench Members.
  Under the Bill, dental consultants in hospitals may use pharmaceutical facilities outside hospital. That conceals the fact that pharmaceutical services in hospitals have been run down to such an extent that they can no longer provide a proper service. That is because of public expenditure cuts. As a result of that provision, prescriptions will cost more and that will lead to greater—not less—public expenditure. We shall pursue this matter in Committee.
  The centrepiece of the Bill is that which deals with private practice. We started off at the time of the 1976 Act with 4,444 hospital pay beds out of a total of 500,000 in our hospitals. Now there are only 2,533. One of the Tory myths

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  is that the private sector can bring money into the Health Service. According to the figures, if the three major health insurance companies—BUPA, PPP and WPA—double their take-up of paying patients, the Health Service will gain by less than 1 per cent. of its total resources. The Bill is irrelevant to the problem.
  The urgent need is to discover a practical way whereby, on the present basis of 84 per cent. of NHS total income coming from taxation, we can finance the Service properly and not by flag days and other peripheral methods contained in the Bill. Between 7·5 per cent. and 8 per cent. of the GNP should be devoted to the Health Service.
  The Bill is a queue-jumper's charter. I shall bore the House with my own experience. There is no problem of waiting when the clinical need is urgent. I had a recent operation for cancer and there was no waiting; I went into hospital immediately. I am pleased to report to my hon. Friends that I am as fit as I am ever likely to be. My only health problems in future are likely to be in growing toe nails or corns. There is no waiting list for serious surgical necessities. However, there is a problem for non-urgent attention like gynaecology. A lady who is in acute discomfort but who will not die from it can be relieved of that discomfort under the Bill by jumping the queue and paying a consultant. That means that another case with the same clinical diagnosis goes to the rear of the queue.
  Hon. Members will know that it is in treatment for hernias, varicose veins and gynaecological problems that the money is made by the private practice consultant, and there is a financial incentive to prolong waiting time.
  I shall reserve for Committee my major arguments. I remind the House of what my late colleague Nye Bevan said when he resigned:
  "Those who live their lives in mountainous and rugged countries are always afraid of avalanches, and they know that avalanches start with the movement of a very small stone. First, the stone starts on a ridge between two valleys—one valley desolate and the other valley populous. The pebble starts, but nobody bothers about the pebble until it gains way, and soon the whole valley is overwhelmed. That is how the avalanche starts, that is the logic of the present situation."—[Official Report, 23 April 1951: Vol. 487, c. 42.]
  That is the logic of the inroad made 30 years ago and is the logic that remains
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  true of this Bill. This is the start of the avalanche which will result, if it is allowed to continue, in the complete destruction of all that is best in our National Health Service. Nye Bevan was a great House of Commons man. He was right then to insist upon the retention of the humanitarian and compassionate reasons for the first National Health Service legislation.
  I cay to the Government and to the financial insurance profiteers and to that small percentage of hospital consultants who put pay before patients that the next Labour Government will restore our Health Service. They will make it democratically responsible to the people whom it is supposed to serve. It is there for the patients, not for the doctors. A Labour Government will make the Service what it used to be, a system under which we shall be "Members one of another" and the healthy continue to take responsibility for caring for the sick and the disabled.
  Mr. Deputy Speaker (Mr. Richard Crawshaw): Order. Before I call the next speaker, I wish to indicate that the 10-minute rule will apply between now and 9 o'clock. I hope that hon. Members will limit their speeches, to save the Chain from having to intervene.
  7.2 pm
  Mr. David Crouch: I shall do my best. I hope that the hon. Member for Brent, South (Mr. Pavitt) realises that he was not so limited, although he voluntarily limited his speech. I was glad to hear him speaking with such vigour, as I know about the illness from which he suffered and to which he referred. It is a pleasure for the House to hear him speaking with vigour on a subject about which he is a considerable expert. For many years I have followed him in these debates on health matters in Committee and on the Floor of the House.
  I have a dual interest in health, not only in keeping fit—and keeping the National Health Service fit and improving it—but as a director of a pharmaceutical company and a member of a regional authority.
  Having fulfilled that little duty, I say this to the Opposition. They are working themselves up into a lather about the Bill. They have almost a synthetic indignation about the aims of the Bill. I

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  understand how they feel about pay beds. They go back to Nye Bevan on this question and they take notice of their consciences and feelings about the morality of pay beds. However, the Bill is not about that. It aims to improve the management of the Health Service. The guts of the Bill are designed to bring management closer to the patient. It is a move in the right direction.
  As a member of a regional health authority, I am involved in the Health Service. I am glad that the area authorities, not the regional authorities, will go. I do not say that in my own interest. I would welcome not having to do additional work. The area health authorities are an unnecessary tier in the management structure. There was a mistake in the structure when those authorities were set up. They seemed to feel themselves primus inter pares with the regional health authorities. They felt that they had direct access to the Secretary of State and could go over the head of the regional authority. That has not made for successful management. In fact, it has impeded good management. It slowed management decisions and produced frustration.
  I confess that I am happy to hear that pay beds are not now to go. I agree with the hon. Member for Berwick-upon-Tweed (Mr. Beith), who spoke for the Liberal Party. I hope that none of us in the House makes this the main issue on the Bill. It will only sour our discussion and consideration of the real issue.
  It is worth trying to raise money by voluntary means. I see nothing wrong with that. It happens at the moment for the various cancer funds. Considerable amounts of money are raised. Such appeals are emotional. It is an emotional aspect of health. I believe that considerable amounts of money could be raised on a local, rather than a national, basis to support the Health Service and particular hospital needs.
  The right hon. Member for Norwich, North (Mr. Ennals), a former Secretary of State, said that he would not mind money being raised for specialist equipment lacking in a hospital because it had not been provided from National Health Service funds.
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  I question the possible value, or advantage, of the voluntary recruitment of money as it might distort the best pattern of health service that we could produce. For example, it could be decided by a district health authority, under the new arrangements, to close a hospital—shall we say a small maternity hospital that was little more than a Victorian house with a dozen or 20 beds in it, which contained little equipment for modern maternity provision and care? Voluntary recruitment of money might distort the proper closure of such a place, as there could be an emotional appeal to keep that place open. When the money is raised, it might be used for something that could be against the best interests of good health care. I hope that my right hon. Friend will bear in mind that this move could produce the wrong result.
  I now refer to the duties, as I see them, of members of health authorities. I have served on one for so long. There is a certain art about being a member of such a body. Officials propose and members decide. That is the structure of management. Members decide after discussion. The debate is always better when the members, or some of them, know what they are talking about, have looked into the problems, and have taken the trouble to find out what it is that they are being asked to consider. It is preferable when they know the medical, regional and local views, or the views of general practitioners, nurses, consultants, ancillary workers or radiographers, and understand what the patients and public think of the problems.
  That is important for those who take part in the decision-making process. The members should know about those views. They should get about more and not concern themselves only with budget considerations. They must share among themselves the responsibility of finding things out, so that they may, as a team, cover the whole area of responsibility. It is here that the public interest can best be safeguarded. I want to see the public interest safeguarded in the management of the National Health Service.
  Mention was made of the community health councils. I have always been an advocate of the CHC. Hansard records my willing acceptance and blessing of the introduction of the idea of CHCs. I have lectured on them at King's College. I have supported them through

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  thick and thin. When CHCs become politically motivated and directed—from whichever side of the political spectrum—they become a disaster and render a disservice to the interests of patients.
  I refer next to the choice and selection of those who serve on health authorities. They should be health-motivated and health-interested persons rather than politically-motivated persons. It is a disaster for management when politics comes in and the political football is introduced. At this point, the professional men in NHS management become frustrated.
  The community health councils have an important function as a focus for public inquiry and interest. However, I do not think that they should be used as a device to frustrate and slow up management. By all means there should be inquiry. Their members have a right to be present and to be heard when a case is being put, but they are not there to frustrate and delay.
  I am sorry that there is no clause in the Bill to make a special case for London, for the 12 teaching hospitals. In some ways there should be a special case for all teaching hospitals, because I would like to insulate them from the problems of short-term patient care. I do not want to see them swamped by the general problems of the NHS that exist around them. This applies particularly in London, where there are 12 such hospitals. London's 12 teaching hospitals are like a special unit in the Army, a special corps that is kept slightly separate, with a separate management, related of course to the Health Service—not divorced from it in any way but completely related and integrated. They deserve special provisions in the general management.
  The chairman of the Royal Commission, Sir Alec Merrison, said in the concluding part of that great report that there would be no blinding revelations in his report, and there are not. Neither does the Bill offer an immediate cure. But 1 would leave with the House the thought that, no matter how much we improve the management and the democracy, we shall still be deficient in one major element in producing better health care in this country—we shall not have enough money in the National Health
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  Service. One day—I pray it will be soon—we shall earn enough in this country again to feed the right amount of money from the State into the NHS, so as to deliver a much better health service in this country.
  7.10 pm
  Mrs. Gwyneth Dunwoody: The hon. Member for Canterbury (Mr. Crouch) said that the Bill was about improving the management of the National Health Service. Frankly, it is about nothing of the kind. It is about giving a specific boost to private practice and it is also specifically involved with the nostalgia and the dogma of the Tory Party. When we make that clear, we know what we are actually talking about. After all, how can it seriously be suggested that we intend to improve the National Health Service and the management structure of it if there are the kind of comments that have been made by the Minister of State? He has suggested—and this has already been revealed—that he believes he will save £30 million by these changes.
  What the Minister does not say is how—if one tier is removed and, for example, we get lid of 30 area health authorities and create in their place 200 district hospital authorities—we improve the service. How shall we improve the structure? If we have different boundaries and retain existing private practitioner committees, and if they are operating on boundaries different from the district boundaries, how shall we improve the management structure in relation to primary health care? How shall we manage the district nurses and the associated health service workers? We cannot do so.
  What we are talking about, as we have seen in so many Bills since this Government came to power, is an attempt to tinker cosmetically with the overall effect, not to do anything which will fundamentally change and improve the Service.
  The NHS is desperately in need of improvement. particularly in the whole realm of industrial relations. What is so very depressing about the Bill is that there is not even any suggestion that there should be elected representatives of the staff working in the Health Service. That is actually ruled out of order. Last winter proved conclusively that we cannot treat

  707
  Health Service workers as if they are different from ordinary workers. We have to listen to their problems and try to find solutions. Most of them work at lower wage rates—and I am talking not about the medical profession but about the ordinary ancillary workers. The very fact that most of them work at lower wage rates than they could get elsewhere should be the reason for our being more aware of their industrial problems and more anxious to help them, not put them in a position where they are less advantaged than workers in other fields. The Bill does nothing to change that situation.
  I am extremely sorry that the Minister of State is not here today because I should like to have said to him that I regard his remarks about a specific instance at Charing Cross as extremely unhelpful, coming from a Minister with responsibility for industrial relations. We really cannot have a situation where people ride their political hobby horses at the expense of the National Health Service, and that is what he was doing in no uncertain terms.
  If, in the short time left to me, I say what I would like to have seen done in the Bill, it is because I believe the Conservative Government are not genuinely looking for the kind of changes that they say they want. I will give the Minister a little help. If he really wants to save the National Health Service a great deal of money, why does he not ask his Government to put a total ban on the advertising of cigarettes and tobacco products? Why does he not ask them to find time to discuss my Private Member's Bill? The amount of money spent by the National Health Service, not only on carcinoma and its treatment, and deaths from carcinoma, but on related diseases, is very much larger than the £30 million that he is suggesting he will save by these marginal changes in the Health Service.
  There is the suggestion that we should change the method of raising money. If the Government are really serious about wanting the district health authorities to have the right to raise money, why not give them the same powers as are available to local authorities? We do not really raise the amount of money needed for health care by putting our nurses out on to the streets with collecting-boxes. There is no constructive way in a modern society, with a rising cost of health care,
  708
  by which we can possibly get enough money. All we do is pander to the nostalgia of those people who think that flag days are days when they are operating effectively. We are bringing the "lady of the manor" mentality into the Health Service.
  I have no doubt in my mind that the timetable which is suggested, which is very vague, will make it impossible to consult all of the relevant parties in the NHS. There is no evidence that there will be a proper consultative procedure. That, after all, should be one of the things included in the Bill. There is already a very considerable planning blight inside the NHS, and the loss of morale is directly connected with this kind of shilly-shallying and change at Government level. There is the danger that we shall lose many of the best of our NHS staff. A further reorganisation will not affect health care at all.
  The problems that we have in this country of an ageing population and of certain specialties which have become Cinderella specialties will not be altered at all by the Bill. People will go on getting older. We shall need more money spent on the NHS. It has become very obvious that we are one of the countries which spends even less money than many other comparable countries in the Community. This Bill is really a gesture, and a rather nasty gesture, in the direction of one aspect of health care—private practice.
  When I was recently in Lesotho I noticed that in the hospitals there, which were very reminiscent of hospitals before the National Health Service was created, a very large and formidable black matron was going round and collecting sixpences from the patients as they sat up in bed. I am sorry to say that I believe that the Conservative Goverment are saying in the Bill that that is the situation they want to see created in this country once again.
  7.20 pm
  Mr. Paul Dean: I welcome the Bill and, in particular, the intention to streamline the administrative structure of the NHS and the provisions to remove the shackles which the previous Administration placed on private practice and to encourage local fundraising. There is a sombre background

  709
  to this debate. First, there is the waiting list in National Health Service hospitals, which increased by no less than one-fourth during the period of the last Administration and now stands at the highest figure ever.
  The right hon. Members for Norwich, North (Mr. Ennals) and for Salford, West (Mr. Orme), who were at the Department concerned, should be hanging their heads in shame at the waiting list which now exists. This Christmas there will be many more people than ever before who will be suffering the anxiety, inconvenience and pain of waiting for hospital treatment. Part of the responsibility was the appalling disruption in the health services that was carried out by a small militant minority of employees during last winter.
  I congratulate my right hon. Friend the Secretary of State on the circular that he has issued, which gives guidance to local health authorities on dealing with disputes. But what a commentary that circular is on the failure of the previous Government to give a lead in maintaining discipline in the observance of contracts and in putting patients first. It is quite extraordinary that my right hon. Friend has had to remind health authorities that they will have his support in enforcing the basic conditions of work—namely, that strikers should not be paid and should not receive bonus or overtime payments that have not been earned, and that working to rule and blacking certain work are usually breaches of contract.
  I hope that my right hon. Friend will go further and try to ensure that no-strike agreements are negotiated within the NHS. There is no place for strike action when caring for the sick. Using patients as hostages, as happened last year, is abhorrent to any fair-minded person. Indeed, it is wholly contrary to the calling of medicine and nursing.
  Mr. Race: Will the hon. Gentleman give way?
  Mr. Dean: I am sorry, but I shall not give way to the hon. Gentleman because of the limitation on time. I hope that he will forgive me.
  Against that sober and sombre background, I wish to mention two particular points with regard to the Bill. The first concerns administration. At Question
  710
  Time the other day, my right hon. Friend hit the nail on the head when he told us of a comment that had been made to him by a head porter in the Health Service—that there was too much administration and not enough management. That, indeed, is the reform that we want to see. Above all, it means that decision-making must be as close to the patient as possible.
  I share the doubts of my hon. Friend the Member for Devizes (Mr. Morrison) about whether getting rid of one tier of management will necessarily improve administration and bring it closer to the patient, which is what we desire. I hope that the Government will maintain flexibility in any proposals that they eventually bring forward. For example, what is right for the county of Avon, with its heavy concentration of teaching hospitals, is not necessarily right for Wiltshire or Somerset. I hope that we shall avoid getting into the position that occurred last time of imposing the same provision throughout the whole country when conditions vary considerably. I also query, as did my hon. Friend the Member for Devizes, whether it is right in every case to abolish the area health authorities.
  The second point to which I shall refer briefly relates to the provisions in regard to private practice. Here I declare an interest in health insurance. I believe that the proposals as my right hon. Friend has described them constitute a sensible, moderate and balanced package. I welcome the restoration of the power to allow private practice in NHS hospitals. That will mean much-needed additional money going to the Service. It will facilitate what the medical profession calls the "geographically whole-time principle", which will enable consultants to work on the same premises and to be available constantly to meet the needs of all their patients, both NHS and private. However, I hope that my right hon. Friend will not attempt to unscramble the omelette and restore all the pay beds that were abolished by Labour. Let us start where we are now and try to ensure that in the future pay beds are available where there is a demand for them and where they can be used and staffed effectively.
  I hope that my right hon. Friend will also take into account, as I am sure he will, that the attack on private practice by the previous Administration has given

  711
  a new lease of life to the independent sector. More people are now insuring than ever before, including many trade unionists. Much more independent hospital building is now taking place than ever before. In my view, we now need to forge new links in the light of the expansion of the independent sector between the NHS and private practice.
  For example, BUPA has carried out some valuable pioneering work in diagnosis and preventive medicne. There has been a rapid development in that area. I hope that the NHS will be able to make use of the pioneering work that has been done in the private sector. That is one of many ways in which the growing private sector can help the NHS. There are ample opportunities for partnership between the two sectors. That partnership need not be limited to pay beds.
  I also accept that Ministers are right—as, indeed, the Royal Commission recommended—to maintain some control over the private sector. It is sensible and practicable to have that reserve power. However, I share the concern of the independent hospital group about the likely effects of clause 10. That clause will allow independent hospitals of 119 beds to be built without the authority of the Secretary of State. That compares with the present figures of 100 beds in London and 75 elsewhere. That may appear to be an improvement on the present position. In practice, it could well prove to be more onerous because of the provisions in the clause relating to the aggregate number of beds in an area. In other words, the freedom of clause 10(1) could be neutralised by the restriction in subsection (2). Any figure is bound to be arbitrary, but I doubt whether it is right to have the same figure in London and for country areas. I believe that we need a more flexible criterion than is in the Bill at present, and I urge the Government to consider this matter again in the light of the representations that have been made by the private sector.
  I am running out of time. I merely conclude by saying that I welcome the Bill as a sensible, practicable measure which I believe will be effective both in strengthening the NHS and in encouraging the private sector.
  7.28 pm
  Mr. Andrew F. Bennett: The hon. Member for Somerset, North (Mr. Dean) began his speech by deploring the length of waiting lists. I agree with him that that is tragic. However, he ought to think carefully about how far those long waiting lists reflect a lack of resources within the Health Service and how far they reflect a policy by some consultants deliberately to make the waiting list long, either to boost private practice or merely as a matter of internal politicking within their own hospitals to improve and increase the resources that they receive. I have a suspicion that some consultants use the waiting lists as a means of boosting the whole concept of private health insurance. Therefore, we must be very careful about reading too much into the waiting lists.
  The Bill is disappointing to all who use or work in the Health Service. The Service is looking for bold and imaginative leadership, yet all that the Bill does is to tinker and patch. It is even worse than that, because it reveals an attitude of despair in its approach to private medicine. Basically, the Government are saying that we cannot provide a good enough NHS to satisfy the rich and the vocal, so rather than improve the whole Service their aim is to buy off that criticism by giving privilege and preference to those who have the money to pay. We should throw out the Bill, but I suspect that the majority in the House will not do that, and there is therefore a strong necessity to modify the provisions regarding private medicine, which feeds like a parasite on the National Health Service.
  If the extra provisions for private practice are enacted, any doctor, nurse or ancillary worker who has been trained in the Health Service and goes into private practice should have to make a contribution to the National Health Service from the money they earn to pay for the training that they have received. The Health Service should not continue to subsidise the private sector in that way. The provisions on private medicine make the Bill unacceptable, but it is also unacceptable because of an omission.
  The Bill makes no mention of preventive medicine. Why will not the Government take on the question of ill health resulting from cigarette smoking? If the Minister really made an effort, far

  713
  greater savings could be made and more resources would be available to the Health Service than any of the administrative changes suggested would provide. Why do not the Government tackle the question of road accidents, which are, often an almost direct result of people driving when they have had too much to drink? That would make more resources available to the Health Service than will come from these administrative changes.
  Why will not the Government tackle the problem of those children who are born with physical and mental handicaps because of the lack of perinatal care? Why does not the Minister improve screening services to ensure that those who suffer from an illness get early treatment at a lower cost? If the Minister wants to offer a lead to the country, he should make a major contribution to preventive medicine. We will get a far better return if we invest money in prevention rather than in cure.
  The Bill does nothing to deal with the scandal of small private hotels that have a specialist clientele comprising the elderly. Those elderly people are often in exactly the same conditions as those who are in old people's homes or in psycho-geriatric wards of hospitals. However, some of those hotels manage to avoid all the regulations that apply to old people's homes. In many cases they exploit and damage those old people in an unacceptable manner. The Minister should legislate for that and should make sure that anyone who is responsible for looking after old people meets minimum standards.
  There is an overwhelming case for making the Health Service responsible to a democratically appointed body. No such measure has been taken in the legislation. Indeed, we are going backwards because we are reducing the number of elected people involved at a local level. It places the chairman of an area health authority or the chairman of a regional health authority and many of his colleagues who are appointed by the Minister in an impossible position. If they kick up a fuss and demand extra resources, the chances are that they will not be reappointed. That is unacceptable.
  Those authorities must have a mandate and be responsible to someone other than the Minister if they are to fight for and
  714
  demand extra resources. The Minister is going even further. Instead of giving democratic backing, he is saying that he will appoint officials. Bearing in mind the financial provisions of the Bill, the Minister will turn those officials into little more than rubber stamps. It is vital that everyone on the area health authority and on the regional health authority should be democratically elected and responsible to an electorate. That will give them power to say to the Minister that the Health Service must have more resources.
  The Bill is a totally bad one, and I hope that it will make no further progress.
  7.34 pm
  Mr. Robert Atkins: I welcome the Bill, especially clauses 7, 8 and 9, which amend section 65 of the National Health Service Act 1977.
  I wish to draw attention to an area of substantial abuse that has been un-quantified in terms of numbers or of cost. Much attention centred during the summer on the problems faced by unfortunate holidaymakers who suffer illness or accidents in foreign countries and do not receive the facilities available to them at home under the National Health Service. That publicity served to highlight the anomaly whereby nationals of those countries with which we do not have reciprocal arrangements for free treatment are not paying for treatment in the United Kingdom, although British citizens who go to their countries are required to foot any bills incurred.
  We have reciprocal agreements only with the other eight EEC States, New Zealand and some of the Warsaw Pact countries, but anyone from another State can obtain free treatment under the NHS for accident or illness. The relevant instruction of the Department of Health and Society Security was outlined earlier this year before the general election. It stated that visitors
  "should be allowed emergency treatment in accordance with the 'Good Samaritan' policy"
  and that
  "an approach should be made to the appropriate Embassy for a guarantee of payment."
  From the correspondence that I have received, it is clear that that is something of a comic performance. In addition, no

  715
  treatment for a pre-existing condition should be given, except
  "sufficient to enable them to return home"
  The key point is that
  "only hospitals which are authorised under Section 65 of the NHS Act 1977 may admit private patients".
  As a result of the Labour Government's policy, hospitals with the necessary pay beds have become few and far between. In practice, a great many emergency or casualty cases end up in hospital without section 65 sanction, and the ruling of the DHSS is quite clear:
  "Neither the hospital nor the consultant who treated the patient would have any authority to charge the patient."
  It is especially ludicrous that foreign nationals have offered to pay the whole or part of the cost of their treatment, only to be refused under the ridiculous section 65. In addition, there is evidence to suggest that a small but consistent number of people arrive in the United Kingdom suffering from the early symptoms of communicable or infectious disease, such as polio or tuberculosis. Those people are taken to NHS hospitals, isolation or otherwise, for treatment. One does not know to what extent there is any danger of infection to those on board the aircraft or ship or to officials at the point of entry that would otherwise not be present or he present to a lesser degree.
  What can be done about this clearly inequitable state of affairs? The former Minister, the right hon. Member for Lewisham, East (Mr. Moyle), wrote in a letter dated September 1978:
  "I do not consider it likely, therefore, that the improper use of the NHS by foreign visitors is as large a problem as my correspondent believes or that there is abuse on a massive scale."
  However, according to a letter from the DHSS only a month later, in October 1978, the Department could not
  "authorise new pay beds…nor can it approve temporary additions to the number of pay beds already authorised."
  It refers to section 121, which embodies the substance of section 17 of the National Health Service (Amendment) Act 1948,
  "empowering Ministers to make regulations whereby charges could be levied on persons not ordinarily resident in Great Britain…No such regulations however have been made."
  Powers exist under the Immigration Act 1971 to charge the carrier of a foreign
  716
  national who has been refused leave to enter the United Kingdom for expenses incurred in hospital care. That is particularly relevant if it is not possible for that person to be deported immediately because of his medical condition. How often are those provisions exercised? The guidance from the DHSS suggests that consideration was given to extending those powers but that it was never followed through. Accordingly,
  "the only possible answer is to provide NHS treatment in these cases."
  A number of people have written to me—and the Minister will doubtless comment on these matters in his reply—with suggestions as to how the problem could be solved. Mention has been made of the medical levy whereby tourists coming into this country pay, say, £10 for six months' emergency cover and of various other schemes involving stamping of passports.
  This problem was first brought to my attention purely coincidentally, when my 3-year-old daughter was in hospital, by a friend who was a practising hospital doctor. Since then I have received the most incredible amount of correspondence. I have a file full of letters from doctors, nurses and others working in the National Health Service, all of which draw attention to various abuses that have been brought to their attention. I shall briefly quote some of them.
  For example, a doctor in Sheffield writes:
  "I have, however, personal experience of a patient presenting himself at Heathrow from Hong Kong without having had a chest X-ray and was found on X-ray at Heathrow to have open tuberculosis. He was immediately admitted to an NHS hospital, and subsequently treated at great expense for the next two years."
  Another doctor says in reference to an American tourist:
  "At a dinner party…a guest who loathed 'socialised medicine' did admit that when he crashed his car on the M1 his care at the Luton and Dunstable Hospital was 'great'—yet they never sent him a bill!"
  Another doctor writes:
  "I was closely connected to a situation where a Portuguese resident was brought to this district with serious leg trouble, which I believe was gangrene. He was admitted to the National Health Hospital, locally, had a leg amputation and a temporary artificial leg fitted and duly returned home. Some months later, again he visited this area on holiday and had a final artificial leg fitted, again under the National Health Service."

  717
  Another doctor from Harley Street writes:
  "Two years ago I wrote to the last Minister of Health, and pointed out that certain Language Schools advertised free medical treatment in their brochures, and that 'Tent City in South London told campers that we had a marvellous free health system here."
  They were therefore not to worry.
  That doctor also comments that Britons travelling abroad are charged for treatment. Officially the money can be claimed back, using a form E111, but, as he said:
  "It just isn't worth it. Firstly you only receive a percentage…and secondly"
  it takes longer than six months to get the money claimed.
  I have here a letter from a consultant at the Hospital for Tropical Diseases who has made a great study of this problem. I shall not quote his detailed letter drawing attention to many examples of abuses of the system by tourists, but he says:
  "It is far easier to stay in the U.K. as a sick immigrant than a healthy one. I will send you many case histories."
  The most incredible example I have is a quote from the Newcastle Morning Herald and Miners' Advocate of Newcastle, New South Wales, Australia. A gentleman who writes regularly in those columns draws attention to a man who had tooth trouble. It was suggested that he hopped on a flight to London, costing him $568, to have his tooth fixed under the National Health Service at an expenditure of some $50, leaving him at least $132 for accommodation and souvenirs from the $750 that he was quoted in Australia. The writer of the column says:
  "That's a good one, eh? Terry, who has British citizenship, thought so too. He's booked himself into a hospital south of London to have the work done next month."
  Everywhere one looks, there is abuse of the health system. I have written to Ministers in various Departments, who had the grace to comment on a number of the points raised, and I have already mentioned the comments of the Under-Secretary. Many of the questions that I have raised are dealt with in clauses 7, 8 and 9 of the Bill, which amend section 65 of the National Health Service Act 1977.
  However, the Bill does not go far enough. The cost is enormous, although it has not been quantified to the extent that I wish. I hope that in Committee
  718
  the Government will bring forward amendments to deal with these problems. There is need for early action to remedy the clearly unfavourable bias directed at Britons travelling abroad, not to mention the cost to the British taxpayer remaining at home. Greater attention than ever before is being paid to cuts in public expenditure, and in this area of the National Health Service careful scrutiny and fair charges could restore some measure of equity and save money.
  I welcome the Bill, particularly clauses 7, 8 and 9. I hope that the Minister will comment on these abuses and the expenditure involved.
  7.43 pm
  Mr. Frank Haynes: Some hon. Members have had experience of the National Health Service. I have carefully read the Bill, and I agree with some measures contained in it.
  Since the reorganisation of the National Health Service, I have been saying that we should get rid of area health authorities, which are costing the National Health Service a great deal of money, but the proposals in the Bill do not provide the right answers. Are the Government thinking of merely transferring bodies down to district level, which appears to be the case? I cannot see how else they can do it, unless they are taking a further step to increase unemployment, which has been growing since 3 May, when I became a Member of this House.
  I compliment the previous Secretary of State for Social Services, who tried hard to reduce the cost of administering the National Health Service. I am an ex-chairman of a community health council and used regularly to attend the area health authority meetings. Those authorities said that they would see whether they could cut out waste, and the previous Secretary of State suggested about a 5 per cent. reduction over a period. The authority that I attended rejected the proposals entirely, and it was no wonder, because all its members were Conservatives. They rejected the suggestion of cutting out waste in the public sector that this Government are now pushing not only for the Health Service but in other areas. That authority made all sorts of excuses why it could not cut down on manning.

