§ 10.1 pm
§ Mr. Bob Cryer (Bradford, South)
On a point of order, Madam Speaker. I understand that motions Nos. 5, 6 and 7 are to be taken simultaneously. They have not yet been considered by the Joint Committee on Statutory Instruments. You will appreciate that the timetabling of these statutory instruments for today is an imposition by the Government, not a request of the Opposition. It is quite unfair of the Government to impose them before the Select Committee set up by the House to examine statutory instruments and report back on any defects has had an opportunity to do its work. I hope that you, Madam Speaker, like me, will deprecate the Government's attitude in what is, in my view, a misuse of time and for denying the Committee the opportunity to do its work.
§ Madam Speaker
I have noted what the hon. Gentleman has said, but he will appreciate that the motions are in order—otherwise, they would not have appeared on the Order Paper for debate today.
§ 10.2 pm
§ Mr. David Blunkett (Sheffield, Brightside)
I beg to move,That an humble Address be presented to Her Majesty, praying that the National Health Service (Optical Charges and Payments) Amendment Regulations 1993 (S.I., 1993, No. 418), dated 2nd March 1993, a copy of which was laid before this House on 2nd March, be annulledI understand that it will be convenient also to consider motion No. 6—That an humble Address be presented to Her Majesty, praying that the National Health Service (Dental Charges) Amendment Regulations 1993 (S.I., 1993, No. 419), dated 2nd March 1993, a copy of which was laid before this House on 2nd March, be annulledand motion No. 7—That an humble Address be presented to Her Majesty, praying that the National Health Service (Charges for Drugs and Appliances) Amendment Regulations 1993 (S.I., 1993, No. 420), dated 2nd March 1993, a copy of which was laid before this House on 2nd March, be annulled.I remind the House of the words you used, Madam Speaker, when you ruled on the manner in which the increases in charges had been announced to the world. You deprecated the way in which the Government had used the procedures of the House to make the announcement, without the opportunity to question Ministers on the regulations. Tonight, I deprecate the fact that the Secretary of State is not here, willing to answer for the Government questions about the increases.
We deprecate the substance of the announcement—the shameful and disgraceful increases in prescription charges, in charges for eye tests and spectacles, and in dental charges. The idea of charging the sick more in order to protect the rich more is a disgraceful act by a Government who have no morality. The increases hit at the most vulnerable people in the country—those who fall just above the income exemption levels or just outside the specific exemption levels. They and others would wish us tonight to question the Secretary of State if she were here, if she had bothered to turn up to defend Government policy, if she were not like Mary Poppins, leaving it to the No. 2 to answer for Government policy and if she were not ducking out of answering for what is a disgraceful act by a Government who know no shame. The Government are 119 prepared, through increased prescriptions, to charge those suffering from cystic fibrosis, arachnoiditis, or chronic asthma or who—week in, week out—must take medication for blood pressure.
When that matter was raised with the Minister of State on a recent edition of BBC's "Question Time", he had the temerity to mislead the studio audience and viewers about whether cystic fibrosis was exempt from charging policy. Only last week I received a letter from a Mr. Brian Mott, who wrote to the Minister asking him to put the record straight. I ask the Minister to do so tonight.
Those young adults—and thankfully there are more of them—who reach the age when they qualify for prescription charges, and who previously would have died but for medical science, are compelled, if they have any income over and above the stringent exemption limits, to pay charges. Is it not time that people suffering from debilitating and life-threatening diseases were exempt from paying? Is it not time that the Government had the courage to admit that they were wrong and to widen the exemption limits? Will the Government allay tonight the fear that, far from increasing the number of prescriptions on the exemption list, they have every intention, either in tomorrow's Budget or in the autumn Budget, of reducing the number? Will the Minister of State make it clear tonight that those rumours are incorrect and that the Government will not tax even more of those who are sick or in need of support or help or of remedial action in order to protect the rich? That is what it amounts to.
One remains untouched by the regulations if one has a good job, good income, good health, good sight and good teeth—and one is lucky enough to have a family and friends who are also blessed in equal proportion in those respects. However, if one is in need of regular prescriptions or medication, one will be dealt with quite differently. Instead of the £14,000 a year gain that those earning more than £70,000 a year enjoy under Conservative tax changes, those most in need are taxed because they happen to be sick.
Raising prescription charges by eight times the rate of inflation—2,100 per cent. since 1979—in the course of 15 changes was done after a promise by the former Prime Minister, the guru of the new right, who on 18 April 1979 said:We have no intention to raise prescription charges.Pardon my bad English, but those were the words of the former Prime Minister. In the same speech she said:Let me make it clear that the Conservative party has no plans for new NHS charges.Will the Minister of State repeat the former Prime Minister's promise?
We are mindful tonight that the Government are on the point of breaking a second promise. Having broken their promise not to increase prescription charges from 20p, they are undoubtedly looking—and have already made it clear from the Treasury—to increase charges so that those receiving NHS treatment will pay for the service rather than taxpayers as a whole.
Why is the Secretary of State not prepared to respond tonight? The answer is simple. Just over 20 years ago, in "Poverty Pamphlet No. 8", she made her position clear. She spelt out why it was that people could not afford the 20p that they were then asked to pay towards their prescriptions. She quoted one mother as saying: 120It's a waste of his time and mine".She was referring to visiting the doctor, because the family could not afford it. The pamphlet went on to say:one harassed mother said 'Eight mothers said that they could not afford the twenty pence prescription charge, and were shopping around the market for home-made cures for minor ailments.'Those are not my words; they are the words of the Secretary of State, who is so timorous—so unusually timorous; so remarkably timorous—that she will not stand up and answer those questions at the end of my speech. I am delighted that the Secretary of State has turned up, albeit late—less like Mary Poppins than like Cinderella at the ball.
Millions of people are concerned about the changes that we are discussing tonight, and about the way in which they are expected to pay the price of the Conservative Government's failure to deal with the economy. The Government have had to raise charges rather than taxes; they are unwilling to fund from general taxation what should rightly be a benefit for those who need medication most. Not only have they failed to keep promises and to protect people who need the occasional prescription; they have failed to protect those who need multiple regular prescriptions, week in, week out. That is why we are praying against the regulations.
A 50p increase per prescription may seem very little to people who earn vast sums out of the hard work of others. It may seem very little to Conservative Members. For many people, however, it will represent a major burden on their income. Three or four prescriptions will constitute a large imposition on those who are struggling just above income support levels, with just enough income to keep their families together. Such people are often on part-time earnings.
§ The Parliamentary Under-Secretary for Health (Mr. Tim Yeo)
What about the poll tax in Sheffield?
§ Mr. Blunkett
All that we get from Conservative Members are cheap remarks about people paying their poll tax. The poll tax and the prescription charge have one thing in common: they do not take from the rich, but they load disadvantages on to the poor. They are an alternative form of taxation. The most regressive taxation taxes those in specific need of medication while alleviating the position of those who could well afford to pay for that medication.
It is worse than that, however. It is nonsensical in itself for someone receiving one form of exemption to be exempt from everything, and for those who are not exempt to have to pay everything. Why should people suffering from cystic fibrosis not be exempt, while those suffering from ailments that are already exempt find that everything else falls into place?
Only this morning, I received a letter from a Mrs. Forbes of Aberdeen. Her son, aged 28, has cystic fibrosis, and is struggling for life. She is fortunate, because he is exempt—not because of the major life-threatening ailment from which he suffers, but because of a related problem that enables him to receive prescriptions. It is nonsensical; everyone knows that. The system needs to be changed, and the amounts that people are paying need to be frozen. Tonight, however, we are debating a 50p increase, and the draconian weighting of that increase on those who can least afford it.
Why are we debating the issue on the eve of the Budget? The answer is simple: the Government are not prepared 121 —as they were not when they made the announcement—to stand up in the light of day and the public arena, knowing that they will be reported, and argue their case. They know that that case is wrong; they know that the charge should not be levied, and that they are being unfair to those who are least able to defend themselves.
