§ Mr. Bob Cryer (Keighley)
On a point of order, Mr. Speaker. May I draw your attention to the statement on the Order Paper that the instrument has not been considered by the Joint Committee on Statutory Instruments? That is not the case, because the Joint Committee considered the instrument at its meeting this afternoon. The Committee asked the Clerk to make representations to the Leader of the House because the Committee took evidence from representatives of the Department of Health and Social Security which is linked to the statement that has been placed in the Vote Office by the Committee this evening in order to help the House.
The evidence could not be printed in time and therefore the Clerk was asked to contact the office of the Leader of the House to see whether this instrument could be deferred and the prayer dealt with next week. The Committee asked that it should be dealt with in that way because the Leader of the House represents the Government who have control over the time of the House. It is not the Opposition who dictate the time for a prayer to be put down and debated.
As you know, Mr. Speaker, the Joint Committee is set up under a Standing Order of the House. The Committee feels that it is extremely foolish for the House to set up a Committee and entrust it with the job of examining instruments and, where a report has to be made, for the House then to ignore the Committee's report by going ahead with the debate tonight.
I should like you, Mr. Speaker, to look at this matter with a view to enforcing the Standing Order in such a way that this position cannot occur again.
§ Mr. Speaker
This prayer was put down by the Leader of the Opposition and Opposition Members and I must follow the Order Paper. However, if the Opposition do not wish to pursue it, the simple remedy is not to move it.
§ Mr. Speaker
I shall take the point of order, but I remind the House that we have now embarked upon the time which will run out at 11.30 pm.
§ Mr. Beith
On a point of order, Mr. Speaker. I apologise, but I understood that the hon. Member for Crewe (Mrs. Dunwoody) wished to raise a point of order. I seek your guidance, Mr. Speaker. The Joint Committee must have been placed in difficulty because the Government originally laid the instrument on 14 June, but withdrew it and tabled another instrument, which differs only in one sum of money and one small bit of wording from the original instrument.
I understand that the Government laid this instrument not because of any defect in the original instrument, but to enable the official Opposition to pray against it, as my hon. Friends and I had already prayed against the first instrument. Is that not why the Joint Committee was unable to consider the second instrument until recently?
§ Mr. Mike Thomas (Newcastle upon Tyne, East)
Further to that point of order, Mr. Speaker. The House is also entitled to know the Government's intentions on the instrument relating to Scotland. That has also been prayed against—
§ Mr. Speaker
Order. That cannot be a point of order. The hon Gentleman has raised a business matter, not a point of order. I must tell the hon. Member for Berwick-upon-Tweed (Mr. Beith) and the hon. Member for Newcastle upon Tyne, East (Mr. Thomas) that I have to follow the Order Paper. The Speaker is not given authority to decide its contents. The rules are simple. The hon. Member for Crewe (Mrs. Dunwoody) wishes to move the prayer and she must be allowed to do so.
§ Mr. Thomas
Further to that point of order, Mr. Speaker. I apologise for pursuing the matter further, but we are entitled to ask whether it is proper for the Government to withdraw an instrument when they see it prayed against by one group of hon. Members so that, apparently, another group of hon. Members can pray against it.
§ Mr. Speaker
It is not for me to interpret the Government's motives. I should be on very dangerous ground if I did so.
§ Mrs. Gwyneth Dunwoody (Crewe)
It does not matter at what point of the calendar the prayer is moved. I beg to move,That an humble Address be presented to Her Majesty, praying that the National Health Service (Charges to Overseas Visitors) (No. 2) Regulations 1982 (S.I., 1982, No. 863), dated 24th June 1982, a copy of which was laid before this House on 24th June, be annulled.The regulations are obnoxious and unacceptable and should be defeated by the House. The original decision to charge overseas visitors was presented to the House by a previous Secretary of State, because, as he said some time ago in an extremely emotive speech at St. Stephen's hospital, the National Health Service was being exploited by people whom he categorised as being well-heeled foreigners.
The former Secretary of State then said that he intended to ensure that the British taxpayer was not in any way penalised. That has been found to be a totally and utterly shallow boast. Although it would be out of order to refer to the Scottish instrument, when I speak from the Front Bench on behalf of the Opposition I do so on behalf of everyone in the United Kingdom, including the kingdom of Scotland. It is sometimes necessary to go outside to discover the reasoning behind the political moves that occur. I have never suspected the Chancellor of the Exchequer of having a sense of humour. To be frank, I have always regarded him as a rather pedestrian thinker. However, we have the Conservative political centre summer school in Cambridge to thank for a really good joke from the Chancellor. At least, if it is not a funny, it deserves to be, especially as it gives us a clue about what is behind the regulations. On 3 July the Chancellor spoke about health and said that the Conservatives had long questionedwhether subsidised universal provision would effectively help those in need".He also said:The use of economic pricing of services is currently restricted to only small areas of the programmes concerned. Opening up the supply of a much wider range of goods and 247 services to something approximating the market place may be a way of enriching and enhancing the quality and variety of what is provided. In some cases, a system of charging can help to direct resources where they are most required and at the same time induce a sense of priorities amongst recipients of the services involved.People do not only get a free service, but apparently they have to be suitably chastened and grateful as well.
The Chancellor went on:In some cases charges might be a preliminary to some form of private sector involvement. As we develop our thinking along these lines we must never cease to proclaim that the objective of such an approach is not to defend a rump of privilege for the few,"—perish the thought—but to enlarge the bridgehead of choice for the many.It does not matter how often the Chancellor tries to put forward that line of thought, no one will believe him. The only thing that can be read into the absolute determination to bring forward these regulations, which are both divisive and unacceptable, is the fact that the Conservative Government are committed to a decision that is racist and unacceptable in every way. They have it in mind, first, to pander to the straightforward xenophobia of the Conservative Party.
Never mind that even after energetic research the Government can produce only the flimsiest evidence of any abuse of the National Health Service. Never mind if the previous Minister's encomium must be scaled down because of a lack of hard facts. The Government have pushed ahead with this destructive scheme, determined to bring it into operation by 1 October 1982. When it was first suggested, the chorus of complaint, not only from organisations representing students but from those representing the immigrant community, forced them at least to accept some consultation, but they have done their best all the way through both to limit the terms of reference of the working party and to ignore many of the representations that were made to it. Their impact on race relations has been wholly unacceptable.
When the working party was set up, the implicit justification for the new charges was to stop abuse of the NHS, but the working party found that, of the 8,152 who were questioned in the survey, only 81, or 1 per cent., were even suspected of being chargeable after stage one of the questioning. During that time the Kensington, Chelsea and Westminster area health authority—an area that must have one of the largest concentrations of overseas visitors to Britain—said that abuse formed a minute proportion of the total work load with no perceptible effect on its waiting lists.
§ Mr. Douglas Hogg (Grantham)
Is it not also true that only 12 of those who were asked objected to answering the questions?
§ Mrs. Dunwoody
If one asks someone to participate in a voluntary scheme often, because of his good manners—a quality not always shared by the Conservative Government—he will respond positively. If he is forced to answer a series of personal questions, his response may be very different.