  719
  I believe that the great man from South Wales who created the National Health Service did so because there was a great need for it and it was necessary to be fair to all. As the years have passed, it has not been fair to all because of the private sector that has grown within the Health Service. I shall give some classic examples of private beds living off the National Health Service.
  The original fairness has disappeared and we have inequalities. People have to wait at the end of a long list for service, but if they went to see the consultant privately they could have treatment the following day. I know of a gentleman aged 70 years in my area who needed to see an orthopaedic surgeon, and he waited 42 weeks. When he got there, the surgeon said that he needed an operation on both legs but that he would have to take his turn in a long list unless he was prepared to pay £200, when he could come in in a fortnight. That elderly gentleman knew of an empty bed on a ward and mentioned that fact. He was told by the consultant "I am sorry. We cannot afford to staff it and that is why it is empty." However, for £200 he could have taken that bed, and that is the immoral proposal that is continued in the Bill.
  In the future, people will be able to buy their way into receiving medical treatment at the expense of those who cannot pay even more than they do now. Let us remember that not so long ago many people got a great deal of money from the Government at the expense of those who provided it. The same thing will apply. The poorer people will have to wait at the end of the queue for an NHS that is being run down. Make no mistake about it. Money will not be collected from the streets, as is being suggested. The policies of the Secretary of State for Industry have been mentioned a number of times during the debate. Not only will we be faced with raffles, bazaars and jumble sales but we shall need the begging bowl as well to run the NHS. It will be like the 1930s, when unemployed people begged on street corners.
  I was on a radio programme last Friday afternoon. The programme received several telephone calls from listeners. One gentleman asked me to men-
  720
  tion his point if I was called to speak in the debate today. He told me that a consultant had taken out a second mortgage on his house to raise funds for equipment he needs—not a television or curtains, but equipment to provide proper services to patients.
  I do not understand the Government's proposals. They will hit at the people who will really feel them—the people Conservative Goverments always hit, those without the necessary finance in their pockets. It is obvious that private beds exist for jumping the queue.
  Another representation was made to me by a person who made inquiries about a private operation. He was quoted a figure but could afford to pay only part of the amount. The consultant said, "Okay, three days in the private unit and two days in an NHS bed". That is the sort of fiddle that goes on, and if the Bill passes matters will become a damned sight worse than that.
  Reference has been made to the pharmaceutical industry. There is a real problem for the community in a lack of pharmacies. Most of them are private and they are closing down right, left and centre.
  Where will the proposals in the Bill take us? The Bill is in the interests of a certain section of the nation and not of us all.
  7.53 pm
  Mr. Richard Alexander: We must be quite honest and say that the reorganisation of the NHS in 1974 was a disaster and that with hindsight no Government—neither Labour nor Conservative—would do the same again. The NHS became cumbersome and heavily administered, and its patient contact with those in need by those who made the decisions was exactly nil.
  I was a member of an area health authority for some years. Without disrespect to my colleagues who worked with me there over the years, I can honestly say that, apart from the time that I spent on the regional economic planning council, my time on the AHA was the least useful that I have spent in several years of public life. Mounds of paper passed to and fro. Structure plans were expensively produced and chewed over while budgets were agonised over. Yet the positive decision-making where

  721
  patient care could be identified was rare. I hope that I do no injustice to my colleagues on the AHA when I say that.
  The amount of paper that was generated was horrific. Few members read it thoroughly, and those who did were not much wiser at the end of the day. The amount of administrative time taken up in preparing the reports was considerable. Here I pay tribute to the work of the administrators in the NHS. It is fashionable to say that the NHS is over-administered—it is. Nevertheless, administrators are carrying out the job that the Government have asked them to do. Most of them spend long hours, often beyond the call of duty, in their thankless jobs. It is the committees and the passing of papers between the RHAs, the AHAs, the CHCs and the DHSS that take up the time of so many of these dedicated men and women.
  The proposal to cut out one of the tiers will enable those people to administer more effectively. I hope that the new district health authorities will take over and complement the excellent work of the CHCs. I know of the working of only two CHCs—Bassetlaw and central Nottinghamshire CHCs. The outstanding benefit of the 1974 reorganisation was the formation of the CHCs. Nearly all the members are involved in closely monitoring local services. They do a valuable service by calling attention to the deficiencies that they discover. If, in their new guise as DHAs, we give them power to act as well as comment, we shall have gone a long way towards making patient contact with those who make decisions positive and effective.
  The people who are best able to judge local needs will be able to do something about those needs. In addition, they must have the power and the authority to tackle and expose the actions of such militants as are employed in the Service. At the moment, however outrageous may be the actions or behaviour of the militants, the chain of command is so remote that nobody has the effective authority there and then to stand up to those people. Still building on the work of the CHCs, it is essential, when the DHAs are appointed, that the local authority members should be appointed by the local authorities and not by the State and my right hon. Friend the Secretary of State.
  722
  Fortunately, the old aldermanic system was got rid of in another reorganisation in 1974. In the old days, the hospital management committee was served largely by the most aged alderman—the one with the time to do the job. He was never thought fit to be replaced by a new change of blood. It was a self-perpetuating oligarchy that had little contact with the local community and patient needs. The 1974 reorganisation did away with that.
  Above all, the Bill, when enacted, will bring management back into the hospitals. The existing area catering officers, area nursing officers, engineers, and treasurers, to whom any major decision must be referred, will go. The person with authority will be the person at hospital or, at the very least, district health authority level. It will be local control over local issues if the Bill goes through. Do we need regional health authorities? Could they not go while we are about it despite the excellent work done by my hon. Friend the Member for Canterbury (Mr. Crouch)? I have read the minutes of meetings of my regional health authority for some years, and I sometimes wonder whether the journey of those who attended was really necessary. Decisions involving money are made by the Department of Health and Social Security. There is virtually no democratic representation on regional health authorities, so the need for them on democratic grounds has not been made out. Those authorities are merely another tier for passing paper to and fro. Perhaps when the Bill goes to Standing Committee consideration may also be given to phasing out regional health authorities, too.
  I make a plea for consideration to be given to the training of more ancillary specialists, who are so vital to the National Health Service. We are short of speech therapists, yet we are producing sociologists, economists and psychologists from our universities. People who want to train for these ancillary specialties find it difficult to get a place to train.
  In all seriousness, I say to the House that nothing in the reorganisation of the National Health Service would please the nation and the nursing profession more than if we were to scrap the title "nursing officer" and once more call a hospital matron "matron". It would bring

  723
  back a human touch to our hospitals, which is what the Bill is all about. I give the Bill a warm welcome.
  8.2 pm
  Dr. Roger Thomas: If one is a doctor and a prospective parliamentary candidate, one is lucky to get away at the end of a meeting without being asked for one's views on private medicine. There is no doubt that within the Labour Party, including the Parliamentary Labour Party, there is an emotive objection to, even an abhorrence of, private medicine. It is felt to be distasteful that money can buy preferential treatment. Sometimes money can buy treatment and care for which there are many disturbing delays within the National Health Service. The reaction, at all levels of the Labour Party, of wanting to ban private and independent medicine is a phenomenon that we as a party have to live with and tolerate.
  If an individual wishes to spend his own money on the care and health welfare of his family, he should be allowed to do so. However, he should be restrained from pursuing that freedom unless the medical treatment has been provided totally by the private, independent sector and no State facilities have been impinged upon or used to the detriment of similar cases on NHS waiting lists.
  As was emphasised during a similar debate in the autumn of 1976, private medicine has often used back-up facilities that were available only within the NHS. There is little evidence to show that such practices are not still as extensive as ever. It would be unfair to say that the majority of consultants are guilty of such practices. Only a minority is involved. However, undoubtedly pressure is used within NHS departments to manipulate waiting lists for essential pathological or radiological treatment. The original consultation is carried out on a strictly private basis, but from that moment things change and there is a fair amount of queue-jumping.
  In the autumn of 1976, the present Secretary of State said that there was no support within the NHS unions for removing NHS hospital beds. He suggested that we should wait until the Royal Commission had reported on Health Service finance and manpower. We now know what precious little
  724
  attention the Minister and his team intend to give to the parts of the Royal Commission report that do not fit snugly into their own future plans for an emasculated NHS.
  Major problems confront the NHS and many of the important decisions within it and the main hospitals cannot be remedied unless adequate finance is provided. When I qualified, I served at various hospitals. At the head of the hospital there was a medical person. It would be good for the NHS if a medical person was once again in charge of our district and general hospitals.
  Hospital porters who notice consultant surgeons leaving much of the morning's surgical work to an able registrar immediately come to the conclusion that the consultant in question may have left to operate on a private patient elsewhere. I have heard that said often. The truth is that it is only a minority who indulge such dubious practices. However, it gives the whole profession an undeserved reputation.
  Twenty-five years in family practice have taught me that, on the whole, the middle classes have received, and will continue to insist they should receive, better and more prompt medical care than the lower classes. It is sad but inevitable that the educated middle classes are often responsible for keeping the primary care team on their mettle. More and more people, when told of long waiting lists, ask why they should pay for private care when they have already paid into the NHS.
  The cuts in 1976, which the present Secretary of State described as symptomatic of a system in despair, were not dissimilar to the cuts of 1979. They deserve the same vivid adjectives. I do not see in what subtle way ward closures under a Labour Government lead to low morale and callous unrest while financial restrictions under the Tories are expected to be accepted as part of a belt-tightening exercise that will help to bring us all to our senses.
  During the debate on the Health Service in 1976, the term "medical apartheid" was coined. The originator of that phrase thought that the Bill then being debated would bring about dual standards. The hon. Member who used that phrase was three years ahead of his time. It is clauses 7, 8 and 9 of this Bill which

  725
  possess all the ingredients for bringing about dual standards in the National Health Service.
  Even three years ago a vigorous, efficient and well-equipped private sector was being forecast. So was a growth in the methods of providing funds through costly insurance schemes. An increase was also forecast in the extras and perks which come with managerial and similar positions. But dual standards in medical care in this country, predicted three years ago, did not come about. The standards in the overwhelming majority of our hospitals, be they acute, general, community-oriented, chronic or geriatric, have been stoutly maintained and the better type of medical attendants, from consultants down to unqualified personnel, have not deserted the Health Service for the predicted greener and more lucrative pastures of private medicine.
  The British Medical Association waited long and patiently for the return of the Tory Government. The gestation period has been only eight months and the end product has been an acute disappointment to the BMA. This month's "News Review" emphasises that the present draconian cuts do little to dispel anxiety. They are producing a lack of confidence and a feeling of fear among members of the general public.
  In reality, the National Health Service has never been adequately financed, particularly in relation to building capital. But now cash limits are affecting the running costs, with the non-productive administrative sectors tending to run riot. Unfortunately, staff care is standing still.
  For these reasons, I strongly oppose the Bill.
  8.12 pm
  Mr. Allan Stewart: I wish to make a general point about part I of the Bill and then comment on clause 10. On part I, it is recognised on all sides of the House that there is widespread dissatisfaction with the present administrative structure. It is costly, and there are criticisms about its bureaucracy and delays in decision-making. However, I do not believe that structural changes in themselves, such as the elimination of one tier—however desirable that may be—will solve the deep-seated problems of management and resource utilisa-
  726
  tion in the NHS. At present there is something of a crisis of morale among the front-line troops—nurses and the doctors—about the effect on them of the bureacracy.
  I draw to the Minister's attention a recent series of articles and comments in the British Medical Journal. A consultant pathologist claims that there is too much so-called democracy in the National Health Service which is causing major problems. He says that hardly any decisions, even comparatively trivial ones, can be made without reference to the recommendations of umpteen committees. A nursing officer writes about carelessness, wastefulness and irresponsibility, all of which have increased. According to a consultant physician, every department in his hospital is overstaffed and he spends half his time on administrative work. His feelings have not been helped by the discovery about his cleaners. For many years he had one cleaner to clean his room. Now he has two, one for the windows and one for the doors. However, there is a demarcation dispute and no one actually cleans his window sills. His feelings were not helped either when he discovered that there was to be a training school for cleaners and that a room was to be set aside, filled with rows of unconnected lavatories and strips of different kinds of carpet. Teaching staff were to be allocated. The mind boggles at the thought of trainee cleaners pushing brushes up and down lavatory pans under skilled supervision. This is perhaps a trivial problem, but it exemplifies a serious crisis. There is a lot of qualitative evidence that resources are not being utilised effectively and that there is a serious crisis of morale among the frontline staff.
  I comment briefly on clause 10. Opening the debate, the Secretary of State put both the philosophical and practical cases for the independent private sector. This has expanded enormously from 500,000 in the mid-1950s to 2·5 million now. I believe that it will continue to expand. Labour Members talk about the adequacy of resources for the NHS, but there is a fundamental problem that, in a service that is substantially one of zero price, demand will inevitably exceed supply. No Government, however sympathetic, will ever supply sufficient resources to meet all possible demands.

  727
  Also, the private sector is helpful as an indicator of patients' needs. As the Royal Commission said, the private sector probably responds much more directly to patients' demands for service than the NHS. Therefore, the private sector provided a useful pointer to areas in which the NHS was defective.
  On the provisions in clause 10, there is a case in theory for asking why there should be any restrictions at all on the private sector. The point made by my hon. Friend the Member for Somerset, North (Mr. Dean) is important. On practical grounds, the magic figure of 120 may be insufficiently flexible. I hope that it can be looked at again, particularly as different considerations may apply in different parts of the country.
  Of course the private sector has a limited role, but I hope that it will expand, not only in London but in the regions. We have some excellent facilities already in Scotland. I hope that eventually Labour Members and the TUC will recognise practical reality and realise that an increase in the demand for private medical services is inevitable and that the private sector has a small but important and effective part to play in the total provision of health services in this country.
  8.18 pm
  Mr. William Hamilton: The hon. Member for Renfrewshire, East (Mr. Stewart) represents, as I do, a Scottish constituency. I hope that, with me, he will object to the way in which Scotland has been hooked into this Bill. The Scottish Health Service is differently organised—we have our own separate legislation and our own problems. We have very little private health provision in Scotland compared with England. As a result of this linking, we will be lucky to have more than one Scottish Labour Member on the Standing Committee on the Bill. In view of the fact that we took more than 40 seats out of 70 in Scotland in the election, this is an insult to the Scottish Labour movement generally and it will not be appreciated.
  It is humbug for the Government to pretend that the purposes of the Bill are to benefit the patient. To link the Bill with the White Paper on patients, as it
  728
  the sole objective of the legislation was to benefit those patients exclusively, is utter nonsense. Indeed, the Bill hardly touches on the fundamental problems of the Health Service. Indeed, it will probably make them worse.
  The Minister referred in a fairly superficial manner to the key clause in the Bill—clause 5, which deals with cash limits. It is clear that the Government will slow down the development of the Health Service. It has been slow in developing for long enough. In fact, the basic difficulty over the last few years has been the eroding effect of inflation and the very poor performance of the economy as a whole. The Bill does absolutely nothing to tackle the fundamental problems. The Health Service will suffer equally with, or to a greater extent than, the other social services from the public expenditure cuts imposed by the Government.
  The main purposes of the Bill are, first, to undo the damage done to the administration machinery by the previous Tory Government. We welcome that as far as it goes, but it needs careful consideration in Committee. Secondly, it seeks to switch limited resources—personnel and finance—increasingly to the private sector of medicine. Thirdly, it proposes to freeze or reduce the resources available to the National Health Service from national taxation.
  The detailed provisions of the Bill are properly dealt with in Committee. I shall make two or three general propositions that will not meet with the approval of the Government, but I believe that it is important to state them. First, medical facilities should be provided for all sections of the community on the exclusive basis of need and not greed. Secondly, the element of competitive rivalry is incompatible with health care. Above all, the law of the market place must not be allowed to govern the quality of the Health Service.
  The main case against private medicine is fundamentally one of political morality. That was the basis on which Nye Bevan acted when the Health Service was introduced, and that basis has been steadily eroded by successive Governments. It is precisely because we still live in a predominantly capitalist society, in which the market place is sovereign, that we hold strongly that the Socialist oasis—that is

  729
  what the Health Service is—must be safeguarded from the ravages of cruel and heartless market forces.
  We are told repeatedly that the role of the private sector in medical care is a minor one. Whenever there is a scandal, we are told to forget about it because the private sector is too small. The size and scope of the private sector in health provision is a threat to the egalitarian, humane nature of the Health Service. The greatest danger to our health comes from the intrusion of the market place and the profit motive—whether it be drugs or private medicine. The hon. Member for Preston, North (Mr. Atkins) spoke of those who came to Britain and filched services from the Health Service. That is grossly exaggerated. I hope that the Minister, either today or in Committee, will give details. It is a grossly exaggerated abuse. It is on a smaller scale than the scandals exposed in the report produced some years ago by my hon. Friend the Member for Wolverhampton, North-East (Mrs. Short) on the private sector of the Health Service, where evidence was given of consultants and surgeons taking on loan expensive equipment from the Health Service and forgetting to return it. If we are to talk of scandals and waste, that side of it must also be considered. It is also known that private patients are jumping the queues and refusing to pay their bills. Hundreds of thousands of pounds are outstanding in bad debts.
  The Government gave hand-outs to the wealthy section of the community in the June Budget. They are finding now that they must retrieve that money through higher prescription charges and a reduced quality of service in the National Health Service. They say that people prefer to have money in their pockets to spend in their own way. If they wish to spend money on health, why should they not? They might spend more money on tins of pork, or whatever. That is the thinking that governs the Government's actions.
  To reduce that to an absurdity, we have what I call the flag day and raffles clause. The mind boggles. The title of the clause is:
  "Power of health authorities, etc. to raise money, etc., by appeals, collections, etc."
  That might mean that the nurses could make jam and sell it at the entrance to
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  the wards. When the visitors are round the beds, they might hand out raffle tickets. There is no reason why the nurses should not run a football pool.
  That sort of behaviour is completely alien to the fundamental principles on which the National Health Service was built. It shows the contempt of the Tory Party for those principles. It believes that the market place can solve the problems of the National Health Service.
  Some years ago, the present Secretary of State for Industry said that we should have two Health Services, one to deal with the mentally ill and the geriatrics and the other in the private sector dealing with the more sophisticated and romantic problems, such as heart transplants. The Tory Government stand for first and second-class citizens, and that is why we shall oppose the Bill tooth and nail in Committee.
  8.25 pm
  Mr. David Atkinson: I welcome the Bill and believe that it is in the best interests of all who are concerned with the National Health Service, not least the patients, the professional staff and the taxpayer.
  I refer to three aspects of the Bill. The first is the proposed structural reorganisation referred to in the consultative document. From the debate this evening there appears to exist a widespread acceptance of the elimination of the area tier. It has proved to be too remote and to have encouraged the practice of buck-passing between various tiers—district, area and regional—and in consequence an avoidance of responsibility.
  The Bill suggests the emergence of a new, dynamic, powerful district authority with a membership reduced to around 20. It will have its work cut out if it wishes to be aware of and to satisfy local needs in the Health Service. It will mean full-time members, especially those who are already members of local authorities, and others with another job. I hope that they will be adequately compensated for loss of earnings. Perhaps my hon. Friend the Minister will refer to that aspect in his reply.
  Paragraph 23 of the consultative document refers to four local authority members representing the district authority. I echo the remark of the right hon. Member for Salford, West (Mr. Orme)

  731
  when he asked "Is that enough?" I also pose that question. Considering that the new district health authorities will probably cover a number of district councils as well as the social service authority, which is the county council, will four local authority representatives be enough?
  Paragraph 24 refers to retaining joint consultative committees. That is a reference to bringing together representatives of the social service authorities and the health authority. The terms of reference will prove to be all-important to the success or otherwise of the new joint consultative committees. The terms of reference should ensure the avoidance of talking shop committees, ivory towers, or semi-prestigious bodies for long-service worthies, as has often been the case in the past. They should be unique representative bodies concerned with health in the widest sense in the area with which they are concerned.
  We should recognise—it is no secret—that doctors have resented the establishment of separate social service authorities following the Seebohm recommendations in the early 1970s. We must recognise that on the part of general practitioners there exists widespread suspicion and dissatisfaction with social service departments. They feel—I do not necessarily share their feelings—that there is too much talk in the social service departments, too much desk work, too many case conferences and not enough field work in support of patients. The new joint consultative committees should recognise that. They should work towards a closer relationship between the general practitioner and the social services department.
  A suggestion that has been made on a number of occasions in the past is that each general practice should have attached to it its own social worker under the direction of the doctor.
  Paragraph 26 of the consultative document refers to the future of the community councils. As a past member of a community health council, I believe that such bodies have a useful role to play in highlighting the shortcomings of the Health Service in the areas that they represent and in voicing the complaints of patients.
  732
  The Community Councils represent good value for the £4 million that is spent annually on their behalf. They should remain—at least for the time being—until the new district health authorities have gained experience, bearing in mind that they will include local authority councillors, who in due course may find that they can replace the community health councils by taking up the complaints of patients and voicing the views of the local community.
  I turn to the part of the Bill that is concerned with the financing of the NHS. It is the part which is aimed at reversing the previous Government's policy of phasing out pay beds and private practice generally. We must recognise a number of factors. First, the NHS has suffered from a serious underfunding for a number of years. It will continue so to suffer. If the Government mean what they say and are determined that there have to be more public expenditure cuts, the NHS should not be excluded from these cuts. We cannot look to other countries to continue to pay for our National Health Service. We must look to the private sector to help to fund any expansion of the NHS if expansion is to take place.
  We must also recognise that attitudes have changed towards the NHS. When the Beveridge proposals were first introduced, they were based on conditions in the 1930s. They were implemented by Bevan in the 1940s. They may not necessarily be what people want in the 1980s, nearly 50 years later. I understand that the Labour Party is to include in its new song book the song entitled "Times they are a-changing". That is a theme that we need to apply to the NHS.
  The Government's annual publication "Social Trends" indicates that people are better clothed, better housed and better fed than they were 30 years ago. Real personal disposable income has doubled in that time. People want the right to choose between providing for the health needs of their family and spending their money on other things—holidays, a new television set, a new car, bingo, and so on.
  Mr. Race: Is the hon. Gentleman in favour of abolishing the National Health Service?
  Mr. Atkinson: I have not said that. They also want a choice between a "free" National Health Service, paid for by the taxpayers themselves, and a better service, for which they are prepared to pay extra, over and above the taxes they pay. That has been borne out—as my right hon. Friend the Secretary of State said in opening the debate—by successive opinion polls.
  Recently, I conducted a poll of opinion in my constituency, using my local Young Conservative organisation. We polled 855 people whose views would apply nationally as well as locally. We put the question "Should the Government encourage people to supplement the National Health Service by providing health schemes?" Five hundred and ten people—approximately 60 per cent.—said "Yes."
  Our National Health Service was once the best in the world. Now, as stated by the Royal Commission, it is no longer the envy of the world. In many ways we have been overtaken by other European
  734
  countries, which rely partly on private financing and partly on a system whereby a fee is paid.
  I welcome the announcement of my right hon. Friend the Secretary of State that a feasibility study of a State health insurance system is to be set up. I hope that the Bill will herald the start of a greater contribution to the National Health Service from the private sector than ever before, by offering incentives—perhaps in the form of tax relief—for the acceptance of greater responsibility. In that way, everyone wins. People who insure against illness, the so-called private patients, will get what they pay for—a better service. The National Health Service patient will get a better deal, because he will benefit from a better-funded Service.
  I turn, finally, to the matter of a better relationship—
  Mr. Deputy Speaker (Mr. Bernard Weatherill): I must tell the hon. Gentleman that he has had his 10 minutes.
  8.38 pm
  Mr. Frank McElhone: I emulate my hon. Friend the Member for Fife, Central (Mr. Hamilton) in resenting that Scottish health legislation has been lumped into a United Kingdom Bill. The Secretary of State for Social Services is amending, among other Acts, the National Health Service (Scotland) Act 1978. The Government are following the same practice with the education, local government, and industry Bills. I am sure that that will be resented by National Health Service staff in Scotland.
  I wish to comment on clauses 3, 4, 8 and 15. In the interests of other hon. Members, I shall be as brief as possible.
  Clause 3 covers joint financing between Health Service and local authority social work departments. As I understand, that system is already operating in Scotland. I do not understand the reference to it in clause 3, where it is stated that the "joint financing" arrangements in England and Wales will be statutory. As I understand, that is the case in Scotland. If I am wrong, I hope that the Minister who replies to the debate will correct me. The previous Labour Government provided extra money for local authorities—especially in the Strathclyde region—to finance the building of 30 hospitals for the mentally handicapped. Will the Minister indicate that that will continue, either through increased aid through the Health Service, or through the joint financing experiments practised under the previous Government?
  I endorse the resentment expressed by my hon. Friends, especially that of my right hon. Friend the Member for Salford, West (Mr. Orme) of the "flag day" society mentality reflected in clause 4. That will also be resented. I hope that the Bill will be amended to indicate that there will be no compulsion or undue persuasion on the staff—nurses or others—to ensure that they raise funds for health services.
  Clause 15 deals with the power to make loans to general practitioners. In what way will this practice be amended? I tell the Minister that in the deprived areas, especially in large housing estates and in some rural parts of Scotland, it is extremely difficult at present to get general practitioners. The main reason is that these areas tend to be those from which
  736
  the young families have migrated to new towns, so that they are left with the chronically sick, the elderly and the unemployed—the people who most regularly visit the GP's surgery. I hope that the Minister will be able to say that clause 15 will not be amended in a way that will affect the provision of greatly improved facilities in such areas.
  If there is any clause in the Bill which makes me feel very angry, it is clause 8, which seeks to amend the National Health Service (Scotland) Act 1978. That Act gave powers to the Secretary of State to allow the use of National Health Service accommodation and services for the treatment privately of patients. I tell the Minister that in my constituency, in the Victoria infirmary on the south side of Glasgow, and the related hospital in Mearnskirk, there has for a long time been a long waiting list, especially for orthopaedic surgery. Some old people in my constituency are suffering grievously from severe arthritis and rheumatic diseases. They are trapped in their homes. However, anyone who has the money can see certain consultants privately in their homes and surgeries, thereby jumping the queue. Clause 8 will be welcomed by that minority. I am second to none in my admiration of the doctors in the Victoria infirmary and in all other hospitals in Scotland, but a small minority of doctors are waxing rich, notwithstanding the misery of the poor people who cannot afford to pay substantial fees for private treatment.
  This is a bad Bill. It is a re-enactment of Cronin's book "The Citadel" and all the misery that was endured in the 1930s by the poor and deprived people in my constituency and in the rest of Scotland. It will be opposed with all the force that the Opposition can command, and I hope that it will be rejected.
  8.43 pm
  Mrs. Elaine Kellett-Bowman: I have the honour to represent a city which has for centuries been the focal point of medical care for a very wide area of north Lancashire, spilling over into Cumbria. It is no exaggeration to call ours a hospital city, since the National Health Service is the largest employer of men and women alike, and service often goes on in an unbroken line from generation to generation. It may well be that it is for this reason that

  737
  industrial relations in our hospitals are extremely good.
  We were fortunate in obtaining a new maternity unit three years ago. Within the money available, our structure is sound, and very old-fashioned mental and subnormality hospitals are being steadily brought up to date. Large wards are being subdivided, antiquated toilet and bath facilities are being updated, and facilities are being provided for the basic domestic and industrial training for the mentally subnormal who can, with such training, go out into the community. I was talking to a number of such people the other day. As low-dependency mentally subnormal patients, they are already going out to do part-time work.
  But, like other health authorities, we could always do with more money. The planning of improvements is very carefully phased, but clearly, if more money were available, modernisation plans would be speeded up. We desperately need a new theatre suite at the Royal Lancaster infirmary. Proposals for this were agreed two years ago, but the money has not been available, and the work is not now expected to be completed until 1987. Clearly, if more money were available, that date could be brought forward or temporary improvements effected.
  That is why I welcome the provisions in the Bill to enable local health authorities to raise their own funds and to put them to whatever purposes they choose. I am not suggesting that they could raise enough money for the full scheme, but they might very well raise enough to provide temporary facilities which would tide us over until the full scheme is completed.
  I also welcome the reversal of the Labour Government's determination to get rid of pay beds in National Health Service hospitals. My constituency is by no means a wealthy area. There will never be a demand for private beds comparable with that in the South-East. But, even in Lancaster, the phasing out of pay beds will cost about £60,000.
  The question of private medicine goes beyond that issue. On a national basis, no less than £30 million comes from pay
  738
  bed revenue. We in the North-West have long complained that the amount spent on health care has been consistently lower than that spent in the South-East. Every pound that is spent on private health care in the wealthier South-East reduces the demands on the National Health Service funds and leaves more for less wealthy areas such as the North-West.
  There is clear and growing demand for private medical treatment. There has been an increase in the number in private health insurance from 500,000 in 1955 to nearly 2·5 million in 1978. The number is going up at an accelerating rate all the time. It is a demand that is not by any means confined, as Opposition Members would like to imply, to the rich. Trade unions are increasingly including private health treatment in their pay bargaining. Shop stewards, members of the Transport and General Workers Union, negotiated private medical treatment for their 1,300 members at Bass Mitchell's, while 40,000 members of the Electrical, Electronic, Telecommunication and Plumbing Union, under the enlightened and modern leadership of Mr. Chapple, did likewise.
  Private medical treatment provides easily the biggest potential input of funds to health care and the best way of reducing waiting lists. I agree with my hon. Friend the Member for Peterborough (Dr. Mawhinney) that putting beds into cottage hospitals may save some of these popular places from closure, as could the raising of funds by people who wish to keep open a small hospital, as suggested by the Secretary of State in his speech.
  It is an interesting fact that the most consistently Socialist state in the Western world, Sweden, forbids private beds outside public hospitals so that doctors do not waste time travelling from one hospital to another.
  It is absurd for the hon. Member for Brent, South (Mr. Pavitt) to describe the Bill as a queue-jumpers' charter. National Health hospital waiting lists will continue to be common. But encouragement of the growth of private hospitals, particularly as they have agreed to play their part in nurse training, will take potential patients off the waiting lists, which grew by 250,000 under Labour, the largest

  739
  increase in our history. This is, indeed, cruel and heartless, to quote the hon. Member for Fife, Central (Mr. Hamilton).
  Mr. D. N. Campbell-Savours: On a point of order, Mr. Deputy Speaker. Is it in order for an hon. Member to read speeches to the House?
  Mrs. Kellett-Bowman: It is indeed in the interests—
  Mr. Deputy Speaker: Order. I am dealing with a point of order. It is not in order for hon. Members to read speeches. It is in order for hon. Members to make liberal use of notes but not to read absolutely from them.
  Mrs. Kellett-Bowman: This is the only way in which hon. Members can keep within the time allotted. I am seeking to do that for the benefit of Opposition Members, some of whom rarely join in debates, particularly those affecting their own areas.
  It is cruel and heartless that waiting lists should have gone up by 250,000, or no less than 50 per cent., under Labour.
  Clauses 1 and 2 confer on the Secretary of State the power to make changes in the structure of the National Health Service. But the Secretary of State has stated categorically that this will not prejudge consultation on the consultative document "Patients First", an excellent document which I trust all hon. Members have read. The document emphasises that people, not organisations, should be responsible for the care and cure of patients. There is no rigid blueprint that will serve for all time. Flexibility is vital, nowhere more so than in that part of the world from which I come, where patient flows cross county boundaries.
  That is an argument for another day. For the present, I welcome the Bill. It will expedite decision-taking and give back the degree of flexibility to the Health Service that it lacks.
  8.49 pm
  Mr. Alfred Dubs: The Bill will do nothing about the main weakness affecting the National Health Service, because successive Governments have starved it of funds. We are getting a National Heatlh Service on the cheap. From the Royal Commission's report we see that, whether looked at in terms of
  740
  expenditure per head or as a percentage of gross domestic product, we are near the bottom of the league. We are endeavouring to get too much out of too small a pot. The Government's suggestion that devices that I remember from my childhood, such as a hospital Saturday fund, will help to correct the problem is completely misconceived.
  I regret that the debate on the Royal Commission's report and on "Patients First" is to be held in the new year. It would seem logical to debate those two documents before the Second Reading of the Bill.
  I turn briefly to the question of democracy in the Health Service, because it is fundamental to those two documents and to the Bill. I was for some time a local council member of an area health authority. In "Patients First" the Government talk about the balance of district health authority members appointed by regional health authorities for the individual contributions that they can make. I question whether it is valid to have the NHS run by people who make only individual contributions. In my experience, almost all decisions that were taken on the area health authority on which I served had to reconcile conflicting interests and pressures. People representing different areas—be they local councillors, doctors or nurses—were accountable to some group within the area health authority. But individual members accountable to no one had no place there, because they could take no sensible part in decisions and in trying to balance conflicting interests. They were not accountable to anybody in the sense that, as a councillor, I always felt that I was answerable to my constituents for the decisions that I made on the area health authority.
  If our National Health Service is to be improved, the key decision is one of democracy and accountability, not a matter of reducing the democratic element by cutting down the numbers of councillors and talking only of members who serve as individuals.
  I wonder about the motives of those who want to go into private practice and of those who argue for these clauses in the Bill. The motive, first and foremost, seems to be money. Doctors want more money and the institutions that provide the basic services for private practice are also after money.