§ The Minister for Health (Dr. Brian Mawhinney)
From 1 April the National Health Service (Charges for Drugs and Appliances) Amendment Regulations 1993, the National Health Service (Dental Charges) Amendment Regulations 1993 and their Scottish equivalents introduce responsible increases in NHS prescription charges and in the maximum and proportional charges for dental treatment. Those charges will be paid only by people who can afford to contribute to the cost of their treatment and medication.
The existing wide-ranging exemptions and remission for people who cannot afford prescription charges are unchanged. No child, no expectant or nursing mother, no state retirement pensioner and no one on income support or family credit pays a charge. They and the people who get free prescriptions because they are exempt on medical grounds or are on a low income are unaffected by the 50p increase.
I shall set the regulations in context. NHS spending is at an all-time high. The gross provision for 1993–94 is over £37 billion, a real terms increase over this year and up by 61 per cent. in real terms since 1978–79. To put it another way, we are spending just over £100 million a day on the national health service. That amounts to £649 for every man, woman and child compared in equivalent constant prices with £417 when the last Labour Government left office.
In 1992–93, £19 of every £20 spent on the NHS will be met from taxes and national insurance contributions. It is estimated that less than 4 per cent. will be met from all the charges in the NHS put together. Nevertheless, that 4 per cent. is not insignificant in terms of better patient care. From 1 April the proposed increase in prescription charges from £3.75 to £4.25 will raise about £278 million a year for the NHS in England alone. Opposition Members may be interested to know that that would fund the building of about seven 300-bed district general hospitals and their running costs, or over 70,000 hip replacement operations or more than 45,000 coronary artery bypass grafts.
§ Mr. Thomas Graham (Renfrew, West and Inverclyde)
Not long ago I wrote to the Minister about a constituent with a chronic disease. The reply that I got only a week or so ago was basically that if the Government gave her an exemption they would need to exempt people with cancer, with dialysis problems, with diabetes—the lot. Does not the Minister realise that our hospital bill will increase if people cannot afford the medicine that will keep them out of hospital? An increase of 50p will deny proper medicine to people on low wages and they will end up in hospital costing £600 to £2,000 a week. Is that the way that the Minister want to go?
§ Dr. Mawhinney
Of course, there must be some truth in the hon. Gentleman's general proposition, but he was not listening to me. I said that those on low income were exempt from charges. Therefore, the hon. Gentleman's point is not valid.
122 On average, people who pay prescription charges receive six items a year on prescription. The new prescription charge, which is still much less than the average total cost of a prescribed item to the NHS, will cost such people £3 a year more than they are paying this year. For the minority who pay charges and who are heavier than average users of prescribed items, the prescription prepayment certificates offer real savings. The new proposed cost of four-monthly and annual prescription prepayment certificates will be £22 and £60 respectively. As hon. Members know, other charges will be increased by a percentage similar to the rise in prescription charges.
Perhaps Opposition Members would like to suggest which of our planned improvements in NHS services next year they would like to cut to make up the shortfall. Such cuts would take place without providing any benefit for the least-well-off because they do not pay prescription charges. The charging structure recognises people's differing ability to pay. Four out of every five prescribed items are now dispensed free—more than at any time since the Labour Government reintroduced prescription charges in 1968. When Labour last left power in 1979, only three out of five prescriptions were dispensed free.
We propose to increase the maximum charge for a course of dental treatment which starts on or after 1 April this year from £225 to £250. I noticed that the hon. Member for Sheffield, Brightside (Mr. Blunkett) did not mention dental charges, so I am grateful to him for his support on this aspect of the regulations. That increase will affect less than 1 per cent. of adult courses of treatment. At the same time, the proportion that a patient contributes to the cost of a course of dental treatment will increase from 75 to 80 per cent. Increases in the proportional and maximum charges for dental treatment will raise an estimated £17 million for the national health service in England in 1993–94 and about £25 million in a full year. And £25 million is equivalent to the annual cost of about 250 general dental practitioners.
As with prescription charges, only those who can afford to do so are asked to contribute towards the cost of their dental treatment. All treatment to those under 18 years of age is free and some 21 per cent. of adult courses of treatment are free. Many others on low incomes get treatment at reduced rates. We are seeking to encourage a positive attitude and changed habits to dental care through the provision of free dental treatment for children and the continuing care which the new contract for dentists introduced for all adults.
Since the introduction of the new contract, more people are coming forward for dental treatment and registering with a dentist. Adult registrations at 31 January were more than 21 million, an increase of 3.3 per cent. since 1 July 1992. More courses of treatment are being undertaken on these people. That does not sound to me like a system under which people are so scared of charges that they put off going to the dentist.
Finally, the National Health Service (Optical Charges and Payments) Amendment Regulations 1993, together with, their Scottish equivalents, increase the value of optical vouchers by an average of 2.75 per cent. Once again this increase is in excess of the current rate of inflation and should preserve the real terms value of the vouchers. About 34 per cent. of the population are entitled to optical vouchers, including children under 16, students under 19, people on income support or family credit, 123 others on low incomes and people who need certain complex lenses. Expenditure on the optical voucher scheme costs the NHS about £100 million a year.
§ Mr. Jimmy Boyce (Rotherham)
Will the Minister be kind enough to explain to the House what he means by "low income" before people have to pay?
§ Dr. Mawhinney
I think that the hon. Gentleman knows the answer to that question. It relates to qualification for existing social security benefits.
Last year, from 1 April, we carried out a wholesale redefinition of voucher bands. This increased the value of voucher A, the most common voucher, by over 20 per cent. and the majority of customers are considerably better off.
The hon. Member for Brightside set out the Opposition's current position on prescription charges. Year by year during the 1980s the Opposition attacked the Government for asking the limited number of people who actually pay prescription charges to contribute more. Year by year, the hon. Member for Livingston (Mr. Cook) attempted to convince the world that he was outraged. Year by year he won his sound bite on the evening news, so when the time came to write the election manifestos, Conservative Members rushed to have a look at what the Opposition would say and see how they would use this opportunity to put their principles into practice. We looked for their pledge to reverse the rises in prescription charges which they had so vehemently opposed. We looked in vain. Labour devoted two pages of its manifesto to health, but, in all that space, it had precisely nothing to say about prescription charges. The hon. Member for Brightside had nothing to say about them this evening. He was but a poor, pale imitation of the hon. Member for Livingston—and we know where he progressed to.
Of course, in their manifesto, the Opposition were willing to remove £500 million from patient care to fund the minimum wage proposals, so beloved of their union sponsors, but even they baulked at having to remove another £240 million by scrapping prescription charges. Unless the hon. Member for Brightside is able to do better than he has this evening, the pages of his speech and all the words that he will pour forth in sound bites tomorrow and in the weeks to come will wind up in the same paper shredder as the words of the hon. Member for Livingston. The hon. Member for Brightside is trying to have it both ways—outrage but no guts to make a commitment that he would reverse the changes that we are announcing tonight.
All Governments have to make choices. We are committed to increasing spending on the NHS and our record is significantly better that than of the Opposition. However, we also have to balance the needs of the service against finite resources. Available resources should be directed at the greater need. The charges for dental treatment and prescriptions, which will apply from 1 April, are a small but nevertheless important contribution towards the funding of the NHS and will continue to be paid only by those who can afford that contribution.
The public understand the usefullness of a limited additional contribution to the NHS from those who can afford it. Their concern is not to engage in party political point scoring, especially of the spurious type so beloved of 124 Labour politicians, but to have the best possible national health service. Those who share the public concern should vote against the motions.
§ Ms Liz Lynne (Rochdale)
I welcome the chance to debate the issues, but not the increases in prescription or dental charges. I welcome the increase in the value of the voucher, although' it does not go far enough.
This is the 15th rise in prescription charges since 1979. There has been a horrendous increase of 2,000 per cent., a 13 per cent. increase on current levels and, at the same time, an increase of only 1 per cent. in real terms in the whole national health service budget. How can the Government justify a 13 per cent. increase in prescription charges but a real terms increase of only 1 per cent. in the NHS budget? So much for the NHS being free at the point of delivery.