The facts in this case have not concerned the Government. Their cavalier attitude to the money that they said would be raised in this way are clear evidence of that. First, we were told that the measures would save £5 million. Then we were told that they would save £6 million, but we have not had evidence for those calculations.
248 The Secretary of State has never offered an estimate of the administrative costs of bringing in the scheme. He must know that if the detailed charging that is revealed in the schedules to the regulations is implemented the extra administration involved will be large, not only because of the exemptions that he has been forced to include—no matter what he says, many people will not be required to pay—but because of the complexity of the categories. It is comforting to know that patients will not be charged for their treatment if they present the hospital with plague.
The creation of a large and detailed price structure is a costly hammer with which to crack a tiny nut, unless the real reason behind the whole elaborate charade is to dismantle the National Health Service as a free service and put in its place after the next general election a system that will force everyone to pay for some of the services that they receive under the National Health Service. If one looks at it in that light, one begins to understand that this statutory instrument is meant not just to damage the interests of students and overseas visitors but to deter those most in need.
Let us consider overseas students. The Government have had to change the arrangements that they initially made. There is a long list of people who will manage to obtain exemptions from the overseas charges, but students who come from the poorest countries overseas will be most damaged by this imposition. The Government have never made it clear whether they intend to take out insurance for Third world students who otherwise would be deterred from coming here because they would not be able to afford the insurance cover so that they could follow their studies. If the Foreign Office and the British Council will have to undertake large payments for the students, is it not true that the savings about which we have been told are illusory?
Is it not clear that this procedure will result in direct and open conflict in our hospitals? We are told that the admission staff will ask everyone the same straightforward set of questions. That will be so throughout the country, whether or not there are large numbers of visitors. Although there has been consultation about that aspect, it is obvious that the Government have no intention of consulting on the second stage of the questioning. It is that second stage that will be the most delicate, most important and most open to misinterpretation.
The manual that should have been provided by the DHSS, which I am told is available, although I have not been able to get hold of it, lays down a number of suggestions on the way in which a patient should be handled. However, a great many questions remain unanswered. Will there be delays? There is a fairly calm assumption in the manual that if a patient presents himself in a hospital and cannot answer the first stage of questioning satisfactorily, unless there is clear evidence of urgency, he must wait for the second stage of questioning, if needs be after consultation with an authority that can establish the patient's right to treatment.
§ Mr. Andrew F. Bennett (Stockport, North)
Does my hon. Friend accept that the manual is unsatisfactory because it shows the short procedure and the detailed procedure for those who do not escape on the first count, but it does not go into whether people can afford to pay for the treatment? The major problem is what happens when someone does not have the insurance to guarantee to the hospital that he has the money. The draft procedure does nothing about how the hospital ensures that people 249 have the money. In the evidence given to the Select Committee today there appeared the major problem of the hospitals giving treatment without being sure that they can get the money.
§ Mrs. Dunwoody
I am grateful to my hon. Friend for making those points.
Such complex charging machinery must be backed up by means of collecting debts. If one collects debts from people who are ill, and if one does it on the word of a questioning procedure that is extremely doubtful and will be easily misinterpreted, one will run into considerable difficulty. If we return to the days when people who were seriously ill were questioned in considerable detail before they could receive any assistance, that is a negation of any sort of civilised treatment. The Government should be ashamed of suggesting it.
The regulations have public health implications for British citizens because it is not clear what the Government intend to do in the case of people with communicable diseases who entered the country within the 12-month period. Clearly such people will be likely not to tell the entire truth about their circumstances. At present, for example, people coming from Third world countries and presenting themselves at large hospitals are routinely screened for open tuberculosis because it is still a common disease in many such countries, although it has been largely eradicated from the British population.
The Minister has a responsibility to make clear what he intends to do about this in future. If people coming into this country know that if they admit to being here for only a short time they will be charged for medical treatment inevitably they will either not present for screening and thus may be a public health danger or they will be encouraged to lie about the circumstances.
§ The Minister for Health (Mr. Kenneth Clarke)
The hon. Lady will see that tuberculosis is one of the communicable diseases exempt from charges under the regulations.
§ Mrs. Dunwoody
My point is much simpler. For example, Asian mothers entering this country are already at much greater risk. There may also be a language barrier. They will not present themselves to the doctors if they think that there is any likelihood whatever of being committed to paying heavy charges, so they will not present themselves for screening.
With regard to ante-natal care, too, it is almost inevitable that instead of coming early for assistance the mothers most at risk will present themselves only as emergencies, with consequent far higher risks to themselves and their babies. That will be the effect of these utterly deplorable regulations.
The scheme is the result of a political decision. It will affect a large number of people in this country in many different ways. There is no clear statement as to how the Government intend to confirm the status of patients presenting themselves at hospitals. The immigrant community in this country may be forgiven for regarding this as yet another extension of internal immigration controls. It is not clear whether they will be asked to produce their passports. People born and brought up here will inevitably resent being closely questioned by hospital admissions staff. Moreover, if the answers given are 250 regarded as unsatisfactory, will the admissions staff be expected to check with the Home Office or some other Government Department to decide whether the patient has the right to be treated?
I shall put some simple questions to the Minister. How will the status of patients be confirmed if they are suspected by hospital staff of being overseas visitors? Will they have an unnecessary wait for treatment? Presumably the estimate of the urgency of the case will be made by the admissions clerk or the senior officer who is called.
What will happen in the case of overseas students? Who will provide insurance cover for them? What plans has the Minister to protect those coming from the poorest countries who will be most deterred by the burden of extra cost?
§ Mrs. Jill Knight (Birmingham, Edgbaston)
I appreciate that the hon. Lady has been kind enough to give way on several occasions. I am following her argument carefully. I am sure that she is aware that a very large number of countries make charges for the medical care of those who visit them for long or short periods. If the other countries which make such charges are able to do it simply and as a matter of routine, why cannot we do so in the United Kingdom?
§ Mrs. Dunwoody
The hon. Lady knows that when this matter was previously discussed there were only three major countries that could be demonstrated to be sending people here who had no cover or reciprocal agreement. I should have thought that behaving in a civilised manner because we have a National Health Service was a matter of pride, to be coveted, and copied elsewhere in the world.
§ Mrs. Dunwoody
Very well. I am proud of the education system in this country and I welcome those who come here to receive post-graduate training, further education, and take back to their countries a new form of education. If we do anything to deter them from doing that, we are behaving in the bigoted way that we now expect from a Conservative Government.
§ Mr. Tom Benyon (Abingdon)
Will the hon. Lady answer the question put by my hon. Friend? The hon. Lady has changed her story. She was referring earlier to those who damage the system the most and to damaging the service irrevocably. Now she says that she is proud of the fact that the service is free. Will the hon. Lady be kind enough to balance the argument?