  741
  What are the patients after? I suggest that the majority want quicker treatment or to have treatment when it suits them, never mind others who are waiting for NHS treatment.
  Those motives are reprehensible and damaging to what the NHS was set up to achieve and is about. Thus, the Opposition reject them utterly.
  Several hon. Members referred to public opinion polls as evidence that people want private practice. It depends on how the question is phrased. If one asks "Do you think that more private medical care would not be a bad thing?" most people will probably say "Yes". If the question is put in real terms "Do you think that an expansion of private practice is desirable, even if it means, as inevitably it will, damaging the National Health Service?" I suggest that most people will say "No". That is the only honest way to put the question.
  About 60 per cent. of NHS expenditure goes on children, the elderly, the mentally ill and the handicapped. Not many private health schemes cover those groups. The private schemes take the fashionable, the easy, acute illnesses, and seek to leave to the NHS those groups of people who are most vulnerable and in need of real help. Therefore, those who argue for an expansion of private practice must do so in the knowledge that they are advocating double standards and do not mind how much damage they do to the basic National Health Service.
  The NHS is a compromise in the sense that, when it was started, we had to have some private practice. It is accepted that some private practice exists. The question is to what extent it will expand before it does serious damage to the principle of the NHS. This Bill encourages that sort of damage.
  Though some parts of the Bill are unwelcome, the suggestion for a simplified management structure is welcome. But, even when these changes are made, major problems will remain, especially in the London area where the problems of NHS organisation are more complex than elsewhere. What will happen to the postgraduate teaching hospitals? Will they become part of the main system or remain separate so that decisions on medical services will not take their particular activities into account?
  742
  Will anything be done to compensate for the wrongs done to the undergraduate teaching hospitals which are being deprived of their just share of resources? No formula yet worked out compensates them for the cost of treating the large number of patients taken from areas outside London.
  In their consultative document the Government say that they do not intend to change the boundaries of the Thames regional authorities. I regret that. Change there might have made NHS organisational problems in London more manageable.
  Various Government documents refer to the difficult problem of links with local authorities. I do not suggest that relations are totally bad or that they do not work at all, but the relationship between the local authorities and the NHS is a particularly difficult one and more thought is required in order to establish better relationships than in the past.
  With the exception of the provision for changes in management structures, this is a bad Bill. The Bill's bad features outweigh the good. It represents a backward step for the NHS.
  8.57 pm
  Mr. A. P. Costain: I have seldom heard a more inane argument advanced against a Bill than that put forward by the hon. Member for Battersea, South (Mr. Dubs). He seems to object to the fact that money needs to be raised for hospitals. He sees the raising of money as nurses rattling tin cans on street corners. I wish that he would come to my constituency, to Etchinghill hospital. Each year 3,000 local people turn out to support that hospital. It is the event of the year. If I were to say that we were against raising money in this way, local children would be completely disgusted. The annual fund raising for the hospital is an event to which the whole village looks forward. It is looked on as a good afternoon's entertainment and we raise about £3,000.
  We made an appeal for the Royal Victoria hospital at Folkestone. One of the nursing sisters there thought that the hospital should have special apparatus to help people suffering from heart disease. Within two days £3,000 was raised.
  An hon. Member indicated that money for hospitals could be raised only in rich

  743
  areas. Let me tell him that the apparatus to which I referred and which cost £4,000 was paid for in two days because the hospital sister went round two of the local establishments, one of which was Dungeness power station. She raised £1,000 in two hours because people like to be associated with raising money for hospitals.
  The difference in approach to this question since the Government took office has created a new attitude in the medical profession. Doctors now look forward to co-operating with the Department of Health and Social Security and helping to carry matters forward. They do not look backwards. Opposition Members have not admitted that the hospital service was not up to proper standards when they were in power.
  Mr. Race: If the hon. Member had listened to the debate, he would have realised that many hon. Members have drawn attention to the serious inadequacies in the National Health Service under both Labour and Conservative Governments.
  Mr. Costain: That is an unfair comment. I have listened to much of the debate. I have been doing other work in the House but I have listened to most hon. Members.
  My time is up. I welcome the Bill and look forward to its quick passage through the House.
  9 pm
  Mr. Roland Moyle: I must tell my hon. Friend the Member for Battersea, South (Mr. Dubs) that we accept the Royal Commission's recommendation that there should be an inquiry into the London health service. I hope that the Secretary of State will convey our condolences to the Minister for Health, who has been a vigorous contributor to our debates on the Health Service for many years. We miss him. We wish that he were here tonight, if only to answer for some of his misdeeds. I hope that he will be back with us soon.
  The Bill is like the curate's egg—good in parts. Anybody who has ever tried to eat the good parts of a bad egg and leave the bad parts will know that it cannot be done. For that reason we reject the Bill and we shall vote against it.
  744
  Clause 1 deals with administrative changes in the Health Service. We welcome the opportunities in that clause. Accord between the two sides of the House is greatest on that part of the Bill. I congratulate the Government on their obvious repentance in view of the damage which the right hon. Member for Leeds, North-East (Sir K. Joseph) did to the NHS when he was Secretary of State between 1970 and 1974. We are pleased to see that the Government intend to avoid using management consultants. I congratulate the Government on following the Royal Commission's recommendations on advice.
  I note in passing that the right hon. Member for Leeds, North-East plans to bring to the leadership of Rolls-Royce the personal qualities that he brought to the leadership of the National Health Service. As an ex-Health Minister I wish Rolls-Royce the best of British luck.
  I commend the Royal Commission's report to the Secretary of State almost in its entirety. That view will emerge even more strongly when we debate the report. I urge the Secretary of State to follow that report wherever possible. If he does that, he will not go far wrong. However, clause 1 does not reorganise the National Health Service. It merely provides the opportunity to reorganise it. The administrative principles set out in "Patients First" appear to be sound, and the idea of substituting district health authorities for a general tier of area health authorities is sound. However, we shall watch the way in which the Secretary of State carries out the reorganisation because his party's track record on reorganisations, particularly of water, local authorities and health services, is not particularly good.
  The hon. Member for Devizes (Mr. Morrison) and Newark (Mr. Alexander) made a number of helpful suggestions about the way in which the reorganisation might be carried out and the problems that must be faced. Those suggestions should be considered. My right hon. and hon. Friends will fight hard for the retention of the community health councils. I was glad to see that many Tory Members supported that view.
  I wish to make one or two comments on the reorganisation. The Minister for Health thinks that reorganisation will save the Health Service £30 million over

  745
  two years. That is the original figure. My hon. Friend the Member for Brent, South (Mr. Pavitt) is too generous in saying that it will save 0·3 per cent. of the Health Service budget in each of those years. It will save only 0·15 per cent. of the budget. In times past the record of Conservative Governments has been that their reorganisations have cost money—not saved it.
  Mr. Patrick Jenkin: May I make clear what is the figure of £30 million? This is a target saving that represents approximately 10 per cent. of the present administrative costs of the National Health Service. We have set ourselves that target. Subject to consultation and acceptance of the proposals, we shall seek to enforce it on the Health Service—but not over two years. It is difficult to put a time scale on it. We hope that that will be achieved when the simplification of the structure and the tightening of the management have been completed and given a chance to work.
  Mr. Moyle: In that case even my estimate of 0·15 per cent. of the health budget saved per year will be a gross overestimate of the savings.
  The argument for reorganising the Health Service is based on the introduction of flexibility, simplicity and decentralisation. At the end of the day, I doubt very much whether anyone in the National Health Service will notice any financial saving.
  On the subject of the family practitioners committees, the Secretary of State, having started by accepting the recommendations of the Royal Commission on the National Health Service, has now tended to backtrack. However, I am pleased that everything in the consultative document is up for discussion and possible decision thereafter, as the Minister makes a pretty strong case for those committees. That is in direct contrast to what the Royal Commission said. At paragraph 20.57, page 327, it said:
  "We recommend the abolition of FPCs in England and Wales and the assumption of their functions by health authorities as a step towards integration."
  It thought that family practitioner committees were an obstacle to health authorities from the point of view of influencing the distribution and quality of surgeries, achieving a balance between
  746
  hospital and community care, moving staff across institutional boundaries. It noted that family practitioner committees were superflous in Scotland and Northern Ireland. As a Minister who held some responsibility for Northern Ireland, I found that in no way were the family practitioner services there inferior to those in England and Wales.
  We oppose the Bill and the consultative document that strengthens it. With the benefit of only six months' office, and without public discussion, the Government are giving the impression of supinely deciding to nail their colours to the family practitioner committee mast. I am glad that this afternoon the Secretary of State was able to resile a little from that.
  I should like to know why joint finance is being made legal under clause 3. We never felt the need to do that. The Royal Commission never recommended it. It seems to be a bit superfluous.
  I should very much like to know why the General Practice Finance Corporation is being given powers to lease premises. I am worried that that may lead to an even greater weakening of control by health authorities over the family practitioner services. I should like that query cleared up.
  We shall raise other issues in Committee. We shall probe them, so I shall not mention them here. I pass on to some of the more contentious clauses. Clause 4 is certainly one of those.
  My right hon. Friend the Member for Salford, West (Mr. Orme), along with many of my hon. Friends, has given voice to the deep sense of moral indignation over the idea of a Government trying to ensure that a substantial portion of Health Service money is raised in these haphazard fashions. It is a very badly conceived clause. We are not talking about extra money for the Health Service raised by voluntary local effort, as I understand it, but about a substantial contribution to the funding of the National Health Service, because the appropriate provisions already exist for the kind of thing that the hon. Member for Folkestone and Hythe (Mr. Costain) was talking about; that is an irrelevance.
  The only assumption that we can make is that Tory Members are thinking that a large portion of the NHS budget will

  747
  come into the National Health Service by these various nefarious means. Quite simply, it means first, that the richer the area, the more money it will raise and the poorer the area, the less money it will raise. In London they will be going down to their friends in the City and raising their £250,000 without any trouble, to add to the substantial, well-equipped teaching and postgraduate hospitals that already exist there. In Sandwell they will have nurses standing on the street corners hoping with a bit of luck to be able to raise £500. That is not good enough.
  This provision will increase the geographical distortion which is already one of the major problems of the Health Service. It will lead to the public going, as is always the practice, for the glamorous acute medicine sector of the NHS, the kidney machines, the EMI-scanners and things of that kind which will attract the money, but not enough to meet the running costs of those things. That will not be glamorous enough. One cannot very easily organise an appeal on that. It will be the geriatrics, the mentally handicapped and others of that kind who will be neglected.
  Finally, the object of this clause is presented as a way of raising more money for the National Health Service. My right hon. Friend the Member for Norwich, North (Mr. Ennals) hit that firmly on the head, because, as the right hon. Gentleman should know better than anybody, the moment that the Treasury realises that substantial sums of money are being raised for the Health Service by these means, at that stage not just a sharp Chancellor of the Exchequer but any Chancellor of the Exchequer will start cutting the central subvention to the NHS. That will be the position. There is no way in which this clause will raise more money for the NHS. All it will do will be to raise the money in a more haphazard, more erratic and less just manner than that in which it is raised now.
  We turn to the clause on statutory cash limits—because that is what it deals with. It seems to me to be a ridiculous clause. It converts an administrative tool into a centralised, legal, rigid despotism. The Secretary of State, during all the time he was in Opposition, during the General Election and in his early months in
  748
  office, stood before the public and the House talking of the need to decentralise decision-making. What he does is come to the House on joint financing and cash limits and impose rigid shackles from the centre on every health authority in the country. That strikes me as being a direct contradiction of all things that he said in Opposition and in his earlier week in office. My right hon. Friend the Member for Norwich, North and myself managed to run the system even under the ramshackle regime of the right hon. Member for Leeds, North-East without the assistance of these draconian measures and I see no need for anything of this kind.
  Now we turn to what the right hon. Gentleman has made the central part of his Bill. Others may think that he might have made reorganisation the central part. There are far more benefits to be obtained from that course than from that upon which he is embarked; but it was a press statement from the right hon. Gentleman's own Department when the Bill was published which started it. The statement said:
  "Health Services Bill fulfils pledge on private practice".
  That is supposed to be the central feature of this Bill. Therefore, the right hon. Gentleman must not complain if that is where we mount our greatest opposition to the Bill. We on this side of the House have a totally different moral approach to the Health Service from that of Tory Members.
  If ever we want a clear, pristine comment on the philosophy of the Conservative Party, without any shilly-shallying and with great integrity, we can always rely upon the hon. and learned Member for Beaconsfield (Mr. Bell), who during the debate in 1976 said about our Bill:
  "The Bill circumscribes how people may offer their services and how other people may buy them."—[Official Report, 27 April 1976; Vol. 910, c. 260.]
  I commend that as a clear statement of the philosophy of the Government and their supporters in these matters. It puts the consultant who offers his services to cure human bodies in exactly the same position as the auctioneer who offers his services to buy and sell cattle in the market place. There is no difference at all. I could reduce it even from that to colour television

  749
  sets, bingo, champagne bottles and the rest. It is the philosophy of the market place.
  Many of my hon. Friends, including my hon. Friends the Members for Fife, Central (Mr. Hamilton), Carmarthen (Dr. Thomas) and Brent, South, referred to that moral difference. We believe that it is not right for a person's medical care to be at the mercy of the fees that he pays. Neither should a person have his medical care postponed because another person pays for his. Broadly speaking, that is the position that we take.
  Most of the consultants in the hospitals declare that they treat their NHS patients in exactly the same manner as they treat their private patients. I personally believe that. If one wants privacy on the NHS, one can get it by going to an amenity bed. Therefore, the only justification for the private bed is that of queue-jumping. That problem will not be solved by the six principles enunciated by the right hon. Gentleman this afternoon.
  One of the significant omissions from those six principles was the recommendation of the Health Services Board that social factors should be taken into account in compiling the common waiting lists. Nowhere was that mentioned in any of the six principles. The inclusion of the word "significant" in the first principle was a worrying introduction from our point of view.
  Mr. Patrick Jenkin: I am surprised that the right hon. Gentleman should say that, because it is taken exactly and precisely from the legislation that was put on the statute book in the previous Parliament.
  Mr. Moyle: There was no legislation on common waiting lists in the previous Parliament. There was a provision that the Health Services Board should report on the introduction of such matters, and we started discussions. The conclusion of those discussions was left to the right hon. Gentleman, and unless closer examination reveals something that I have missed, he has not produced a solution this afternoon.
  Mr. Patrick Jenkin: The right hon. Gentleman cannot get away with that. If he says that the word "significant" is the thing that causes him the greatest anxiety, he must know that section 62 of the
  750
  National Health Services Act 1977 contains the phrase:
  "will not to a significant extent interfere with the performance by him of any duty imposed on him by this Act to provide accommodation or services of any kind".
  Mr. Moyle: That is in a totally different context from the six principles that the right hon. Gentleman enunciated this afternoon. The inclusion of the word "significant" in the first principle renders null and void all the other principles. For that reason, we do not think that that is a solution.
  What has happened is that the right hon. Gentleman has resurrected a dead controversy. There has been peace—
  Mr. Ennals: If the purport of the six principles is to ensure that there is no difference whatever between the private patient and the public patient, no one would ever again need to go private. Therefore, does not my hon. Friend agree that there must be some snag, be it the word that he chose or some other word?
  Mr. Moyle: I think that we can leave this matter at that point and press on.
  I agree with my right hon. Friend the Member for Norwich, North that there has been peace on this issue ever since the 1976 Act was placed on the statute book, in spite of the fact that 2,000 private beds have disappeared from the Health Service during that time. Together with the hon. Member for Berwick-upon-Tweed we are worried about what will happen now that the Health Services Board has gone. I pay tribute to the board and its work. That board combined some disparate elements but produced good team work and presided with judicious balance over the phasing out of more than 2,000private beds—1,000 beds under the Act and 1,000 beforehand.
  It is unusual for a member of one party to pay tribute to a politician of another party, but I pay tribute to Lord Wigoder, the chairman of the Health Services Board, for making such a contribution to the exercise. Of course, he is a Liberal Whip in another place, but he made an outstanding contribution. Who will now stand between private hospital development and the interests of the National Health Service? There is no doubt that a top limit of 125 beds in the NHS is more likely to cause damage to the

  751
  interests of the National Health Service than the limit imposed in our Bill.
  The first port of call when a private project is recommended is the area health authority. The area health authority is the one body that resists the development of private practice and private hospitals more than anything else. Therefore, the private sector will not regard area health authorities as impartial. But appeal will lie to the Secretary of State.
  By introducing this Bill, which allows for greater expansion of private medicine, particularly in the NHS, the Secretary of State will have deprived himself of any right to say that he is impartial. The introduction of the Bill removes that possibility. What happened to all the practical arguments that Conservative Members used against the introduction of our Bill in 1976? I have been studying some of the speeches that were made at that time. In that debate the present Secretary of State said:
  "This absurd policy will cost £40 million to £50 million".
  Of course, it has cost nothing like that. We are now in possession of the figures, and it has cost a loss of only £5·8 million in charges. If the Secretary of State looks at the answers given by his hon. Friend the Minister for Health he will see that that figure must be reduced by the redeployment of the resources from the private sector into the National Health Service. That is an offsetting factor that is difficult to calculate. Therefore, the Secretary of State was wrong.
  Mr. Patrick Jenkin: The right hon. Member is playing with words and figures. If his policy had been as successful as he tried to pretend to his hon. Friends, and if all the beds that were supposed to go had gone, there would have been a further loss of £30 million. If he phased out the pay beds, he would lose that.
  Mr. Moyle: The Minister for Health has said that the figure was £31 million and that must be reduced by the reallocation of resources from the private sector into the National Health Service. Therefore, the right hon. Gentleman's calculations in 1976 were wildly out. During the 1976 debate, the right hon. Gentleman went on to say:
  "if pay beds go and the consultants who wish to continue to take advantage of the private practice undertaking are forced to divide their
  752
  time between two locations, some of the most distinguished will leave the NHS altogether and cease to be available for NHS patients."
  However, on 30 September 1975 there were 30,503 doctors employed in hospitals in England and Wales. Last 30 September that figure was 33,275. There has been an increase of medical input into the National Health Service.
  During that debate the Secretary of State also said:
  "Not only patients but medical education will be affected".
  I sought aid from the Under-Secretary of State for Education and Science, the hon. Member for Brent, North (Dr. Boyson), who has some responsibility for these matters these days. He told me that in 1975–76 there were only 3,786 full-time academic staff in our medical schools. In 1977–78, two years after the passage of the Bill, that figure had risen to 4,240, an increase approaching 500. Medical education was not affected either.
  I said that I was sorry that the Minister for Health was not with us. He envisaged a flight of the swallows—a departure of everybody to the rest of the Common Market after the Bill had been passed. He said:
  "In a year or two when we get the figures, we shall be wringing our hands in distress."
  We now have those figures. In 1977, 117 doctors applied for authorisation to practise in Europe and in 1978 the figure was 134, which is approximately one-third of 1 per cent. of all the doctors in hospitals in England and Wales. However, even if they were authorised to go, it does not mean that they went, and even if they went it does not mean that they did not come back. We are therefore talking about the largest possible figure.
  The right hon. Gentleman, in his 1976 speech, added:
  "It is nothing less than a tragedy that so much time, effort and passion should have had to be expended on what is, in the last resort, a peripheral issue."
  The first thing that he does, however, when he gets the initiative is to compound the passion, time and effort by introducing a Bill that forces us to go back over the same ground.
  That is strange, and it is even stranger because his plea was:
  "I am saying that we should withdraw the Bill and refer the matter to the Royal Commission."—[Official Report, 27 April 1976; Vol. 109, c. 218–319.]

  753
  The Royal Commission's advice is now available, and it says:
  "From the point of view of the National Health Service the main importance of pay beds lies in the passions aroused and the consequential dislocation of work which then occurs. The establishment of a Health Services Board led to a welcome respite from discussions on this emotional subject."
  The Royal Commission concedes one part of our case, and that is the advice that the right hon. Gentleman wanted to see. Why, then, is he introducing the Bill at this stage? We are beginning to realise that it is a first step on a long road taken by the right hon. Gentleman and his right hon. Friends.
  Dr. Mawhinney Dr. Mawhinney rose—
  Mr. Moyle: The hon. Gentleman would not give way to me and I shall not give way to him.
  Ten days ago, the right hon. Gentleman was extensively reported in the press as saying that he wanted an insurance-based National Health Service with doctors paid on item of service. In other words he wants to destroy the National Health Service as we have known it since 1948, and this Bill is a step towards so doing.
  First, he is trying to introduce item of service payments for doctors. Colloquially translated, that means putting consultants on piecework. Many of the most distinguished in the profession will oppose that idea and we shall support them.
  The most damaging part of the Bill is the idea of an insurance-based scheme, which destroys the moral basis of the National Health Service as we know it. It will no longer be an organisation primarily for aiding the sick. People will have to pay for what they get and will get what they pay for. The inference in an insurance-based scheme is that the poor will get less and the rich will get more. We shall have two health services, which is what the right hon. Member for Leeds, North-East called for during the previous Administration. It will be a workhouse service for the great mass of the population and a Harley Street service for the small section who can afford to pay.
  What are we letting ourselves in for? On 4 December there was a letter in The Times saying
  "I joined…Private Patients' Plan when in my thirties shortly after the war. I regarded
  754
  my membership, which has continued without interruption, as a protection against the likely illnesses which would probably increase as my wife and I got older.
  I assumed that PPP by receiving subscriptions from healthy young people would be able to fund the advertised benefits for members as they became older. I was therefore rather shocked a few years ago when PPP informed me that as I had reached a certain age the rate of my subscription would have to be increased solely because of my age."
  That is what we shall let ourselves in for under an insurance-based Health Service.
  The scheme is well launched. There are to be 70p prescription charges, road accident charges have been increased by substantial amounts and growth in the Health Service has been limited to 0·8 per cent. next year. As the right hon. Gentleman well knows, unless the Health Service has a growth rate of 1 per cent., it stands still. There has been no increase in cash limits despite—
  Mr. Patrick Jenkin: But that is precisely the growth rate planned by the previous Government.
  Mr. Moyle: Yes. But we did not double VAT in the Budget, we did not put up the health costs of the NHS by substantial amounts and we did not create an inflation rate of 17 per cent. and refuse to increase cash limits. We shall now have the retention of pay beds in the National Health Service and the funding of private hospitals. Now is the time when we shall start to fight back. The people of this country must get rid of the Government before their schemes for the NHS come to fruition.
  9.30 pm
  The Under-Secretary of State for Health and Social Security (Sir George Young): The debate has been wide-ranging. It has covered not just the specific points in the Bill but the related issues raised in our consultative document "Patients First".
  As my right hon. Friend the Secretary of State explained when he opened the debate, there will be another occasion in the new year for a debate on the consultative document. I hope that the House will understand if I leave until then some of the points raised on the future structure and concentrate on specific issues that are raised by the Bill.
  Clauses 1 and 2, which deal with the structure, do not commit us to a particular structure. No decision will be taken

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  until consultation is complete. The right hon. Member for Salford, West (Mr. Orme) opened the attack on behalf of the Opposition. I should like to deal with his remarks on clause 4. Opposition Members have totally misunderstood the object of clause 4. It deals with the power of health authorities to raise money by appeals and collections. It is a permissive clause. Our objective is to enable hospitals to play a more positive role in local fund raising. While authorities can now accept voluntary contributions and donations, they cannot be engaged in fund-raising activities themselves. As a result of that, some hospitals have been lumbered with expensive equipment which has not been a priority for the local health service. Clause 4 will partly overcome that problem by enabling the local health authority to initiate and participate in local fund-raising and to steer it in the right direction.
  We are talking about the better use of voluntary fund-raising and about building up a more effective link between the health authority and local fund-raising activities. I cannot see how anybody can sensibly object to that. Let me make absolutely clear that any money that is raised in this way will be in addition to the allocations made by my right hon. Friend the Secretary of State. There is no question of clawback. We will maintain next year's expenditure on the NHS budget at the level set by our predecessors. That will fully compensate for the inflation that has taken place this year.
  Mr. Ennals: Including VAT?
  Sir G. Young: Yes, there will be full compensation next year for this year's inflation. There will be no disbenefit to the Health Service from the implementation of clause 4. I hope that the hysteria that has been expressed about clause 4 will subside. Indeed, for the hon. Member for Crewe (Mrs. Dunwoody) to say that we shall go back to the position that exists in Lesotho with large black matrons extracting sixpences from patients is a credit to her imagination and nothing else.
  The right hon. Member for Salford, West found himself in some difficulty when my hon. Friend the Member for Lancaster (Mrs. Kellett-Bowman) asked him whether the £1·75 million that was raised in the North-West by Pat Seed was
  756
  obscene. He was forced to admit that his Government should have found that money. In my constituency, Age Concern raised £500,000 for a geriatric day centre based at the Central Middlesex hospital. Should the right hon. Gentleman's Government have found the money for that as well? Was that obscene? Where do we stop? It is impossible for for the NHS to meet every need and there will always be a role for local fundraising. What we are trying to do is to ensure that the institutions that benefit from fund-raising will be associated with the activity from the outset.
  Mr. Beith: I share the Minister's enthusiasm for local fund-raising, but his right hon. Friend specifically referred to a clause in the Bill which would prevent any clawing back by the Treasury of the equivalent in money raised locally. Has the Minister been able to identify that clause, because I have not?
  Sir G. Young: I apologise to the hon. Member for Berwick-upon-Tweed (Mr. Beith). So far I have been unable to identify that clause. Perhaps it is something that we can explore further in Committee. The right hon. Member for Salford, West said that we were strengthening regional health authorities. There is nothing in the Bill about regional health authorities and our consultative document leaves the question of the future role of those authorities wide open.
  We have a genuinely open mind on community health councils. We have come to no pre-judgment on their role and we shall welcome an informed debate on that and on whether they are the best or right way to secure consumer representation.
  The right hon. Member for Salford, West accused my right hon. Friend of reducing accountability. One of the main objectives of the Bill is to abolish the Health Services Board and to restore the powers held by that board to the Secretary of State, who is answerable in this House. The right hon. Gentleman's accusation about reducing accountability is, therefore, totally without foundation. He admitted that in principle he would like to see a Health Service with no private sector whatever. He must recognise that that suggestion goes against a commitment given by the previous Administration of which he was a member. On Third Reading of the previous

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  Health Services Bill I think that it was said that it was not the policy of the Labour Administration to do away entirely with private practice. At some point Opposition Members must come clean and tell the country exactly where they stand on private medicine.
  My hon. Friend the Member for Devizes (Mr. Morrison) criticised the 1974 reorganisation. He was not alone in that. He asked how we proposed to secure economies if we moved from area health authorities to smaller districts. It is true that there may be more authorities, but the cost lies not with the authority itself, but with the management structure underlying it, based on the staff.
  For example, in Wiltshire there is one area health authority and three health districts. In effect, therefore, there are four management teams. If we proceed on the lines that we have outlined, we hope to reduce that number to two or three. That is where the potential saving lies. There will naturally be consequences for the staff. This is conceded in paragraph 13 of the consultative document. We accept that there will have to be negotiations.
  The right hon. Member for Norwich, North (Mr. Ennals) had the effrontery to give us a lecture on the National Health Service. He managed to do that without once mentioning the events of last winter. He clearly suffers from a distressing illness—selective amnesia. He told us that strong emotions would be aroused by our Bill because it threatened industrial relations in the hospitals, with the consequence that patients would suffer. He did not mention the chaos over which he presided last winter.
  Mr. Ennals Mr. Ennals rose—
  Sir G. Young: I shall give way in a moment. When my right hon. Friend needs advice on industrial relations in the National Health Service one of the last places he will call for that advice will be Norwich, North.
  Mr. Ennals: I was not expressing an opinion; I was simply quoting from the Royal Commission's report. If the Minister is saying that his right hon. Friend does not need the advice of the Royal Commission on industrial relations, that is a very serious statement.
  Sir C. Young: Throughout the debate on his Bill the right hon. Gentleman made it quite clear that if the pay beds problem could be solved, that was the key to better industrial relations. The history of events since that time has shown that he was absolutely wrong. Pay beds were irrelevant to the problems over which he presided last winter.
  We recognise the strong feelings that are held in the NHS. For that reason, my right hon. Friend announced earlier in the debate the six principles, which I believe are valuable and which will go some way to reassuring people about our policies. In addition, my right hon. Friend has retained specific safeguards to look after the interests of the NHS, and I shall return to that.
  Dr. Mawhinney: Bearing in mind that my hon. Friend told the House that a majority of people in the country, including trade unionists and Labour Party members, as well as a majority in this House, wanted private medicine to continue in the National Health Service, will he agree that if there is any fury arising from the Bill it will be the responsibility of Labour Members to tell their radical friends that they must obey the democratic wishes of Parliament?
  Sir G. Young: My hon. Friend is quite right. However, I hope that our proposals will be accepted by all those who work in the Health Service and that no attempt will be made by Labour Members to stir things up.
  The right hon. Member for Norwich, North asked about administrative savings resulting from reorganisation. It is envisaged that these will accrue to the Health Service. I said earlier that I was unable to locate the specific clause of the Bill which dealt with preventing the Treasury's clawing back. The provision is on page 14 of the Bill in subsection (5)—
  "sums shall be disregarded for the purposes of this section".
  Therefore, the assurance that the right hon. Member seeks is in the Bill. This is a matter for Committee where we can explore further the issue of safeguarding the NHS.
  It has been alleged throughout the debate that we are embarked on a fundamental attack on the principles of the Health Service. We have been accused