How many more people will be put off going to their general practitioner for a prescription? The pharmaceutical industry has said that increases could be dangerous because many patients will have to choose between which prescription they collect. I know of people in my constituency who have already had to choose between painkillers and antibiotics. Of course, they opt for the painkillers because they want to kill the pain, but they are storing up problems for the future. If they do not take the antibiotics, they will cause long-term problems which will cost the health service more. The Government's attitude is, therefore, very short-sighted.
The Minister has just said that those who cannot afford to pay will not pay, but I disagree. Many people on very low incomes will not be able to afford to pay. They will not be included in the exemptions and they are not included at the moment. For example, students who receive loans are not exempt. Many students do not get free prescriptions, free eye tests or any of the other free services that they used to get. Certain people on invalidity benefit, for example, will not get free prescriptions.
The citizens advice bureaux brought the case of a constituent to my attention. He has to have medication to thin his blood and he cannot get that medication free. The medical exemptions were probably good enough when they were drawn up in 1968, but they must now be changed. I urge the Government to look at the matter seriously and to extend the list of medical exemptions to cover the advances in medicine in the past few years. My constituent might then be included in such a list of exemptions.
I know that the drugs bill is large—nobody disputes that. I know that the Government have said that we cannot afford the present drugs bill. Perhaps we should consider other areas, such as over-prescribing. I know that the Minister has done some work on that, which I welcome. Some general practitioners over-prescribe and issue repeat prescriptions far too often. GPs should also consider referring people for alternative medicine instead of putting them on to particular drugs. I understand that GPs can already do that under extra-contractual referrals, but I believe that many GPs are not aware that they can do that and I should like the Government to make GPs more aware that alternative medicine is available. That could mean that a patient could be referred for chiropractic, for example, instead of being given drugs.
125 Dental charges are up by 6.7 per cent. I know that that increase is not as great as the increase in prescription charges and I suppose that we should be grateful for small mercies; personally, I do not think that we should be. The patient's contribution is up from 75 per cent. to 80 per cent. As the Minister said, the maximum payable has increased from £225 to £250. In the past few years, NHS dentistry has been damaged beyond repair. Some dentists already refuse to take NHS patients. The regulations will make it even more difficult for patients to get treatment.
I have heard of a child in my constituency—I am looking into the case at the moment, so I do not know how true it is—who has been refused NHS treatment for a brace. She is a fairly young child and her father has brought the case to my attention. These regulations will not help patients to go to the dentist. Many people refuse to go to the dentist now for check-ups because they cannot afford it.
Then we turn to vouchers for glasses. The Federation of Ophthalmic and Dispensing Opticians, in a survey in 1992, found that the cheapest spectacles were £38.55 inclusive of VAT. The voucher was £23.70 and has gone up to £24.40. Where is the £14.15 to come from for those who need glasses and who are supposed to be getting them free? The voucher does not cover the cost of the spectacles.
A mother in my constituency has talked for the past few years to me and to anyone who will listen about her daughter, who keeps falling and breaking her glasses. She can get them repaired, but the voucher does not cover the cost completely. Each time her daughter falls and breaks her spectacles, she has to go to the optician and top up the money over and above the voucher. That is not good enough.
§ Dr. Mawhinney
May I point out to the hon. Lady that the most recent survey of spectacle retailers showed that 50 per cent. of retailers were able to offer spectacles at within the voucher value?
§ Mr. Graham
Does the hon. Lady realise that I represent a rural constituency and that if my people had to keep running into the centre of town for prescriptions, they would pay pounds and pounds in transport costs—if they were lucky enough to get a bus in the first place?
§ Ms Lynne
I take the hon. Gentleman's point.
The Under-Secretary of State for Health said in 1991 that people would not have to top up. I gather that he meant that they would not have to top up at all. On 11 December 1991, in the Committee that considered the National Health Service regulations, the Under-Secretary said:The hon. Gentleman also sought reassurance that voucher values would be sufficient to permit anyone holding a voucher to have access to the purchase of spectacles without needing to pay a supplement. That is, indeed, the Government's view."—[Official Report, Second Standing Committee on Statutory Instruments, &c., 11 December 1991; c. 14.]Obviously it is not the Government's view any more, because the Minister refers to a figure of 50 per cent. Do the Minister and the Secretary of State think that the vouchers will cover costs in all cases? I doubt whether the hon. Gentleman could stand up at the Dispatch Box and say that, in every case, the voucher would cover the cost of spectacles.
126 There is real fear that people will not be able to get the treatment that they need. They will not be able to get their prescriptions. In many cases, they will not be able to get the dental care or the eye care that they need.
On 11 March 1993, Virginia Bottomley herself—[HON. MEMBERS: "Order"."]—the Secretary of State for Health said:above all, the NHS will continue to offer care on the basis of need, not ability to pay.I hope that the Government take that into account, because if the regulations go through tonight, that will certainly not be the case.
§ Mr. Jerry Hayes (Harlow)
It is always a joy to follow the hon. Member for Rochdale (Ms Lynne). Whatever she tells the House, she tells it with great aplomb. The trouble is that she never tells us very much. It was most interesting to hear what the hon. Lady had to say. I refer her to a document that her party published in February 1992, entitled "Restoring the Nation's Health". The sum total of the Liberal Democrats' views on prescription charges can be paraphrased thus: the total abolition of charges is not necessarily desirable. So I ask the hon. Lady, "What is the Liberal Democrats' policy?"
Never mind the Liberal Democrats; let us deal with those on the Opposition Front Bench. A great thing happened to this nation last week. Mr. Yentob of the BBC made the cataclysmic announcement that "Eldorado" would he taken from our screens. Some of us occasionally switched on at 7 o'clock in the evening and watched totally inadequate, totally hopeless people limping from crisis to crisis, without any idea of what on earth they were doing. Where will we look now to make us look adequate? I suggest that we look at the health team on the Opposition Front Bench. I cannot attack their policy on prescriptions because I do not know what their policy is, and if I do not know what their policy is, I know that they do not know what their policy is.
In the run-up to the general election, the hon. Member for Livingston (Mr. Cook) said that Labour would freeze prescription charges and that, over time, they would decline in value.
§ Mr. Paul Flynn (Newport, West)
On a point of order, Madam Deputy Speaker. This is a specific debate about the Government's proposals and has nothing to do with Opposition policies. Many hon. Members wish to catch your eye to talk about the specific proposals before us. The hon. Member for Harlow (Mr. Hayes) has spoken for some minutes now without mentioning the Government's proposals.
§ Madam Deputy Speaker (Dame Janet Fookes)
I usually allow a little latitude, but the word is "little". I am sure that that point will be taken on board.
§ Mr. Hayes
I always obey your rulings in these matters, Madam Deputy Speaker. In my constituency of Harlow, we live in a nuclear free zone. Obviously the Opposition Front Bench lives in a policy-free zone.
I was simply trying to constrast what Opposition Members have been saying with Government policy. That is a perfectly fair and reasonable thing to do. The Opposition spokesman did not tell us what the Opposition were going to do.
§ Mr. Hayes
The Opposition are praying against the regulations. They should have the courage to tell us what they are going to do. The House and the general public deserve an answer, but we have not heard an answer tonight.
What did we hear from the hon. Member for Sheffield, Brightside (Mr. Blunkett) tonight? Perhaps he, or one of his colleagues, will tell us later what the Opposition will do. Would they freeze prescription charges or abolish them? Would they bring more money into the health service? Or is the hon. Gentleman going to continue, as the press reports that he is, to attack my right hon. Friend the Secretary of State for Health?
In the Financial Times the hon. Member for Brightside accused my right hon. Friend the Secretary of State for Health for caving in to the Treasury. He said that the Government were prepared to tax the sick, not the rich. Therefore, according to the hon. Member for Brightside, my right hon. Friend is caving in to the Treasury. The proposals in the regulations involve £278 million. Is that money going to the Treasury? No, it is going directly to health care and directly to the patients. As my hon. Friend the Minister said so eloquently a moment ago, it will go to hospitals, into coronary bypasses and into reduced waiting lists. [Interruption.] I am sorry. The hon. Member for Brightside may have said something about a policy. Is he attacking that amount of money?