§ Mrs. Dunwoody
The hon. Gentleman should do me the courtesy of listening. I said that the education system in this country is good and that is why students from overseas, particularly from the Third world, want to come here. I also believe that if they come from poor countries they will be deterred by the enormous increase in fees imposed by the Government and by the heavy insurance they will have to carry to make sure that if they are ill they can receive treatment. If that is the hon. Gentleman's idea of civilised behaviour, I have news for him—it is not mine.
I do not want to take up much time on the details of this scheme. Whatever organisation has been asked to comment on it, without exception the response has been one of appalled denial that such an idea should have been brought into operation. The World University Service said that it was very worried about the exemptions and that 251 individuals who come here as refugees, or to visit refugee relatives, from outside the European Community will not be covered. The Joint Council of the Welfare of Immigrants, the Commission for Racial Equality and students' organisations all regard the decision to charge overseas visitors as politically unacceptable, administratively unworkable and a clear sign that the Conservative Government are more concerned with their prejudices than with the administration of the National Health Service.
We shall vote against this nasty little prayer tonight because it is a racist and divisive measure.
§ Mr. Deputy Speaker (Mr. Bernard Weatherill)
Before I call the Minister, I remind the House that it will be necessary for me to put the motion to the House at 11.30 pm.
§ The Minister for Health (Mr. Kenneth Clarke)
The attack of the hon. Lady the Member for Crewe (Mrs. Dunwoody) on the regulations was so excited and yet so confused that she ended by inviting the House to vote against her own prayer. However, I got the gist of her argument. At times her general intention was to widen the debate into arguments about the validity of charges in the National Health Service generally. She said that the regulation was a threat to a free service and that it was racialist, and she made various other accusations. She was, however, shot out of the water by the question put to her by my hon. Friend the Member for Birmingham, Edgbaston (Mrs. Knight). My hon. Friend indicated that practically every other country charges overseas visitors, including British visitors, for health treatment. Most people will see ours as a fairly commonsense change to make more effective and fairer long-standing arrangements that are supposed to apply in this country. We are introducing a more effective arrangement to levy charges against short-term visitors to this country.
The proposition defended by the Government is that short-term visitors should usually insure themselves against medical costs and pay for their medical treatment when they fall ill just as British subjects make similar arrangements when making visits abroad. We have made wide exemptions to ensure that this principle does not give rise to hardship. We exempt those who come here to work, who have been here for more than a year and who come from countries with which we have reciprocal agreements. We exempt accident and emergency treatment, and communicable diseases, including tuberculosis. We exempt refugees and the seriously mentally ill. To charge the ordinary short-term visitor, who is probably a tourist who will expect to insure himself before arriving, will raise a potential £6 million. This would benefit the National Health Service and the taxpayer.
§ Mr. Douglas Hogg
Does my hon. and learned Friend agree that it is remarkable to hear the Labour Party denounce the regulations when one considers the 1949 and the 1977 statutes for which they were responsible? Both statutes empower the Minister to make precisely this kind of regulation.
§ Mr. Clarke
We are using Labour powers to make the regulations. The trouble is that the regulations were never made. It is a system that the Opposition operated but about 252 which they did nothing while in power that turns out to be racially discriminatory, haphazard and ineffective in raising revenue for the Health Service.
We shall raise £6 million in a fairer and better way. That amount cannot be waved aside given that the Government say that the benefit can be kept by the health authorities.
§ Mr. Clarke
I shall give way when I have made this point.
The estimate that we have made is comparatively modest. As the hon. Member for Crewe has pointed out, a small number of patients is potentially involved. If only 0.5 per cent. of the cost of all acute hospital treatment was raised by this measure, we would raise about £15 million. A figure of 0.25 per cent. of the total cost would raise £7.5 million. The sum of £6 million is therefore a modest estimate of the benefit that we expect.
I underline how little we are changing the principles of the present position. Those hon. Members who have already spoken appear to imply that it has always been the case that everyone who happens to be in this country at any time is eligible for National Health Service treatment. That is not the case. The hon. Member for Crewe sounded dangerously near to saying that. The National Health Service is only available broadly to ordinary residents of the United Kingdom, people who have temporarily been abroad, people who are here to work and visitors staying for not less than a year. We also have reciprocal agreements with other countries. In theory, all others have not been eligible for treatment in this country. They should be treated as private patients. The only guidance ever issued on the subject in 1963 assumes that this will be the case.
In fact, some are treated as private patients. Some are treated on the National Health Service. As my hon. Friend the Member for Grantham (Mr. Hogg) says, the Labour Government took powers in the 1949 Act to charge those who were not eligible, but no regulations were ever made under it. A number of visitors have been charged. As a matter of law, there was no means legally whereby charges could be recovered if patients failed to pay. That was the ramshackle system that we inherited. It gave rise to risk of abuse. It led us to examine the system and to decide how best to raise revenue that should be raised in a fair manner.
§ Mr. Alexander W. Lyon (York)
The Minister is a lawyer. He has referred to the legal position. Does he not agree with the minority report of the Select Committee that there has never been any legal right to charge anyone prior to the introduction of these regulations? The 1949 Act enabled powers to be taken to make regulations but they were never made. Any money deducted was therefore probably deducted illegally.
§ Mr. Clarke
That is more or less what I have just said. The 1949 Act, which was introduced by a Labour Government, enabled regulations to be made, and charges to be levied. No regulations were subsequently made, and we are using those powers to make these regulations. Charges have sometimes been collected in a rather haphazard way. If the patient had refused to pay there was almost certainly no legal basis upon which the charges could have been recovered.
That unsatisfactory position led us to look at the procedure and to contemplate a system of charges. We 253 found that the existing system was used in a way that gave rise to a serious risk of racial discrimination. The regulations and the draft manual of guidance are steps to eliminate the discrimination against ethnic minorities that the working party that we set up found existed. The working party included representatives of ethnic minorities and we were careful to ask the working party to look at that problem. Ministers asked that care should be taken to ensure that any procedures that were proposed were fair and acceptable to all patients and should not disadvantage ethnic minorities living here.
When the working party looked at the present arrangements it found that the way charges are levied depends upon the intuition of the staff and the practice in individual hospitals. Its finding was:The present arrangements pose a distinct risk of discrimination against members of ethnic minorities living here.We decided that that must be stopped. We have devised a procedure, about which we are consulting, in the manual of guidance that seeks to eliminate that risk. There must be a simple procedure so that the same questions are directed at all patients, and no longer must those with the wrong colour skin or funny foreign names be concentrated upon.
§ Mr. Clarke
It is no good the right hon. Gentleman saying "Come on". He was obviously not aware while he was in office of the fact revealed by the working party that that is the present practice in some of our great hospitals. We shall now ask all patients the same simple questions aimed at establishing residence. When the hon. Member for Crewe studies the manual of guidance—anyone is entitled to do so, and we invite comments because we are consulting upon it—she will find that passports are dealt with quite explicitly. The assumption throughout the manual is that officials will ask only for passports for European Community countries and others with which we have reciprocal agreements because the passport is the quickest way to prove entitlement. There are strong warnings against using passports in other cases because of their sensitivity.