  759
  of going back to the 1930s, and even to 1911. When this Bill is on the statute book, the NHS will have greater protection against possible adverse effects from private practice than it had from 1964 to 1970. My right hon. Friend will have safeguards that were not thought necessary by the two Labour Administrations of that time.
  The hon. Member for Berwick-upon-Tweed asked about the General Practice Finance Corporation. Clauses 15 and 16 refer to this. The corporation has power to borrow money and to lend it to doctors to buy, improve or build surgery premises. Without doubt the corporation has been a great help to GPs over the years. It has now committed the full £25 million that it was entitled to borrow under the 1966 Act. Clause 16 raises the borrowing limit to £40 million, with power to increase it, by order, to £100 million.
  Clause 15 contains a new power which allows the corporation to buy premises and lease them to GPs for their surgeries. Both the corporation and the profession believe that this will help doctors, particularly in the inner cities where high building costs and high rents make it extremely difficult for practices to find suitable premises. Some doctors are still unwilling to practise in health centres, and leasing from the corporation may be attractive to them. This power will be operated in accordance with the scheme to be approved by Ministers. Therefore, there will be proper control.
  The hon. Member for Berwick-on-Tweed asked a number of specific questions. Perhaps I could write to him about some of them. I emphasise to him that the Health Services Board is still in existence. How it proceeds is a matter for the board. It may take the view that on the Second Reading of this Bill it is not worth proceeding with further proposals for phasing out pay beds.
  The hon. Member also spoke about cuts in the future. Next year's planned expenditure will be 3 per cent. higher in real terms than the likely expenditure this year. We have honoured our predecessors' expenditure commitments on the Health Service for next year.
  My hon. Friend the Member for Peterborough (Dr. Mawhinney) made a positive and thoughtful contribution based
  760
  on his knowledge of the Health Service. Under the Bill it will be possible to have pay beds in cottage hospitals if there is sufficient demand for them.
  The hon. Member for Brent, South (Mr. Pavitt) on two occasions described savings of £30 million as being "candle ends". This expansive approach is not one that the country needs at the moment.
  My hon. Friend the Member for Canterbury (Mr. Crouch) made a knowledgeable speech based on his service on the regional health authority. He made a forceful point about London, and, as a London Member, I understand what he says about the dominance of teaching hospitals here. I hope he will accept that paragraph 41 of our consultation document deals with the special role of London.
  The hon. Member for Crewe was not at her best today. She implied that no restructuring was necessary, thus destroying what had been up to then a happy consensus.
  My hon. Friend the Member for Somerset, North (Mr. Dean), as did my hon. Friend the Member for Devizes, stressed the need for flexibility in reorganisation. They are both right. My hon. Friend the Member for Somerset, North asked whether all the pay beds that had been phased out would be restored. It is unlikely that that would happen because so many of the beds were not used. He spoke of the need for partnership between the public and private sectors of medicine, and I hope to return to that later. He raised a specific point about clause 10 and the number of beds needed before the matter could be referred. That is something we could usefully consider in Committee.
  The hon. Member for Stockport, North (Mr. Bennett) and other Opposition Members spoke of the private sector feeding like a parasite on the National Health Service. Opposition Members are totally unable to accept that there could be a relationship between these two sectors that could be to the advantage of both. I hope to return to that theme later.
  Mr. Pavitt Mr. Pavitt rose—
  Sir G. Young: I am sorry, but I cannot give way. My hon. Friend the Member for Preston, North (Mr. Atkins)

  761
  raised the issue of the abuse of the hospitality of the National Health Service by visitors from overseas, sometimes referred to as gate-crashers. We have that matter under review. The right approach would be to persuade other countries to be as hospitable to our tourists as we are to theirs. We are making progress in that direction.
  The hon. Member for Ashfield (Mr. Haynes) made a somewhat hysterical speech. Nothing that anyone could say to him could ever shake his conviction that private medicine is an organised conspiracy to rob the taxpayer. I am not going to attempt to persuade him now. However, I ask him to consider the six principles enunciated by my right hon. Friend in his opening speech, and perhaps to concede that they are steps in the right direction.
  Much of the concern expressed in the debate related to allegations of queue-jumping, and I wish to make our position absolutely clear. It is totally unacceptable that the treatment of an NHS patient who is seriously ill or in need of urgent medical care should be pre-judiced because priority had been given to a private patient in less need. It is equally unacceptable that a patient who has had a private consultation should, as a result, be given a higher degree of priority for treatment under the NHS than would have been available to any other patient whose medical needs are the same.
  The general principles that have been agreed with the medical profession unequivocally outlaw that sort of thing. Indeed, they go substantially further than any other arrangements made in the past towards ensuring that private practice in the NHS is conducted properly and fairly.
  Mr. Pavitt: Will the Under-Secretary of State tell me whether the six principles that he has enunciated also cover the priority queue-jumping that takes place in out-patients departments? He will know that the present practice, when a patient goes for diagnosis, is that there are two forms, one that is marked PP and another that is marked NHS. Those with forms that are marked PP go straight in and those with forms marked NHS have to wait two or three hours. Will the six principles affect that?
  Sir G. Young: That was covered by the second principle mentioned by my right hon. Friend in his opening remarks.
  Clause 3 makes statutory the present informal arrangements for joint financing under which health authorities contribute to personal social services projects run by local authorities. Joint financing was started by the previous Government and is being carried on by the present Government. It has been successful in many areas in fostering collaborative planning between health and local authorities. It is contributing to a more rational economic use of available health and social service facilities.
  Hitherto, authority for joint financing has rested with the approval of the Treasury on the Estimates and on the confirming appropriation Acts. Joint financing is now an established feature of health and social services, and it is right that it should become statutory. The House should know that in the plan for NHS spending next year we are providing around £50 million for jointly financed projects—a 16 per cent. increase in real terms over the current year's allocation.
  A number of points raised dealt with the position of staff on reorganisation. While the consultative paper clearly points to cut-backs in bureaucracy and reduction in management costs, it recognises the need to treat the staff of the NHS, at whatever level they are working, both fairly and openly. The programme of implementing the changes proposed in the consultative paper has been framed with a view to limiting disruption and minimising the impact of change on staff. With the disappearance of both the area and sector levels of management, some staff will be affected, although it is not possible to estimate how many at this stage. We hope that most of the necessary staff reductions can be handled through natural wastage. That is one of the reasons why we are proposing a fairly lengthy time scale for both restructuring and for the review of management arrangements, though there may have to be some redundancies. In deciding what arrangements will need to be made for filling posts in the new service and for treating fairly those who may be displaced, we shall be taking into account the views of both NHS management and staff interests.

  763
  We attach great importance to proper consultation with staff interests throughout the process of reorganisation. We shall be starting consultations at national level as early as possible.
  There were one or two defects in the arguments deployed by the right hon. Member for Salford, West. Happily, pay beds have not been totally phased out. For that reason the forecasts that my right hon. Friend the Secretary of State made during the passage of the previous legislation have not been fulfilled. The Government consider that to be a matter for rejoicing.
  The main debate has been about the relationship between the National Health Service and the private sector. It seems that there are four options open to any Government on policy for the National Health Service. Two options are extreme and the other two occupy the middle ground. One extreme is the State monopoly, with the total abolition of all private practice. The second extreme is a free-for-all for anyone who wishes to enter the market. In the middle are two other options that have been adopted by Government. One involves the existence of a private sector that is separate from the NHS. That is what the Labour Government practised. The second involves not merely the existence of the private sector but a co-existence with the National Health Service.
  First, I shall deal with the more extreme arguments. Some Labour Members object on ideological grounds to private medicine for the same reason that leads them to object to private education, private ownership of the means of production, and private ownership of wealth. The type of society that they envisage, in which there is no alternative to a State-provided service, is not one in which most people wish to live.
  Even if the National Health Service were perfect, and even if it could meet all the demands made on it, I still think that it would be right for there to be an alternative, so that someone would be able to say "Thank you very much. I know that there is a National Health Service and that I am entitled to use it, but I wish to go elsewhere." That in no way invalidates the concept of a National Health Service, any more than the existence of owner-occupiers threatens the
  764
  existence of council tenants. There is no case in a free society for the establishment of a monopoly in the supply of health services.
  The second extreme option is what might loosely be called a free-for-all, with free entry into the health market for anyone who wishes to invest in it. My right hon. Friend has explained that we are retaining some controls on private sector development. He explained why such controls are necessary and why there should be controls that can be exercised where there is a threat to the National Health Service.
  This is not a control on the size of the private sector. It is merely a safeguard where there is a possible threat in any locality. Health care resources, both public and private, are too valuable to be wasted, and where there would be prejudice there will be powers of control.
  I mentioned the two options between the two extremes that have been adopted by Government. Both presuppose the existence of a private sector alongside the National Health Service, with some controls over it. There is a difference in the relationship between the two. The first option was the Labour Government's policy—the private sector was there and they did not like it although their legislation presupposed it so that they could ensure that pay beds would be phased out. The theme was no co-operation and no communication. The phasing out of pay beds was the severing of the institutional link between the two sectors, the link provided by the "geographical whole-time consultant"—the consultant who did some private work within National Health Service hospitals rather than, as would have happened under present legislation, miles away at a private hospital.
  The fourth option, which is our option, is positive, and not negative, co-existence. We want the two sectors to co-operate to make the best use of resources. The two sectors can and should complement each other. The National Health Service already makes use of private sector facilities. It did so even under the Labour Administration. That is a sensible system. There are about 4,000 beds in non-NHS institutions that are used by the NHS on a contractual basis. That more than outnumbers the present number of pay beds. We shall encourage authorities to make greater use of spare capacity in

  765
  the private sector where this rather than direct NHS provision is a sensible use of resources.
  It has always seemed to be a total nonsense that Labour Members say to the public "You may spend your money on any activity that you like—motor cars, holidays overseas and bingo—but on no account are you to make a voluntary deduction from your own income to make provision for yourself when you are ill." That is Socialism at its worst. These are important issues about the freedom of the individual.
  Part of our message is that the individual must assume greater responsibility for his health. The National Health Service does not have a "pill for every ill". The major improvement in the nation's health will come from people voluntarily deciding to adopt healthier life styles. There is no difference of opinion between Labour and Conservative Members on that point. It is entirely consistent with our philosophy of individual responsibility that we shall encourage each individual to make provision for himself privately. That provision having been made, the resources which are accumulated should be put to the most effective use.
  I quote from an article in the News of the World by Frank Chapple. [Interruption.] Labour Members spend much time quoting the advice of trade union leaders to us. I should like to return the compliment.
  The article is entitled
  "A severe case of hypocrisy".
  Mr. Chapple writes:
  "There is a great deal of hypocrisy in the trade union movement. And it was spelt out loud and clear at Blackpool when holier-than-thou union leaders attacked the private health treatment deal negotiated by 40,000 of my members. I make no bones about defending it. Whatever was said, then or in the future, will not affect the deal. It will stand because it makes good sense.…It could be justifiably argued that private health care could ease the strain on the NHS. What the largely ill-informed critics of the scheme have so far failed to prove is how the cover offered in our private scheme can possibly weaken the NHS…Hypocrisy taints all these accusations that it is my deal which is badly injuring the NHS. There is no condemnation when Liverpool women accepted the offer of open heart surgery in a private hospital because they could not get in it on the NHS. There is no condemnation when industrial disputes
  766
  delay the building of new hospitals and so deprive the public of medical services."
  I am still quoting the remarks of Frank Chapple. He adds:
  "Those who condemn our agreements conveniently overlook the fact that many leading policitians and trade union leaders have received private treatment. The outcry seems to have arisen simply because the rank and file are now being offered the same facilities.…What it boils down to is that blue-collar workers are about to get the preferential treatment that has long been available to white collar and managerial working groups.…It is sheer hypocrisy on the part of NUPE and COHSE. They have added to the NHS problems through their industrial disputes for higher wages. Now they have the cheek to assert that it is my agreement that will undermine the service."
  Those views expressed by Frank Chapple on behalf of his union members are shared by many other trade union members—for example, the National Union of Seamen.
  My right hon. and hon. Friends are convinced that the relationship between the public and private sectors of medicine should be one of partnership. The policy of separate development embarked on by the previous Government was misguided. The private sector is not a threat to the National Health Service to be distanced from it but a potential ally to be brought closer.
  If the Opposition are concerned about the development of a two-tier Health Service—one tier for the rich, and another for the poor—their policy of separation would inevitably have brought that about. The enforced phasing out of pay beds and their hostility to the private sector would have led to a greater surge of interest in private medicine from people in all walks of life and from all income levels.
  Our policies are designed to ensure that the National Health Service and the private sector co-operate. We want to ensure that the best use is made of our health resources, from wherever they come. Labour Members want to drive a wedge between the two, whereas we wish to build a bridge. If we can get the relationship right, it will be to the benefit of the National Health Service. The Health Service will lose if Labour Members turn their backs on the private sector.
  I invite all hon. Members who care about health services as a whole to give the Bill a Second Reading.
  Question put, That the Bill be now read a Second time: —
  The House divided: Ayes 320, Noes 250.

  Division No. 129]

  AYES

  [10pm]

  Adley, Robert

  Edwards, Rt Hon N. (Pembroke)

  Knox, David

  Alexander, Richard

  Eggar, Timothy

  Lang, Ian

  Alton, David

  Emery, Peter

  Langtord-Holt, Sir John

  Amery, Rt Hon Julian

  Eyre, Reginald

  Latham, Michael

  Ancram, Michael

  Fairbairn, Nicholas

  Lawrence, Ivan

  Arnold, Tom

  Fairgrieve, Russell

  Lawson, Nigel

  Aspinwall, Jack

  Faith, Mrs Sheila

  Lee, John

  Atkins, Rt Hon H. (Spelthorne)

  Farr, John

  Lennox-Boyd, Hon Mark

  Atkins, Robert (Preston North)

  Fell, Anthony

  Lester, Jim (Beeston)

  Baker, Kenneth (St. Marylebone)

  Fenner, Mrs Peggy

  Lewis, Kenneth (Rutland)

  Baker, Nicholas (North Dorset)

  Finsberg, Geoffrey

  Lloyd, Ian (Havant & Waterloo)

  Banks, Robert

  Fisher, Sir Nigel

  Lloyd, Peter (Fareham)

  Beaumont-Dark, Anthony

  Fletcher, Alexander (Edinburgh N)

  Loveridge, John

  Beith, A. J.

  Fletcher-Cooke, Charles

  Luce, Richard

  Bell, Ronald

  Fookes, Miss Janet

  Lyell, Nicholas

  Bendell, Vivian

  Forman, Nigel

  McAdden, Sir Stephen

  Benyon, Thomas (Abingdon)

  Fowler, Rt Hon Norman

  McCrindle, Robert

  Benyon, W. (Buckingham)

  Fox, Marcus

  Macfarlane, Neil

  Best, Keith

  Fraser, Rt Hon H. (Stafford & St)

  MacGregor, John

  Bevan, David Gilroy

  Fraser, Peter (South Angus)

  MacKay, John (Argyll)

  Biffen, Rt Hon John

  Fry, Peter

  Macmillan, Rt Hon M. (Farnham)

  Biggs-Davison, John

  Galbraith, Hon T. G. D.

  McNair-Wilson, Michael (Newbury)

  Blackburn, John

  Gardiner, George (Reigate)

  McNair-Wilson, Patrick (New Forest)

  Blaker, Peter

  Gardner, Edward (South Fylde)

  McQuarrie, Albert

  Body, Richard

  Garel-Jones, Tristan

  Madel, David

  Bonsor, Sir Nicholas

  Gilmour, Rt Hon Sir Ian

  Major, John

  Boscawen, Hon Robert

  Glyn, Dr Alan

  Marland, Paul

  Bottomley, Peter (Woolwich West)

  Goodhew, Victor

  Marlow, Tony

  Bowden, Andrew

  Goodlad, Alastair

  Marshall, Michael (Arundel)

  Boyson, Dr Rhodes

  Gorst, John

  Marten, Neil (Banbury)

  Bradford, Rev. R.

  Gow, Ian

  Mates, Michael

  Braine, Sir Bernard

  Gower, Sir Raymond

  Mather, Carol

  Bright, Graham

  Grant, Anthony (Harrow C)

  Maude, Rt Hon Angus

  Brinton, Tim

  Gray, Hamish

  Mawby, Ray

  Brittan, Leon

  Greenway, Harry

  Mawhinney, Dr Brian

  Brocklebank-Fowler, Christopher

  Grieve, Percy

  Maxwell-Hyslop, Robin

  Brooke, Hon Peter

  Griffiths, Eldon (Bury St Edmunds)

  Mayhew, Patrick

  Brotherton, Michael

  Griffiths, Peter (Portsmouth N)

  Mellor, David

  Brown, Michael (Brigg & Sc'thorpe)

  Grist, Ian

  Meyer, Sir Anthony

  Browne, John (Winchester)

  Grylls, Michael

  Miller, Hal (Bromsgrove & Redditch)

  Bruce-Gardyne, John

  Gummer, John Selwyn

  Mills, Iain (Meriden)

  Bryan, Sir Paul

  Hamilton, Michael (Salisbury)

  Mills, Peter (West Devon)

  Buchanan-Smith, Hon Alick

  Hampson, Dr Keith

  Miscampbell, Norman

  Buck, Antony

  Hannam John

  Mitchell, David (Basingstoke)

  Budgen, Nick

  Haselhurst, Alan

  Moate, Roger

  Bulmer, Esmond

  Hastings, Stephen

  Molyneaux, James

  Burden, F. A.

  Havers, Rt Hon Sir Michael

  Monro, Hector

  Butcher, John

  Hawksley, Warren

  Montgomery, Fergus

  Butler, Hon Adam

  Hayhoe, Barney

  Moore, John

  Cadbury, Jocelyn

  Heath, Rt Hon Edward

  Morris, Michael (Northampton, Sth)

  Carlisle, John (Luton West)

  Heddle John

  Morrison, Hon Charles (Devizes)

  Carlisle, Kenneth (Lincoln)

  Henderson Barry

  Morrison, Hon Peter (City of Chester)

  Carlisle, Rt Hon Mark (Runcorn)

  Heseltine, Rt Hon Michael

  Mudd, David

  Chalker, Mrs. Lynda

  Hicks, Robert

  Murphy, Christopher

  Channon, Paul

  Higgins, Rt Hon Terence L.

  Myles, David

  Chapman, Sydney

  Hill, James

  Needham, Richard

  Churchill, W. S.

  Hogg, Hon Douglas (Grantham)

  Nelson, Anthony

  Clark, Hon Alan (Plymouth, Sutton)

  Holland, Philip (Carlton)

  Neubert, Michael

  Clark, Dr William (Croydon South)

  Hooson, Tom

  Newton, Tony

  Clarke, Kenneth (Rushcliffe)

  Hordern, Peter

  Normanton, Tom

  Clegg, Walter

  Howe, Rt Hon Sir Geoffrey

  Nott, Rt Hon John

  Cockeram, Eric

  Howell, Rt Hon David (Guildford)

  Oppenheim, Rt Hon Mrs Sally

  Colvin, Michael

  Howells, Geraint

  Osborn, John

  Cope, John

  Hunt, David (Wirral)

  Page, Rt Hon R. Graham (Crosby)

  Cormack, Patrick

  Hunt, John (Ravensbourne)

  Page, Richard (SW Hertfordshire)

  Costain, A. P.

  Hurd, Hon Douglas

  Parkinson, Cecil

  Cranborne, Viscount

  Irving, Charles (Cheltenham)

  Parris, Matthew

  Critchley, Julian

  Jenkin, Rt Hon Patrick

  Patten, John (Oxford)

  Crouch, David

  Johnson Smith, Geoffrey

  Pattie, Geoffrey

  Dean, Paul (North Somerset)

  Johnston, Russell (Inverness)

  Pawsey, James

  Dickens, Geoffrey

  Jopling, Rt Hon Michael

  Penhaligon, David

  Dorrell, Stephen

  Joseph, Rt Hon Sir Keith

  Percival, Sir Ian

  Douglas-Hamilton, Lord James

  Kaberry, Sir Donald

  Peyton, Rt Hon John

  Dover, Denshore

  Kellett-Bowman, Mrs Elaine

  Pink, R. Bonner

  du Cann, Rt Hon Edward

  Kershaw, Anthony

  Pollock, Alexander

  Dunn, Robert (Dartford)

  Kilfedder, James A.

  Porter, George

  Durant, Tony

  Kimball, Marcus

  Prentice, Rt Hon Reg

  Dykes, Hugh

  King, Rt Hon Tom

  Price, David (Eastleigh)

  Eden, Rt Hon Sir John

  Kitson, Sir Timothy

  Prior, Rt Hon James

  Knight, Mrs Jill

  Proctor, K. Harvey

  Sims, Roger

  van Straubenzee, W. R.

  Pym, Rt Hon Francis

  Skeet, T. H. H.

  Viggers, Peter

  Raison, Timothy

  Smith, Dudley (War, and Leam'ton)

  Waddington, David

  Rathbone, Tim

  Speller, Tony

  Wakeham, John

  Rees, Peter (Dover and Deal)

  Spence, John

  Waldegrave, Hon William

  Rees-Davies, W. R.

  Spicer, Jim (West Dorset)

  Walker, Rt Hon Peter (Worcester)

  Renton, Tim

  Sproat, Iain

  Walker, Bill (Perth & E Perthshire)

  Rhodes James, Robert

  Squire, Robin

  Waller, Gary

  Rhys Williams, Sir Brandon

  Stanbrook, Ivor

  Walters, Dennis

  Ridley, Hon Nicholas

  Stanley, John

  Ward, John

  Ridsdale, Julian

  Steen, Anthony

  Watson, John

  Rifkind, Malcolm

  Stevens, Mar In

  Wells, John (Maidstone)

  Rippon, Rt Hon Geoffrey

  Stewart, Ian (Hitchin)

  Wells, Bowen (Hert'rd & Stev'nage)

  Roberts, Michael (Cardiff NW)

  Stewart, John (East Renfrewshire)

  Wheeler, John

  Roberts, Wyn (Conway)

  Stokes, John

  Whitelaw, Rt Hon William

  Ross, Wm. (Londonderry)

  Stradling Thomas, J.

  Whitney, Raymond

  Rossi, Hugh

  Tapsell, Peter

  Wickenden, Keith

  Rost, Peter

  Taylor, Robert (Croydon NW)

  Wiggin, Jerry

  Royle, Sir Anthony

  Tebbit, Norman

  Wilkinson, John

  Sainsbury, Hon Timothy

  Temple-Morris, Peter

  Williams, Delwyn (Montgomery)

  St. John-Stevas, Rt Hon Norman

  Thatcher, Rt Hon Mrs Margaret

  Winterton, Nicholas

  Scott, Nicholas

  Thompson, Donald

  Wolfson, Mark

  Shaw, Michael (Scarborough)

  Thorns, Neil (Ilford South)

  Young, Sir George (Acton)

  Shelton, William (Streatham)

  Thornton, Malcolm

  Younger, Rt Hon George

  Shepherd, Colin (Hereford)

  Townend, John (Bridlington)

  Shepherd, Richard (Aldridge-Br'hills)

  Townsend, Cyril D. (Bexleyheath)

  TELLERS FOR THE AYES:

  Shersby, Michael

  Trippler, David

  Mr. Spencer Le Marchant and

  Silvester, Fred

  Trotter, Neville

  Mr. Anthony Berry.

  NOES

  Abse, Leo

  Dempsey, James

  Homewood, William

  Adams, Allen

  Dewar, Donald

  Hooley, Frank

  Allaun, Frank

  Dixon, Donald

  Horam, John

  Anderson, Donald

  Dobson, Frank

  Howell, Rt Hon Denis (B'ham, Sm H)

  Archer, Rt Hon Peter

  Dormand, Jack

  Huckfleld, Les

  Armstrong, Rt Hon Ernest

  Douglas, Dick

  Hudson Davies, Gwilym Ednyfed

  Ashton, Joe

  Douglas-Mann, Bruce

  Hughes, Mark (Durham)

  Atkinson, Norman (H'gey, Tott'ham)

  Dubs, Alfred

  Hughes, Robert (Aberdeen North)

  Bagier, Gordon A. T.

  Duffy, A. E. P.

  Hughes, Roy (Newport)

  Barnett, Guy (Greenwich)

  Dunn, James A. (Liverpool, Kirkdale)

  Janner, Hon Greville

  Barnett, Rt Hon Joel (Heywood)

  Dunwoody, Mrs Gwyneth

  Jay, Rt Hon Douglas

  Benn, Rt Hon Anthony Wedgwood

  Eadie, Alex

  John, Brynmor

  Bennett, Andrew (Stockport N)

  Eastham, Ken

  Johnson, James (Hull West)

  Bidwell, Sydney

  Edwards, Robert (Wolv SE)

  Johnson, Walter (Derby South)

  Booth, Rt Hon Albert

  Ellis, Raymond (NE Derbyshire)

  Jones, Rt Hon Alec (Rhondda)

  Boothroyd, Miss Betty

  Ellis, Tom (Wrexham)

  Jones, Barry (East Flint)

  Bottomley, Rt Hon Arthur (M'brough)

  English, Michael

  Jones, Dan (Burnley)

  Bradley, Tom

  Ennals, Rt Hon David

  Kaufman, Rt Hon Gerald

  Bray, Dr Jeremy

  Evans, Ioan (Aberdare)

  Kerr, Russell

  Brown, Hugh D. (Provan)

  Evans, John (Newton)

  Kilroy-Silk, Robert

  Brown, Robert C. (Newcastle W)

  Ewing, Harry

  Kinnock, Neil

  Brown, Ronald W. (Hackney S)

  Faulds, Andrew

  Lambie, David

  Brown, Ron (Edinburgh, Leith)

  Field, Frank

  Lamborn, Harry

  Buchan, Norman

  Fitch, Alan

  Lamond, James

  Callaghan, Rt Hon J. (Cardiff SE)

  Flannery, Martin

  Leadbitter, Ted

  Callaghan, Jim (Middleton & P)

  Fletcher, L. R. (Ilkeston)

  Leighton, Ronald

  Campbell, Ian

  Fletcher, Ted (Darlington)

  Lestor, Miss Joan (Eton & Slough)

  Campbell-Savours, Dale

  Foot, Rt Hon Michael

  Lewis, Ron (Carlisle)

  Canavan, Dennis

  Ford, Ben

  Litherland, Robert

  Cant, R. B.

  Forrester, John

  Lofthouse, Geoffrey

  Carmichael, Neil

  Foulkes, George

  Lyon, Alexander (York)

  Carter-Jones, Lewis

  Fraser, John (Lambeth, Norwood)

  Lyons, Edward (Bradford West)

  Cartwright, John

  Freeson, Rt Hon Reginald

  Mabon, Rt Hon Dr J. Dickson

  Clark, Dr David (South Shields)

  Garrett, John (Norwich S)

  McCartney, Hugh

  Cocks, Rt Hon Michael (Bristol S)

  Garrett, W. E. (Wallsend)

  McDonald, Dr Oonagh

  Cohen, Stanley

  George, Bruce

  McElhone, Frank

  Coleman, Donald

  Gilbert, Rt Hon Dr John

  McKay, Allen (Penistone)

  Concannon, Rt Hon J. D.

  Ginsburg, David

  McKelvey, William

  Conlan, Bernard

  Golding, John

  MacKenzie, Rt Hon Gregor

  Cook, Robin F.

  Gourlay, Harry

  Maclennan, Robert

  Cowans, Harry

  Graham, Ted

  McMahon, Andrew

  Craigen, J. M. (Glasgow, Maryhlll)

  Grant, George (Morpeth)

  McMillan, Tom (Glasgow, Central)

  Crowther, J. S.

  Grant, John (Islington C)

  McNally, Thomas

  Cryer, Bob

  Hamilton, James (Bothwell)

  McWilliam, John

  Cunliffe, Lawrence

  Hamilton, W. W. (Central Fife)

  Magee, Bryan

  Cunningham, George (Islington S)

  Harrison, Rt Hon Walter

  Marks, Kenneth

  Cunningham, Dr John (Whitehaven)

  Hart, Rt Hon Dame Judith

  Marshall, David (Gl'sgow,Shettles'n)

  Dalyell, Tam

  Hattersley, Rt Hon Roy

  Marshall, Dr Edmund (Goole)

  Davidson, Arthur

  Haynes, Frank

  Marshall, Jim (Lelcester South)

  Davies, Rt Hon Denzil (Llanelli)

  Healey, Rt Hon Denis

  Martin, Michael (Gl'gow, Springb'rn)

  Davles, Ifor (Gower)

  Heffer, Eric S.

  Maxton, John

  Davis, Terry (B'rm'ham, Stechford)

  Hogg, Norman (E Dunbartonshire)

  Meacher, Michael

  Deakins, Eric

  Holland, Stuart (L'beth, Vauxhall)

  Mellish, Rt Hon Robert

  Dean, Joseph (Leeds West)

  Home Robertson, John

  Mikardo, Ian

  770

  771

  Millan, Rt Hon Bruce

  Roberts, Gwilym (Cannock)

  Thomas, Mike (Newcastle East)

  Mitchell, Austin (Grimsby)

  Robertson, George

  Thomas, Dr Roger (Carmarthen)

  Mitchell, R. C. (Soton, Itchen)

  Robinson, Geoffrey (Coventry NW)

  Thome, Stan (Preston South)

  Morris, Rt Hon Alfred (Wythenshawe)

  Rodgers, Rt Hon William

  Tilley, John

  Morris, Rt Hon Charles (Openshaw)

  Rooker, J. W.

  Torney, Tom

  Morris, Rt Hon John (Aberavon)

  Roper, John

  Urwin, Rt Hon Tom

  Moyle, Rt Hon Roland

  Ross, Ernest (Dundee West)

  Varley, Rt Hon Eric G.

