HC Deb 28 July 1988 vol 138 cc745-56 5.28 am
Mr. Simon Burns (Chelmsford)

I should like to take this opportunity to thank my hon. Friend the Parliamentary Under-Secretary of State for Health for being present at this unearthly hour of the morning, and I apologise for subjecting her to being present for the debate.

The purpose of the debate is not to discuss the funding of the National Health Service but to consider the effect of lotteries in providing additional funds for the Health Service.

People in this country enjoy a justifiably high reputation for giving generously to good causes. The Charities Aid Foundation has calculated that in 1985 there were 160,000 charities in England and Wales, which raised over £12.5 billion for good causes. Just under 9 per cent. of those charities raised money for health-related services.

Since that time, there have been the phenomena of Live Aid, telethons, the Wishing Well appeal and other fund-raising events, which have shown that we are a nation of givers.

In addition to high-profile fund-raising activities, there are different forms of local lotteries across the country, which raise money for a variety of richly deserving causes, including the Health Service.

In my constituency there is the excellent Friends of St. John's hospital, which is always raising funds through lotteries, even if they are called raffles. Two children's intensive-care cots were provided for the local hospital by people in the area joining together and raising money through fetes, collections and raffles.

In the past two months, Trafford health authority has announced the setting up of a local lottery to help finance a breast cancer screening unit, a coronary-prevention programme and a scheme to help children who have special emotional and learning needs. All these enterprises are laudable, but I wonder whether the prizes of dinner for two in an air-raid shelter, a trip down the Manchester sewers or a day at an operating theatre as an observer will appeal to everyone.

While raffles and other fund-raising activities have gone from strength to strength in the past few years, the same cannot be said of local lotteries, which are allowed under the Lotteries and Amusements Act 1976. They must be registered with the Gaming Board for Great Britain or a local authority.

In the past five years, total ticket sales and the number of lotteries have declined dramatically. In 1983–84 there were 4,045 local lotteries registered with the Gaming Board for Great Britain, with total ticket sales of £40.;4 million. In 1987–88 the number had fallen to 1,401 lotteries, with total ticket sales of £21.5 million. These figures show a decline of 76 per cent. and 59 per cent., respectively, over that period.

Why have local lotteries, which raise additional funds for the Health Service and other good causes, fallen off so much while other forms of fund raising have done so well? The answer is that local lotteries are too small to generate enough interest to be a success. They dilute their effects, and the maximum prize money of £2,000 or £6,000 is too low. The fact that draws do not take place for weeks or months after the sale of tickets dilutes excitement, anticipation and interest to the point where most people will not participate.

I am convinced that the answer to that problem, which would bring immense additional financial benefit to the National Health Service, would be a single, legal national lottery. It would help to avoid the problems that we have seen over the past few months. Organisations, such as the National hospital trust, have tried to get round existing lotteries laws and jump the gun. With a properly run national lottery, over £1 billion could be raised for the National Health Service by the fourth year of its operation. That money could be spent on extra equipment, such as kidney machines, computerised axial tomographic scans, intensive-care cots or on providing more accommodation so that parents could live near the hospital when their children had to stay in hospital for more than a day.

A national lottery would harness the deep-seated generosity of the British public and provide invaluable additional funds in a way that would create excitement and the reassurance that if somebody does not win a prize they will at least have the satisfaction of knowing that the money they have lost has gone to a good cause. In that way they would not feel that it was money down the drain. The vast majority of British people are not puritanical. They enjoy a harmless flutter and would warmly welcome an initiative of this nature.

It must not be forgotten that this idea is not particularly new or revolutionary. The first lottery in England was in 1569 to raise money for repairing the Cinque ports and our sea defences.

Mr. Peter Thurnham (Bolton, North-East)

Will my hon. Friend accept that there is more than one sort of lottery in life? Some people are born healthy and others are born unhealthy. Some people who are born with handicaps are able to go to court and come out with £500,000 if they can blame somebody else, but some people come out with nothing and have to carry a burden all their life. Any source of funds that can help the Health Service is of help to them.