The Opposition always talk about cuts. I talk about them as well. I remember the cuts in the pay of doctors and nurses under the last Labour Government.
§ Madam Deputy Speaker
Order. The subjects of tonight's debate are the regulations that make increases. Those regulations are being prayed against. The hon. Member for Harlow (Mr. Hayes) should consider the pros and cons of the proposals.
§ Mr. Hayes
You are absolutely right, Madam Deputy Speaker. However, I thought it only fair, right and proper to put the record straight. The trouble is that the Opposition have no policy that we can attack. They have all the balance of a wet blancmange.
Hon. Members have asked me to consider the achievements in the drugs budget. We are talking about more than £2.3 billion being spent every year. Opposition Members said that we are taxing the sick and the poor. Four out of five prescriptions are free. They are free if one is pregnant, a child, elderly, or in receipt of income support. The provisions are the most generous in the western world. If the Opposition had any decency or honesty, they would admit that.
I do not want to provoke any of my Conservative colleagues who might be regarded as the gnomes of Maastricht—mercifully they are not here tonight—but perhaps I can refer to Europe. The Opposition are great at praying in aid what happens in Europe. Let us consider what happens in Europe.
§ Mr. Hayes
The hon. Gentleman may say, "Order", but my point is directly relevant to the debate. The Opposition tell us what happens in Europe and what should happen in this country in relation to Europe. They tell us how much money we should be spending vis-a-vis Europe. Perhaps I 128 can remind hon. Members what happens in Europe. The German Government intend to reduce the drugs budget by 5 per cent. It is the intention of this Government——
§ Mr. Kevin Hughes (Doncaster, North)
On a point of order, Madam Deputy Speaker. Is the hon. Member for Harlow (Mr. Hayes) trying to address the 50p increase in prescription charges that the Government have imposed on the people of this country or is he auditioning for a part in "Eldorado"?
§ Mr. Hayes
I am deeply grateful for that.
We are talking about a 50p increase for many people who are not poor, frail or most in need. It is the equivalent of two copies of the Daily Mirror, if anyone in his right mind wishes to read the Daily Mirror and I am not suggesting that the hon. Member for Doncaster, North (Mr. Hughes) is in his right mind.
Spain and Britain are the only EC countries to exempt pensioners from prescription charges. German pensioners have 6.25 of their state pension deducted. In socialist France, with 3 million unemployed, pensioners are expected to pay £4.60p a day for hospital charges, and in Belgium pensioners pay up to 25 per cent. of a doctor's consultation fee. What are the Opposition praying against? A 50p increase in the charge? We are talking about £278 million that is going not into the hands of the Treasury but directly into patient care. I cannot understand, and I doubt whether the general public can possibly comprehend, what on earth they are complaining about.
§ Mrs. Alice Mahon (Halifax)
I wish to add my voice to those who object to a tax on the sick. I do not think that the poor or sick will gain any comfort from the speech of the hon. Member for Harlow (Mr. Hayes), and certainly not from the Minister's hard and unfeeling speech. He presented an almost Dickensian figure at the Dispatch Box. Far from protecting those who are on low incomes and need medication, the Government have placed an intolerable burden on them. The Minister tried to defend the indefensible, which probably accounted for his rather heartless rhetoric.
Fourteen months ago, I introduced the Health Benefits Bill, which would have exempted from prescription charges all people in receipt of other benefits. Conservative Members do not realise or recognise that people who claim poll tax benefit, housing benefit, invalidity benefit or disablement benefit are not entitled to free prescriptions, yet their low incomes are recognised by the fact that they need help with such basic needs as housing. The Minister was challenged about the level of incomes of people who are in receipt of benefits, but he did not have an idea. I do not think that he lives in the same world as anybody else.
My Bill would have exempted from prescription charges anybody who was diagnosed as chronically sick. It seems eminently sensible that if people have chronic illnesses the least a caring society should do is to ensure that they have free medication. It would have exempted people requiring long-term medication, to whom my hon. Friend the Member for Sheffield, Brightside (Mr. Blunkett) referred, such as those with chronic bowel disease. A constituent of mine has Crohn's disease. He 129 received an increase in benefit of just 8 per cent., which took him above the level at which he could get free prescriptions. He needs them weekly—all the time, in fact. So he ended up with a cut in his weekly income of £3.
I wish that the Minister had taken more notice of my Bill, which would have taken care of such people. Those with asthma, multiple sclerosis and cancer do not automatically get free prescriptions.
One of the saddest categories of people whom the Government continually ignore is that of the mentally ill. I have a great deal of contact with a self-help group in Halifax. The group is for people who have suffered from a mental illness, and it is called Calderdale Survivors Speak Out. Its members would clearly tell the Minister about their friends who, when faced with electricity and other bills, often pay the bills but do without their medication. They then get progressively worse and end up back in hospital, costing the system a lot more than if they had had free prescriptions in the first place. It is obvious to all that such people will be badly affected by the increase proposed tonight.
The Bill that I presented drew attention to the help that may be derived from the health benefits scheme. Those benefits are for dental and optical charges, and for travel costs—but they offer little or no help with prescriptions. In practice, the scheme does not meet its objectives. It is terribly bureaucratic, and thousands of people are deterred from claiming health benefits because of the scheme's complexity.
I sent the Minister a copy of the form that people are expected to fill in to claim back small amounts. Its 20 pages contain 50 questions. Not surprisingly, there was no reply from the Minister.
In reply to a question from a Conservative Member almost two years ago, the Secretary of State for Health promised:During 1991, the Department of Health will undertake a review of the administration of the low income scheme. The review will produce proposals by the end of 1991 for simplifying the claim form AG1 and other administrative procedures."—[Official Report, 22 May 1991; Vol. 191, c. 530.]Nearly two years on, we are still waiting for the Secretary of State to do something about this complex and wasteful system.
The system has failed. Almost 1 million people a year try to get help through it. The National Association of Citizens Advice Bureaux said last year that almost 100,000 people a year go to them for help to fill in the forms. Even so, 35 per cent. of all forms are sent back to the claimants because they are incorrectly completed.
The Government have a duty to tell us tonight what they intend to do about the health benefits scheme. It offers some help, but it is so complex that it is failing to help those who need it most.
I felt ashamed this evening to hear the Minister trying to defend the £4.25 that the Government now charge for each prescription. The Minister talked about the last Labour Government. The charge was 20p in 1979. The Minister cannot defend an increase that attacks the most vulnerable people in society—who go without the treatments that they require because the Government have callously decided to tax the sick.
§ Mr. Geoffrey Dickens (Littleborough and Saddleworth)
There is no question but that our national health service is the finest in the world. It is the envy of the world and many people from all over the world come here to examine in great detail the way in which we handle it. Perhaps because it is the best in the world, it is one of the most costly and the taxpayer does not have a bottomless pit of money. The Government do not have any money at all. What they have is taxpayers' money, which they have to circulate——
§ Mr. Dickens
I am not being stupid. The Government have to recirculate the money and spend it in a wise way, to the benefit of everyone.
I suspect that, if I were in opposition, I might be praying against the regulations. However, I would not be doing it for genuine reasons—I would be doing it to make political advantage, as the Opposition are doing this evening. If only four out of five people pay for prescriptions, aid must be targeted on those in greatest need. It is marvellous that not one pensioner nor person on income support has to pay for a prescription.
I feel sorry for some people—those who are in the narrow band of the poverty trap. They are considered too rich to get any benefits, but they are often a little too poor to keep paying ever-increasing prices. We appreciate that a line has to be drawn somewhere. I often used to get letters from people saying that they would willingly pay more tax to do something about this or that. I would write saying that my local hospital would be grateful to receive a donation towards various units, but those units never got any money from my constituents. Sometimes, such claims are false.
People are nervous about their health and they should be pleased that we have such a wonderful health service. I do not want to make a long contribution, because I know that some—[HON. MEMBERS: "Go on!"] Well, in that case, I will. Many hon. Members wish to speak. We have had some thoughtful contributions.