  Mulley, Rt Hon Frederick

  Rowlands, Ted

  Wainwright, Edwin (Dearne Valley)

  Newens, Stanley

  Sandelson, Neville

  Walker, Rt Hon Harold (Doncaster)

  Oakes, Rt Hon Gordon

  Sever, John

  Watkins, David

  Ogden, Eric

  Sheldon, Rt Hon Robert (A'ton-u-L)

  Weetch, Ken

  O'Halloran, Michael

  Shore, Rt Hon Peter (Step and Pop)

  Wellbeloved, James

  O'Neill, Martin

  Short, Mrs Renée

  Welsh, Michael

  Orme, Rt Hon Stanley

  Silkin, Rt Hon John (Deptford)

  Whitehead, Phillip

  Owen, Rt Hon Dr David

  Silkin, Rt Hon S. C. (Dulwich)

  Whitlock, William

  Palmer, Arthur

  Silverman, Julius

  Wigley, Dafydd

  Park, George

  Skinner, Dennis

  Willey, Rt Hon Frederick

  Parker, John

  Smith, Rt Hon J. (North Lanarkshire)

  Williams, Rt Hon Alan (Swansea W)

  Parry, Robert

  Snape, Peter

  Wilson, Gordon (Dundee East)

  Pavitt, Laurie

  Soley, Clive

  Wilson, Rt Hon Sir Harold (Huyton)

  Pendry, Tom

  Spearing, Nigel

  Wilson, William (Coventry SE)

  Powell, Raymond (Ogmore)

  Spriggs, Leslie

  Winnick, David

  Prescott, John

  Stallard, A. W.

  Woodall, Alec

  Price, Christopher (Lewisham West)

  Stewart, Rt Hon Donald (W Isles)

  Woolmer, Kenneth

  Race, Reg

  Stott, Roger

  Wrigglesworth, Ian

  Radice, Giles

  Strang, Gavin

  Young, David (Bolton East)

  Rees, Rt Hon Merlyn (Leeds South)

  Straw, Jack

  Richardson, Jo

  Summerskill, Hon Dr Shirley

  TELLERS FOR THE NOES:

  Roberts, Albert (Normanton)

  Taylor, Mrs Ann (Bolton West)

  Mr. James Tinn and

  Roberts, Allan (Bootle)

  Thomas, Dafydd (Merioneth)

  Mr. George Morton.

  Roberts, Ernest (Hackney North)

  Thomas, Jeffrey (Abertillery)

  Question accordingly agreed to.
  Bill read a Second time.
  Bill committed to a Standing Committee pursuant to Standing Order No. 40 (Committal of Bills.)

  HEALTH SERVICES [MONEY]
  Queen's Recommendation having been signified—
  Resolved,
  That, for the purposes of any Act of the present Session to make further provision with respect to the health services in England, Wales
  772
  and Scotland and their use by private patients and with respect to hospitals and nursing homes outside those services, to dissolve or make further provision with respect to certain bodies connected with or with persons providing services within those health services, it is expedient to authorise—

  (a) the payment out of money provided by Parliament of any expenses incurred by the Secretary of State for the purposes of the said Act of the present Session;

  (b) any increase attributable to the provisions of that Act in the sums payable under any other Act out of money so provided or out of the Consolidated Fund; and

  (c) any payment into the Consolidated Fund.

  —[Mr. Patrick Jenkin.]

  TACHOGRAPHS
  10.15 pm
  The Minister of Transport (Mr. Norman Fowler): I beg to move,
  That the draft Passenger and Goods Vehicles (Recording Equipment) Regulations 1979, which were laid before this House on 29 November, be approved.
  I shall seek to be reasonably brief, because I know that a number of hon. Members on both sides of the House wish to speak. My hon. Friend the Parliamentary Secretary will reply to the points that may be raised in the debate.
  These regulations are intended to bring to an end the controversy and uncertainty that have surrounded the application of the EEC tachograph regulation in this country. It is not a recent argument and it certainly pre-dated our entry to the EEC. Indeed, it was Mrs. Barbara Castle, when she was Minister of Transport, who first introduced statutory measures for compulsory tachographs in the Transport Act 1968. So several years before entry to the Common Market the case was considered sufficiently strong for a Labour Minister of Transport to include it in an Act of Parliament. Although never implemented, it remains on the statute book.
  The EEC law on tachographs came in a year or two after that, in 1970. It made the use of tachographs compulsory in most goods vehicles over 3½ tons gross and in passenger vehicles not on regular services. So the position was that when we joined the Community we accepted this regulation as part of our commitments under the Treaty of Accession. We should have begun phasing it in in 1976.
  However, we decided not to do this. Instead the then Government introduced a measure which allowed a tachograph to be used as an alternative to a log book on a purely voluntary basis. That was essentially for the convenience of the increasing number of lorry drivers on journeys to other EEC countries where the regulation was enforced.
  In 1978 the European Commission took us to the European Court for not complying with EEC law. The United Kingdom's counsel argued before the court that we already had a highly effective system of enforcing the law on drivers' hours which effectively achieved
  774
  the purpose of the tachograph regulation. That was our case. He also pointed to the substantial costs which introduction of the tachograph would impose on the industry and the possible consequences in industrial disruption.
  The court rejected this case. It ruled that none of these arguments could alter our fundamental legal duty under the Treaty to give effect to Community law. The court's ruling was on 7 February this year. On 5 March the then Secretary of State for Transport, the right hon. Member for Stockton (Mr. Rodgers), announced that the Labour Government had accepted that decision. Let me emphasise that it was an acceptance not just by the Secretary of State for Transport but by the last Labour Government, binding at the least those right hon. and hon. Gentlemen who were members of that Government. The right hon. Member for Stockton added that he would be consulting the employers' organisations, trade unions and the Commission on a timetable to achieve full implementation. In due course, he said, he would lay the necessary regulations before the House.
  That was the positon that we inherited and on 21 May I made it clear that the Government accepted and supported the statement of the last Government. Like them. I believe that the ruling of the European Court is fundamental in this case. Respect for the law and the judgment of the European Court is the only basis on which the Community can function. In other areas we seek to insist that other member States obey the law. Surely it follows that we have to do so ourselves. As my right hon. Friend the Prime Minister, speaking about the European Community on 23 October, said, we believe in the rule of law and we must obey it. That is fundamental to these draft regulations.
  I also believe that the opposition to the tachograph has been very considerably overstated. I agree with The Guardian, which said in a leader that the tachograph has real road safety benefits. I also agree with those who say that it probably does more than anything else to eliminate the cowboy operator—the operator who is prepared to break the rules.
  The tachograph is a device which looks much like an ordinary speedometer. It is a combined speedometer and clock

  775
  which records automatically on a paper disc the vehicle's speed, distance travelled and time spent on the road. The intention is that it should simply replace the log book as the main record for purposes of enforcing the rules on drivers' hours. It is thus essentially an aid to road safety, helping to keep tired drivers off the roads.
  It can achieve more than this if drivers and their employers are prepared to work together to make the most of it. It can assist drivers to improve their own professional skills and achieve substantial savings in fuel consumption as well as in wear and tear on engines and tyres. It can give management information on the use of vehicles, and help to increase the efficiency and productivity of the operation. It presents absolutely no threat to the honest driver in this country. Indeed, some European trade unions, as I know from a visit to West Germany, believe that it is a positive benefit to their members.
  The essential purpose of the draft regulations is to enable the existing EEC tachograph regulations to be brought into full operation in the United Kingdom in a smooth and orderly way. They are the product of long and detailed discussion with representatives of the road haulage and freight transport and bus industries.
  Mr. D. N. Campbell-Savours: The right hon. Gentleman says that the German trade unions have accepted this in principle. Have the French and Italian trade unions accepted the tachograph? Is he aware that hon. Members on both sides of the House know that they abuse the system and that they refuse to operate it in many areas?
  Mr. Fowler: The hon. Member is confusing two matters. I think that he is referring to the problem of enforcement in those countries. I do not claim that in all EEC countries the regulation is enforced to the standard that we would expect. I understand that the EEC is examining that problem. Many people genuinely believe that it is a safeguard for the driver and not the threat that many people in this country wrongly believe it to be.
  I take the opportunity to pay full tribute to the constructive way in which these consultations have been approached. I appreciate that representatives of the industries would have preferred to avoid
  776
  compulsion, but they have accepted that the law must be implemented, and their comments and advice have been both constructive and helpful.
  It is no secret that the European Commission pressed us very hard to give effect to the ruling of the court in what I considered to be too short a period. Of course it recognises that we cannot achieve full implementation of the regulation overnight, but it felt that, as we had already been in breach of our legal obligation since January 1976, there was a strong onus on us to come into line quickly. I am glad to say that I persuaded it to accept that a longer transitional period was necessary than that which it had originally suggested and thought necessary.
  Under these proposals tachographs will have to be fitted in accordance with a programme phased over two years, starting with the newest vehicles and ending with the oldest. The use as opposed to the fitting of tachographs in place of log books will become compulsory on domestic journeys from the beginning of 1982. In the meantime, there will be no change in the existing rules which allow the use of a tachograph as an alternative to a log book on a voluntary basis.
  I recognise that this timetable is still fairly tight. Its practicability depends largely on there being enough approved tachograph calibration centres across the whole country. At present there are nearly 200. By this time next year we aim to have 450.
  Mr. Ron Leighton: Is the Minister saying that this is not his policy and that he is just the messenger boy of an alien institution, over which we have no control, introducing law into Britain?
  Mr. Fowler: That is a remarkably silly intervention. The alien institution to which the hon. Gentleman refers was something for which the vast majority in this country voted.
  I shall, of course, be keeping a close watch on progress during the phasing-in period. If for any reason the programme should prove to be impracticable, I would not hesitate to take whatever steps appeared to be necessary in the circumstances to put matters right. Let me assure the House that it is no part of my

  777
  scheme that drivers or operators should find themselves on the wrong side of the law through practical difficulties with the programme which are no fault of their own and be put at risk. But I firmly believe that the job can and will be done in the two-year period.
  There are special problems in the remoter areas of the country, particularly in parts of Scotland. It is true that at the moment there are not enough approved tachograph centres to meet their needs. I recognise that this is a real problem and I have already taken steps to deal with it. My Department will very shortly be publishing details of a special new modified standard for centres in such areas.
  Islands present a related problem. Even with the modified standard for approval, very few of them could support a tachograph centre. Vehicles would have to go by ferry, sometimes over considerable distances, to have tachographs installed and calibrated. I have no powers to exempt the remote islands from the requirements of the EEC regulation itself. But, under my draft regulations, vehicles based on the United Kingdom islands which are not connected by road to the mainland need not have tachographs fitted until the end of the phasing-in period on 31 December 1981, irrespective of the date of registration of the vehicle. In other words, operators can choose the most convenient moment to get their vehicles fitted within the overall two-year period.
  Mr. Les Huckfield: The Minister will realise that there are certain parts of the country in which no calibration stations exist. He says that he proposes to make arrangements and take action. Is he trying to assure the House that he will by the end of the statutory period have sufficient calibration stations to cover the whole of the country without operators having to go long distances to have their vehicles calibrated? What he says goes a lot further than any Minister ever before. Does he understand what he is saying?
  Mr. Fowler: I sometimes think that the hon. Gentleman should give other Members the credit for understanding what they are saying—apart from himself.
  778
  I explained that at the end of the consultation period, in which we took the views of industry—that was the purpose of the consultation period—we came to the conclusion that there were special problems in the remoter areas and the islands. We shall be publishing details of a special new modified standard for tachograph centres in such areas. However, the point is that this will greatly reduce the capital investment in these tachograph centres and allow such centres to be set up. If the hon. Gentleman wants to pursue this matter, he is entitled to do so, and my hon. Friend the Parliamentary Secretary will seek to give him more information. The hon. Gentleman is right: what I am saying is new, and that is why I am saying it during the debate.
  I know that many people would like to see the range of exemptions from the EEC tachograph regulation extended, but in this country we have to implement Community law as it stands. If we want changes, they will have to be brought about through the legislative processes of the Community, with the agreement of all nine member States.
  Mr. Dennis Skinner: What puzzles me is how his policy squares with the Conservative Party's election manifesto which, roughly translated, said that we must get the Government out of the small employer's pocket, we must release all these energies and allow these freedoms to operate. How does the right hon. Gentleman reconcile the introduction of these massive controls—the spy in the cab—merely as a result of the activities of the Common Market, with the Conservative Party's manifesto?
  Mr. Fowler: One of the Government's major planks is to observe the rule of law. As I have said, that is exactly what we are seeking to do here. I remind the hon. Gentleman that we are not alone in this. The Labour Government also accepted the European Court's ruling. Perhaps the hon. Gentleman did not, but we do not yet have a party that is able to take in all the prejudices of the hon. Gentleman.
  I have taken steps in my proposals to ensure that vehicles will not have to be taken off the road simply because it is not possible to get the tachograph system repaired or resealed immediately. My draft regulations provide a defence against

  779
  convictions for using a vehicle with a defective or unsealed tachograph if it can be proved that it was not reasonably practicable for the equipment to be repaired or resealed. I believe that this provision, which is also new and which I have again included as a result of comments made during my consultations, will greatly reduce the costs incurred as a result of a vehicle being off the road, and so remove one of the most serious worries of the vehicle operators.
  Mr. Tony Marlow: Can my right hon. Friend say how much this scheme will cost, how many additional civil servants or others will be employed, what the capital cost of the scheme will be avid what he likely cost will be to any operator who has to go back and forth to have his tachograph calibrated?
  Mr. Fowler: I am not running away from that question. There will, of course, be additional costs on the industry. We know that. There is no secret about that. That has been known for a long time. I am sorry that it may come as a surprise to my hon. Friend, but that is the position—[HON. MEMBERS: "What is the cost?"] The estimates vary considerably, but it is obviously in tens of millions of pounds for the industry.
  I believe that it is high time that we got the tachograph question settled in this country once and for all. The mistrust and general uncertainty generated by years of argument have been of no help whatever to the industry as a whole, or to the management and drivers who work in it. The sooner the whole matter can be firmly settled, the better it will be for all concerned. The central question in the debate is one of respect for the law. I believe that that is right; it is basic and essential.
  I ask the House to support the motion.
  10.34 pm
  Mr. John Prescott: This seems to be a day for saying that we must obey the law. I understand the point that is being made, but, in view of the statement today on the Bingham report, it is an unfortunate day upon which to make it. The regulation follows from the European Court's decision of February 1979. I do not want
  780
  to avoid the implications of the statement made by the Labour Government concerning the decision of that court.
  The former Minister of Transport, my right hon. Friend the Member for Stockton (Mr. Rodgers), said in February 1979 that he had reluctantly concluded that he must accept the decision and that in due course he would lay the necessary regulation before the House for its consideration. His case was based on the phrase, "in due course". That statement was made after a period of delay, when the Commission was asking for the law to be complied with. As the Minister has pointed out, for three years we refused to implement the tachograph requirement for several reasons. Those reasons are relevant to our decision tonight.
  My right hon. Friend said then that he believed in a voluntary system. The House passed legislation in line with that belief and the tachograph was not made compulsory. It was consistent with his decision that the installation of the tachograph should be voluntary and not compulsory. He did not think that the regulation would be helpful to industry, and he acted accordingly. Because the Commission disagreed with the Labour Government's attitude and did not accept the Labour Government's justification for it, it took the issue to court. The court said that, according to Britain's treaty obligations, we should implement the tachograph decision.
  Despite what the Minister said and despite all the consultations and decisions, both sides of the industry are still opposed to the compulsory installation of the tachograph. The Freight Transport Association would prefer not to have the tachograph. When opposing the Commission's attempt to impose the tachograph, we argued that it was expensive for the industry to implement and for the consumer. I was interested to hear the Minister say that the cost of implementation would be tens of millions of pounds. I do not know whether I shall shock him, but the estimates given in 1978 were £100 million just to install it. The latest statement by the Freight Transportation Association puts the cost at £350 million.
  Mr. Fowler: Probably the best estimate is between £200 million and £300 million compared with operating costs of

  781
  substantially more. The hon. Member has put the cost of the tachograph with the cost of the vehicle, which is a very small percentage of it.
  Mr. Prescott Mr. Prescott That is a debatable proposition. I shall not pursue the points about the tens and hundreds, but the Minister might like to go away and reflect on some of his answers.
  Insufficient consideration has been given to the implications of the compulsory imposition of the regulation. Even if we accept the Minister's argument about a cost of £250 million to £300 million, that is nearly three times more than the estimate in 1978. Goodness knows what the cost will be in 1981, 1982 or 1983, with the present rate of inflation.
  Mr. Roger Monte: Will the hon. Gentleman make his argument clear? Is he saying that if there had been a Labour Government they would not now be introducing these regulations? That is hardly credible.
  Mr. Prescott: I suggest that the hon. Gentleman listens to my speech before judging whether it is credible. After hearing my arguments, the House will be better placed to assess my conclusions on what action should be recommended. The Minister clearly demonstrated that we should go through the arguments first so that we understand the implications of the regulation before making judgments, although he made his judgment and brought the regulation before the House.
  Secondly, the Minister has said that overall tachographs would be safer, but the lorry drivers and owners do not agree. However, I rest my case, not on the arguments of drivers and owners, but on the Foster report published in November 1978. That was an inquiry into road haulage industry operators licensing. The report said:
  "We believe that there are as good and perhaps better ways of spending the money tachographs would cost, on safety. The judgment of the European Court will probably make our recommendations irrelevant, but if not we would recommend leaving it to operators and drivers to agree on the installation of tachographs where both find it useful."
  Thirdly, the argument is that the regulations will eliminate obstacles to competition, although the owners totally oppose compulsory imposition and it has not been
  782
  argued that road haulage is a monopoly industry. If anything, there is an excess of competition, which can lead to lowering of standards.
  The present checks and laws could perhaps be improved, but, as the Minister said, they are generally adequate, and the compulsory imposition of the regulation could lead to serious disruption. The Government claimed that a lorry drivers' strike would have had wide-ranging effects. If lorry drivers go on strike, there is considerable disruption, as last winter showed. The previous Government were concerned with imposing wage controls, and compulsory imposition would certainly have considerable consequential repercussions on wages, affecting their anti-inflation policy. We also reject the argument that the regulation will eliminate obstacles to competition.
  We have the regulation before us because of the European Court's decision. It is said that we are in default of our obligation under the Treaty of Rome. The judgment of the court did not say that the regulation should be imposed because of safety, to remove obstacles to competition, or to make for better enforcement in the industry. It said:
  "It cannot therefore be accepted that a Member State should apply in an incomplete or selective manner provisions of a Community regulation so as to render abortive certain aspects of Community legislation which it has opposed or which it considers contrary to its national interests…practical difficulties which appear at the stage when a Community measure is put into effect cannot permit a Member State unilaterally to opt out of fulfilling its obligation."
  The regulation is clearly being imposed because it is a constitutional requirement or a legal obligation arising out of a treaty.
  Sir Nicholas Bonsor: Does the hon. Gentleman seriously suggest that the Government should not honour the international obligations which the Labour Government undertook to honour?
  Mr. Prescott: That sort of argument is constantly before us—on fishing, lamb and a number of other issues. We have seen the stopping of the clock in the Common Market. A number of Treaty obligations are not being implemented or delayed. I sat for four years in the European Parliament and was constantly told that import controls were illegal, yet I served on

  783
  a committee where Commissioner Davignon brought in such controls almost every week. There are many bends and twists in matters relating to the interpretation of the Treaty in the Community. The French understand that much more than us and that is why they have a better deal.
  Mr. Fowler: Do the Opposition accept the decision of the European Court? That is a basic question. The Opposition should make their position clear.
  Mr. Prescott: If the right hon. Gentleman had listened to the beginning of my speech when I quoted the speech of my right hon. Friend the Member for Stockton, who was the Minister responsible for saying that in due course the obligations of the Treaty would be implemented, he would have heard me make clear that the previous Government observed the court's decision.
  Mr. Fowler: Is that the position of the Opposition?
  Mr. Prescott: Yes, it is the position of the Opposition. I am bound to say that to the right hon. Gentleman. That is why I started with that fact clear in my mind. However, the hon. Member for Nantwich (Sir N. Bonsor) asked me whether the obligations should be totally accepted. Certainly, in the instances of fishing and lamb, it is argued that we should be sticking to but not necessarily totally observing the letter of the law.
  A number of consequences could be triggered off by the compulsory imposition of the regulations. The Minister should realise that he is not free from the consequences which might follow if the regulations are passed. Indeed, the consequences may even be counterproductive to his declared aim to ensure that the regulation is implemented.
  The Freight Transport Association—the industry, not the unions—has said:
  "Given a free choice, therefore, industry would oppose the compulsory installation and use of tachographs and it firmly believes that the case for such a regulation has never been proven beyond the point of the UK having to accept such a ruling as part of its condition of entry into the Community."
  The industry also believes that, if the regulation is accepted, it will be in considerable difficulties. The Minister referred to those difficulties. He referred
  784
  to the timetable, the 500,000 lorries in the country, the 195 to 200 present centres and the aim to achieve 450 centres. I hope that when the Parliamentary Secretary winds up the debate—which the Opposition will not be doing because of the time that I have taken in the debate—he will explain how capital costs will be reduced to allow out-of-the-way places to be able to deal with the calibration points. The industry says that it wants three years and it asks the Government to delay the implementation of the measures by one year.
  The drivers feel strongly about the spy-in-the-cab proposal. Their grievance is that they have been told that it is being implemented to harmonise Community legislation. But the EEC regulations will lead to longer working by the drivers. They may not be driving for as many hours but they can work a lot longer under these regulations than under our legislation. Drivers could become more tired by the implementation of the legislation. The Minister said that the requirement to keep records for two days only rather than seven will make it easier for drivers, but a requirement of seven days in order to see whether the drivers work their rest-day periods at the weekend is dealt with under our legislalation. Offences on the Continent such as speeding are dealt with differently from Britain. There are fines on the spot which are not recorded at a central registry as is the case in our system. Therefore, the Commission's licensing provisions are affected.
  The Commission is bound to have to take into account before granting a licence any speeding offence. So though we may be harmonising provisions on hours with the tachograph, the penalties will be much harder on drivers in this country than they are likely to be on drivers in the rest of the Community.
  We are also concerned that more restriction on hours will mean that fewer places will be available where drivers may stop on motorways—or even lorry parks—which may cause them to contravene regulations. That was a point raised with me by my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry).
  The Minister must be aware that the Commission is reviewing some of these matters. One of the Commission's recommendations to Governments, under the

  785
  European transport agreement, is to allow lorries that go through any Community country to countries outside the Community to go through Community areas without a tachograph but with a log book.
  Already exemptions are being made. On the one hand, the Commission takes us to court and we are told that we cannot adjust the regulations, yet, on the other hand, exemptions are being given to EEC lorry owners and drivers going to countries outside the Community via the Community without a tachograph. That is a peculiar inconsistency.
  The position that we shall adopt tonight is consistent. We ask the Minister to withdraw the regulations. First, the full implications of putting this measure into effect should be considered. Secondly, the consolidation of the existing road traffic laws and the offences under them should be considered. If the Government wish to harmonise them, it should be done through the Transport Bill that is now being considered in Committee.
  Thirdly, the implications of the Foster report on control of lorries should be considered. Fourthly, the Government should await the outcome of the referendum that the trade unions are conducting to decide whether industrial action should be taken because of the imposition of this regulation. I believe that the final decision will be made this week.
  Finally, the Government should mitigate the cost to the industry and the consumer of the imposition of the regulation. If it is not withdrawn tonight, the inevitable conclusion drawn by the industry will be that Parliament is forcing the regulation down its throat, not for safety reasons or better control on competition, but because of an obligation under a Treaty for which we must all pay. The Minister could mitigate the effects of the regulation by withdrawing it tonight.
  10.52 pm
  Mr. John MacKay: I want to talk about the special problems which these regulations will pose for my island constituents.
  On 12 November I asked the Minister whether any special consideration could be given to vehicles based on the Scottish islands, and my right hon. Friend said in his reply:
  786
  "No exemption is provided in the EEC tachograph regulations…and the United Kingdom cannot make such exemptions unilaterally."
  He added:
  "I am however considering what can be done within the regulation to deal with the special problems which implementation of the regulations will present to island based vehicles."—[Official Report, 12 November 1979; Vol. 973, c. 460.]
  Indeed, my right hon. Friend has been as good as his word, at least in part, in that in the regulations vehicles on the islands off the coast of the United Kingdom, other than the Isle of Wight, will have until 31 December 1981 before having the tachograph fitted. But that is only a concession to put us in the group at the end of the table. Vehicles registered before 1 August 1973 have until 1981, so we are merely put into that category.
  I welcome this concession, because it will help my island constituents, but the extent of it is not great and does not deal with the long-term and continuing problem that the tachograph will impose on these islands. It is not only the fitting of the tachograph that is the problem, but the need for recalibration two or three times a year, and the need for resealing each time the seal is broken. Each time that happens on an island the lorry will have to go to the mainland to the nearest calibration centre. If a fault occurs in a tachograph, the vehicle cannot be used again until it has been to the centre and the fault has been rectified. Considerable difficulty and chaos will be caused on the island.
  The island of Islay is known to my right hon. Friend the Prime Minister. If a 16-ton lorry based on that island had to go to the nearest calibration centre at Glasgow, it would take at least two days to reach the centre. It would leave the island at the beginning of the first day and it would perhaps return to it at the end of the second day. The total cost for a £10 test fee would be £264. That assumes that when the driver reaches the calibration centre he will be able to drive straight in. If he is not able to do that, he will be on a three-day visit to the mainland. That will increase the cost to over £300.
  I am pleased to hear that my right hon. Friend is aware of the special problems of the islands. However, as the House may know, our current United Kingdom legislation on plating and testing makes a

  787
  special exemption for island-based vehicles. I cannot understand why the tachograph legislation cannot make a similar exemption. If we have to persuade our EEC colleagues to do that, let us set about persuading them. I fail to understand what influence a lorry based for the whole of its working life on the island of Mull has on free trade between the partners of the European Economic Community.
  I support the principles and ideals of Europe, but it is this sort of bureaucracy that brings the Community into considerable disrepute. Despite some of the remarks by Labour Members, I appreciate that on long and medium haul journeys there are some major safety positives to be gained from fitting tachographs in lorries. As a Member who represents an agricultural constituency and wishes to see the French obeying the rules of the Common Market on mutton, I recognise that we are under a similar obligation to do likewise in respect of tachographs. However, I make a special plea to the Minister and the people of Europe on behalf of my island constituency. If what I am seeking can be met by the instrument before us or by the plating and testing regulations, surely it can be met by the ongoing regulations that govern the tachograph.
  I do not see the Common Market breaking apart by making such a small exemption for the islands round our coast. The small exemption that I seek would be of great benefit to my island constituents. If made, it would show that the Common Market is concerned with the remote areas of the United Kingdom. I urge my right hon. and hon. Friends to give my constituents and one some hope that the Government will press our case on our European partners and ensure that they look favourably on the making of an exemption for my island constituency.
  10.58 pm
  Mr. Leslie Huckfield: I declare an interest as a sponsored Member—
  Mr. Deputy Speaker (Mr. Bernard Weatherill): Order. Mr. Speaker has not selected the amendment of the hon. Member for Nuneaton (Mr. Huckfield). I think that the hon. Gentleman knows that.
  Mr. Huckfield: I accept, of course, what you say, Mr. Deputy Speaker.
  788
  I declare an interest as a sponsored Member of the Transport and General Workers'Union. I have close connections with the Birmingham and district 5/35 commercial branches. Members of the branches, as some of my hon. Friends know, and as I think the Minister knows because some members live in his constituency, have been vociferous in their opposition to the introduction of the tachograph legislation that is now proposed.
  The magnitude of the problem over which the Minister thinks he can skate lightly has not yet been revealed. We are talking about the introduction of tachographs in about 600,000 vehicles. The bulk of the installations will have to be completed in less than two years. The timetable is January 1980 to October 1981. I do not make that two years.
  I am glad that the Minister has been forced to admit that the total cost of installation could be about £300 million. That estimate is on the low side. Much of the equipment will have to be imported. We do not know the price of the imported equipment. We do not know the exchange rates. I am willing to bet that £350 million is a better estimate.
  We shall also have all the problems of installation, over which the Minister skated lightly. For example, why must we so slavishly follow the timetable to which the Irish Government adhered? I do not understand that. In a letter of 26 October, the Parliamentary Secretary told me:
  "Nor are we 'slavishly' following the Irish timetable—or, indeed, following it at all."
  In fact, the Government are pretty well exactly following the timetable to which the Irish Government adhered.
  Anyone who takes a cursory glance at the map will find that we are dealing with two totally different countries. The geography, the road network, the whole conditions of transport, the whole infrastructure, are totally different in the Irish Republic, yet we still have roughly the same time scale laid down simply because the Minister has taken it into his head that the Commission attaches importance as a precedent to the timetable offered by the Irish Government.
  Who will pay for this in the end? Who will pay the £350 million? It will be the consumer. The Government have

  789
  already put up the cost of living by 17½ per cent., on their own estimates, by their own Budget. By how much will installations of this kind put up the cost of living again, as a direct result of these policies?
  I have always found the Freight Transport Association a very reasonable crowd. Its members certainly are not mavericks, a bunch of wild men. The association has said that the installation period should be at least three years.
  We must take into account the vastly different circumstances in different parts of the country. Cannot the Minister understand that it is not just the Highlands and Islands that we are talking about? We are talking about the fact that there is not a calibration station anywhere between Newcastle and Edinburgh. When we talk about Wales we are not talking only about rural Mid-Wales. There are vast parts of Wales which do not have calibration stations. Yet the Minister says that it will be all right as long as the employer has shown that he has taken reasonably practicable precautions. How can the Minister dare even to try to enforce such a condition?
  Will the Minister say that we shall have 24-hour calibration stations up and down the country? Are they to be open morning, noon and night? Does he not realise that lorry drivers work at night, that we have overnight trunking, that the bulk of heavy road freight in fact moves at night? Are the stations to be open 24 hours a day, or is that matter the kind of reasonably practicable exemption that employers will be able to plead?
  The basic trouble is that this is yet another of those actions under section 2 of the European Communities Act 1972 that we have to take. The Minister thinks that he must do it in precisely this manner, and I strongly disagree.
  It is true that regulation 1463/70 does not allow for different circumstances in different countries. But I am sure that the hon. Gentleman could have pleaded extenuating circumstances before the Commission, in view of the need to set up the calibration stations, the large number of vehicles and the resistance on both sides of the industry. It is not simply the Transport and General Workers'Union or the United Road
  790
  Transport Union. Surely it would have been possible for the hon. Gentleman to plead something different.
  Then the right hon. Gentleman talks about the abolition of log sheets—the lorry driver's dream. I do not know what he will do with all those gentlemen in black raincoats who wait in cafe doorways at three o'clock in the morning. I am not sure whether he proposes to make them redundant. If so, the guessing game that lorry drivers usually play will have to end.
  But it is not as easy as that. One cannot simply put the clock in and take the log sheets out. For example, what will happen to the measurement and recording of non-driving time? Even the most sophisticated clock on the market does not record the time that the driver spends out of the cab. It is a clock, but it cannot measure the time that the driver spends in connection with his driving duties.
  Does not the Minister appreciate that even in Germany, where there has been hitherto a fairly rigid adherence to the tachograph and its regulations, there are still numerous cases of lorry drivers working 90 hours a week because the tachograph cannot measure non-driving time? It is not possible to get rid of log sheets in that way. There will have to be some provision for measuring more than one driver. There will have to be some provision for measuring shifts. There will have to be some kind of provision whereby non-driving time and on-duty time—the spread-over period—are measured. But the Minister does not understand that. He seems to think that it is a very simple mechanism—out with the log sheets and in with the clock.
  Then the Minister tells us that it is a great safety device. I doubt whether he has the figures to prove that. He ought to know that the accidents occurring to heavy goods vehicles per 100 million miles have been diminishing. I will give the Minister the exact figures. Heavy goods vehicle accidents fell from 202 per 100 million miles in 1971 to 152 per 100 million miles in 1975, so HGV accidents are declining all the time. If the Minister can produce statistics to show that increased safety has been achieved as a direct result of the installation of the clock, I shall be very interested to see them, because we have not seen any such figures.