Mr. Burns

I am grateful to my hon. Friend for his remarks and I agree with him.

Since 1569 and the first lottery, lotteries have been used to raise money to bring fresh water to London and for the ransom of English slaves in Tunis in 1660. Just as the Sydney opera house was built by lottery money, so was the British museum in the 1750s, with the first prize being a staggering £200,000.

Since then, supporters of national lotteries have ranged from the 1978 Royal Commission on gambling, which concluded that there should be a single national lottery for good causes", to Sir Robin Day, who wrote in The Times in May 1987 that he believed that a national lottery would greatly enrich the national life…and be hugely popular into the bargain. Even the noble Lord Lord Jenkins of Hillhead, in a previous incarnation as Labour's Chancellor of the Exchequer in the 1960s, supported the idea of a national lottery.

A national lottery for the Health Service would be monopolistic. That might seem odd coming from someone like myself who believes passionately in deregulation. However, I have reached that conclusion because all the advice I have been given from directors of state lotteries in New Jersey, Massachusetts, Rhode Island and Ontario is that it is only with a single lottery that the scheme will work properly because it will not dilute the effect of maximising the fund-raising initiative or general excitement generated, which is so important to the success of a lottery.

There should be an independent monitoring body such as the Gaming Board to ensure that the lottery was being run properly and honestly. The day-to-day running of a national lottery should be put out to private tender and a private company with proven expertise in that business should be appointed to run it. The successful company should have a fixed-term contract of three or five years and should provide all the money to finance the investment in setting up the system, as is done in the United States.

I would envisage 20,000 to 25,000 retail outlets using the latest technology and all linked to a central computer to register the sale of tickets and make the draw. Points of sale would be in existing retail outlets such as tobacconists, confectioners, newsagents, supermarkets, corner shops and sub-post offices. It would provide a valuable additional income for those outlets. In certain instances it may help to keep open small shops in rural areas.

There would be a series of games costing either 50p or £1 and would include lotto, which has proved to be so popular in newspapers such as The Sun, and instant games. The lotto games would be drawn daily and weekly with a number of smaller prizes and one large prize at the top of the pyramid. If the large prize was not won, it would be rolled over to the next draw and in that way substantial prizes could be won. Again, that would contribute to the publicity of the scheme and would help generate excitement and encourage people to buy tickets.

Lotto, which is used in some of our national newspapers, and the football pools show that people are attracted by the idea of being able to win a substantial sum of money in one go. Looking at the money that would then go to the National Health Service, the costs would break down as follows. Operating and advertising would initially be no more than 15 per cent. of the total sales revenue per year. That figure should and could be reduced to between 8 and 10 per cent. once the lottery is firmly established. Prize money would be 50 per cent. of sales revenue and the money that would go to the National Health Service would start at 35 per cent. of sales revenue in the first year and rise to 40 per cent. by the fifth year.

The example of other countries—we are the only country in Western Europe that does not have a national lottery—suggests that by the fourth year of operations a British national lottery could raise £1 billion for the Health Service on a total sales revenue of £2.8 billion. That figure is arrived at by projecting the revenue for the Health Service of £246 million in the first year on a sales revenue of £703 million; of £564 million in the second year on a sales revenue of £1.6 billion; and of £836 million in the third year on a sales revenue of £2.2 billion.

If hon. Members doubt those figures, I suggest that they examine the sales revenues that have been generated in other countries. In Spain, in 1986, the sales revenue was £3.5 billion; in the 22 states in America that have lotteries it was £7.3 billion; and the story is similar in France, West Germany and Australia. With that sort of money being created, the Great Ormond street Wishing Well appeal could have received its money in two weeks and Peter Pan's profits could have been used for further items of expenditure in that hospital.

The other issue at stake is that when 1992 arrives and we have a European internal market I understand that there will be nothing to stop lottery tickets from France, Spain, West Germany or anywhere else in the Community being sold legally in this country. If there is no lottery here for the National Health Service or any other good cause, the people who buy those tickets in this country in the hope of winning a prize will be contributing their money to some foreign good cause rather than to one in this country. In my view, that would be a grave error.