The manual of guidance is aimed at eliminating racial discrimination. The campaigning has been pretty silly when it comes from Labour Members who claim that we are introducing a racialist measure when in fact we are correcting an abuse of which they were not aware all the time that they were in office.
The hon. Member for Crewe argued about the cost of introducing the new arrangements. We were sensitive to that and the working party was asked to look at that aspect. The working party included administrators who would be mindful of any cost to the service. The request to the working party by Ministers was:That the procedures should be as simple as possible and should not be unduly burdensome to the National Health Service or costly to operate.The working party found that the present arrangements were haphazard and, as I have said, relied on the intuition of staff, and that the staff complained about their lack of guidance. It found that the present administration needed improvement. I quote paragraph 7 of the working party's report: 254There is a need for clearer guidance irrespective of the Government's present proposals to introduce National Health Service charges.The working party held a trial of the system that we propose and found that it worked in a simple and effective way and that it could be implemented without additional staff being employed. It was found also that the staff reaction was generally favourable. My hon. Friend the Member for Grantham has said that over 80,000 patients took part in the trial and that only 12 of them, when asked specifically, said that they objected to being asked the questions. The working party's conclusion was that our proposals should be capable of being implemented by health authorities without any significant increase in administrative costs.
I accept that the second stage will involve the recruitment of a few additional staff in some hospitals. The costs involved in a few hospitals taking on the odd additional administrative officer will be far outweighed by the financial benefits of finally getting round to levying properly the charges that should be paid by the short-term overseas visitor.
§ Mr. Clarke
I wish to refer to students without taking the entire debate. We have tried to accommodate students within our proposals because we do not wish to victimise students who are already here by imposing costs upon them. The arrangements that we have arrived at are substantial concessions for students and others. We have reduced the period of residence before exemption from charges from three years to one year. New students will not be exempt in the first year. However, we have announced transitional arrangements, which provide that students will be exempt if they have enrolled here and commenced their studies by 1 October 1982, which is the proposed commencement date for the entire arrangements.
There are some who have argued about the commencement date of 1 October 1982. It is claimed that it is unfair to students who are not here and have not commenced their studies prior to 1 October. There are bound to be problems with any commencement date. We are making some special arrangements for students vis-a-vis other people, but in practically every category there will be some who come on 2 October who find that they are worse off than those who came here on 30 September.
The idea was that students already here would be exempt in their first year, but we have gone beyond that and some students who arrive for the first time will be lucky. They will enrol and start their studies before 1 October and they will be exempt. The idea that some students will be lucky because of the transitional arrangements should not be extended to become argument for exempting all students enrolling this year for the first time, thereby giving them a complete year's exemption.
There has been plenty of warning of the arrangements. The history of this issue goes back to March 1981, when we first began to moot a change in the arrangements. Draft regulations were issued, the working party was appointed and there have been consultations. On 22 February a statement was made to the House. We made it clear that we intended to bring the new arrangements into effect on 1 October. We made substantial concessions to students, but those who come after 1 October will have to insure like other people. There will be insurance costs, which will 255 probably amount to £100. That is not a large sum compared with the thousands of pounds that it costs to educate a student in Britain.
There are arrangements for assisting students from poorer countries with their education in Britain, but that is a matter for my right hon. Friend the Minister for Overseas Development, and the Overseas Development Administration, who have the task of determining insurance cost arrangements for poorer students. Students from America, Canada, Australia and the Middle East—these are the students who come to Britain from more prosperous countries than the United Kingdom to further their education—cannot regard it as too onerous if, after the transitional arrangements are over, they have to pay a modest charge to receive treatment like other people. That is the basis upon which we move the regulations.
I shall not deal in detail with the Joint Committee's proposals and the report that has been made available today. We have amended the regulations and before doing so we withdrew them. The prayer of the hon. Member for Newcastle upon Tyne, East (Mr. Thomas) has been lost and the hon. Member for Crewe had the dubious privilege of moving the misconceived motion that is before us. We withdrew the original regulations and amended them in line with suggestions that came from the Joint Committee, whose chairman, the hon. Member for Newcastle upon Tyne, East, has expressed such indignation that we are ignoring his suggestions. The Committee's report, which became available today, contains detailed drafting proposals to which I shall reply if I have the opportunity to do so. I probably will not, and in that event I shall take up the detailed proposals in correspondence. However, they are before the House and the details are available in the Vote Office. They are all capable of answer either in this debate or afterwards.
The policy has been before us since March 1981. The Government have gone through the most laborious process of producing draft regulations, withdrawing them, and then amending them. There have been consultations and a working party with representatives of ethnic minorities and professional administrators. Concessions have been made to students. What we have now achieves the commonsense aim enunciated by my hon. Friend the Member for Edgbaston. To say that there is still room for abuse, hardship, racialism and all the other nonsense is fanciful nonsense, which neither the regulations nor the prayer will support.
§ Mr. Deputy Speaker
Order. I again remind the House that it will be necessary for me to put the Question to the House at 11.30. I therefore appeal for short speeches.
§ Mr. Bob Cryer (Keighley)
I shall be as brief as I can. First, I wish to express the views of the all-party Joint Committee on Statutory Instruments, which was set up in 1979 to scrutinise instruments coming before the House. It is not good enough for the Minister to say that, when the first regulations were put before the Committee and we asked for a number of questions to be answered, they were all met, because that is not the case. We asked for a memorandum on the first regulation which we received virtually simultaneously with the second set of regulations, which were also defective. We considered those items and put a report in the Vote Office. I said, on a point of order, that the Government dictate the time of Parliament and not 256 the Opposition. The Opposition were right to seize the opportunity to debate the instrument because we feared—our fears were confirmed by the Minister's rapid progress through the various points—that if the time to debate the prayer was lost tonight it would not reappear. On the basis of parliamentary procedure, it would have been fairer and better had the Government said "We will not debate the regulations tonight. We will provide time, but only when the House has had time to read and understand the report and also when the Committee has had time to provide the evidence." That evidence was taken this afternoon. We spent about 35 minutes cross-examining representatives from the Department of Health and Social Security. That evidence contained some useful points that would benefit the House. Otherwise we would not have bothered to undertake the expense of printing it.
The Committee felt that to debate the prayer would be to ride roughshod over the procedures of the House. I can well remember the present Lord Chancellor talking about an elective dictatorship when we had a Labour Government, but tonight we have had an example of an elective dictatorship riding roughshod over our procedures.
§ Mr. Alexander W. Lyon
If my hon. Friend is feeling injured because of the neglect of the Select Committee report, he may notice that speeches were made from both Front Benches, neither of which referred to the Select Committee on Home Affairs, which considered this important issue. Its report was published only a few months ago.
§ Mr. Cryer
I do not want to go into the relative merits of Select Committees, but the Joint Committee on Statutory Instruments is designed to help the House over specific instruments. It considered this specific instrument this afternoon. It listed a number of ambiguities and reported the instrument to the House on the basis that it needed elucidation. As I said before, it is not true that all the various points were met. I do not propose to go into them, because they are in the report. The Minister will reply, but that is not the same as answering the points in a debate. If the report is tabled and the Minister has time to read it, those points can be made and put on the record.