  791
  I rather fancy that the Minister is governed by his haste to introduce these regulations and not by any real need to introduce them. He does not seem to appreciate that there are numerous American and Canadian precedents showing that these devices have been installed purely for management reasons—not to measure hours, not to cut accidents, not to increase safety performance, but simply as a productivity and management measuring device. Cannot he understand that there is a great deal of feeling on the union side of the industry that this is the reason why a good many employers would like to introduce these devices in this country—not as an aid to safety, not to reduce accidents, but simply as an aid to management?
  The Minister ought to know something of what a modern tachograph can do. It is not simply a clock in the speedometer. Does he know that the kind of device that he proposes to instal in the lorry driver's cab can, for example, measure whether a lorry driver started off five minutes late, whether he broke the speed limit by 2 mph, whether he forgot to switch over, whether he put down the wrong mileage on his sheet to London, whether he misspelt the destination town, whether he was caught opening the clock when he should not have been, whether he stopped on an unauthorised break, whether he took too long changing over, whether he took too long before setting out, whether he took too long roping down, whether he overslept by eight minutes, whether he changed into the wrong gear, whether he was too heavy on the brakes, or whether he went up and down the gearbox too rapidly?
  All those can be measured on the tachographs which are on the market—and that is before the admission of the silicon chip into the tachograph. We shall soon have a tachograph that can tell the colour of the driver's socks. That is the kind of technological progress being made in the industry.
  Mr. Fowler: The hon. Gentleman is making a fundamental case against the tachograph. Unlike many other hon. Members who will speak in the debate, the hon. Gentleman was a member of the last Administration. Did he accept the recognition by the then Secretary of State for Transport and his own Govern-
  792
  ment of the European Court's decision on the tachograph? If he did not, why did not he resign?
  Mr. Huckfield: I am quite clear on what my hon. Friends have said. I believe and they believe that there is no need to introduce the tachograph in this fashion. That is the position which has been adopted, and that is what was said from the Opposition Front Bench. It is quite conceivable to go to the European Commission to plead the extenuating circumstances that we have in this country. There is no need to adhere slavishly to the kind of pattern and timetable that were followed by the Irish Government.
  I shall finish with this question, Mr. Deputy Speaker, because I realise that other hon. Members wish to speak. Cannot the right hon. Gentleman understand that the Italians get round this by a procedure of fines, bribes and fiddles on the spot? I could tell him a few, if he wishes to know them. Cannot he understand that the French get round it by having a man in the firm whose permanent job is to pay the fines. Cannot he understand that the Belgians get round it simply by ignoring the regulations? Does he not know that the Belgians, until fairly recently, had a driving limit of 1,200 hours over six months governing lorry drivers? How the Dutch get round it, we shall never know. No one understands how the Dutch manage to make their haulage rates per ton so cheap.
  I have to tell the right hon. Gentleman that there is widespread abuse. There are widespread fiddles and widespread evasion on the Continent. I do not see why both sides of the British road haulage industry should be so severely penalised in this way.
  11.11 pm
  Mr. Iain Mills: I consider the tachograph to be a totally unwelcome, unsatisfactory and expensive European fact of life. When that is accepted, we must make the best use of this measure.
  The hon. Member for Nuneaton (Mr. Huckfield) seemed to pose all the reasons against but offered no real practical solutions for. It is vital that, if this measure has to be accepted, it is accepted with practical realism to make the best of an undoubtedly bad job. Its strength is the availability of legal and practical analysis

  793
  of events shown on the sheet. For those hon. Members who have never seen it—I suspect there are many—I have some in my possession.
  Its weakness, however, is the high cost of well over £350 million a year and the inevitable bureaucracy that will be involved. I suggest, therefore, that flexibility is the only answer to the problems. I welcome the flexibility my right hon. Friend has shown in the changes he has made in the regulations as a direct result of the observations of practical people who have to live with it. One example is that the sheets have to be retained only for two days.
  I should like to ask hon. Members whether, having seen the sheet, they consider it would be practical for it to be kept for a longer period in someone's pocket. I have had 18 years' working experience. Hon. Members should perhaps try for themselves.
  Mr. Albert Booth: Does the hon. Gentleman believe that it is practicable for the police, trying to enforce driving hours regulations, to find out whether a driver has had a rest day in the last seven if there is only a two-day log?
  Mr. Mills: The right hon. Gentleman must bear in mind that, while the driver has to keep the sheet for only two days, for all practical purposes the employer keeps it on a spike in his office. The right hon. Gentleman's point has no validity.
  I wish to be brief as I know that a number of hon. Members wish to contribute. Flexibility is needed by the haulage industry in its use of the benefits. I have seen an analysis showing the accident benefits. This defies other forms of analysis. It is a real benefit. Flexibility is needed by the Ministry of Transport, perhaps going beyond that shown by my right hon. Friend. Tachographs represent the least acceptable face of our membership of the European Community. It is tragic that in the latest green Euro-document this represents the only contribution to European transport. New horizons are not created in this way.
  Making the best of a bad job leaves some questions to be answered by my right hon. Friend. How will the regulations affect crews of two or three? Will they still have to use the EEC log books?
  794
  Or will one driver use the tachometer sheet?
  It is vital that flexibility is shown over the number of TCCs. I have discovered that in my constituency of Meriden, which encompasses a large stretch of the M6 and all the M42, save about 10 miles, there are at present no TCCs. The hon. Member for Nuneaton might be interested to know that.
  I feel strongly that, by the time the necessity to fit tachographs is arrived at, we must ensure that there are either relaxations or sufficient TCCs to do the job. The nearest to my constituency is in Birmingham. I ask my hon. Friend to define more clearly those valuable suggestions that he has already made in the proposed section 97A on this point and how he thinks the term "reasonably practicable" will be interpreted.
  I should also like a repair to a damaged tachometer or a broken seal to be considered on an exemption basis by the road hauliers themselves on a temporary basis, particularly in the first two years up to 1984 in which the regulations will apply.
  I also ask my hon. Friend to say whether fork-lifts and dump trucks over 3½ tonnes will still require tachographs, as many of these will undoubtedly not have to leave factories, so it seems irrelevant to have them.
  Cheap haulage is essential if we are to achieve the consumer prices that we want. While implementing the regulations—it seems to me that we have no choice, and right hon. and hon. Gentlemen who say anything else must be living in the sand—could we not consider a period of two years' grace during which we interpret "reasonably practicable" in a free, gentle and reasonable way? If we have no choice with these regulations, I suggest that that kind of flexibility is the only answer to the points raised by the trade unions and the road hauliers.
  11.17 pm
  Mr. Austin Mitchell: The essence of the argument against the tachograph generally is that it is being imposed on us as part of the mindless drive towards standardisation stemming from the Common Market.
  My hon. Friend the Member for Kingston upon Hull, East (Mr. Prescott)

  795
  made out a telling case against the pressure that has been put on this country. Therefore, I hope that he will join me in opposing these regulations and the pressure that has been imposed on us. This pressure takes no account of national circumstances, particularly our safety record of heavy goods transport. As my hon. Friend the Member for Nuneaton (Mr. Huckfield) pointed out, our safety record is very good and is getting better. Indeed, in many instances it is better than the records of many countries that use the tachograph.
  There is a danger that the tachograph could be detrimental to our safety record, because it allows eight hours' driving time. That is what it is regulating. It is not regulating the stresses, strains, pressures and exhaustion produced by preparation and loading time and all the other activities imposed on drivers. These aspects and the effect on a driver's constitution are not measured. All that is measured is eight hours' driving time, and that is permitted. Therefore, the use of the tachograph makes possible a posse of exhausted, strained and stressed drivers driving vehicles with mechanical safety devices in their cabs designed to measure safety.
  The Parliamentary Secretary to the Ministry of Transport (Mr. Kenneth Clarke): I hope that the hon. Gentleman is not under the misapprehension that we are changing the drivers' hours regulations in some way. I am sure that he appreciates that the restriction is eight hours' driving time whether measured by a log book or a tachograph. We are arguing only about the device that measures drivers' hours.
  Mr. Mitchell: I would argue that there is a conflict with our regulations. I suggest that our approach is better, because of our regulations, than this mechanical recording device which is to be installed in the cab of a vehicle. It takes no account of the stresses and strains on the driver or of the reality of accidents that usually occur in the first two hours in areas near to base. These pressures are not measured by the tachograph. I do not accept the safety argument for the tachograph.
  On the basic argument, I should like to emphasise a local note. I cannot speak
  796
  for national pressure and interest groups, but I can speak about the opinion of the two sides of the industry in my constituency—an area with important transport interests that will be vitally affected by the use of this device. Those interests feel that this device is being imposed on them without their consent. Indeed, both sides of the industry locally view it with reluctance and hostility. They see it as interference with the present balance. On my assessment, the employers are more against than for the tachograph. Most of them if they have an attitude towards it at all, regard it as a nuisance which could upset the delicate balance of negotiations in the industry.
  The Common Market is imposing not only personal surveillance in the cab but complete interference in collective bargaining in this one industry alone. That is resented on both sides of the industry. Employers see the possibility of the delicate balance being upset by this intrusion.
  The opinion of the drivers has been demonstrated all too clearly by the fact that Grimsby suffered from a long, difficult and expensive stoppage over the tachograph in January 1978. For a whole week the port and town were brought to a halt by a drivers' strike localised to the area and precipitated by the fear that the tachograph was to be imposed on them.
  The tachograph was part of the complex of feelings and complications which produced the strike of January this year. We have therefore suffered two serious strikes caused by the tachograph. The owner drivers see it as yet another unnecessary restriction on their operations.
  The threat to the industry caused by the tachograph—resented in my constituency—poses other problems. The tachograph regulations do not operate in the same framework of law enforcement as is applicable to the rest of the country. We have a much stricter framework of enforcement in this country than in Europe and a machine designed to operate in a more lax enforcement context is now being forced into operation here.
  The drivers see themselves as the forgotten men of industry. They know that British industry depends on lorry drivers, but they see themselves badly treated as a group. This feeling of

  797
  alienation was one of the causes of the transport strike of last January. They feel that something extra is being imposed on them without any acknowledgement of the problems that they face. There are problems of accommodation, of parking and of keeping on driving. In very difficult circumstances, they are being forced to live a hand-to-mouth existence. In other words, they feel that up to now nothing has been done for them and here is something more being imposed on them. The tachograph is being imposed without any of the ameliorative factors which exist on the Continent.
  The drivers say that if the tachograph is to be imposed on them they should enjoy the same advantages as their colleagues on the Continent. There should be on-the-spot, or, at least, seven-day fines. Why should drivers have to travel down to South Wales from Grimsby for court proceedings when that kind of disadvantage is not faced by lorry drivers in Continental countries?
  Our lorry drivers want standard fines and split licences so that offences committed in the private sphere do not necessarily count against a man's job. They want to enjoy the same advantages as Continental drivers if they are to be forced to accept the tachographs.
  There is also a problem of administration and recalibration. It exists because there are not enough calibration centres. Though the number is to be increased, there will still be the problem of lost time. Recalibration is necessary not only for a breakdown in the tachograph itself but with any difficulties with the speedometer cable, the gear box and even, I understand, if there is a puncture in the drive wheel tyres. All this will cause queues at calibration stations with resulting lost time in an industry whose economy depends critically on making the maximum use of its vehicles.
  Lost time for a driver is lost time for the industry and there are not enough calibration stations. Even the extra provision of such stations will not benefit a place such as Grimsby which has only one calibration station within reasonable distance and which will face long queues of waiting drivers.
  Mr. Ivan Lawrence: Will the hon. Gentleman give way?
  Mr. Mitchell: I am sorry, but time is short and I cannot give way.
  If the Minister cannot eliminate the queues at his own testing stations, how can he provide an adequate calibration service for an industry which will be under strain?
  We receive a trickle of reports from the Continent about fiddles with the tachograph. The Minister has given full answers to a series of questions which I tabled. I was prompted to ask those questions by drivers in Grimsby. We have heard of how Continental drivers use duplicate discs, throw-out discs and how companies hire unemployed men and use their names to back a disc. We have not heard how such fiddles can be eliminated in Britain.
  The device is being forced upon us. We are unprepared to operate it. The industry does not want it. It regards it as another grievance on its grievance-littered back. The timetable is not of our choice. My hon. Friend the Member for Nuneaton said that we were close to the Irish timetable. It was argued in the Irish debates against the tachograph, to paraphrase Robert Emmet, "Let no man count my mileage whereas no man who knows my mileage dare not question it. Let not ignorance of machinery harrow my way to the grave".
  I do not wish to end on such a note as that, but I mention it only because of the Irish precedent and the timetable that we must follow.
  The industry believes that it labours already under a series of grievances. It sees this as another unnecessary intrusion into its complex labour relations and its already sophisticated and adequate enforcement machinery. I share the industry's frustration. When told that the industry does not want the tachograph, hon. Members are forced into making half apologies and inadequate explanations. We have to say that it is necessary because of the European Court's ruling. It is another example of how Parliament has lost control over our destiny. We are in an inadequate position to deal with an industry which is angry about this device.
  11.27 pm
  Mr. Roger Moate: Given a free choice, almost no hon. Member

  799
  would support the compulsory introduction of the tachograph. However, we have no free choice. The Freight Transport Association states:
  "Given a free choice, therefore, industry would oppose the compulsory installation and use of tachographs and it firmly believes that the case for such a regulation has never been proven beyond the point of the UK having to accept such a ruling as part of its condition of entry into the Community."
  The association has opposed this measure for a long time. It states:
  "Nevertheless…UK operators now accept that they have no alternative but to follow the ruling of the European Court and that the regulations before the House are an inevitable consequence of that ruling."
  That is our position. We have no alternative but to follow the ruling of the European Court. That is a sad and sorry situation, but it is a fact of life.
  I sympathise with many hon. Members who object to the tachograph and object in principle to the Treaty of Rome. Of course they find this unacceptable. But they must understand that the Labour Party committed its Government to accepting the ruling of the European Court. The Freight Transport Association, in its document, makes it quite clear. It says:
  "we recognise that Parliament cannot amend the regulations before it".
  Labour Members are deceiving their supporters and the House if they believe that we have any option. Many of us might regret the current situation. The simple question we have to ask is: while the Community exists in its present form, and we are members of it, do we or do we not respect the rule of law? This matter has been to the European Court. There have been efforts made by successive Governments to try to gain time and to amend the position for our benefit.
  Can we honestly complain about the French disobeying the rulings of the European Court over lamb and then refuse to recognise its rulings in respect of another matter? The position is unpalatable for almost all of us, but we cannot alter things. It is wrong of Labour Members to try to put forward a different proposition.
  Mr. Douglas Jay: Is the hon. Gentleman saying that, here again, we have a proposal which is not
  800
  in the interests of this country but which we must accept simply because we are members of the Common Market?
  Mr. Moate: The position is that £350 million in unnecessary costs will be imposed upon industry. There is no disguising that. Eevery hon. Member has to answer the question: do we or do we not believe in the rule of law? We might, many of us, wish to change that law, and we ought to do so. Until we change that law—and it might come sooner than many of us expect—we have no option but to accept the situation. Let us try to gain time, exemptions and flexibility.
  The Labour Government were forced into accepting these proposals. This Government are in exactly the same position. We are carrying out their inheritance as much as our own. We have no option but to proceed. The whole House ought to be supporting my right hon. and hon. Friends in respect of these regulations which are being imposed upon us. They will produce very little benefit. There will be some benefit in some areas, perhaps. Generally speaking, they will be a considerable disadvantage to this country. They arise from our Treaty obligations.
  Mr. Peter Temple-Morris: Does my hon. Friend agree that tachographs are already in use in about 10 per cent. of lorries in use in this country and that many managements and unions who successfully operate those fleets claim that they represent a considerable benefit, not least a financial benefit?
  Mr. Moate: I conclude by saying that many of us would accept that, voluntarily installed, throughout many parts of industry these devices would be beneficial. To act compulsorily is wrong. Compulsion would normally be opposed by this House. In these circumstances, as a result of a pre-accession obligation—undebated at the time of accession and arising from an unamendable Bill—we have no choice. The proposal deserves our support and that of the Opposition.
  11.33 pm
  Dr. Edmund Marshall: I wish briefly to convey to the House specific areas of concern about the tachograph which have been put to me by both sides of the road haulage industry in my constituency—an industry based upon important firms and the port of Goole. I have

  801
  heard considerable doubt expressed as to the viability of the timetable laid down on page 4 of the regulations. Doubt has been expressed as to whether there are sufficient tachometers and whether they can be installed and calibrated in time.
  Although the Minister said that he would display a measure of flexibility in implementing these provisions, it does not appear to me, from reading the regulations, that the flexibility rests with him. The flexibility will rest with the enforcing authorities. He is not in a position to tell us whether the authorities will fail to abide by the letter of the regulations. The article dealing with reasonable practicability, to which my hon. Friend the Member for Meriden (Mr. Mills) referred, relates not to the installation of the tachometers but to keeping them in good repair. We shall run into a problem over the timetable for installing these pieces of equipment.
  Secondly, I have heard some concern expressed about the admissibility of the tachograph record as evidence in courts of law. The proposed section 97Bwhich is set out on page 3 of the regulations says that it would be admissible evidence under the part of the Transport Act 1968 to which the new section will belong. Does this mean that, in relation to other road traffic offences which are not in that part of that Act, the tachograph will not be regarded as admissible evidence in a court of law?
  11.35 pm
  The Parliamentary Secretary to the Ministry of Transport (Mr. Kenneth Clarke): If the regulations are approved tonight, the use of the tachograph will become compulsory in this country by 31 December 1981. To begin by expressing a purely personal opinion, I suspect that when we reach that stage, and thereafter, it will be difficult to remember what all the fuss was about when it came to installing tachographs.
  I accept that at present there is a great deal of concern about tachographs.
  Mr. Peter Fry: If that date is reached and it is found that, because of manufacturing problems and the question of calibration, it is not possible for all the vehicles to which the regulations apply to be so fitted, will the Minister give an undertaking that he will not put the British transport
  802
  industry into a situation where it has to take vehicles off the road in order to comply with the law?
  Mr. Clarke: My right hon. Friend said in his opening speech that he would consider the position if that arose. We are certainly prepared to be flexible, but flexible within the two-year limit which has been achieved by my right hon. Friend as a result of hard negotiations with the Commission and which, I can assure the House, is not the time limit which the Commission would have preferred. Within that time limit, there will certainly be flexibility, but the time limit has been arrived at following consultations. It is our belief—it is the only basis on which we put the regulations forward—that there should be no practical problems in implementing the regulations.
  Let me tell the House why I think that some of the concern which is expressed about the tachograph will prove to be misplaced. Obviously there is great concern about the tachograph. There is great concern about heavy lorries generally amongst the general public and those who drive heavy lorries. The first concern must be road safety. I acknowledge that, as the hon. Member for Nuneaton (Mr. Huckfield) said, the road safety record of heavy goods vehicles is steadily improving. In order to maintain those safety standards, we have rules on drivers' hours. There is universal acceptance of those driver's hours. It is desirable, in the interests of the safety of lorry drivers and members of the public, that an eight hours' driving maximum is adhered to.
  What we are talking about, therefore, is what means are to be used to measure the maximum period. The debate is about whether we should stick to the traditional British log book or move to the European and other international standard tachograph.
  Mr. Les Huckfield Mr. Les Huckfield rose—
  Mr. Clarke: May I deal first with the points raised by other hon. Members? If I give way to interventions, I shall not reply to those who have spoken in the debate. I have already referred to the hon. Member.
  Let me deal with what the hon. Member for Kingston upon Hull, East (Mr. Prescott) said about the penalties imposed

  803
  on British drivers and with what the hon. Member for Grimsby (Mr. Mitchell) said about the differences between penalties here and those in the rest of Europe. The penalties for breaches of the drivers' hours regulations are our existing penalties. Nobody is talking about relaxing the penalties on drivers for breach of the drivers' hours regulations. They are not affected by these regulations. We are talking about merely whether the necessary records should be kept for enforcement of drivers' hours by somebody writing down in a log book what he has done, or by having a speedometer-type device with a card which records what is done and making manual records at times—for instance, for a driver to record his duty time in the usual way when he takes the tachograph card out of the machine.
  I come to the question of cost which was raised by the hon. Members for Newham, North-East (Mr. Leighton) and for Kingston upon Hull, East. There is great concern about the cost.
  As my right hon. Friend frankly conceded, there is no escaping the fact that considerable capital and running costs will be involved. We do not dispute the global figures that have been put forward, but they are all extremely vague. I do not dispute that they are of the magnitude of £100 million, £200 million or £250 million. But they must be viewed against equally vague total figures of £15,000 million in relation to the operating costs of vehicles. That is an extremely loose estimate on which I would not rely, but it is of the right order.
  Let me try to produce some realistic figures, because all the others are extremely vague. We estimate that for a particular vehicle the fitting of a tachograph would cost about £300, and that the annual cost of recalibrating and maintaining it would be about £45. The total operating cost differs enormously depending on the size of the vehicle, but it is about £20,000 to £30,000 a year. Yet here we are talking about £345 with regard to the tachograph
  Another aspect of the cost is that of the calibration centres and the costs of going to those centres, particularly in outlying areas. My hon. Friend the Member for Argyll (Mr. Mackay) asked about the islands in Scotland and outlying areas generally. I was pressed for more
  804
  details about the new lower standards that we are prepared to approve to meet this important point. These will apply to new centres that are more than 25 miles by road from another approved centre. That will be of particular benefit in parts of Scotland and Wales. The main difference in the full approval standard will be the standard of testing equipment that is needed. Remote area centres will not require the very expensive rolling road for tachograph testing. Other changes will reduce the need for building works or for bigger premises. Therefore, these changes will make it much easier for tachograph centres to be paying propositions in areas where there are few commercial vehicles. Centres are coming along well in other parts of the country. We expect there to be a network, and that new lower standard for approvals will ensure that it is extended much more widely.
  In the brief time that is left I can devote no more than another minute to the speech of my hon. Friend the Member for Argyll. However, I should like to deal with the question of the islands. We envisage that the network of centres will get as far as the islands. For example, by the end of 1981, with the sort of reduced capital costs about which we are now talking, there could well be a remote area tachograph centre on the island of Mull, and we know that on certain Scottish islands tachograph centres are being built. Therefore, facilities will possibly be available on the islands. If not, lorries will have to go to the nearest mainland station. Oban will almost certainly have one. We do not foresee the need to travel to Glasgow which my hon. Friend foresaw. I hope that his constituents will be reassured that the cost of attending the centre will be substantially less than he feared. That is another concession that we have made.
  One aspect which could prove to be expensive is if a seal is damaged and the tachograph is returned to be resealed. However, a person will be able to use the defence that he has gone to a centre as soon as reasonably practicable. My hon. Friend the Member for Meriden (Mr. Mills) asked me to define "reasonably practicable". This will be a question for the courts in each case. All that I can say is that it is a familiar phrase in the law. I have been familiar with it for

  805
  many years in respect of the Factories Acts, and it gives rise to no difficulties there. I do not think that it will give rise to any difficulties under this legislation.
  Mr. Campbell-Savours: Does the Minister accept that we would comply with the directive and the requirements if under the new section 97A we substituted the sum of £1 for £200 and retained the use of the log book? I shall not go into what that implies, but it is quite clear what we are doing; we are retaining the present system while complying with the directive.
  Mr. Clarke: That sounds terribly ingenious, and I am sure that it would have the same measure of success as the previous Government's arguments before the European Court when they tried to avoid applying the regulation. However, I cannot answer that point in two minutes when the hon. Gentleman has produced it from his pocket and read it out.
  I turn to the EEC requirement, which is the point of the debate. My hon. Friend the Member for Faversham (Mr. Moate) is a long-standing opponent of
  the EEC, but he accepts the legal obligations that flow from our membership. Of course, this is an EEC requirement. That is why we are here. That is not in itself a reason to be against it. The hon. Member for Grimsby would be against motherhood if that was a requirement of the EEC. It so happens that this is an EEC requirement, although not wholly an EEC requirement. Mrs. Barbara Castle tried to introduce tachographs in 1968. Austria, Switzerland and Sweden now have them, and while we are members of the EEC we must abide by the rule of law. The Community cannot work without abiding by the rule of law. The international community cannot function if Western industrialised countries such as Britain defy the rulings of courts.
  We must comply with the ruling and we must approve the regulation, as we have won a good battle with the European Commission to get a two-year period of grace and a sensible and flexible timetable within that period.
  Question put:
  The House divided: Ayes 108, Noes 25.

  Division No.130]

  AYES

  [11.45 pm

  Alexander, Richard

  Hogg, Hon Douglas (Grantham)

  Renton, Tim

  Aspinwall, Jack

  Hooson, Tom

  Rhodes James, Robert

  Banks, Robert

  Hunt, John (Ravensbourne)

  Roberts, Michael (Cardiff NW)

  Beith, A. J.

  Jopling, Rt Hon Michael

  Rossi, Hugh

  Berry, Hon Anthony

  Lang, Ian

  Rost, Peter

  Best, Keith

  Lawrence, Ivan

  Sainsbury, Hon Timothy

  Bevan, David Gilroy

  Le Merchant, Spencer

  St. John-Stevas, Rt Hon Norman

  Blackburn, John

  Lester, Jim (Beeston)

  Shepherd, Richard(Aldridge-Br'hills)

  Bright, Graham

  Lloyd, Peter (Fareham)

  Silvester, Fred

  Brinton, Tim

  Lyell, Nicholas

  Sims, Roger

  Brotherton, Michael

  Macfarlane, Neil

  Speller, Tony

  Bruce-Gardyne, John

  MacGregor, John

  Spicer, Jim (West Dorset)

  Cadbury, Jocelyn

  MacKay, John (Argyll)

  Squire, Robin

  Carlisle, John (Luton West)

  Major, John

  Stevens, Martin

  Carlisle, Kenneth (Lincoln)

  Mather, Carol

  Stradling Thomas, J.

  Carlisle, Rt Hon Mark (Runcorn)

  Maude, Rt Hon Angus

  Tebbit, Norman

  Chalker, Mrs. Lynda

  Mawby, Ray

  Temple-Morris, Peter

  Chapman, Sydney

  Maxwell-Hyslop, Robin

  Thompson, Donald

  Clark, Hon Alan (Plymouth, Sutton)

  Meyer, Sir Anthony

  Thorne, Neil (Ilford South)

  Clarke, Kenneth (Rushcliffe)

  Miller, Hal (Bromsgrove & Redditch)

  Waddington, David

  Colvin, Michael

  Mills, lain (Meriden)

  Wakeham, John

  Cope, John

  Mitchell, R. C. (Soton, Itchen)

  Waldegrave, Hon William

  Dorrell, Stephen

  Moate, Roger

  Walker, Bill (Perth & E Perthshire)

  Douglas-Hamilton, Lord James

  Morrison, Hon Peter (City of Chester)

  Waller, Gary

  Dover, Denshore

  Murphy, Christopher

  Ward, John

  Dunn, Robert (Dartford)

  Needham, Richard

  Watson, John

  Eyre, Reginald

  Nelson, Anthony

  Wells, Bowen (Hert'rd & Stev'nage)

  Faith, Mrs Sheila

  Neubert, Michael

  Wheeler, John

  Fenner, Mrs Peggy

  Newton, Tony

  Wickenden, Keith

  Fletcher-Cooke, Charles

  Normarrton, Tom

  Wilkinson, John

  Forman, Nigel

  Page, Rt Hon R. Graham (Crosby)

  Williams, Delwyn (Montgomery)

  Fowler, Rt Hon Norman

  Parris, Matthew

  Wolfson, Mark

  Fox, Marcus

  Patten, John (Oxford)

  Younger, Rt Hon George

  Garel-Jones, Tristan

  Penhaligon, David

  Gow, Ian

  Pollock, Alexander

  TELLERS FOR THE AYES:

  Griffiths, Peter (Portsmouth N)

  Rathbone, Tim

  Mr. Peter Brooke and

  Hawksley, Warren

  Rees-Davies, W. R.

  Mr. Robert Boscawen.

  Heddle, John

  NOES

  Atkinson, Norman (H'gey, Tott'ham)

  Huckfield, Les

  Ross, Wm. (Londonderry)

  Bagier, Gordon A. T.

  Jay, Rt Hon Douglas

  Skinner, Dennis

  Crowther, J. S.

  Lamond, James

  Soley, Clive

  Cryer, Bob

  Marshall, David (Gl'sgow.Shettles'n)

  Spearing, Nigel

  Cunliffe, Lawrence

  Marshall, Dr Edmund (Goole)

  Welsh, Michael

  Davis, Terry (B'rm'ham, Stechford)

  Marshall, Jim (Leicester South)

  Dixon, Donald

  Mitchell, Austin (Grimsby)

  TELLERS FOR THE NOES:

  Golding, John

  Molyneaux, James

  Mr. D. N. Campbell-Savours and

  Grant, George (Morpeth)

  Parry, Robert

  Mr. Andrew F. Bennett.