I should now like to deal briefly with those critics who claim that a national lottery for the Health Service would encourage gambling or take money from existing fund-raising activities. I accept that there are people who have serious misgivings about gambling, but I wonder how many take part in lotteries when they go to their local church fete, their Conservative garden party, their SLD Chablis and Brie do, or their Labour fund-raising functions. All such functions hold raffles to raise money. It is the most elementary form of lottery in this country, but nobody raises a hair because in the view of the people attending the money is going to a good cause. To my mind, a national lottery for the Health Service would come in the same bracket.

Similarly, people will claim that a national lottery would deter other fund-raising activities. That is true but only with regard to the football pool companies. Over a number of years, their revenue would decline because the number of people who play the football pools would decline correspondingly as they bought tickets in the national lottery instead. Football pools are, to all intents and purposes, a national lottery, but with the difference that, although they pay taxes to the Treasury and donate about £16 million to the football clubs, any profits that they make go into the companies' coffers. Surely that money would be better going to the Health Service. Perhaps there should be a system that complements the football pools with a lottery. People would then have a choice between the two.

Some people also fear that a national lottery would deprive existing charities of funds. I do not share that fear, nor do many charity organisations and organisers with whom I have discussed this. They also believe that a national lottery would simply complement the existing system and in some ways would help the charities because, by encouraging people to give money to good causes, they would be encouraged to give money to a local charity as well. The experience in Massachusetts and Ontario shows that charities do not lose out by the presence of a national lottery.

There is also an argument that the Treasury would try to get its hands on the money and absorb it into general public expenditure. That is a too cynical view of the Treasury and how it behaves. The Treasury would not behave like that, because it would consider the experience in other countries where treasuries or exchequers do not poach the money.

If people are worried that the Treasury would hover over the money like a vulture waiting to grab it, the money can be denied to the Treasury if it is never given to it. The money could be placed in a separate fund, organised by the great and the good who have experience of running charities or of the health care sector. Local hospitals could contact them directly with appeals for money or equipment and hospitals that met the criteria could receive money.

Lotteries have a role to play in providing additional funds for the Health Service. I believe that a single national lottery would fulfil that role, providing a great deal of money for the Health Service and an immeasurable amount of fun for millions of people who would welcome the idea by supporting it and buying the tickets. They would ensure that it was the success that I passionately believe it would be.

5.46 am
Mr. Peter Thurnham (Bolton, North-East)

I congratulate my hon. Friend the Member for Chelmsford (Mr. Burns) on his good fortune in being drawn in the ballot in such a position that his debate has been reached. I also applied for a place in this debate and was drawn at No. 16. However, it is unlikely that I shall be reached.

I welcome all sources of additional funds for the National Health Service. My hon. Friend the Member for Chelmsford made an excellent case for a major lottery. I believe that a large national lottery could stimulate the collection of funds in small local lotteries. However, some people feel that a large national lottery would draw funds away from small local lotteries which have always done so much to raise funds for local hospitals.

In Bolton a great deal of money has been raised for equipment for the local hospitals and for the larger hospitals in the region, such as the Christies hospital for cancer in Manchester. Such small local lotteries could well be stimulated by general interest in a larger lottery for the Health Service.

I welcome the introduction of another source of funds for the Health Service, because health itself is a lottery. The point that I made to my hon. Friend the Member for Chelmsford earlier is that it is all a matter of luck. Some people are born with good health and some without it. Some 2 per cent. of children are born with a registrable handicap. Scientists have said that cancer is, in many cases, a purely random process. It is all a matter of chance whether some of us will suffer from a disease that will kill us while others will live.

About one child in 50 is born with a registrable handicap. Of those, a further one in 50 has a major handicap which presents massive problems to the family when the child is born. Many of the children fail to survive, but with modern medicinal methods increasing numbers survive to become adults. Parents may have been able to cope with young children, but as they grow old they struggle desperately to manage youngsters who may grow physically into adults, but have severe mental handicaps.