My second point is that the manual of guidance and explanation of application of the regulations is an integral part of the regulations. When people express fear and concern about the application of the regulations, if there is a manual of guidance that fear and apprehension will apply to it, too. The manual was not supplied by the Department of Health and Social Security to the Committee. We were told, on examination of the witnesses, that a copy had been placed in the Library. The Committee has expressed regret that copies of the manual of guidance were not placed in the Vote Office or the equivalent Office in the House of Lords. It is an affront to the legislative process to have a manual of guidance which is being circulated to regional and area health authorities and to the medical organisations but which is not provided for the very body that is scrutinising the legislation. Moreover, it has not been provided for the Committee that was set up to scrutinise the legislation.
§ Mr. Kenneth Clarke
The manual of guidance has been in the Vote Office for a long time. It is attached as 257 an annex to the draft circular, which the hon. Gentleman, despite his careful scrutiny, has not had the time to read, beyond page 1.
§ Mr. Clarke
I am told that the witnesses said that the manual was in the Library. It is from that that on careful consideration the Committee has leapt to the conclusion that it was not in the Vote Office. Surely the Committee should have asked the witnesses or gone to the Vote Office to find out.
§ Mr. Cryer
The Minister is on thin ground if he attempts to argue that point. If he were really concerned about the Committee, he ought to have ensured that copies of the manual reached it in time for consideration of the instrument this afternoon. Moreover, the hon. and learned Gentleman ought to have ensured that the explanatory note to the instrument referred to the manual of guidance so that people were not unaware of the fact that other official documents were in circulation.
Paragraph 3 of the manual of guidance states:Hospitals should use the 'Liability to Charges' Form … or may adapt their patient registration form to include its contents. It is important that the wording of the questions should be preserved".A form is included in the manual. Why not make it a prescribed form? If it is so important to preserve the wording, make it a statutory requirement. The Committee would like an answer on that point.
The hospital authorities will be judge and jury in disputes regarding charges. They will decide whether a charge will be applied. They will also decide whether a refund should be made and what evidence is required to prove that a refund is necessary. That cannot be right, particularly when, as I understand it, the Minister has powers to establish the well-known tribunal system to administer this sort of thing.
The Minister's representatives told the Committee that there would be reference to the courts. I cannot imagine a more difficult process than arguing a dispute over charges through the courts.
The Committee came to the conclusion that:More generally, the Committee are concerned about the practical problems posed by a patient who may in fact fall within one of the categories of visitor exempt for charges under Regulation 4, but who because of his illness is unable to supply the information necessary to establish his exempt status. The witnesses agreed that the burden of proof would be placed on the person claiming exemption".That places a difficult burden on that person and diminishes the rights of citizens. That is the limit of the Committee's views, because it does not examine the merits of the instrument, only the powers exercised by the Minister within the framework of the primary legislation and the application of the statutory instrument.
That conclusion of the Committee indicates that there are real reservations about the merits of this instrument. It will place citizens at considerable disadvantage. That does not strike at the Committee's report but at the merits of the instrument, which in its application to the procedures of the House as well as its merits, is defective.
§ Mr. Teddy Taylor (Southend, East)
I am in favour of the principle of these regulations which the Minister has argued so ably.
I wish to put three brief questions which I hope my hon. and learned Friend will think about. First, is it sensible and wise again to pass regulations that so clearly discriminate against the Commonwealth, particularly after the events in the Falklands when the Commonwealth made its views so clear? Is it right and sensible that when someone presents himself to a hospital as a short-term visitor, if he is Australian he will be liable to be charged whereas if he is Irish he will be automatically exempt?
Secondly, if someone requiring health care comes from Guyana, is it the case that if they come from British Guyana they will have to pay, but, if they come from French Guyana, they will not have to pay because they are exempt?
§ Mr. Kenneth Clarke
There is a simple answer to all these questions—it all depends on what treatment the countries extend to British visitors. If there are reciprocal agreements, we treat visitors from those countries on the same basis as we treat our residents. That means that the country in question has agreed to do the same with our visitors. In the case of Australia and British Guyana, they would charge a British visitor having health treatment in their country.
§ Mr. Taylor
The case is not as simple as that. If the Minister will read his Secretary of State's evidence on page 28, paragraph 146 of the report of the Select Committee on Home Affairs, he will see that it says that the procedure in the Common Market is different from that of our country, and accepted to be so by the Government.
§ Mr. Clarke
That is not what I said. The principle is that where there is a reciprocal agreement, the country concerned treats visitors to that country on the same basis that it treats its residents. We therefore treat German visitors here on the same basis as British residents and the Germans treat British residents in the same way as they treat German residents. That is broadly the principle that is applied.
§ Mr. Taylor
I am aware of the position that the Minister has explained and has mentioned time and again in the annexes. However, does he not think that this is unfortunate and regrettable? This is particularly so in view of the fact that we have just considered another set of regulations that would mean, for example as it affects students, that a medical student from Australia who wishes to study to become a doctor at a British university will now pay £6,000 a year, while a student from any EEC country will have to pay £500 and will have an automatic grant of £5,100 a year from the British taxpayer.
If we accept that the basis is so-called reciprocity, although the Secretary of State said in his evidence that the procedures were different in Britain and the EEC, will the Minister give us an assurance that any Commonwealth country seeking reciprocal agreement with the United Kingdom will be granted this provision? For example, if Australia or Canada, or other Commonwealth countries, say that they would like the same reciprocal agreement, will the answer be "Yes"? It is important that if we are preserving the alleged principle of reciprocity, it should be available, particularly, to Commonwealth countries.
259 Thirdly, will the Minister explain the meaning of the second part of paragraph 4 of annex A? It refers to EEC nationals who expressly seek treatment. They are not casual visitors or holidaymakers but people who want to come to the country for medical treatment. If the person is Australian or American, he pays, but an EEC national does not pay and all that is needed is a certificate from the local social security institution saying that that treatment is not readily available in the country.
There then follows this statement:Such patients … must be given the same priority as patients living in the UK.This is a facility available only to those who are in the EEC. They will get free treatment for advanced arranged treatment not available in their country. For example, it is not possible to have a heart transplant in Italy. An application can be made to a British hospital and the person concerned must be given the same priority as a patient in the United Kingdom.
What does that mean when our hospitals have extensive waiting lists, particularly for the costly and difficult treatment? Does it make sense when many of our people and taxpayers are waiting, often in pain and great difficulty, for such treatment, that we should insist that the same priority must be given to any EEC national who comes for the same treatment in this country? Is this correct, do the Government mean it and do they intend to implement it?
While I am in favour of the principle, I hope that the Minister will give two assurances—that a Commonwealth country seeking reciprocity will achieve it, and that he does not mean the second to last sentence in paragraph 4 of annex A.