I congratulate my very dear friends the Secretary of State and the Minister for Health on what they are doing for the health service. Many of our reforms, which cost an awful lot of money, meet initial opposition. All the medics were up in arms and against reforms, but now they are rushing to be budget holders and to be part of an NHS trust. They can see the benefits, but those benefits have to be paid for. As the Secretary of State and the Minister realise that throwing resources at everything is not always the answer, they have introduced streamlining and efficiency. That is why we have such a great health service.
Each and every hon. Member should be honest. We have something very precious. They must not whinge and run it down. If those who can afford have to pay a little more, they should remember that the money will not go to build motorways. It will go into the NHS for further patient care. Who knows, the constituents who write to Opposition Members may need that care and they will thank God that we have a health service. Perhaps they will even thank Him that we charge those who can pay just a little more. We should remember that some people can get a season ticket. [HON. MEMBERS: "Oh!"] Hon. Members asked me to continue.
131 You know me and my generous disposition, Madam Deputy Speaker. I would not take advantage of all those who want to continue to rubbish the health service. One day, Opposition Members, or their constituents, might be glad of the NHS. They should thank God—I know that they are praying against the regulations—that they are fortunate enough to live in the United Kingdom, comforted by a health service second to none—I defy anybody to tell me of a better one—paid for by the taxpayer. He pays for new techniques, new operations and procedures that were not even thought of only a few years ago. We are delivering them now.
Hon. Members should remember that ours is the best health service in the world. I shall now be fair and let others speak in the debate.
§ 11 pm
§ Mr. Jimmy Boyce (Rotherham)
The hon. Member for Harlow (Mr. Hayes), who is no longer in his place, was clowning, as usual. His feet were planted firmly in the air. The hon. Member for Littleborough and Saddleworth (Mr. Dickens) followed the example of his hon. Friend and we heard the same nonsensical rhetoric.
The Opposition are not arguing that the moneys collected from prescription charges will not go to the health service. We are not saying that they will go to the Treasury. We are arguing that the moneys, if necessary, should come from the Treasury. We are engaged in an economic debate because with the rundown in the economy the health service can no longer be funded properly. We are not talking about where the moneys that will be collected from the outrageous increases will be spent. We simply say that the increases are outrageous. After all, we are faced with a current charge of £3.75.
I take four forms of medication a day for a minor ailment. Under the Government's proposal, I would be faced with a charge of £17. I am extremely fortunate because I can afford that.
§ Dr. Mawhinney
If the hon. Gentleman cared to buy a season ticket, the charge would be £22 for three months.
§ Mr. Boyce
That is right. I could afford that. In fact, I have a season ticket. The Minister should understand, however, that some people would not be able to afford a charge of £17, let alone £22. People are having to make choices and I doubt whether they are going without their medicine. Indeed, they could not do so. That means that they do not spend on other things. If the poll tax suffers—their payments—they will be hounded. They will be put under pressure for the non-payment of an iniquitous tax. We know that all Conservative Members voted in favour of that pernicious tax and imposed it on working people.
Earlier, I asked the Minister about the level of benefits. The hon. Gentleman said that I should be aware of it. I am only too well aware. After all, it was a rhetorical question. We are talking about those who are slightly above income support level, who are the poorest in society. I knew the answer to my question.
There will be a time of reckoning. The time will come when the Conservative party will have to account for all the misery that it has inflicted on ordinary people. If the Government want to find the money without increasing 132 charges—my opinion may not be shared by all my right hon. and hon. Friends—they should scrap the nuclear arms programme.
§ 11.4 pm
§ Mr. Thomas Graham (Renfrew, West and Inverclyde)
I am astounded that the poor and the sick of our nation are expected to pay increased prescription charges. I never thought that the Government would have the audacity once again to increase the charges. I listened to the hon. Member for Harlow (Mr. Hayes), and I thought that I was listening to Jean Harlow, an actress. As for the hon. Member for Littleborough and Saddleworth (Mr. Dickens), what an example we present of fat, healthy people. However, we have £31,000 a year and can afford the increase in charges. Many people in my constituency cannot pay the current prescription charges.
I have written to the Department on a number of occasions, seeking exemptions for chronically sick constituents. The answers that I received were horrific; they were insensitive to the problems of sick people. How can any Health Minister say that he will not give an exemption to a chronically sick person? How can he say that he will not give an exemption to someone suffering from cancer?
A woman constituent wrote to me about her husband, who was suffering from cancer. She had to buy £16 worth of medicine a week. She did everything possible to give her husband aid and succour in his dying days. I wrote to the Minister about that case. How, for God's sake, can we inflict such pain and suffering on the sick? Can hon. Members imagine being sick, going to the chemist with four prescriptions and saying, "Pick the one I don't need"? A doctor—a professional with the skills and ability at least to try to make someone well—has written four prescriptions, but the patient cannot afford them. Hang your head in shame, Minister——
§ Madam Deputy Speaker
Order. I know that the hon. Gentleman feels strongly, but would he please remember that he is addressing me, not the Minister?
§ Mr. Graham
I apologise, Madam Deputy Speaker. Unfortunately, such matters get me wound up. If I do not fight for the sick and disabled, who will?
The Minister cannot get away with simply saying that the orders are the way to save £300 million in the health service. There is no saving when people are being denied proper medication because they cannot afford it. The Government should be trying to improve the provision of medication if there is a problem—and there is. There is a massive problem with thousands and thousands of constituents not getting the medication that they need. People are already suffering because of low pay; the regulations will make matters worse.
I do not want to take up parliamentary time. I am becoming so angry that I am likely to breach parliamentary order and privilege. My sick constituents deserve better from the Government. The hon. Member for Littleborough and Saddleworth said that there was not a bottomless pit. These regulations should be named the Bottomley pit. It is a pit of the Government seeking once again to tax the sick in our community.
There should be a new regime to look after the health of Great Britain, and under no circumstances should it be that lot sitting in the Department of Health. We do not 133 want anyone—Tory, Liberal, nationalist or Labour voters—to suffer the indignity of a Government driven continually by the market place, by a free market. At the end of the day, millions of people are unemployed and thousands are on low pay. We sat for weeks and weeks listening to the Government talking about a trade union reform Bill. They abolished the wages councils, so we will see the spread of low pay, which will drive people further into bad health and sickness. They will not be able to recover because they will not have enough money to pay for prescriptions—and that will be because of the Government's unthinking, uncaring and sheer heartless attitude.
§ 11.9 pm
§ Mr. John Gunnell (Morley and Leeds, South)
Even though I have been in the House only a short time, I realise that it is traditional to refer to the remarks of the previous speaker. I can truthfully say that I have never been so strongly in agreement with the speaker who immediately preceded me, my hon. Friend the Member for Renfrew, West and Inverclyde (Mr. Graham), as I am now. I will emphasise a number of his points and comment on tonight's announcement and our reaction to it. It is worth remarking on the nature of the announcement, the manner in which it was made, and the Government's defence—although I was able to agree with my hon. Friend that the Government have ceased to defend any of their proposals. The announcement was made in a matter-of-fact way, as if it were just a 50p increase. The point has already been made that prescription charges have in fact increased 2,000 per cent. under successive Conservative Governments.
The 50p rise in prescription charges represents a 13.33 percentage increase. The Government constantly boast about low inflation and the level of wage increases that should be sought—but the charges represent a 13 per cent. increase and the Government do not bat an eyelid. They think that it should be accepted without protest and query the fuss that we are making tonight.
The announcement was cynical and was delivered as though it was of little importance to anyone. The information was just slipped out. We learnt of the increase a week ago through a parliamentary procedure that did not involve a public announcement which would have allowed the public to react. The Opposition had to make it clear that the announcement had been made and to publicise it—just as it is left to the Opposition to comment on the increased charges tonight.