  Haynes, Frank

  Powell, Raymond (Ogmore)

  Question accordingly agreed to.

  Resolved,

  That the draft Passenger and Goods Vehicles (Recording Equipment) Regulations 1979, which were laid before this House on 29 November, be approved.

  EUROPEAN COMMUNITY (UNITS OF MEASUREMENT)
  Mr. Nigel Spearing: On a point of order, Mr. Deputy Speaker. The business was announced last Thursday by the Leader of the House. Those of us who went to the Vote Office last week for the document received the Government explanatory memorandum No. 5247/79, dated 20 March, and the EEC regulation of that reference. However, I understand that a matter has arisen and that an additional memorandum has been deposited in the Vote Office, dated today. That document is not signed. Therefore, hon. Members who received documents last week—even my hon. Friend 'the Member for Waltham Forest (Mr. Deakins), who has put down an amendment—are unaware of the development. No indication is given on the more recent document as to when a change of decision at the Council of Ministers took place. Clearly it was subsequent to 28 March o this year.
  If the Council's decision was taken as recently as yesterday or last Thursday, the existence of the additional memorandum could be understood. I hope that we shall receive an explanation before the debate starts. As you know, Mr. Deputy Speaker, lack of documentation on these matters has been a cause of considerable difficulty.
  Mr. Deputy Speaker (Mr. Bernard Weatherill): I am well aware that lack of documentation has been a source of difficulty in the past. I understand that the second document has been in the Vote Office for some hours—since 8 o'clock anyway, which is some hours—and I also understand that the hon. Member for Waltham Forest (Mr. Deakins), in whose name an amendment stands, has been happy to substitute for it a manuscript amendment. On that basis, I believe that we should proceed with the debate. No doubt the Under-Secretary will explain what has occurred.
  Mr. Douglas Jay: On a point of order, Mr. Deputy Speaker. Is it a desirable precedent for the House to debate the measures on the basis of documents that have been available only to those who have been lucky enough to discover the facts in the space of the few hours that have been referred to?
  Mr. Deputy Speaker: No, it is not a desirable precedent. The matter was drawn to my attention earlier this evening and I am delighted to know that the documents were eventually placed in the Vote Office. However, although it is not a desirable precedent, in view of the fact that there is a manuscript amendment, I believe that we should proceed with the debate.
  11.59 pm
  The Under-Secretary of State for Trade (Mr. Reginald Eyre): I beg to move,
  That this House takes note of EEC document No. 5247/79, as amended, on Units of Measurement.
  First, I shall refer to the points of order that have been raised. I emphasise that copies of the memorandum were placed in the Vote Office, as you pointed out, Mr. Deputy Speaker. In the course of my speech I shall refer to the memorandum. The right hon. Member for Battersea, North (Mr. Jay) and the hon. Member for Newham, South (Mr. Spearing) will see that the slight amendment is entirely favourable from their point of view.
  Mr. John Fraser: It is regrettable that this happened and it is more regrettable that the memorandum was not signed by a Minister. We have waited many months for this debate. Indeed, I signed the previous Government memorandum. Now we have an unsigned memorandum from the Government. I hope that this will not occur again.
  Mr. Jay: Will the Minister at least tell us who is responsible for the memorandum that is not signed?
  Mr. Eyre: I am not able to answer the question of the right hon. Member for Battersea, North. I apologise for the tightness of the timing. It will become apparent as I proceed that the effect of the amendment is slight and favourable.
  Following the European Economic Community decision in 1971, incorporated in directive 71/354, to move towards the exclusive use of the metric—SI—system throughout the Community, the United Kingdom accepted this commitment on its accession in 1973. The timing of the phasing out of Imperial units was, however, largely left open for further consideration.

  811
  In 1976 an amending directive—76/770/EEC—set out a partial timetable for the removal of certain Imperial units, although the future of the most commonly used units was left open. The amending directive was introduced by the hon. Member for Norwood (Mr. Fraser) and was welcomed by the House after a full debate on 7 July 1976.
  Since then the United Kingdom has participated in discussions in Brussels on the future of Imperial and other non-SI units. The result is that the present draft directive, originally published as COM (79) 89, was considered by the Select Committee on European legislation on 28 March this year. It has since been slightly amended, as I shall explain in a moment.
  Mr. Tim Sainsbury: Will my hon. Friend confirm that had we not become members of the Community it would still have been necessary, and in conformity with Government policy, for action such as is included in the directive to be taken because of the programme of metrication upon which both Labour and Conservative Governments had embarked?
  Mr. Eyre: It is not possible for me to speculate accurately on the question raised by my hon. Friend the Member for Hove (Mr. Sainsbury). It is difficult to envisage where we would have been had we not taken the important step of becoming members of the Community.
  The new directive, which will replace the two earlier directives, sets out to regulate the use of units in certain areas of activity—for example, for economic, safety or administrative purposes. In practice, this means that as units of measurement cease to be authorised, reference to such units in legislation must be replaced.
  It should be stressed that the directive does not introduce controls in areas where they do not already exist. For example, sport makes widespread use of units of measurement but it is not subject to legislative control. The furlong, for example, which ceased to be authorised at the end of 1977, can continue to be a feature of race meetings if the organisers so choose. For consumer protection reasons we have exercised control on the use of units for weights and measures purposes
  812
  for very many years. The directive will apply in that area.
  The new directive, which will replace the two earlier directives, comes into force on 1 October 1981. It assumes that the Imperial units not in chapter III will by then have been removed from use in legislation in accordance with the timetable in the earlier directive. The United Kingdom has already partly implemented that timetable. The units of measurement regulations of 1978—statutory instrument 1978 No. 484—phased out a number of the less widely used units, such as the chain, the furlong and the rood and the dram. The next step is for a further group of Imperial units to be removed from use in legislation by the end of the year. There have been delays in finalising the new amending directive the necessary implementing leg cannot be introduced until early next year.
  There is one small but significant amendment to the earlier draft, COM (79) 89. Three units—the yard, the square yard, and the therm—would have had to be removed from legislation at the end of the year. That was not acceptable to the Government as the early demise of the yard and the square yard would effectively compel the use of metric units only for certain retail sales, and the gas industry needed to use the therm for some time. We have negotiated an amendment to the original proposal that safeguards the position of the three units. They are now included with the other common Imperial units in chapter III of the draft directive. That means that their future need not be discussed again for 10 years.
  The Government have accepted that the other Imperial units in the original proposal may be removed from legislation on the basis that all the legislation that uses them either has been amended or is in the process of being amended. The phasing out of the use of Imperial units by industry has been the subject of the most widespread consultation. We know of no special difficulties likely to arise now that we have safeguarded the units that I have mentioned.
  Mr. Roger Moate: Will the decision to cease to authorise these Imperial units in 1989 have to be unanimous? Could the United Kingdom, even at that stage, prevent these units from being phased out against its will?
  Mr. Eyre: There is 10 years ahead of us for consideration. It will then be necessary for the matter to be brought again to the House before any final step is taken.
  Mr. Spearing: Before the Minister moves on to its substance, perhaps we may deal with the matter of the amendment. My concern is not for its substance but for the procedure. There could well have been a major change in the opposite direction. Other than those hon. Members who have been to the Vote Office since 8 o'clock, hon. Members who took their documents last week would not have known of it. When was the change made subsequent to the Select Committee's meeting of 28 March? Was it last week or was it much longer ago?
  Mr. Eyre: I cannot answer precisely now, but I shall seek to do so in the course of the evening, or write to the hon. Gentleman. It may be helpful if I tell the House that there is only one amendment of any significance to the draft directive considered by the Select Committee on European Legislation on 28 March this year. Three units of measurement—the yard, the square yard and the therm—which under the terms of the earlier directive—71/354/EEC as amended by 76/770/EEC—would have to cease to be authorised at the end of this year, have now been included in chapter III of the draft directive. This means that they are grouped with other commonly used Imperial units on which a decision need not be taken before—as I have emphasized—31 December 1989.
  Mr. Jay: Can the hon. Gentleman answer a little more clearly the question asked by his hon. Friend the Member for Faversham (Mr. Moate)? The Minister said that before there was any change the matter would have to come to the House. But is there not also a decision by the Council of Ministers? After all, we were told on another issue earlier tonight that, although it was before the House, the House had no option but to decide one way, because the Council of Ministers had so decided. Is the Minister's hon. Friend right in thinking that before such a decision was taken it would have to come before the Council of Ministers, and we should have a veto if we wished?
  Mr. Eyre: I should like to come in more detail to the point that the right
  814
  hon. Gentleman and my hon. Friend the Member for Faversham (Mr. Moate) have raised. I wish first to complete my remarks about the effect on industry.
  We shall make the maximum possible use of the directive's provisions relating to the continued use of existing equipment. This is very important in certain parts of the country. It is no part of the Government's policy to make unnecessary difficulties for industry, and the implementation of the directive will be tailored to fit the realities of everyday life.
  Mrs. Peggy Fenner: At the strictly practical level, will local authorities cease requesting metric measurements for planning applications? It seems to me that they have been doing that for years, against the decision of this House. I realise that this is not a matter for my hon. Friend's Department, and if he is not prepared to answer tonight, perhaps he will write to me.
  Mr. Eyre: I am grateful to my hon. Friend for the very considerate way in which she posed that question. It is highly technical, and I do not believe that it would be possible for me to obtain for her immediately an answer that properly considered all the implications. I realise the practical importance of the matter, and I shall see that proper inquiries are made and that a full answer is sent to my hon. Friend. I hope that she will enjoy reading it during the Christmas Recess.
  The most commonly used Imperial units are all included in chapter III of the amending directive—including now the yard, the square yard and the therm. A decision on the future of all these units will have to be taken by the end of 1989. This does not mean that they could not continue in use after that date—simply that a decision is to be reached by then on a date or dates after which they will cease to be authorised. Consequently, these units can continue to be used within the United Kingdom for trade and in our prescribed quantity regulations relating, for example, to some basic foodstuffs, coal and so on. Their continuing use will be as I have described.
  The decision in Council would have to be unanimous and would therefore be subject to a veto.

  815
  As has already been made clear to the House by my right hon. Friend the Minister for Consumer Affairs, the Government do not intend to compel metrication by legislation. Accordingly, voluntary timetables can be drawn up by the trade interests directly concerned.
  The Government share the view of the previous Administration—I thought that the hon. Member for Norwood made this clear when he introduced the motion in 1976—that the directive should not seek to dictate the pace of metrication but that it should reflect the change of pace here. This has a very important practical implication for the House. That pace of change goes on and we have to reflect it. That is the Government's approach in introducing the motion.
  Mr. Nicholas Winterton: I am grateful to my hon. Friend for giving way. Before he sits down, could he perhaps indicate why any specific date is given in the order? Why does not the order say that these measurements can be authorised until further notice? Why set a date on it? Would not my hon. Friend agree that it looks as if the Commission—the bureaucracy in Europe—ismerely trying to make further work for itself to justify its existence? I believe that these measurements are popular in this country and that people want them to stay. Why should not they remain ad infinitum or until further notice? Why do we have to have a date on the order?
  Mr. Eyre: The history of these matters is extraordinarily complicated, but I assure my hon. Friend that as a consequence of earlier measures that date is in being, but its operation is qualified in the way that I have described, which means that we shall have an opportunity to consider the matter again before the results become final.
  Mr. Deputy Speaker: Before I call the next speaker, may I say to the House that Mr. Speaker has selected the manuscript amendment in the name of the hon. Member for Waltham Forest (Mr. Deakins). This replaces the amendment which is printed on the Order Paper.
  12.17 am
  Mr. Eric Deakins: I beg to move as a manuscript amendment, at the end, to add
  816
  "but affirms that no decision on the phasing out of those imperial units which the EEC Directive requires to be reviewed by the end of 1989 should be taken before the House has first given its approval."
  The amendment seeks to establish the principle that this House should decide if and when the remaining Imperial units should be phased out. I understand that it is acceptable to the Minister and I hope that he will confirm that. This principle may have been explicit in the explanatory memorandum of my hon. Friend the Member for Norwood (Mr. Fraser) but it is not explicit here, and on such an important matter it is absolutely essential that we make the position clear.
  Before the end of 1989, the Council has to decide on a date for phasing out Imperial units. In those circumstances, the Government of the day, if they agree with the Council view, will have to get the prior approval of this House.
  12.20 am
  Mr. John Fraser: I think that the whole House will welcome the directive. I am not saying that in a spirit of self-congratulation because I signed the memorandum. I am sure that it is acceptable, as is the amendment moved by my hon. Friend the Member for Waltham Forest (Mr. Deakins).
  I mean no discourtesy to the Under-Secretary of State, but it is a pity that the Minister for Consumer Affairs, who has strong views on and departmental responsibility for these matters, is not present. The right hon. Lady has made a number of statements outside the House on these subjects.
  The matter covered by the directive is deferred for 10 years. Even at the end of that time, as the Under-Secretary of State said, we are not bound to take any decision. If the rest of our partners in the Community decided that there would have to be a phasing-out, we should have a right of veto and the matter could be put off for another discussion to take place in about 10 years' time.
  Mr. Jay: Is my hon. Friend certain that the veto operates, from our point of view, in the right direction? Is he sure that this is not a situation in which the special relationship lapses should any other country exercise the veto?
  Mr. Fraser: My clear understanding, when I prepared the memorandum, was

  817
  that there was deferment of any decision, that any decision to phase out remaining Imperial units would require a unanimous decision by the Council of Ministers, and that a British Minister would be able to veto that decision. It is simply a deferral of any decision at all.
  It is explicit that the veto would reside in this country. I hope that I put the matter properly in the memorandum before the House, saying that the pace of metrication is best determined inside the United Kingdom and not determined for us by our membership of the Community. There is little to argue about, or discuss, in the Community proposal. The matter is put off. We are left to our own domestic devices in deciding what to do.
  But we cannot ignore some discussion in the House about the way in which we should proceed at our own domestic pace towards a completely metric system. This matter divides each side of the House. I think, from my recollection, that it also divides the Liberal Party. It would be a pity if what is very much a scientific matter were to become an issue in which one party was in favour of measuring an area by multiplying a chain by a furlong while the other party favoured measuring an area of land by the hectare. Any idea that clear party lines can be established on these matters is ludicrous and would do no credit to the House.
  We have to continue to consider the pace and the desirability of moving to a completely metric system. One can move more quickly in some areas than in others. I want to put a number of points for consideration.
  First, there is the compelling argument about simplicity. I should like to give an illustration. If one wanted to find the capacity in cubic yards of the Dispatch Box before which I am standing, one could measure first in inches and divide the result by 1,728 to convert into cubic feet and then divide by 27 to convert into cubic yards. I think that that is a fairly good illustration. On the other hand, if one were working it out in cubic metres, one would measure in centimetres and move the decimal point. There is a point about simplicity here. Anybody who has struggled through O-level physics on the Imperial system and has seen others doing it rather more easily on the metric system will know what I mean.
  818
  Secondly—this is not unimportant—we have about 16 million people educated solely in the metric system. Looking through CSE and both O-level and A-level examinations, I think that I am right in saying that we find not one examination conducted on the Imperial system. We have some responsibility to children and adults educated solely in the metric system.
  Mr. Sainsbury: On the subject of education, on which the hon. Gentleman appears to have some knowledge, will he tell the House whether he has any information on the time advantage that can be derived from teaching children subjects, such as physics and mathematics, in the metric system, which he has graphically demonstrated is so simple, as opposed to teaching them in both systems or just in the Imperial system?
  Mr. Fraser: The hon. Gentleman mentioned time.
  Mr. Sainsbury: I have in mind the time that it takes to go through the educational process. I have heard it suggested that it takes an additional year in the mathematical curriculum if one has to teach people in both the Imperial and metric dimensions.
  Mr. Fraser: Frankly, I would not know. From what little mathematics teaching I have done, I have found it easier and speedier to teach in the metric system. I think that is beyond dispute.
  We have been progressing in education on the metric system for almost 15 years. I think that it was in 1965 that my right. hon. Friend the Member for Bristol, South-East (Mr. Benn) first began a programme of change to metrication. I am not sure whether he was followed or preceded in that by my right hon. Friend the Member for Battersea, North (Mr. Jay). It has taken a long time. We must consider how long we should continue with a dual system.
  The third reason why we have to consider these matters is that Britain is an international trading nation. We do not trade in glasses of beer and pints of milk. Successive Governments have given commitments to retain the pint for both milk and beer. That is relatively unimportant, but there are other areas where trading considerations are of importance. If I

  819
  interpret the Government's attitude properly, they regard the change to metrication as inevitable but they have no clear idea when the change will take place. I ask the Minister to say a little more about the Government's philosophy on that matter.
  The Minister for Consumer Affairs has made clear that she does not believe in compulsion. When there is a change from Imperial to metric, the trade generally agrees upon a date when the change will take place. In that sense it is voluntary. The trade agrees upon a date for transition from one form of measure to another, but, for the sake of orderliness, it likes the Government to prescribe that date as a matter of law. There is no possibility of converting from the Imperial to the metric system by voluntary means, particularly in the retail sector, as I think the hon. Member for Hove (Mr. Sainsbury) will confirm. The word "compulsion" has been invested with rather more force than it deserves. A phasing-out order puts a Government imprimatur on the agreement reached by the trade itself about the way in which it will phase from one system to another.
  I ask the Government to consider whether voluntarism should be allowed to progress to the stage where it becomes anarchy and chaos. There is danger in relying too heavily on voluntarism and in not providing an orderly framework within which industry can make the transition if it so wishes. I hope that we can on some future occasion have the Government's reflections on how they see the process eventually taking place.
  When we considered the Weights and Measures Bill I gave a commitment to publish an annual statement about voluntary and compulsory changes to metrication. Perhaps we can have an undertaking from the hon. Gentleman that that annual statement about progress towards metrication will continue to be published to the House so that hon. Members, industry, and the general public will know what is the basis of the Government's thinking and what kind of timetable they have in mind.
  12.31 am
  Mr. Graham Page: I should be delighted if I could congratulate somebody on having saved yards, square yards
  820
  and the therm. Unfortunately, I do not know whom to congratulate, because the memorandum on this subject is not signed. I should have liked to offer my congratulations because whoever it is has done a lot better than the hon. Member for Norwood (Mr. Fraser) when he was in charge of this subject.
  He put before the House a memorandum of 20 March this year in which he was quite prepared to accept the loss of the yard, the square yard and the therm. At that time the Select Committee on European legislation reported to the House. It called our attention to this proposal and recommended that it should be considered by the House.
  We are only just having the debate on the issue following the report from the Select Committee in March. In that report the Select Committee on European legislation made this comment:
  "Some familiar units such as the yard and the calorie are not included in the list of legal units of measurement that may continue to be authorised."
  Obviously the Select Committee puts some weight on the fact that we were to lose the yard. Had the Select Committee been informed of the fact that we have now saved the yard it might well have recommended to the House that this debate was unnecessary.
  There is an undertaking to put before the Select Committee on European legislation any significant alterations in the proposals that are to go to the Council of Europe, so that the Select Committee may reconsider a proposal on which it has already reported to the House. In this case the Select Committee had reported to the House in March last on a proposal as described by the hon. Member for Norwood when he was in charge of the Department. It is a great pity that this new and welcome proposal was not brought before the Select Committee. It might have saved the House a lot of trouble tonight. There it is, and I still do not know whom to congratulate.
  I do not even know when this decision was made. If it was made even a week ago it could have been brought before the Select Committee. If it was made only yesterday, or today, I congratulate whoever made it. The yard has just been born "in the vestry" as it were, just in time. I am pleased that we have it back.

  821
  Is my hon. Friend quite satisfied that he has construed the relevant article correctly?
  Article 1 of the draft directive states:
  "The legal units of measurement within the meaning of this Directive which are necessary for expressing quantities shall be:…
  (c) until a date to be fixed by those Member States, those listed in Chapter III of the Annex in those Member States where they were authorised on 21 April 1973; this date may not extend beyond a date which shall be set by the Council under Article 100 of the Treaty before 31 December 1989."
  It is possible to construe that as meaning that the date of termination of legality must be a date prior to 31December 1989. The Minister has said that it means that if before 31 December 1989 the Council fixes the date for termination of the legality of those measures, the date can be any date—five, 10 or 20 years after 1989. However, I am not certain that that is the right construction.
  Mr. Ivan Lawrence: Has not my right hon. Friend considered that article I has been amended by a memorandum that will be in the Vote Office tomorrow and available to hon. Members in a week or two?
  Mr. Page: I was tempting the Minister to amend this article so that it is certain that all that must happen is that before 31 December 1989 a date is set but that, apart from that, the matter is left wide open.
  A date must be set before 1989. It is right that any proposal should come before the House. Normally it would go first to the Select Committee that deals with European legislation. That Committee may recommend that it be debated by the House. If the Committee so recommends, the Minister cannot take steps to implement the proposals until the House has debated it. That is the purport of the amendment. The amendment states only fact. Present procedures should be emphasised. The amendment is acceptable as a statement of the present position.
  Mr. Deakins: That is not my understanding of the amendment. Under the present procedure, when the Select Committee recommends that there should be a debate, it normally takes place on the Floor of the House, on a Government
  822
  motion to take note. Under the amendment, which I hope is acceptable, the House will have to take a positive decision—the Government will have to move a motion to approve the action that they propose to take in the Council.
  Mr. Page: I am obliged to the hon. Member for Waltham Forest (Mr. Deakins) for explaining his amendment still further. I agree with his amendment even more. I am sure that hon. Members agree that the House should debate an affirmative resolution. I want to be certain that the other member States will not construe this article to mean that a date of termination of the validity of these measurements must be fixed before 31 December 1989. I hope that the Minister will negotiate better wording for article 1 (c).
  12.40 am
  Mr. David Penhaligon: By training I am an engineer and therefore probably have more sympathy for going metric than most other people. I recognise the reluctance on the part of some people to follow this trend. My beloved mother in Cornwall still buys potatoes by the gallon, which is the way that people in Cornwall have always bought potatoes and, although I tell my mother that I am sure that it is absolutely illegal, she will buy potatoes by the gallon until the day she dies and, frankly, as far as I am concerned, I cannot see why she should not.
  There is, however, one problem. I am not quite clear how we now measure a number of things in this country. How, for example, do we define the pressure to which we pump tyres on cars? We have in this document the possibility of using newtons/m2, pounds per square inch, or bars. I do not know whether the old kg/cm2 is still alive and kicking, but certainly the previous three are mentioned in this document.
  This is the problem when there are two or three systems operating at the same time. Very few people understand the connection between one set of units and another. The point I raise is relevant to a number of other possible combinations of units dealt with in this document. How do we measure the pressure to which tyres are inflated? How do we measure the maximum stress at which steel becomes plastic? How do we

  823
  measure stress and pressure in general terms? Have we ended up with the ludicrous situation of having a different system for measuring stress in steel from that which we use for measuring pressure in tyres? That is the problem when there are two systems operating together.
  I make a confession. When I am thinking of how warm the Chamber is I think in degrees Fahrenheit. When I think of the temperature at which steel melts I think in degrees Centigrade. It is a crazy system by which to bring up young people. Certainly the schoolchildren understand only the new units. I believe that the trend must be general. My specific question is: how do we measure pressure?
  12.43 am
  Mr. Tim Sainsbury: It seems rather unfortunate that the move to metrication, which it has been pointed out has been going on in this country officially for 15 years and has been under discussion for about 100 years—indeed, I believe that it was nearly carried in this House 100 years ago—has become confused with the directives of the European Community. If it causes no other problem it brings into the debate certain Labour Members whose prejudices against the Community would override even their strongest affection for the logical system of measurement which metrication represents.
  This situation rather muddies the waters in a discussion on something which I would have thought that anyone who considered the situation logically and took into account schoolchildren, the consumer and industry—three fairly important groups in society—would have to support. I detected, underlying the opening remarks of the Minister, almost a welcome for the idea, as he said, that the matter need not be discussed again for another 10 years. I can only say that if, for 10 more years, our schoolchildren, our industry and our consumers are to be kept in the ridiculous confusion that we have now, they will bitterly regret it. We shall all come to realise what an unnecessary problem we are causing the whole of our country.
  My hon. Friend the Under-Secretary said that he did not expect any special difficulties to arise. He should appreciate that a great many special difficulties are
  824
  already in existence as a result of the lack of clarity in the Government's metrication policy and the lack of clarity at times displayed by the previous Government. The difficulties are already there. The first one concerns education. The hon. Member for Norwood (Mr. Fraser) said that already 16 million children had been educated either entirely or principally in the metric system. Are we to continue educating children in the metric system and then ask them to come out into a world where we persist in using an archaic system which is hardly used in any other part of the world? I should like my hon. Friend, if he cannot answer that now, to write to me.
  Are we proposing any change in the education system, because in 10 years' time it will not be 16 million; it will be 26 million or 30 million who will have been educated in the metric system and will then be expected to spend the remainder of their lives grappling with these extraordinary measurements which everybody else has been sufficiently sensible to give up.
  We then come to the question of trade. I was interested to receive an answer from one of my right hon. Friends to the effect that only 0·4 per cent. of our exports go to countries which either have not metricated or have not got a committed timetable for metrication already. Do we—one of the greatest trading nations in the world—wish to stay with the 0·4 per cent.? It imposes absurd difficulties upon our manufacturing industry if it has to produce in Imperial measures for the home market and in metric measures for exports.
  Some of my hon. Friends share, I am sure, my desire that our heritage should be preserved. However, the right place to preserve the heritage is in places like museums. One does not use one's model T Ford for driving up and down a motorway every day; it is a piece of industrial archaeology. Perhaps it is because it is called the Imperial system that some of my hon. Friends find it so attractive, but that is a false reason for having such affection for this peculiar system.
  Mr. Nicholas Winterton: I certainly do not drive up the motorway in an old Ford car, but I do like to know how many miles I am driving on the motorway. My hon. Friend, who I am sure accepts the

  825
  Government's move towards reducing Government expenditure, would surely not like huge sums to be spent on changing all the motorway signs at a cost of hundreds of thousands, if not millions, of pounds. The British people are very proud of their mile. There is no reason why this Imperial measure should be changed, just as there is no reason why the pint or the yard should be changed.
  My hon. Friend talks about our heritage, but surely there are many Imperial units that could be used ad infinitum in this country without damaging industry. If only 0·4 per cent. of our exports are to countries that have Imperial measurements, surely industry can adapt itself and that will not inconvenience the British people.
  Mr. Sainsbury: I do not think that my hon. Friend could have been listening to what I was saying. There is the problem of education and trade. If a manufacturer is producing an article in a world market, as practically all people who try to export are, he does not want to have to produce and package that article in Imperial and in metric measures. It complicates the whole process and leads to fewer exports because it is therefore the more difficult to export. My hon. Friend must try to bring himself to think about the matter logically. It is very romantic to be attached to the mile. There is no reason why we should necessarily drop the mile, anyhow in this century. My hon. Friend may not be aware that the only Imperial measure that has any remaining significance in the world of sport is the mile. The mile is still occasionally run with distinction. Those in athletics have not been running any other distance expressed in Imperial terms for years—I think I can almost say decades—but the mile can be preserved. If we can keep that and go metric on the rest, perhaps that will satisfy my hon. Friend.
  Those most adversely affected by the present state of confusion are the consumers, and that means every person in the country. It is all very well to talk about keeping the pint, but is my hon. Friend aware that by the end of next year milk in retail shops will be sold only in metric measurements, while milk delivered to the doorstep will be sold only in Imperial measurements? We shall then have a system whereby a very standard commodity is sold in two totally different
  826
  and incompatible systems of measurement.
  Is my hon. Friend aware—I am sure that my hon. Friend the Member for Rochester and Chatham (Mrs. Fenner) is, even if he is not—that if one takes a recipe that requires the use of butter and cheese, butter will be bought in metric packs and the cheese will be bought in Imperial packs? That is not exactly helpful to either cooks or consumers.
  We are in a state of total and ridiculous confusion, which is damaging to education, trade and the consumer. The House should take note of this directive in the hope that we shall not have to wait another 10years in our present state of total confusion, at great cost to our education system and manufacturers and at growing confusion to the consumer.
  As my hon. Friend knows, as each month goes by more and more goods in metric packs come into the High Street shops of our country. At the same time, as the hon. Member for Norwood suggested, unless we have a Government created, co-ordinated programme of conversion, conversion of weighed-out goods will not take place. Therefore, weighed-out goods will continue to be sold in Imperial measures, whereas all packaged goods will be sold in metric measures.
  Mr. Nicholas Winterton: How much will it cost?
  Mr. Sainsbury: The cost to the consumer and to education will be infinite, and the cost to the manufacturer will become progressively more damaging. However much we love our imperial past, it is time that we said "Goodbye" to the daily use of this relic of imperialism.
  12.52 am
  Mr. Ivan Lawrence: If a week is thought to be a long time in politics, 10 years must be infinite hereafter. Apart from my hon. Friend the Member for Hove (Mr. Sainsbury), who is a hardliner for metrication, the subject of the debate has the unanimous agreement of every hon. Member. I am sure that every hon. Member would agree with the amendment of the hon. Member for Waltham Forest (Mr. Deakins). From the nodding of the Minister—which I took to be nods of awareness and awakeness—I took it that he agreed with it also.
  Mr. Eyre: It may help the House if I indicate that I am glad to accept the amendment tabled by the hon. Member for Waltham Forest (Mr. Deakins).
  Mr. Lawrence: I am most grateful, as I am sure are all hon. Members, to hear of the Minister's acceptance. That only goes to underline my second point, because I believe that the subject matter of the debate has exhausted itself. Had we known about the matter, perhaps we would not now be wasting public time and money, and subsidies for the Refreshment Department and all the other things that follow, keeping the House here unnecessarily.
  I hope that the House will not mind if take a moment to mention a matter that I think is far more important than any hint of disagreement that has arisen during the debate. That concerns the procedure by which we have come here. I remember sitting close to where the hon. Member for Waltham Forest now sits—unhappily, for too long—when in debate after debate on EEC motions I drew attention to the lack of provision of documentation for an EEC debate.
  I remember being supported by my own Front Bench at that time. Time and again we stood up and criticised the Government for failing to take the necessary steps to acquaint the House on matters that were far more contentious than any that have been debated tonight. I was not one of those who went to the Vote Office to check on the documentation, because it never occurred to me that year after year of complaint about the way in which Back Benchers are treated would have been ignored by my Government. That Government came into power promising as much assistance to the Back Bencher as possible.
  It never occurred to me that if I bothered to go to the Vote Office I would find inadequate documentation. As we noticed in the previous debate, we are not always happy with what the Common Market forces on us. Those of us who are strongly in favour of the values of the EEC—the fact that we are a member of the club that, above all else, helps to secure world peace and co-operation in international affairs—give up some of our independence as Back Benchers because we trust the Government to make sure that EEC matters are brought before us
  828
  completely, properly, and in a way that is beyond procedural and technical dispute.
  However, what has always happened is still happening. We used to complain about the administration of the House—that somebody had not bothered to make sure that the documents got to the Vote Office. However, a decision seems to have been taken in Europe that is of great importance to tonight's debate, yet about which no one knows anything. We only know that we have a piece of paper, bearing the name of the Department of Trade with today's date at the bottom, saying that the rules have been changed.
  As my right hon. Friend the Member for Crosby (Mr. Page has courteously and properly said, it is not just that he would like to congratulate whoever brought about that change; he wants to know who is responsible for the piece of paper. Why do those responsible for the paper not think it necessary to acquaint the Minister with fundamental details as to when it was negotiated, who negotiated it, who produced it, and who signed it? The absence of any answers—for which I do not blame my hon. Friend the Under-Secretary, who has performed his task with great distinction—is symptomatic of the contempt in which we fear that Back Benchers are held by bureaucrats. Following hon. Members from all parties, I have had to complain about the utter failure to produce these documents and of the failure to acquaint the Minister of something that is fundamental to the debate.
  Mr. Spearing: Will the hon. Gentleman concede that the complaints that he mentioned when his party was in opposition were more often than not initiated by hon. Members on the Government side? The real culprits are not necessarily the servants of the House or Government, but the manner in which the EEC legislates and changes one document into another, by what we would technically call an amendment, in secret and by procedures that are arcane in the extreme. Is that not at the bottom of the difficulty?
  Mr. Lawrence: I do not know whether the hon. Gentleman is right. We are simply not in a position to know, as we have not been given an explanation.
  Mr. Deakins: Perhaps the Minister will confirm whether this is correct, but is