§ Mr. A. J. Beith (Berwick-upon-Tweed)
It is deplorable that the House should have so little time to comment on such an important matter, and that it should do so in the absence of the report from the Joint Committee. I shall say a few brief words to explain why I hope that my hon. Friends will vote against the regulations.
I want to stamp out abuses—as, I assume, do the Government—in the use of the Health Service by overseas visitors who come here, for example, for the purpose of obtaining treatment. However, the existing system provides for that, and its defects could have been dealt with without resorting to these procedures.
First, it is obvious that ethnic minorities will inevitably find themselves the subject of greater scrutiny than other groups, especially as they will be brought into the second stage of the procedure. Secondly, it is quite wrong that anomalies should be built into the system such as that mentioned by the hon. Member for Southend, East (Mr. Taylor), in that citizens from French overseas territories, for example, will be treated more favourably than citizens of some of our own dependencies and Commonwealth countries. The effect on students from poor countries is particuarly regrettable at a time when they face many other burdens.
Moreover, it is stupid of the Government to have chosen 1 October as the starting date. That adds to the administrative complications and divides the intake of students between those who will be affected and those who 260 will not. The Government could quite easily have chosen the end of December, when the number of students and tourists coming in is much smaller than at other times.
The Government have failed to cost the scheme and have failed to explain what the real savings will be. That is a grave deficiency.
Lastly, the Government have confused everyone by introducing two sets of regulations. The differences between the two are very slight. One of them is quite extraordinary. The new instrument makes it dearer to stay in a dormitory in a mental hospital than to stay in a single room, whereas the original instrument, quite properly, made it cheaper to stay in a dormitory than in a single room. In my opinion, the second was a device to enable the Labour Party to be the party which prayed against it. That is a device that is unworthy of the Government on a matter of this importance.
§ Mr. Douglas Hogg (Grantham)
First, I support one of the criticisms made by the hon. Member for Keighley (Mr. Cryer) about regulation 8. He is right when he says that it is unsatisfactory that the authority should be a final judge on refunds when the charges have already been paid. The authority is, of course, the beneficiary, and it is undesirable that it should have the final say in the matter. I should like a system of appeal to the existing courts Moreover, the point is compounded when I reflect that if someone declines to pay, the only way to enforce payment is to sue that person in the courts, and that person then has recourse to the courts. I hope that the Minister will look at that anomaly.
The hon. Member for Crewe (Mrs. Dunwoody) was entirely wrong to denounce the regulations as racist. I do not agree. The criteria are quite clear. They depend on 12 months' residence or occupation, or an intention to settle here permanently. There are, of course, some minor exemptions, they are dealt with clearly in form L, which contains three specific questions. Those questions are wholly free of racial overtones. They can be answered very simply. The cry that this is a racist measure is wholly unsubstantiated, alarmist and, if I may say so, disgraceful.
Lastly, I am satisfied that this system is entirely cost-effective. The working party looked at it carefully. It was tested in, I think, 10 hospitals. The hospital authorities approved it. It was found that stage 1 could be performed without taking on any additional staff, and stage 2 will require few additional staff, if any.
These regulations are worthy of the House's support, and I hope that they receive it.
§ Mr. David Ennals (Norwich, North)
These regulations are absolutely unnecessary. There is no proof whatever, and the Minister did not attempt to give any, that there has been any significant abuse of the present system. He says that he will save £6 million. He has given no costing whatever. He said absolutely nothing about what will be spent on staff training, administrative and clerical staff, the cost of drawing up bills, the legal costs of going to court for those who do not pay, and so on.
The Minister says that the regulations are not racist, but he knows perfectly well that the people who will be most affected, the people who will be asked to complete the forms—particularly section 2—will be ethnic minorities, people whose faces are black. He knows, although he 261 denies it, that the present system has never led to racial discrimination in the Health Service. That is what the Minister is doing. He has not given the House a reason. The cost of administration will be as high as the value of the money that he will bring in. The order is a load of bureaucratic nonsense to satisfy the ignorance and prejudice of many Government Back Benchers.
§ Mr. Mike Thomas (Newcastle upon Tyne, East)
The World University Service represents a group of 100 to 150 student refugees who have been given refuge by—