The Government have offered no defence. The Minister says that the poorest will be protected. Even the hon. Member for Littleborough and Saddleworth (Mr. Dickens) pointed out that those at the margin are in the most difficult position. The same was said by my hon. Friend the Member for Renfrew, West and Inverclyde and other of my hon. Friends. To many, the increase represents a massive rise. For them, £4.25 for every prescription that they need is a lot of money. The Minister would not disagree that many people need double prescriptions and they will have to pay £1 more and a total bill of £8.50p. Many at the margin will have great difficulty paying those higher charges.
The hon. Member for Rochdale (Ms Lynne) mentioned certain categories who would suffer, such as students. I have engaged in correspondence with the Minister about a student in my constituency, who wrote to me setting out 134 his budget. He said that he felt that, given his income, he should not have to pay the prescription charges. He was determined to get through his college course without recourse to a student loan; as he explained in his letter, he would much prefer to be free of debt when he graduated. He was trying not to draw heavily on his parents' resources, while also trying to complete his course without a loan.
When I asked the Minister why that student was having to pay prescription charges, it was explained to me that he was being charged as if he had drawn his student loan. He had been told that he had a notional student loan. He had been lent no actual money, but the fact that a loan was available to him apparently meant that the money that he had not claimed still counted against him. That is just one small indication of the lengths to which the Government will go to penalise, in this case, a student who was determined to complete his course and be free to pursue employment—if he could find it, that is—without the hindrance of a loan.
That student was forced to pay prescription charges on the basis that he had claimed a loan that he rightly had not claimed. He is just one of a category of people for whom the imposition of extra charges will be the last straw. A 13 per cent. increase in a charge that is so important to so many people is simply not acceptable. The defence advanced for the charges has been negligible; such a level has never been justified.
§ Mr. Jack Thompson (Wansbeck)
An increase is now being proposed in the number of items being taken off the list that a doctor can prescribe. Those receiving the benefit of not having to pay prescription charges are now having to pay normal chemist shop prices. They are being hit twice. If they are elderly, for instance, they will get away with not paying prescription charges, but they will probably have to pay more for the same medicine than they would have paid otherwise.
§ Mr. Gunnell
I thank my hon. Friend for raising that important point, which has been raised by others. I only hope that the Chancellor will not impose VAT on medicines tomorrow. I noted that the pamphlet provided by the House of Commons Library included medicines among the items that might attract VAT; certainly, many people would be affected by that. As others have pointed out, there are quite different ways in which a Minister could choose to tackle the allegations of waste in prescribing.
§ Mr. Barry Porter (Wirral, South)
I agree with my hon. Friend the Member for Littleborough and Saddleworth (Mr. Dickens) that our national health service is the best in the world. Can the hon. Gentleman tell me which country in the western industrialised world has lower prescription charges than those proposed in the regulations and which has exemptions more generous than those provided here? There is none.
§ Mr. Gunnell
I shall have to refer the hon. Gentleman to the paper that I have received from the Library. What I know, however, is that the Conservatives voted against the NHS when it was set up in 1947.
§ Madam Deputy Speaker
Order. If the hon. Member who has the Floor does not give way, hon. Members trying to intervene must sit down.
§ Mr. Gunnell
I think that I have said enough to make it clear that I, like my right hon. and hon. Friends, find the scale of the increases and the way in which they have been announced unacceptable. Once again the Conservative party is proving that the NHS is not safe in its hands.
§ Ms Dawn Primarolo (Bristol, South)
In the few minutes that are left to me to sum up for the Opposition, it is important to return the debate to the subject of the regulations—the 13 per cent. increase in prescription charges. That is higher than the 1.5 per cent. pay increase that the Government forced on health service workers, whose lobby we saw today. The increases will take dental charges to 80 per cent. of the total cost of treatment for national health service patients. It is part of the Government's strategy to force dentistry out of the NHS.
There has been a great deal of misinformation from the Government about exemptions from charges and about who can or cannot afford to pay the increases. We should be under no illusions. The increases are a result of the Government's failed economic strategy. They are a tax on the sick to pay for the health service because the Government's economic strategy is not delivering the resources.
The increases will weigh heavily on those who just fail to qualify for the benefit that hon. Members have mentioned. Forty per cent. of the population pays national health service charges. Perhaps in his winding-up speech the Minister will reveal the information in the Government's possession about the true failure of their income and exemption schemes. The Minister wrote to Ms Ann Abraham, chief executive of the National Association of Citizens Advice Bureaux, on 16 July 1992. His letter followed the report by the association entitled "Health Warning" which pointed to the problems with the exemption scheme.
For example, people have to apply for exemption on a 19-page form. Even those who administer the scheme find the form difficult to understand and make erratic and incorrect judgments on people's entitlement. What must it seem like to people applying for needed medication? The grounds for exemption are not consistent. For instance, a pensioner is exempt from prescription charges but not from other charges. A pregnant woman can get help with most charges, but not with hospital visits. The maximum help that is available does not cover the total cost of, for example, optical charges.
The Government agreed that the system did not work and that the people they were trying to help were not helped by the system. In his letter to Ms Abraham the Minister said:As you know, the Government has been concerned to keep the arrangements for providing help with NHS charges under close scrutiny. The decision to carry out the Review announced by my predecessor shortly before the…report…was published, reflected our concern to improve…the Scheme.Although the Review has been completed, more detailed work is being carried out on the wider implications of…the proposals. This will assist the decision making process.Where is that review? What does that tell us about the Government's empty promises about helping people in need? Why did they not implement the review before looking at increasing the charges?
136 If we need further evidence about the complications of the scheme, I refer the Minister to a letter of 10 August 1992 to Baroness Hollis about the disability working allowance—a special allowance to help disabled people get back into work. However, they are not exempt from paying prescription charges, despite the fact that they are on low incomes.
The Royal Pharmaceutical Society of Great Britain said that more people will be unable to have the medicines that they need. The president asked the Government to consider the implications—that people will be forced back to their doctors because they will have to choose between the drugs that they need instead of having them all. The British Medical Association calls this rise a tax on illness. It is illogical; it is unfair; it is discriminatory; and it bears no resemblance to the Government's rhetoric this evening. There should be no increases.
§ Miss Joan Lestor (Eccles)
On a point of order, Madam Deputy Speaker. I believe that the Minister has to ask for the permission of the House to speak again. As a Member for the House, having been disgusted by the behaviour of those who have been on the Treasury Bench during the debate, I should like to deny the Minister the opportunity to speak again. If I may give you my reasons for this——
§ Madam Deputy Speaker
Order. That is not necessary. A single objection, when a Minister seeks leave to speak again, is sufficient.
§ Mrs. Mahon
Further to that point of order, Madam Deputy Speaker. May I add my voice to that of my hon. Friend the Member for Eccles (Miss Lestor).
§ Mr. Rhodri Morgan (Cardiff, West)
On a different point of order, Madam Deputy Speaker.[Interruption.]
§ Miss Lestor
Perhaps I may explain why I do not believe that the Minister should be allowed to speak again.
§ Madam Deputy Speaker
Order. We do not need to have a debate about that. A single voice uttering dissent is sufficient.
§ The Secretary of State for Health (Mrs. Virginia Bottomley)
Once again, Madam Deputy Speaker, we have had a catalogue of whingeing and moaning and a lack of policy from the Opposition. My hon. Friends are not prepared to put with their diatribes. Time and again——
§ Miss Lestor
Yes. The right hon. Lady came in late to 137 this debate. [HON. MEMBERS: "You weren't here, either".] Oh, yes I was. [Interruption.]
§ Madam Deputy Speaker
Order. I am already dealing with a point of order. [Interruption.] Order. I do not expect to be interrupted when I am addressing the House. Objection was taken to the Minister replying to the debate. Therefore, it seemed to me to be perfectly reasonable that the Secretary of State for Health should be given the opportunity to speak.
§ Mrs. Virginia Bottomley
Every week, Madam Deputy Speaker, there are 2 million more free prescriptions than there were in 1979.
§ Mr. Hughes
Yes. When the Secretary of State for Health stood up at the Dispatch Box, my hon. Friend the Member for Eccles (Miss Lestor) was on her feet. She ought surely to have been allowed to finish what she was saying.