If parents cannot manage, their children may have to go into a National Health hospital or into some other institution, or be adopted or fostered by other families who are able to cope. I draw attention to an appeal for funds by the British Agencies for Adoption and Fostering, which says that it costs £2,000 to find new parents for each severely handicapped child. It is appealing for an extra £50,000 during 1988 to meet the increasing demand for its services. Perhaps that is the sort of cause that could benefit from the moneys raised in a national lottery.

Bolton has a better record than most both for care in the community and for the fostering and adoption of not only healthy, but handicapped children. It has been chosen as a pilot area for care in the community.

I should like to address my remarks to the funding of this aspect of the Health Service which would benefit from the moneys raised in a lottery. Care in the community has been the Government's policy for 25 years, but it still causes a great deal of confusion. I was surprised to read that that confusion exists not only in the minds of the public, but in the minds of mandarins. New Society of 18 September 1987 stated that a former DHSS permanent secretary apparently said to his staff: If you are not confused about community care, it shows you are not thinking clearly. I felt then that I had, perhaps, been thinking clearly about this subject all along.

As I said, Bolton has been chosen as a pilot area for care in the community policies. Families who live in the area feel that there is good statutory provision up to the age of 19, but after that there is a cliff edge with little beyond. The families say that they need good respite care so that they can cope for part of the time themselves with the confidence that their handicapped young adult is being properly cared for during the rest of the week.

In Bolton I helped to carry out a survey of families with handicapped children over the age of 19. That showed that many of them are unhappy with the services available to them. If respite care was more readily available, many. parents feel that the respite homes could become more permanent homes as their children become older and they themselves reach the end of their lives.

In my constituency some of the most desperate cases that I have come across fall into that category. I have encouraged parents to form a handicapped action group, and I have helped them to prepare a survey of their needs. After interviews with some 40 carers with very severely handicapped children—that includes people who may have the minds of children, but have the bodies of 30 or 40-year-olds—it was clear that there was a need for much improved services.

My hon. Friend the Member for Chelmsford will be aware of the Audit Commission's report and the Griffiths report, which first reflected the tension which inevitably exists between individuals, the Health Service and other providers in the local area and central Government.

We would all like to know what the Government's response will be to the Griffiths report on care in the community. I hope that the Government will make clear which Minister has responsibility for care in the community, especially after the division of the Department of Health and Social Security.

Madam Deputy Speaker (Miss Betty Boothroyd)

I appreciate the hon. Gentleman's interest in the subject, but at the same time I feel that he is poaching on another hon. Member's debate. If he relates his remarks much more to funding the National Health Service rather than to care in the community, I will hear him out. I ask him to try to relate his comments much more to the subject before us.

Mr. Thurnham

I am grateful for your clarification, Madam Deputy Speaker.

More funding is needed for Health Service provision in this area. The feeling that there is insufficient funding, and of uncertainty about how it is to be provided, has led to confusion about provision for the mentally ill and those who suffer from some mental disorder. There is confusion nationally as well. Funds must be allocated properly.

If additional funds were made available through a lottery, perhaps they could be used to smooth out the difficulties caused by funding by different local departments. The division of the Department of Health and Social Security may add to the confusion. I do not know whether responsibility for care in the community will lie with the Department of Health or with the Department of Social Security, the address of which may now be known as the DOSS house. Perhaps my hon. Friend the Minister has not been able to establish which is responsible in the short time that the two Departments have been established.

No doubt my hon. Friend the Minister will be able to tell us how funds that are made available nationally will be divided between the two Departments. Griffiths said that the problem is essentially local. His solution is to give greater responsibility to local authorities. I take a different view, and ask the Government to carry out a full audit of every area in the country to assess how each area is coping. The audit could be carried out by the Social Services Inspectorate or the Audit Commission, or perhaps both, but the SSI will have to be beefed up for such a task.

I have heard good reports of both bodies, so both could make a contribution. The Government have not said when the Disabled Persons (Services, Consultation and Representation) Act 1986 will be implemented in full. Reports, especially by the SSI, will be needed on sections 7 and 11 when they are implemented. Section 8 has already been implemented. It would be nice to know what advice my right hon. Friend the Secretary of State is to give to local authorities on services that should be provided for the carers.