§ It being half-past Eleven o'clock, MR. DEPUTY SPEAKER put the Question pursuant to Standing Order No. 4 (Prayers against statutory instruments, &c. (negative procedure)):—
§ The House divided: Ayes 220, Noes 276.263
|Division No. 259]||[11.30 pm|
|Abse, Leo||Douglas, Dick|
|Adams, Allen||Dubs, Alfred|
|Allaun, Frank||Duffy, A. E. P.|
|Alton, David||Dunwoody, Hon Mrs G.|
|Anderson, Donald||Eastham, Ken|
|Archer, Rt Hon Peter||Edwards, R. (W'hampt'n S E)|
|Ashley, Rt Hon Jack||Ellis, R. (NE D'bysh're)|
|Ashton, Joe||Ellis, Tom (Wrexham)|
|Atkinson, N.(H'gey,)||English, Michael|
|Bagier, Gordon A.T.||Evans, Ioan (Aberdare)|
|Barnett, Guy (Greenwich)||Evans, John (Newton)|
|Barnett, Rt Hon Joel (H'wd)||Ewing, Harry|
|Beith, A. J.||Faulds, Andrew|
|Benn, Rt Hon Tony||Flannery, Martin|
|Bennett, Andrew(St'kp't N)||Fletcher, Ted (Darlington)|
|Bidwell, Sydney||Foot, Rt Hon Michael|
|Booth, Rt Hon Albert||Ford, Ben|
|Boothroyd, Miss Betty||Forrester, John|
|Bradley, Tom||Foster, Derek|
|Bray, Dr Jeremy||Foulkes, George|
|Brocklebank-Fowler, C.||Fraser, J. (Lamb'th, N'w'd)|
|Brown, Ronald W. (H'ckn'y S)||Freeson, Rt Hon Reginald|
|Buchan, Norman||Garrett, John (Norwich S)|
|Callaghan, Rt Hon J.||Garrett, W. E. (Wallsend)|
|Callaghan, Jim (Midd'tn & P)||Ginsburg, David|
|Campbell, Ian||Golding, John|
|Campbell-Savours, Dale||Graham, Ted|
|Canavan, Dennis||Grant, John (Islington C)|
|Cant, R. B.||Hamilton, James (Bothwell)|
|Carmichael, Neil||Hamilton, W. W. (C'tral Fife)|
|Carter-Jones, Lewis||Hardy, Peter|
|Clarke, Kenneth (Rushcliffe)||Harrison, Rt Hon Walter|
|Clarke,Thomas C'b'dge, A'drie||Hart, Rt Hon Dame Judith|
|Cocks, Rt Hon M. (B'stol S)||Hattersley, Rt Hon Roy|
|Coleman, Donald||Haynes, Frank|
|Cook, Robin F.||Healey, Rt Hon Denis|
|Cowans, Harry||Heffer, Eric S.|
|Cox, T. (W'dsw'th, Toot'g)||Hogg, N. (E Dunb't'nshire)|
|Craigen, J. M. (G'gow, M'hill)||Holland, S. (L'b'th, Vauxh'll)|
|Crowther, Stan||Homewood, William|
|Cryer, Bob||Hooley, Frank|
|Cunliffe, Lawrence||Howell, Rt Hon D.|
|Cunningham, Dr J. (W'h'n)||Howells, Geraint|
|Dalyell, Tam||Hoyle, Douglas|
|Davidson, Arthur||Huckfield, Les|
|Davies, Rt Hon Denzil (L'lli)||Hughes, Mark (Durham)|
|Davis, Clinton (Hackney C)||Hughes, Robert (Aberdeen N)|
|Davis, Terry (B'ham, Stechf'd)||Hughes, Roy (Newport)|
|Deakins, Eric||Janner, Hon Greville|
|Dean, Joseph (Leeds West)||Jay, Rt Hon Douglas|
|Dewar, Donald||John, Brynmor|
|Dixon, Donald||Johnson, James (Hull West)|
|Dobson, Frank||Johnson, Walter (Derby S)|
|Dormand, Jack||Jones, Rt Hon Alec (Rh'dda)|
|Jones, Barry (East Flint)||Roberts, Allan (Bootle)|
|Kaufman, Rt Hon Gerald||Roberts, Ernest (Hackney N)|
|Kerr, Russell||Roberts, Gwilym (Cannock)|
|Kilroy-Silk, Robert||Robertson, George|
|Kinnock, Neil||Robinson, G. (Coventry NW)|
|Lambie, David||Rooker, J. W.|
|Lamond, James||Roper, John|
|Leadbitter, Ted||Ross, Ernest (Dundee West)|
|Leighton, Ronald||Ross, Stephen (Isle of Wight)|
|Lestor, Miss Joan||Rowlands, Ted|
|Lewis, Ron (Carlisle)||Sandelson, Neville|
|Litherland, Robert||Sever, John|
|Lofthouse, Geoffrey||Sheldon, Rt Hon R.|
|Lyon, Alexander (York)||Shore, Rt Hon Peter|
|Mabon, Rt Hon Dr J. Dickson||Short, Mrs Renée|
|McDonald, Dr Oonagh||Silkin, Rt Hon J. (Deptford)|
|McElhone, Frank||Silkin, Rt Hon S. C. (Dulwich)|
|McGuire, Michael (Ince)||Silverman, Julius|
|McKay, Allen (Penistone)||Skinner, Dennis|
|McKelvey, William||Smith, Rt Hon J. (N Lanark)|
|MacKenzie, Rt Hon Gregor||Snape, Peter|
|Maclennan, Robert||Spearing, Nigel|
|McMahon, Andrew||Spriggs, Leslie|
|McNamara, Kevin||Stallard, A. W.|
|McTaggart, Robert||Steel, Rt Hon David|
|McWilliam, John||Stoddart, David|
|Magee, Bryan||Stott, Roger|
|Marks, Kenneth||Strang, Gavin|
|Marshall, D(G'gow S'ton)||Straw, Jack|
|Marshall, Dr Edmund (Goole)||Summerskill, Hon Dr Shirley|
|Marshall, Jim (Leicester S)||Thomas, Mike (Newcastle E)|
|Maxton, John||Thomas, Dr R. (Carmarthen)|
|Maynard, Miss Joan||Thorne, Stan (Preston South)|
|Meacher, Michael||Tilley, John|
|Millan, Rt Hon Bruce||Tinn, James|
|Miller, Dr M. S. (E Kilbride)||Torney, Tom|
|Mitchell, Austin (Grimsby)||Wainwright, E.(Dearne V)|
|Mitchell, R. C. (Soton Itchen)||Watkins, David|
|Morris, Rt Hon A. (W'shawe)||Welsh, Michael|
|Morris, Rt Hon C. (O'shaw)||White, Frank R.|
|Morris, Rt Hon J. (Aberavon)||White, J. (G'gow Pollok)|
|Moyle, Rt Hon Roland||Whitehead, Phillip|
|Mulley, Rt Hon Frederick||Whitlock, William|
|Newens, Stanley||Wigley, Dafydd|
|Oakes, Rt Hon Gordon||Willey, Rt Hon Frederick|
|O'Neill, Martin||Williams, Rt Hon A.(S'sea W)|
|Orme, Rt Hon Stanley||Williams, Rt Hon Mrs (Crosby)|
|Palmer, Arthur||Wilson, Gordon (Dundee E)|
|Park, George||Wilson, William (C'try SE)|
|Parker, John||Winnick, David|
|Parry, Robert||Woodall, Alec|
|Pavitt, Laurie||Woolmer, Kenneth|
|Pendry, Tom||Wright, Sheila|
|Powell, Raymond (Ogmore)||Young, David (Bolton E)|
|Price, C. (Lewisham W)||Tellers for the Ayes:|
|Race, Reg||Mr. George Morton and|
|Richardson, Jo||Mr. Hugh McCartney.|
|Aitken, Jonathan||Blaker, Peter|
|Alexander, Richard||Body, Richard|
|Alison, Rt Hon Michael||Bonsor, Sir Nicholas|
|Ancram, Michael||Boscawen, Hon Robert|
|Arnold, Tom||Bottomley, Peter (W'wich W)|
|Aspinwall, Jack||Bowden, Andrew|
|Atkins, Rt Hon H.(S'thorne)||Boyson, Dr Rhodes|
|Atkins, Robert(Preston N)||Braine, Sir Bernard|
|Atkinson, David (B'm'th,E)||Bright, Graham|
|Baker, Kenneth (St.M'bone)||Brinton, Tim|