§ Madam Deputy Speaker
Order. That is a matter for me. If the criticism is of me, there is a regular way of dealing with it, which is by substantive motion tabled in the House—not now.
§ Mrs. Bottomley
The Opposition are trying to deprive the House of the opportunity of hearing the sensible reasons why we have taken these decisions.
§ Mr. Prentice
Is it appropriate for the Secretary of State to reply to the debate as she arrived late and did not hear all the contributions?
§ Mrs. Bottomley
I have full confidence in the Minister. He was ably explaining to the House the reasons for the decisions, but the Opposition refused to hear them.
§ Mr. Morgan
Could you, Madam Deputy Speaker, tell the House whether you have received a request for a statement on the collapse of the Government's court case between the Welsh Office——
§ The House proceeded to a Division——
§ Mr. Hayes
(seated and covered): On a point of order, Madam Speaker. Will you rule on whether there has been a gross abuse of procedure? Although the Opposition objected, properly, to my hon. Friend the Minister of State speaking, when my right hon. Friend the Secretary of State rose to speak, they refused to hear her arguments.
§ Madam Deputy Speaker
It is not appropriate for me to deal with that now. Points of order taken during a Division must relate to the Division.
§ The House having divided: Ayes 229, Noes 289.142
|Division No. 194]||[11.30 pm|
|Abbott, Ms Diane||Cunningham, Jim (Covy SE)|
|Adams, Mrs Irene||Cunningham, Rt Hon Dr John|
|Ainger, Nick||Dafis, Cynog|
|Ainsworth, Robert (Cov'try NE)||Darling, Alistair|
|Allen, Graham||Davidson, Ian|
|Anderson, Ms Janet (Ros'dale)||Davies, Bryan (Oldham C'tral)|
|Armstrong, Hilary||Davies, Rt Hon Denzil (Llanelli)|
|Ashton, Joe||Davies, Ron (Caerphilly)|
|Austin-Walker, John||Davis, Terry (B'ham, H'dge H'l)|
|Banks, Tony (Newham NW)||Denham, John|
|Barnes, Harry||Dewar, Donald|
|Barron, Kevin||Dixon, Don|
|Battle, John||Dobson, Frank|
|Bayley, Hugh||Donohoe, Brian H.|
|Beckett, Rt Hon Margaret||Dowd, Jim|
|Beith, Rt Hon A. J.||Dunwoody, Mrs Gwyneth|
|Benn, Rt Hon Tony||Eagle, Ms Angela|
|Bennett, Andrew F.||Eastham, Ken|
|Benton, Joe||Enright, Derek|
|Bermingham, Gerald||Etherington, Bill|
|Berry, Dr. Roger||Evans, John (St Helens N)|
|Betts, Clive||Fatchett, Derek|
|Blunkett, David||Field, Frank (Birkenhead)|
|Boateng, Paul||Fisher, Mark|
|Boyce, Jimmy||Flynn, Paul|
|Boyes, Roland||Foster, Don (Bath)|
|Bradley, Keith||Fraser, John|
|Bray, Dr Jeremy||Fyfe, Maria|
|Brown, Gordon (Dunfermline E)||Galbraith, Sam|
|Brown, N. (N'c'tle upon Tyne E)||Galloway, George|
|Bruce, Malcolm (Gordon)||Gapes, Mike|
|Burden, Richard||Garrett, John|
|Byers, Stephen||Gerrard, Neil|
|Caborn, Richard||Godman, Dr Norman A.|
|Callaghan, Jim||Godsiff, Roger|
|Campbell, Mrs Anne (C'bridge)||Golding, Mrs Llin|
|Campbell-Savours, D. N.||Gordon, Mildred|
|Canavan, Dennis||Graham, Thomas|
|Carlile, Alexander (Montgomry)||Griffiths, Nigel (Edinburgh S)|
|Chisholm, Malcolm||Griffiths, Win(Bridgend)|
|Clapham, Michael||Grocott, Bruce|
|Clarke, Eric (Midlothian)||Gunnell, John|
|Clarke, Tom (Monklands W)||Hain, Peter|
|Clelland, David||Hall, Mike|
|Clwyd, Mrs Ann||Hanson, David|
|Coffey, Ann||Hardy, Peter|
|Cohen, Harry||Harman, Ms Harriet|
|Connarty, Michael||Hattersley, Rt Hon Roy|
|Cook, Robin (Livingston)||Heppell, John|
|Corbett, Robin||Hill, Keith (Streatham)|
|Corbyn, Jeremy||Hinchliffe, David|
|Corston, Ms Jean||Hoey, Kate|
|Cousins, Jim||Hogg, Norman (Cumbernauld)|
|Cox, Tom||Hood, Jimmy|
|Cryer, Bob||Hoon, Geoffrey|
|Cummings, John||Howarth, George (Knowsley N)|
|Cunliffe, Lawrence||Howells, Dr. Kim (Pontypridd)|
|Hughes, Kevin (Doncaster N)||O'Hara, Edward|
|Hughes, Robert (Aberdeen N)||Olner, William|
|Hughes, Roy (Newport E)||Orme, Rt Hon Stanley|
|Hughes, Simon (Southwark)||Parry, Robert|
|Illsley, Eric||Pendry, Tom|
|Ingram, Adam||Pickthall, Colin|
|Jackson, Glenda (H'stead)||Pike, Peter L.|
|Jackson, Helen (Shef'ld, H)||Pope, Greg|
|Jamieson, David||Powell, Ray (Ogmore)|
|Jones, Barry (Alyn and D'side)||Prentice, Ms Bridget (Lew'm E)|
|Jones, Lynne (B'ham S O)||Prentice, Gordon (Pendle)|
|Jones, Martyn (Clwyd, SW)||Prescott, John|
|Jowell, Tessa||Primarolo, Dawn|
|Kaufman, Rt Hon Gerald||Purchase, Ken|
|Keen, Alan||Quin, Ms Joyce|
|Kennedy, Jane (Lpool Brdgn)||Randall, Stuart|
|Khabra, Piara S.||Raynsford, Nick|
|Kinnock, Rt Hon Neil (Islwyn)||Rogers, Allan|
|Kirkwood, Archy||Rooker, Jeff|
|Leighton, Ron||Rooney, Terry|
|Lestor, Joan (Eccles)||Ross, Ernie (Dundee W)|
|Lewis, Terry||Rowlands, Ted|
|Litherland, Robert||Ruddock, Joan|
|Livingstone, Ken||Sheerman, Barry|
|Lloyd, Tony (Stretford)||Sheldon, Rt Hon Robert|
|Llwyd, Elfyn||Short, Clare|
|Loyden, Eddie||Skinner, Dennis|
|Lynne, Ms Liz||Smith, Andrew (Oxford E)|
|McAllion, John||Smith, C. (Isl'ton S & F'sbury)|
|McAvoy, Thomas||Smith, Llew (Blaenau Gwent)|
|Macdonald, Calum||Soley, Clive|
|McFall, John||Spearing, Nigel|
|McKelvey, William||Spellar, John|
|Mackinlay, Andrew||Squire, Rachel (Dunfermline W)|
|McLeish, Henry||Steel, Rt Hon Sir David|
|McMaster, Gordon||Steinberg, Gerry|
|McNamara, Kevin||Stevenson, George|
|Madden, Max||Strang, Dr. Gavin|
|Mahon, Alice||Taylor, Mrs Ann (Dewsbury)|
|Mandelson, Peter||Taylor, Matthew (Truro)|
|Marshall, David (Shettleston)||Tipping, Paddy|
|Marshall, Jim (Leicester, S)||Turner, Dennis|
|Martin, Michael J. (Springburn)||Walker, Rt Hon Sir Harold|