The survey which has been conducted in my constituency shows considerable dissatisfaction with services provided by the health authority and others. One of the worries is that if someone who suffers from a severe mental disorder is to go to one of the new neighbourhood network homes, he or she must first go to one of the local large mental institutions such as Brockhall or Calderstones to qualify for funds to come out again into a neighbourhood network home. That is bureaucratic nonsense. We must provide for people to go straight from their own family home to a neighbourhood network home without the nightmare of two moves and going into a large institution, which the family will have struggled all their lives to prevent the child from entering. That was one cause of concern.

Another was the fact that a child with a mental disorder could go to Pendlebury children's hospital, but from the age of 19 could not be seen locally and would have to go to a mental health institution to be provided with the necessary drugs or whatever. Great anxiety was expressed in the interviews, and perhaps I may write to my hon. Friend and tell her of the anxieties brought to my attention so that she can be aware of local feelings.

Without taking up further time, I conclude by again thanking my hon. Friend the Member for Chelmsford for affording me time in his debate to draw the attention of the House and the public to some of the problems in this sector of the NHS which could be eased considerably if additional funds were provided by a lottery. I hope that it would be sufficiently flexible to sort out some of the difficult areas in the care-in-the community policy where the bureaucratic nightmare of the provision of funds between all the Departments involved could be overcome by the discretion which could be exercised by the trustees of a large lottery-funded provision.

6.1 am

The Parliamentary Under-Secretary of State for Health (Mrs. Edwina Currie)

This has proved to be an interesting end to a lively week for this Minister and I am grateful to my hon. Friend the Member for Chelmsford (Mr. Burns) for offering us, in a well informed and argued speech, this opportunity for considering once again some of the possible alternative forms of funding for the National Health Service. My hon. Friend will realise that policy on lotteries is a matter for my right hon. Friend the Home Secretary, and I shall ensure that he is aware of the points that have been made today.

My hon. Friend the Member for Bolton, North-East (Mr. Thurnham) did me the courtesy earlier today of discussing some of these matters with me and I hope that he will accept that at present I should like to note his thoughtful remarks. I know that he will send the fruits of some of his research in Bolton to me and I look forward to it. I take his point about exactly how the allocation of responsibilities for aspects of community care will be met, and I assure him that the announcement of ministerial responsibility will be made in due course.

My hon. Friend the Member for Chelmsford mentioned some of the lotteries in the United States. A great deal of research work has gone into this. There is a strong tradition there because some of the earliest English public lotteries were run to support the new colonies. I think that the earliest was for Jamestown, Virginia. Contrary to some of the ecclesiastical history in this country, the colonists in America relied heavily on lotteries to support their churches, which were among the primary beneficiaries. There were a number of other good causes and many of those lotteries trace their history back to that time.

At roughly the same time, European Governments seized on lotteries as sources of new money. Official lotteries were started in the Netherlands in 1726, in Denmark in 1754, in Spain in 1763 and so on, and some of these lotteries are continuing. By the mid-1800s Government lotteries were falling prey to abuse and fraud, as was everything else at that time. Licensing procedures and communications were simply inadequate to the task of ensuring the integrity of the games. Profits were diverted to middle men and to pay bribes, so that the money flowing through to the designated beneficiaries was no longer sufficient to make the operation worthwhile. Therefore, by 1900 there were virtually no official lotteries in the English-speaking world, although they continued un-broken in many parts of Europe. That is why there is such a diversity of experience now between us and Europe.

Today Government lotteries are big business and represent important sources of money to many countries. Governments around the world use lottery profits to the benefit of good causes or to enlarge their general fund. Of all the countries in the developed world, not just western Europe, only the United Kingdom is without a national lottery.

My hon. Friend mentioned some countries in detail. Many people come across the glossy promotions which they give to their national lotteries and think that we should do something similar. They do not realise the cost of prizes and promotion. Administration in some established lotteries usually consumes a large proportion of the takings—sometimes as much as 60 per cent. The net benefit is comparatively modest.