|Baker, Nicholas (N Dorset)||Brittan, Rt. Hon. Leon|
|Banks, Robert||Brooke, Hon Peter|
|Beaumont-Dark, Anthony||Brotherton, Michael|
|Bendall, Vivian||Brown, Michael (Brigg & Sc'n)|
|Benyon, Thomas (A'don)||Browne, John (Winchester)|
|Best, Keith||Bruce-Gardyne, John|
|Bevan, David Gilroy||Bryan, Sir Paul|
|Biffen, Rt Hon John||Buchanan-Smith, Rt. Hon. A.|
|Biggs-Davison, Sir John||Buck, Antony|
|Blackburn, John||Budgen, Nick|
|Bulmer, Esmond||Haselhurst, Alan|
|Butcher, John||Hastings, Stephen|
|Cadbury, Jocelyn||Havers, Rt Hon Sir Michael|
|Carlisle, John (Luton West)||Hawkins, Sir Paul|
|Carlisle, Kenneth (Lincoln)||Hawksley, Warren|
|Carlisle, Rt Hon M. (R'c'n)||Hayhoe, Barney|
|Channon, Rt. Hon. Paul||Heddle, John|
|Chapman, Sydney||Henderson, Barry|
|Churchill, W. S.||Heseltine, Rt Hon Michael|
|Clark, Hon A. (Plym'th, S'n)||Hicks, Robert|
|Clark, Sir W. (Croydon S)||Higgins, Rt Hon Terence L.|
|Clarke, Kenneth (Rushcliffe)||Hill, James|
|Cockeram, Eric||Hogg, Hon Douglas (Gr'th'm)|
|Cope, John||Holland, Philip (Carlton)|
|Corrie, John||Hooson, Tom|
|Costain, Sir Albert||Howe, Rt Hon Sir Geoffrey|
|Cranborne, Viscount||Hunt, David (Wirral)|
|Critchley, Julian||Hunt, John (Ravensbourne)|
|Crouch, David||Irvine, Bryant Godman|
|Dickens, Geoffrey||Irving, Charles (Cheltenham)|
|Dorrell, Stephen||Jenkin, Rt Hon Patrick|
|Douglas-Hamilton, Lord J.||Jessel, Toby|
|Dover, Denshore||Johnson Smith, Sir Geoffrey|
|Dunn, Robert (Dartford)||Jopling, Rt Hon Michael|
|Dykes, Hugh||Joseph, Rt Hon Sir Keith|
|Eden, Rt Hon Sir John||Kaberry, Sir Donald|
|Edwards, Rt Hon N. (P'broke)||Kershaw, Sir Anthony|
|Eggar, Tim||Kimball, Sir Marcus|
|Elliott, Sir William||King, Rt Hon Tom|
|Eyre, Reginald||Knight, Mrs Jill|
|Fairgrieve, Sir Russell||Knox, David|
|Faith, Mrs Sheila||Lamont, Norman|
|Farr, John||Lang, Ian|
|Fell, Sir Anthony||Latham, Michael|
|Finsberg, Geoffrey||Lawrence, Ivan|
|Fisher, Sir Nigel||Lawson, Rt Hon Nigel|
|Fletcher, A. (Ed'nb'gh N)||Lee, John|
|Fletcher-Cooke, Sir Charles||Lennox-Boyd, Hon Mark|
|Fookes, Miss Janet||Lester, Jim (Beeston)|
|Forman, Nigel||Lewis, Kenneth (Rutland)|
|Fowler, Rt Hon Norman||Lloyd, Peter (Fareham)|
|Fraser, Peter (South Angus)||Loveridge, John|
|Fry, Peter||Luce, Richard|
|Gardiner, George (Reigate)||Lyell, Nicholas|
|Gardner, Edward (S Fylde)||McCrindle, Robert|
|Garel-Jones, Tristan||Macfarlane, Neil|
|Glyn, Dr Alan||MacGregor, John|
|Goodhart, Sir Philip||MacKay, John (Argyll)|
|Goodhew, Sir Victor||Macmillan, Rt Hon M.|
|Goodlad, Alastair||McNair-Wilson, M. (N'bury)|
|Gorst, John||McNair-Wilson, P. (New F'st)|
|Grant, Anthony (Harrow C)||Madel, David|
|Gray, Hamish||Major, John|
|Greenway, Harry||Marland, Paul|
|Griffiths, Peter Portsm'th N)||Marlow, Antony|
|Grist, Ian||Marten, Rt Hon Neil|
|Gummer, John Selwyn||Maude, Rt Hon Sir Angus|
|Hamilton, Hon A.||Mawby, Ray|
|Hamilton, Michael (Salisbury)||Mawhinney, Dr Brian|
|Hampson, Dr Keith||Maxwell-Hyslop, Robin|
|Hannam, John||Mayhew, Patrick|
|Meyer, Sir Anthony||Shersby, Michael|
|Miller, Hal (B'grove)||Silvester, Fred|
|Mills, Iain (Meriden)||Sims, Roger|
|Mills, Sir Peter (West Devon)||Smith, Dudley|
|Mitchell, David (Besingstoke)||Smith, Tim (Beaconsfield)|
|Moate, Roger||Speller, Tony|
|Monro, Sir Hector||Spence, John|
|Montgomery, Fergus||Spicer, Michael (S Worcs)|
|Moore, John||Sproat, Iain|
|Morgan, Geraint||Squire, Robin|
|Morris, M. (N'hampton S)||Stainton, Keith|
|Morrison, Hon C. (Devizes)||Stanbrook, Ivor|
|Morrison, Hon P. (Chester)||Stanley, John|
|Mudd, David||Steen, Anthony|
|Murphy, Christopher||Stevens, Martin|
|Myles, David||Stewart, A. (E Renfrewshire)|
|Neale, Gerrard||Stewart, Ian (Hitchin)|
|Needham, Richard||Stokes, John|
|Nelson, Anthony||Stradling Thomas, J.|
|Neubert, Michael||Tapsell, Peter|
|Newton, Tony||Taylor, Teddy (S'end E)|
|Onslow, Cranley||Tebbit, Rt Hon Norman|
|Oppenheim, Rt Hon Mrs S.||Temple-Morris, Peter|
|Page, John (Harrow, West)||Thomas, Rt Hon Peter|
|Page, Richard (SW Herts)||Thompson, Donald|
|Parkinson, Rt Hon Cecil||Thorne, Neil (Ilford South)|
|Parris, Matthew||Thornton, Malcolm|
|Patten, John (Oxford)||Townend, John (Bridlington)|
|Pattie, Geoffrey||Trippier, David|
|Pawsey, James||Trotter, Neville|
|Percival, Sir Ian||van Straubenzee, Sir W.|
|Peyton, Rt Hon John||Vaughan, Dr Gerard|
|Pollock, Alexander||Viggers, Peter|
|Porter, Barry||Waddington, David|
|Prentice, Rt Hon Rug||Wakeham, John|
|Price, Sir David (Eastleigh)||Waldegrave, Hon William|
|Proctor, K. Harvey||Walker, B. (Perth)|
|Raison, Rt Hon Timothy||Waller, Gary|
|Rathbone, Tim||Walters, Dennis|
|Rees, Peter (Dover and Deal)||Ward, John|
|Rees-Davies, W. R.||Warren, Kenneth|
|Renton, Tim||Watson, John|
|Rhodes James, Robert||Wells, Bowen|
|Rhys Williams, Sir Brandon||Wells, John (Maidstone)|
|Ridley, Hon Nicholas||Wheeler, John|
|Ridsdale, Sir Julian||Whitelaw, Rt Hon William|
|Rifkind, Malcolm||Whitney, Raymond|
|Rippon, Rt Hon Geoffrey||Wickenden, Keith|
|Roberts, M. (Cardiff NW)||Wiggin, Jerry|
|Roberts, Wyn (Conway)||Wilkinson, John|
|Rossi, Hugh||Williams, D.(Montgomery)|
|Royle, Sir Anthony||Winterton, Nicholas|
|Rumbold, Mrs A. C. R.||Wolfson, Mark|
|Sainsbury, Hon Timothy||Young, Sir George (Acton)|
|St. John-Stevas, Rt Hon N.||Younger, Rt Hon George|
|Shaw, Giles (Pudsey)||Tellers for the Noes:|
|Shepherd, Colin (Hereford)||Mr. Anthony Berry and|
|Shepherd, Richard||Mr. Carol Mather.|
§ Question accordingly negatived.