  829
  it possible that the piece of paper that we have received from the Vote Office today is not an additional explanatory memorandum, and hence it is not signed? It purports to be a notice bringing to the attention of the House an amendment to the draft directive. In those circumstances it is odd that it should have come from the Department of Trade. An amendment to a directive should normally come from somewhere in Brussels and be signed by the President of the Council.
  Mr. Lawrence: The text of the document that we have tends to support the hon. Gentleman's proposition. It says that there is only one amendment of any significance to the draft directive.
  I think that all hon. Members will agree that it is a highly unsatisfactory situation, for whatever reason. If anything of importance and value results from tonight's discussion to justify hon. Members being here at this late hour it will be if the Minister gives a personal undertaking that this matter will be thoroughly looked into to see why this happened. Perhaps he will be good enough to write to hon. Members present who have shown an interest in the matter or, failing that, give an explanation in due course.
  More importantly, he should make sure that this never happens again. If anyone's backside has to be kicked, it should be kicked, and if anyone's head has to be banged, it should be banged, if this Government wish to maintain the loyalty of their Back Benchers in support of proposals that we often reluctantly feel obliged to support because we are supporters of the Common Market. This country has voted overwhelmingly to support the Common Market, and we have to continue trusting the Government and the various Departments. We should not be led into the situation in which we are driven to doubt whether we are being run by robots rather than by people who care about issues that concern this House.
  1.2 am
  Mr. Roger Moate: My hon. Friend the Member for Burton (Mr. Lawrence) made valid points on procedure, but I hope that they will in no way detract from a warm welcome for this additional item that has been presented to us. The amendment allows the yard, the square yard and the furlong to survive
  830
  for a further 10 years as legal units of measurement in this country. I sincerely congratulate my right hon. and hon. Friends on this important achievement, which will be much appreciated throughout the country.
  I welcome the general change of direction taken by the Government on metrication. Although the hon. Member for Norwood (Mr. Fraser) hoped that there had not been a change of direction, clearly the abolition of the Metrication Board and the statement that there will be no further compulsory metrication denotes a significant change of direction, which I warmly welcome. As long as we have a Conservative Government, which will certainly be until 1989, when this matter comes up for decision, and, I hope, many years thereafter, we shall have what I would describe as a permanently mixed economy on different systems of measurement. Few people will regret that or be confused by it, although my hon. Friend the Member for Hove (Mr. Sainsbury) admitted that he was totally confused by the two systems.
  Mr. Sainsbury: The one thing that I am not is confused. Perhaps I should have declared an interest, as a retailer. We serve well over 2 million customers a week and they are all in the permanent state of confusion that my hon. Friend the Member for Faversham (Mr. Moate) wishes to remain. People are required to go about their daily business in schools, shops and manufacturing and commercial enterprises using two incompatible systems of measurement.
  Mr. Moate: I am grateful to my hon. Friend for declaring his interest, of which I was not previously aware. He has been hiding his light under a bushel, if he will excuse the Imperial reference. However, I suggest that he underestimates the common sense of the British people if he believes that his customers are as confused as he suggests. They are capable of buying goods in a metric pack and then ordering a pound of potatoes in an Imperial unit without suffering any confusion.
  People should not be compelled to fit into the neat, logical pattern of life that my hon. Friend the Member for Hove and the hon. Member for Norwood suggest. That is not my understanding of

  831
  the British way of life or the Conservative philosophy. For decades hence—perhaps for infinity—we can continue to have both systems operating alongside each other. Industry can go metric on a voluntary basis if it wishes and needs to. At the same time, workers in industry will continue to use pounds, ounces, miles yards, inches, pints and gallons fully understanding them and not suffering from any confusion.
  Many millions of people have been educated in the metric system. In school, they are taught a certain system, but education is also given in the home. In the home and in shops children will learn all the different measurements. If we asked people in the street—tomorrow, not tonight; it is too late—about their knowledge of the different systems, we should discover that they had just as much familiarity with the Imperial system as with the metric system. The change of direction makes sense. It will be welcomed generally and I welcome the Government's action in the matter.
  I accept that in 1989 we shall have the right of veto. Yet, the more I read and re-read the document the more confused I become. On the one hand, it could be implied that until 1989 the measurements remain legal. If that is the case, a new proposal in 1989 will be required and in those circumstances the veto could operate against us. If, on the other hand, the measurements continue indefinitely—unless the Council takes a decision against us—the veto will operate in our favour and we can prevent any change. The answer is simple, but I am somewhat confused by the document. I want to be certain that, with or without the amendment that will pass tonight—not necessarily overriding the directive—we shall have the continuing power of veto.
  If we do have the veto, it is important to retain that power and not to move over to majority voting.
  1.10 am
  Mr. Eyre: With the leave of the House, it might be convenient for me to reply to a number of points that have been raised during the debate, in particular to the point referred to by the hon. Member for Faversham (Mr. Moate), which my right hon. Friend the Member for Crosby (Mr. Page) raised at an earlier stage. I
  832
  am grateful to my hon. Friend the Member for Burton (Mr. Lawrence) for the opportunity to intervene and accept the amendment moved by the hon. Member for Waltham Forest (Mr. Deakins).
  Again I apologise to my hon. Friend the Member for Burton for being unable to answer his procedural question. As he knows, I should have liked to be able to take some credit for what is a favourable change. I am sure that some credit must be due to my right hon. Friend the Minister for Consumer Affairs. I hope that my hon. Friend will accept an assurance that I shall consider the matter. I agree that it is not entirely satisfactory. I hope that I shall be forgiven if I do not write to all those who are present. The Parliamentary Private Secretary and I keep arguing about who was present when we attempt to draw up a list.
  Mr. John Fraser: I have tabled a question to the Minister for Consumer Affairs, asking her to give a full reply after the recess.
  Mr. Eyre: I am sure that my right hon. Friend will do all that she can to clear up the question of procedure and ensure that a misunderstanding of this sort does not arise again.
  Mr. Spearing: Will the Minister assure the House that in any statement or answer that is given it will be made clear at what meeting of the Council of Ministers the change we have learnt about tonight was made, under what sort of procedure, what Minister was present, and on what date?
  Mr. Eyre: I am sure that the hon. Member for Newham, South (Mr. Spearing) will understand that Ministers are not physically present at all meetings—
  Mr. Fraser: They are not present at any of them.
  Mr. Eyre: I accept the nature of the hon. Gentleman's inquiry and I shall do my best to ensure that it is properly answered.
  I thank the hon. Member for Waltham Forest for moving the manuscript amendment. On behalf of the Government, I am glad to accept it. The hon. Member for Norwood (Mr. Fraser) made a series of powerful points in support of the motion and I am grateful for the welcome that he gave it. He called for a certain

  833
  measure of orderliness in the way in which trading interests respond to the requirements of phasing out.
  Undoubtedly, trading associations will consider how they are to respond to the regulations. I have been told that the petrol retail trade recently decided to go metric voluntarily. Perhaps that decision will have an effect on other trade associations. I mention that because I hope that it will be helpful to my hon. Friend the Member for Hove (Mr. Sainsbury), who expressed his anxiety in this connection.
  Mr. Sainsbury: I assure my hon. Friend that there is evidence, as his Department knows, that there is no prospect of the trade in catch weight perishable commodities going metric voluntarily without a Government arrangement for a cut-off date. Unless that is introduced, confusion is bound to continue. It will be worsened by the petrol trade going metric and other trades not going metric.
  Mr. Eyre: I respect my hon. Friend's expert knowledge. I am sorry that he speaks in such strong terms. However, I am grateful for the further contribution that he made about the educational implications. I am sorry that I cannot answer it now, but I shall get a full answer for him and write to him.
  My right hon. Friend the Member for Crosby, who has given great service to the House as a member of the Select Committee on European legislation and who has a great knowledge of these matters and a whole range of other matters, asked whether the article was correctly construed. I am always worried when my right hon. Friend intervenes to raise such a matter. When he did so on an earlier occasion in Committee the Government were defeated. I am always apprehensive of, and careful in my approach to, my right hon. Friend.
  My right hon. Friend asked about dates. His inquiry was repeated by my hon. Friend the Member for Faversham. At present the end date is wide open. However, a date will have to be set by 1989. In coming to that decision the veto will be available to member States. The date that has to be determined by the Council by 1989 may be a date much later than that. I hope that that simple statement will clear up all the doubts and reservations that have been expressed, and will
  834
  satisfy my right hon. Friend, who I note is shaking his head.
  Mr. Moate: What will happen if the veto is used and no date is set?
  Mr. Eyre: I think that we would all have to consider that carefully.
  The hon. Member for Truro (Mr. Penhaligon) asked how stress is measured. At that time I was feeling it keenly. How do we distinguish between that measurement and the measurement of pressure in tyres? I feel that there are differences between the two measurements. I have been waiting for inspiration, but it has not come. It is a technical matter, even a medical matter. I hope that the hon. Gentleman will accept my assurance that when I have been able to consider it I shall write to him to convey the relevant technical information.
  The Government share the view of the Labour Adminstration that the directive should seek not to dictate the pace of metrication but to reflect the pace of change. I urge my right hon. and hon. Friends to support the measure, as amended.
  Amendment agreed to.
  Main Question, as amended, put and agreed to.
  Resolved,
  That this House takes note of EEC document No. 5247/79, as amended, on Units of Measurement, but affirms that no decision on the phasing out of those imperial units which the EEC Directive requires to be reviewed by the end of 1989 should be taken before the House has first given its approval.

  ETWALL HOSPITAL, DERBYSHIRE
  Motion made, and Question proposed, That this House do now adjourn.—[Mr. Waddington.]
  1.19 a.m.
  Mrs. Sheila Faith: I am grateful to you, Mr. Deputy Speaker, for allowing me to speak at this hour, and to my hon. Friend the Under-Secretary of State for Health and Social Security, who is to reply to the debate, who I know has had a particularly tiring day. However, I can justify my calling upon you and taking your time, because a serious situation has arisen in my constituency.
  The area health authority has ordered the temporary closure of a 94-bed

  835
  rehabilitation hospital in my constituency, and the nursing staff have now taken over the hospital and are staging a work-in, after conducting a poll that showed that 92·5 per cent. were in favour of doing so. The area officer of the National Union of Public Employees, who is in the Strangers Gallery tonight, has assured me that the activities will be moderate and that there will be no mass picketing. NUPE has asked the ambulance men to co-operate with it and not to transfer patients to other units.
  When I visited the hospital recently I saw that the building was well maintained and structurally sound. I spoke to the doctors, nurses and staff, and I have received a huge correspondence. Everyone is agreed that the area health authority must be persuaded to reconsider its decision.
  The hospital is situated two miles from Etwall, a pleasant village, which I believe my hon. Friend has visited, and it is surrounded by beautiful countryside. It has, therefore, a soothing atmosphere, which makes it eminently suitable for recuperation and convalescence, and it is also the ideal location for elderly people. Patients appreciate the peace and quiet of the countryside. Although officially named a rehabilitation hospital, it also caters for the young chronic sick and geriatric and psychogeriatric patients. The unit caters for the terminally ill, as well as those recovering from accidents and serious operations.
  All the doctors, nurses and staff that I have spoken to say that they prefer to work in a small unit. They are all on friendly terms with the patients, and some of these patients have been resident for several years and have become accustomed to each other. Both staff and patients would suffer dreadfully if the link were broken.
  Etwall hospital has become a prestigious rehabilitation centre for in-patients and out-patients with locomotor disabilities after orthopaedic surgery, accidents, strokes, amputations, arthritis, neurological and neurosurgical disease, and is recognised as a national rehabilitation centre.
  The rehabilitation team consists of two consultants, nursing, physiotherapy and occupational therapy staff, in addition to
  836
  an engineer, speech therapist and social worker. This is a very skilled and dedicated team, which has been slowly built up over the years. If it were disbanded as proposed, it could not easily be built up again.
  The hospital is pre-eminent in the Midlands as a rehabilitation unit for the heavily disabled patient and is the envy of large neighbouring teaching centres at Nottingham, Leicester and Sheffield, which have no comparable facilities. The hospital also provides care for the younger chronic sick.
  An excellent feature of the hospital is the harmony that prevails among the staff. During the industrial trouble of last winter, disturbance at Etwall hospital was minimal. As is often the case in small hospitals, the auxiliary staff know the patients well and feel involved with them, and they refuse to take action that would be to their detriment.
  The consequence of closing surgical and preconvalescent beds at Etwall will be a concentration of care upon Derbyshire Royal infirmary and the City hospital, and this will mean an accumulation of post-operative patients in the acute beds, less surgery will be carried out, and therefore waiting lists will lengthen.
  There is an increasingly elderly population in Derbyshire, and the Derbyshire county council's homes for the elderly are already overcrowded. The closure of Etwall will cause a backlog of elderly people and add to the shortage of part III accommodation. The closure, therefore, will have an effect on already hard-pressed facilities, and this is particularly worrying because it is acknowledged that Derbyshire is already a seriously deprived area in the Trent region.
  The nurses at Etwall, some of whom are in the Gallery tonight, are not staging this work-in because they are fighting for their jobs. They have all been offered alternative employment. They are fighting to save a hospital that they love and for the right to continue serving their own patients, for whom they have developed a genuine feeling of affection.
  The hospital is an economic way of providing treatment, as the cost per in-treatment day is £44·60 at the Derbyshire Royal infirmary, whilst it is only £22·92 at Etwall. The patients do not

  837
  all require the complex equipment that is available at the larger hospitals and, indeed, some may be transferred to Derwent and Bret by hospitals. These units are also more costly per patient—day than Etwall.
  The local community takes a most active interest in Etwall hospital, and the league of friends makes its own contribution, not only by providing facilities—for example, equipping day rooms and giving television sets and so on—but by bringing moral support to the patients. There is an amazing degree of local enthusiasm for and loyalty to this hospital.
  I have spoken to patients and ex-patients who have contacted me and they all say that the closure of Etwall hospital would be a tragedy. They tell me that the hospital has given them a new lease of life. They all say that they know of waste in administration and organisation and they are appalled that little has been done as yet to reduce the bureaucracy. Doctors associated with the hospitals in the area insist that savings could be made by cutting down unnecessary tests and X-rays and by making changes in prescribing. Constituents have written to me telling me of waste in the ambulance service, as ambulances are being used by mobile people, and I feel that great savings could be made in this way throughout the country.
  My colleagues, my hon. Friends the Members for Derbyshire, West (Mr. Parris) and for Derbyshire, South-East (Mr. Rost), are supporting me tonight, and they have put many ideas to me of ways in which further cuts could be made. I know that they would like to say a few words later. I have also been supported by my hon. Friend the Member for Burton (Mr. Lawrence) and the hon. Member for Derby, North (Mr. Whitehead).
  The strange thing is that all my letters, including those I have received from doctors and nurses, blame the administration and wonder whether it fully comprehends the consequence of its action. They all say that the bureaucrats are making a poor job of being their own executioners and there is much disappointment that firm Government action has not already been taken.
  838
  We know, of course, that the National Health Service is one of the largest enterprises in the world, and therefore change cannot happen overnight. We also know that the Government have produced a consultative document, "Patients First", which has set out plans for changing the organisation of the National Health Service and to abolish a tier of administration. I am glad to see that this document shows that the Government also intend to strengthen management at hospital level and to see that doctors' and nurses' voices are more fully heard by the health authorities.
  The current situation at Etwall hospital demonstrates clearly the need for these changes, and I hope that it will be recognised that had the document already been presented to Parliament, perhaps hospitals and other services would have been saved, including Etwall.
  Everyone knows that the Government inherited a depressing economic situation and that a Labour Government would have also had to make cuts in expenditure or alternatively imposed very righ rates of taxation.
  The previous Government said that there would be no increase in cash limits to cover inflation. As a result of last winter's action, the Government have had to honour the results of the Clegg Commission, and therefore it was obvious that some cuts in services would be inevitable.
  The feeling in my constituency is that there are far too many administrators, and that this makes the system clumsy and immobile and unresponsive to changing situations.
  The area health authority should have known since last winter the financial implications of increased pay awards, and it has no excuse for not having gone ahead with making cuts in its own staff. In other parts of the country the delay in shedding staff is more understandable, but in the Derby area the rate of unemployment is 3·6 per cent. lower than most other parts of the country.
  Employers tell me that skilled jobs are available in the building, engineering and other industries and are going begging at salaries of between £120 and £200 per week. When I visited the local skillcentre in the summer, I was told that there were vacancies for engineering training. The

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  Derbyshire area health authority could therefore lead the country in encouraging people to relinquish jobs in the bureaucracy, without the fear that they will create long-term unemployment.
  I ask the Minister to speak to the Derbyshire area health authority and persuade it to cut its staffing levels. It is the fit and able who should be asked to make sacrifices and changes in their lives, not the sick and elderly.
  I hope that the Minister will do all that she can to save Etwall hospital, even at this eleventh hour.
  1.30 am
  Mr. Matthew Parris: My constituency adjoins Belper. I am grateful to my hon. Friend the Member for Belper (Mrs. Faith) for allowing me time to comment. I am glad to see on the Opposition Benches the hon. Member for Derby, North (Mr. Whitehead). Concern about closures in Derbyshire transcends political differences.
  I support the remarks of my hon. Friend the Member for Belper. Our area health authority has been misguided and its members have been weak. Derbyshire has always believed in centralising health care. Its financial problems are real. But these provide a ready-made excuse for accelerating a campaign of closures already under way long before the present Government came to power. That is what the authority believes in doing. It has told me so.
  At the time of the election, the axe was raised over Parwich, a village hospital in my constituency. The reason given was staff shortages. But nurses have been turned away since then. Now the Smedley Memorial hospital in Matlock is also threatened. As at Etwall, temporary closure is sought to reverse the status quo, to shift the burden of proof and disperse the evidence. It is called temporary closure. The furniture was taken away from Smedley this afternoon.
  As at Etwall, members of the authority were reduced to a rubber stamp. Incredibly. I believe, no paper on the Etwall closure was provided for members beforehand. As at Etwall, public support has been overwhelming. Our meetings at Parwich have attracted more than 1,000 people. Hundreds have written to me. If the Minister could meet the
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  nurses and patients involved, and if she could have seen the crowds standing quietly outside packed village halls at Parwich on a bitter winter's night, she would see that Government and people are of one mind. It is health bureaucracy that has come between us. Our town, our district and county councils and our Peak Park planning board all support us. Our community health councils feel isolated and exposed. In a few months it will be too late. We appeal to the Minister not merely for a generalised expression of support for small hospitals but for her help in saving ours.
  1.32 am
  Mr. Peter Rost: I congratulate my hon. Friend the Member for Belper (Mrs. Faith) on raising this important issue. I thank her for allowing me to support her. We are aware—I know that the Minister is—that the Trent area has been the Cinderella in the national allocation of funds. The matter has been raised several times in the House in recent years. We now have an understanding that the Government are allocating increasing amounts to put that situation right over forthcoming years.
  It is not a deprivation of cash that has created this crisis. Increases in VAT have added to pressures on the budget. Pay increases resulting from the strikes of last winter and the subsequent inflation have added to the considerable pressures. But that is not an adequate excuse for what is happening to health provision for patients in Derbyshire.
  It is not only Etwall that is affected. In my constituency, Draycott hospital is being temporarily closed. I understand that it is to be a 15-months'closure. I wonder what is the definition of "temporary" when we are talking in terms of 15 months. The real cause of the trouble is that the area health authority has not provided early enough for the inevitability of tighter budgeting.
  It has continued overspending. It has not done enough to improve its efficiency, cut out waste and top-heavy administration. I should like to put some questions to which I hope the Minister can address herself or make subsequent inquiries.
  What administrative savings have been made by the area health authority over

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  the past year since it became aware that pressures were building up on the budget? What could be saved by better hospital management—I am referring not simply to management but to administration in the hospitals—if a real economy drive were undertaken? I found the answer, as anyone could find it, by speaking to nurses and staff in hospitals. All can point to areas of waste in the daily administration of hospitals.
  Thirdly, why is it that the Draycott hospital is fully staffed, yet half the beds are empty? This is another post-operational hospital, just like Etwall, which could have been reducing the pressure on Derbyshire hospitals, where there are long waiting lists. Yet Draycott hospital has been starved of patients who must be waiting.
  Fourthly, I think that we are entitled to know why, at the Draycott hospital—I cannot speak for others—in recent months there has been a considerable amount of capital expenditure of a maintenance and repair nature that was not essential but has been carried out. The area health authority must have been aware that the budget was tight and that other hospitals were about to be temporarily closed. Why, during that time, was expenditure of an unnecessary and inessential kind continued? I maintain, and the area health authority has admitted, that the financial crisis, as it describes it now, was anticipated. If so, why were precautionary measures not taken earlier to cut some of the spending?
  Fifthly, why were the community health councils not consulted properly and their constructive advice taken on how economies could have been made to avoid these closures?
  Sixthly, why has no effort been made to use more voluntary support? The league of friends of the Draycott hospital—an excellent organisation—would have been prepared, and still is prepared, to provide more support rather than see the hospital close.
  Finally, if the pay awards of last winter resulted in budget excesses—which they have done—why have there not been more reductions in the service staff rather than a closing of the hospital beds?
  Until these questions are satisfactorily answered, the suspicion must remain that
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  the area health authority has mismanaged its finances and is now, in an unnecessary and unacceptable way, depriving Derbyshire of services and taking it out on patients. This is not good enough. I hope that the Minister will call in the area health authority to account for its present position.
  1.37 am
  The Under-Secretary of State for Health and Social Security (Mrs. Lynda Chalker): I am grateful to my hon. Friend the Member for Belper (Mrs. Faith) for raising this issue, which I know is causing so much concern, not only to her but to the hon. Member for Derby, North (Mr. Whitehead) and to my hon. Friends the Members for High Peak (Mr. Le Marchant), for Derbyshire, South-East (Mr. Rost), for Derbyshire, West (Mr. Parris) and for Burton (Mr. Lawrence), all of whom are here at this late hour because of their concern about what is happening to hospital services in Derbyshire.
  I fully understand the feelings of all who are confronted with the closure of hospitals to which they have contributed so much over the years. I know that I do not have to remind my hon. Friend the Member for Belper of the Government's firmly held view that health authorities, many of which we know are facing severe financial difficulties, should look first to administrative and other items of expenditure not directly related to the provision of patient services to see what savings can be made. The closure of hospitals or other reductions in services direct to patients should not be countenanced until every other avenue has been thoroughly explored.
  It may be helpful if I go over the background to the decision of the Derbyshire area health authority to close Etwall hospital temporarily. I must stress the word "temporarily", because I think that there may be misunderstanding locally about it.
  The Trent region and the Derbyshire area have suffered from a legacy of funding considerably below the national average, to which my hon. Friend the Member for Derbyshire, South-East referred. Although a certain amount of progress has been made over recent years towards rectifying the balance, there is still some way to go.

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  This financial year Derbyshire AHA is heading towards an estimated overspending of about £1·4 million. The Government have told all health authorities that they must be prepared to grapple with the problem of living within their cash limits, difficult though this may be in some cases. I am glad to say that the Derbyshire AHA fully accepts this. It aims to meet its cash limit by March 1981, but, to do so, it has decided that some hospital closures are inevitable. I know that it has not considered the closure proposals lightly. Each of the three health districts is heading for an overspend this year, the biggest being in south Derbyshire. This has resulted in the proposals that were approved at the area health authority's meeting earlier this month.
  We fully appreciate the difficulties that all health authorities and their districts face—especially those which have been under-resourced as in this case—in absorbing the effects of excess pay and price inflation, but, given the serious economic and financial situation that we have inherited and the urgent need to reduce the burden of public expenditure overall, I do not think that anyone could reasonably expect the National Health Service to be wholly exempt from general financial pressures. Nevertheless, the current arrangements for adjustment of health authorities' cash limits are distinctly more favourable than for other areas of Government spending.
  Etwall is, of course, not the only hospital that will be affected in Derbyshire, as has already been mentioned. The AHA aims to save £½ million in a full year from these closures, permanent or temporary, and £300,000 from the temporary closure of Etwall hospital. Consultation documents have been issued on the closure of Parwich hospital and the Smedley Memorial hospital at Matlock. Both of these are proposed for permanent closure. I understand that Smedley hospital is now empty, and the AHA proposes to keep it closed in the new year while consultation takes place on the proposed permanent closure.
  In addition to Etwall, the other hospital to be closed, at Draycott, and the theatre and surgical ward at Derwent hospital, will be closed temporarily. I can well understand that, given the position in which the AHA finds itself that there
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  are fears that, once closed temporarily, these hospitals will not be able to open again—or worse, that the AHA is merely using temporary closure as a cosmetic to disguise the eventual permanent closure.
  I am told by the AHA that this is not so. It is its firm intention to reopen Etwall and Draycott hospitals and the theatre and surgical ward at Derwent hospital as soon as circumstances permit. The AHA hopes that this can be done early in 1981. Meantime services will be kept under review.
  The other point that I should make about Etwall hospital is that the temporary closure will be phased. Closure will not take place until the end of February 1980 at the earliest. The AHA, after full consultation with and on the advice of the consultative medical staff, has decided that admissions to the hospital should cease from yesterday, Tuesday 18 December. It will clearly take time for arrangements to be made for the transfer from Etwall of those patients who will not be able to be discharged during the next few months.
  My hon. Friend the Member for Derbyshire, South-East asked a number of detailed questions. I think that at this late hour and with the information that I have to hand I should be foolish to try to answer those questions, in case I misled my hon. Friend and the House. I assure him that my colleague the Under-Secretary of State for Health and Social Security—my hon. Friend the Member for Ealing, Acton (Sir G. Young)—will write to him and to other hon. Members involved in this debate as soon as he can.
  All the points that have been made, whether bound up with the temporary closure of Etwall or the permanent closure of Parwich, are bound to have an effect on services to patients in south Derbyshire. We know that there is very little slack elsewhere in hospital services in this district and in the wider area. Although the AHA cannot at this stage be specific about the precise extent of these closures, waiting lists are bound to be affected.
  None of us likes to see proposals for the closure of hospitals that have given such good service in the past, but some closures may from time to time occur. I think that we all accept that. Area

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  health authorities such as Derbyshire face a difficult task. Not only do they have to grapple with the cash limits that have been set; they have been told to plan on the basis that cash limits will be increased to cover most of the excess cost of pay awards. We have been able to provide an extra £250 million for this purpose but we must face the fact that there is no more money available in the NHS this year.
  Next year, we envisage small growth in real terms in the amount of money available to the NHS—about 0·5 per cent. overall. We are of course aware that regions like Trent and areas like Derbyshire will be looking for continued redistribution of resources between health authorities, but the exent to which this can be done will clearly be restricted by the amount of overall growth money available next year and thereafter.
  I return to the particular case of Etwall hospital. I am told that the staff are reluctant to accept the decision of the area health authority. I can understand their concern but I hope that good sense will prevail and that the planned meeting between the AHA and hon. Members, which is to take place shortly, will bring together the facts and the impressions that hon. Members have gained. I hope that this deep problem will be resolved. Much is to be gained by both sides in discussing the nitty-gritty in greater detail than we are able to do in the House, where the AHA cannot speak up for itself.
  I welcome the meeting. If, after the meeting, areas of doubt and difficulty remain, my hon. Friend the Minister for
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  Health has said that he will meet those concerned and consider what further can be done, within available resources, by the Derbyshire AHA to overcome the difficulties facing health services in that county. I realise that little that I have said will do much to lessen hon. Members' anxiety. The only way that I could do that would be to hold out a promise of substantial extra resources. That I cannot do.
  The Government have asked all health authorities to look first at administration and other items of expenditure which are not directly related to the provision of patient care in making the savings. I hope that when the meeting takes place between hon. Members, the AHA and others who are concerned about hospital provision in the area and the present financial plight of the authority, the argument of the Minister of State and others will be considered in a constructive spirit.
  Above all, the lesson that we all have to learn, whether in the Government, local government or health authorities, is that we must manage within available resources. It is up to all good men and women to ensure that every idea is brought to bear upon the problems of the health services in the area. If the meeting does not resolve the issue, my hon. Friend the Minister for Health will readily meet those concerned to see what might further be done. We hope that it is possible to resolve the problems locally without intervention by the Minister.
  Question put and agreed to.
  Adjourned accordingly at twelve minutes to Two o'clock.