Apart from that, such schemes do not enjoy consistent support. After the first year or so people tend to lose interest and new incentives must be devised to try to maintain support.

I have a little experience of lotteries myself. When I was a councillor in Birmingham, we tried to take the opportunity presented to us by a local lottery, which went very successfully for a while. A substantial sum was raised in the city. However, as with other local lotteries, after a couple of years interest dropped away and so did the money. Fairly rapidly, the administrative costs started to swallow a much larger proportion of the money that was being offered by Birmingham citizens.

My hon. Friend will know that a Royal Commission on gambling reported in 1978. It concluded that it would be inappropriate to use a national lottery to help fund services such as the NHS which have a statutory source of funding. I hope that my hon. Friend will forgive me if some of my remarks, which will show some sympathy for the report, seem a little negative. We always welcome additional ideas, especially for more money for the National Health Service. I suspect, however that a national lottery for the Health Service would neither produce the net return nor be as trouble free as my hon. Friend seems to claim.

Even if the entire estimated net yield from a national lottery were devoted to the National Health Service it would probably continue to contribute only a tiny percentage to the costs of running the service. All sorts of figures have been bandied around, but given that the National Health Service is costing about £23.5 billion a year to run now, we could not expect a lottery to provide more than a tiny percentage. There would also be considerable problems in allocating this comparatively small sum to provide any worthwhile addition to normal funding, with no guarantee of a steady income.

My hon. Friend mentioned the question of European Community countries selling lottery tickets here. However, he should be aware that our legal advice is that the development of the European Community's internal market cannot be used by other countries to set up a national lottery in this country. The Lotteries and Amusements Act 1976 does not permit a national lottery and other countries cannot escape that. I refer my hon. Friend to the answer given by my hon. Friend the Minister of State, Home Office on 8 July: There are no measures in the single market programme at present specifically relating to lotteries and, in their absence, the controls which United Kingdom law places on lotteries would not appear to be affected."—[Official Report, 8 July 1988: Vol. 136, c. 765.]

Mr. Burns

I fully understand my hon. Friend's point, but does she not accept that, although European countries could not set up a national lottery in this country, after 1992 there would be nothing to stop them selling tickets in this country for their own lotteries back home in France, Germany or Spain?

Mrs. Currie

As I said a few moments ago, that is a policy matter for my right hon. Friend the Home Secretary. I understand that it is not legal to sell such lottery tickets and that no change of the law is proposed in 1992. If my hon. Friend will allow me, I shall ensure that my colleagues in the Home Office have their attention drawn to this point. They will be able to give him a more substantive answer than I can.

In the debate on the report of the Royal Commission on 29 October, most of those who spoke were firmly against the idea of a national lottery because of the difficulties that they mentioned of control and bureaucracy and especially because it would take money away from local voluntary effort. Although attitudes have shifted somewhat, those remain our concerns.

There is a genuine fear that money might be diverted from the existing fund-raising effort for local good causes. The Health Services Act 1980 gave health authorities the power to raise money locally, but its provisions did not extend to local lotteries. In 1986–87, the most recent year for which I have figures, the fund-raising activities by the health authorities generated about £3 million, but that was only a small proportion of all their charitable income, which totals nearly £117 million, much of it from legacies and other such sources.

Large sums of money can be, and are being, raised for health care through fund-raising activities and there is no doubt that the success of one-off appeals for funds—for example, the Great Ormond street appeal, which is proving to be very successful—or by national charities is to be commended and welcomed. But that is no indication of how successful a national lottery might be, whether it was organised by the Government or, as my hon. Friend wisely suggested, by some outside body.

Charitable appeals seek unconditional donations and may be only an annual event or, as in the case of Great Ormond street, an event of a generation. A national lottery would be much more frequent, would have to run for a number of years, and would appeal mainly to gambling motives. We are genuinely concerned about the effect that a national lottery would have on many voluntary and charitable groups who do much good work to raise money locally for NHS hospitals.

These people work to low overheads and are mostly volunteers. By choosing a specific fund-raising target, such as the purchase of an advanced piece of equipment, they attract considerable support from the local community. We would not want to see that support undermined by some counteraction, such as a national lottery with its conversely small net return.

I suspect that my hon. Friend's letter dated 30 March 1988 to the present Secretary of State for Social Security recognised this problem, for he wrote saying that such a measure …would help to harness the existing local charitable fund-raising activities". I am not sure what he thought he meant by "harness", but there is at least a slight suspicion that it might mean "compete" or "detract from." One must be aware that that danger would need to be dealt with.

The other side of the issue is that some money could possibly be diverted from other forms of gambling, such as betting or bingo. That may be regarded as a thoroughly desirable change, but the NHS and national Exchequer do rather well out of the tax revenue from gambling; in Britain in 1986–87 it amounted to almost £800 million. The pools alone yield about £250 million in tax a year. A switch in gambling habits to support a national lottery could cause the Government to lose as much or more in taxation as it might receive from a lottery.

Some careful calculations on this have been done and they show that the lottery would not be starting from scratch. We are already getting a great deal of money from the gambling habits of the British people and we would be wary of challenging that behaviour in too dramatic or drastic a way for fear that we might end up losing more than we gained.

We feel that these fears are genuine. For example, an article in The Economist of 9 July 1988 pointed out that bingo clubs felt that they had suffered badly from the introduction of newspaper bingo. Meanwhile, in Spain the national lottery suffered when the gambling laws there were liberalised. That too was pointed out in an article published on 16 January 1988 in The Economist, which seems to take a close interest in these issues. I notice that some of the reforms in Spain did not turn out to be quite what the Spanish Government intended.

The Spanish spend about £13 billion a year on gambling, half of which goes through slot machines. Recently they have tried to reform some of their lottery legislation. For example, says the article, they have a normal diet of three lotteries a week. One of these is the Primitivo, introduced by the Government three years ago as a supposedly simpler and easier-to-play lottery. However, Mr. Carlos Solchaga"— my opposite number there—

the economy minister, recently admitted on national radio that he did not know how to fill in a Primitivo lottery form. So it could not have been quite that easy. The Catalonian Government started two lotteries of their own last year and intend to use some of the money to help finance the Barcelona Olympic games in 1992.

They found in Spain on the restoration of democracy in 1977 that the liberalised gambling laws presented gamblers with a feast of choices, and one result was that the lottery income was damaged. If it works one way, we suspect that it might work the other way as well and that if one were to promote lotteries heavily some of the other income which we already get from other forms of gambling might be damaged. I think that my right hon. Friend the Chancellor would be unwilling to forgo much of the £800 million currently raised from such sources.

We have said many times, and we remain of the view, that we wish to encourage the long-standing tradition of charitable support for the National Health Service. Such support is often aimed at specific goals such as research into or treatment of particular conditions or the provision of improved facilities or new equipment for a particular hospital, and such effort is extremely effective. In that sense, therefore, we should. recognise that the money currently coming in from gambling is already being spent on kidney machines, CAT scanners, parents' accommodation and so on, but we would always encourage and wish to benefit from the enthusiasm, interest and inspiration of local people who wish to express their appreciation of the work of the Health Service by raising money locally. I have been involved in such activities both as a local citizen and as chairman of a health authority and it is very valuable indeed. I often wish that those who object to such activities realised how much personal satisfaction the people involved obtain. It often helps bereaved people to express their appreciation and assuage their grief in this entirely laudable way. We must also take into account the fact that by its very nature income from lotteries is unpredictable and thus not always conducive to the system of longer-term service planning that we are trying to improve in the National Health Service.

My hon. Friend the Member for Chelmsford wrote to my right hon. Friend the present Secretary of State for Social Security asking for lotteries to be considered as part of the review of the National Health Service. He should be aware that lotteries are being discussed rather more broadly by colleagues and if there is anything new to be said about our views it will be said in due course.

I am grateful to my hon. Friend for raising the subject today and to my hon. Friend the Member for Bolton, North-East for setting out once again his thoughtful views on care in the community for people with mental handicap. We shall take the views expressed by both my hon. Friends very seriously and will hope to make progress.