|Maxton, John||Wallace, James|
|Meacher, Michael||Walley, Joan|
|Meale, Alan||Wareing, Robert N|
|Michael, Alun||Watson, Mike|
|Michie, Bill (Sheffield Heeley)||Wicks, Malcolm|
|Milburn, Alan||Williams, Rt Hon Alan (Sw'n W)|
|Miller, Andrew||Williams, Alan W (Carmarthen)|
|Moonie, Dr Lewis||Wilson, Brian|
|Morgan, Rhodri||Winnick, David|
|Morley, Elliot||Wray, Jimmy|
|Morris, Rt Hon A. (Wy'nshawe)||Wright, Dr Tony|
|Morris, Estelle (B'ham Yardley)||Young, David (Bolton SE)|
|Morris, Rt Hon J. (Aberavon)|
|Mowlam, Marjorie||Tellers for the Ayes:|
|Mudie, George||Mr. Jack Thompson and|
|Murphy, Paul||Mr. Peter Kilfoyle.|
|Oakes, Rt Hon Gordon|
|Adley, Robert||Beresford, Sir Paul|
|Ainsworth, Peter (East Surrey)||Biffen, Rt Hon John|
|Alexander, Richard||Blackburn, Dr John G.|
|Alison, Rt Hon Michael (Selby)||Body, Sir Richard|
|Amess, David||Booth, Hartley|
|Ancram, Michael||Boswell, Tim|
|Arbuthnot, James||Bottomley, Peter (Eltham)|
|Arnold, Jacques (Gravesham)||Bottomley, Rt Hon Virginia|
|Arnold, Sir Thomas (Hazel Grv)||Bowden, Andrew|
|Ashby, David||Bowis, John|
|Atkins, Robert||Boyson, Rt Hon Sir Rhodes|
|Atkinson, Peter (Hexham)||Brandreth, Gyles|
|Baldry, Tony||Brazier, Julian|
|Banks, Robert (Harrogate)||Bright, Graham|
|Bates, Michael||Brooke, Rt Hon Peter|
|Batiste, Spencer||Brown, M. (Brigg & Cl'thorpes)|
|Bellingham, Henry||Browning, Mrs. Angela|
|Bendall, Vivian||Bruce, Ian (S Dorset)|
|Budgen, Nicholas||Hawksley, Warren|
|Burns, Simon||Hayes, Jerry|
|Burt, Alistair||Heald, Oliver|
|Butler, Peter||Heathcoat-Amory, David|
|Butterfill, John||Hendry, Charles|
|Carlisle, Kenneth (Lincoln)||Higgins, Rt Hon Sir Terence L.|
|Carrington, Matthew||Hill, James (Southampton Test)|
|Carttiss, Michael||Horam, John|
|Cash, William||Hordern, Rt Hon Sir Peter|
|Channon, Rt Hon Paul||Howard, Rt Hon Michael|
|Clappison, James||Howarth, Alan (Strat'rd-on-A)|
|Clark, Dr Michael (Rochford)||Howell, Rt Hon David (G'dford)|
|Clarke, Rt Hon Kenneth (Ruclif)||Hughes Robert G. (Harrow W)|
|Clifton-Brown, Geoffrey||Hunt, Rt Hon David (Wirral W)|
|Congdon, David||Hunt, Sir John (Ravensbourne)|
|Conway, Derek||Hunter, Andrew|
|Coombs, Anthony (Wyre For'st)||Hurd, Rt Hon Douglas|
|Coombs, Simon (Swindon)||Jack, Michael|
|Cope, Rt Hon Sir John||Jackson, Robert (Wantage)|
|Couchman, James||Jenkin, Bernard|
|Cran, James||Jessel, Toby|
|Currie, Mrs Edwina (S D'by'ire)||Johnson Smith, Sir Geoffrey|
|Curry, David (Skipton & Ripon)||Jones, Gwilym (Cardiff N)|
|Davies, Quentin (Stamford)||Jones, Robert B. (W Hertfdshr)|
|Davis, David (Boothferry)||Jopling, Rt Hon Michael|
|Day, Stephen||Kellett-Bowman, Dame Elaine|
|Deva, Nirj Joseph||Key, Robert|
|Dickens, Geoffrey||Kilfedder, Sir James|
|Dorrell, Stephen||King, Rt Hon Tom|
|Douglas-Hamilton, Lord James||Kirkhope, Timothy|
|Dover, Den||Knapman, Roger|
|Duncan, Alan||Knight, Mrs Angela (Erewash)|
|Duncan-Smith, Iain||Knight, Greg (Derby N)|
|Dunn, Bob||Knox, David|
|Durant, Sir Anthony||Kynoch, George (Kincardine)|
|Dykes, Hugh||Lait, Mrs Jacqui|
|Eggar, Tim||Lang, Rt Hon Ian|
|Elletson, Harold||Legg, Barry|
|Emery, Rt Hon Sir Peter||Leigh, Edward|
|Evans, David (Welwyn Hatfield)||Lennox-Boyd, Mark|
|Evans, Jonathan (Brecon)||Lester, Jim (Broxtowe)|
|Evans, Nigel (Ribble Valley)||Lidington, David|
|Evans, Roger (Monmouth)||Lightbown, David|
|Evennett, David||Lilley, Rt Hon Peter|
|Faber, David||Lloyd, Peter (Fareham)|
|Fabricant, Michael||Lord, Michael|
|Fenner, Dame Peggy||Luff, Peter|
|Field, Barry (Isle of Wight)||Lyell, Rt Hon Sir Nicholas|
|Fishburn, Dudley||MacGregor, Rt Hon John|
|Forman, Nigel||MacKay, Andrew|
|Forsyth, Michael (Stirling)||Maclean, David|
|Forth, Eric||McLoughlin, Patrick|
|Fox, Dr Liam (Woodspring)||McNair-Wilson, Sir Patrick|
|Fox, Sir Marcus (Shipley)||Madel, David|
|Freeman, Roger||Maitland, Lady Olga|
|French, Douglas||Malone, Gerald|
|Fry, Peter||Mans, Keith|
|Gale, Roger||Marland, Paul|
|Gallie, Phil||Marlow, Tony|
|Gardiner, Sir George||Marshall, John (Hendon S)|
|Garel-Jones, Rt Hon Tristan||Martin, David (Portsmouth S)|
|Gill, Christopher||Martin, Michael J. (Springburn)|
|Gillan, Cheryl||Mawhinney, Dr Brian|
|Goodlad, Rt Hon Alastair||Merchant, Piers|
|Goodson-Wickes, Dr Charles||Milligan, Stephen|
|Gorman, Mrs Teresa||Mills, Iain|
|Gorst, John||Mitchell, Andrew (Gedling)|
|Grant, Sir Anthony (Cambs SW)||Mitchell, Sir David (Hants NW)|
|Greenway, Harry (Ealing N)||Moate, Sir Roger|
|Griffiths, Peter (Portsmouth, N)||Monro, Sir Hector|
|Grylls, Sir Michael||Montgomery, Sir Fergus|
|Hague, William||Moss, Malcolm|
|Hamilton, Rt Hon Archie (Epsom)||Needham, Richard|
|Hamilton, Neil (Tatton)||Nelson, Anthony|
|Hampson, Dr Keith||Neubert, Sir Michael|
|Hannam, Sir John||Newton, Rt Hon Tony|
|Hargreaves, Andrew||Nicholls, Patrick|
|Harris, David||Nicholson, David (Taunton)|
|Haselhurst, Alan||Nicholson, Emma (Devon West)|
|Hawkins, Nick||Norris, Steve|
|Onslow, Rt Hon Sir Cranley||Sackville, Tom|
|Ottaway, Richard||Sainsbury, Rt Hon Tim|
|Page, Richard||Scott, Rt Hon Nicholas|
|Paice, James||Shaw, David (Dover)|
|Patnick, Irvine||Shaw, Sir Giles (Pudsey)|
|Pattie, Rt Hon Sir Geoffrey||Shephard, Rt Hon Gillian|
|Pawsey, James||Shepherd, Colin (Hereford)|
|Peacock, Mrs Elizabeth||Shepherd, Richard (Aldridge)|
|Pickles, Eric||Shersby, Michael|
|Porter, Barry (Wirral S)||Sims, Roger|
|Porter, David (Waveney)||Skeet, Sir Trevor|
|Portillo, Rt Hon Michael||Smith, Sir Dudley (Warwick)|
|Rathbone, Tim||Smith, Tim (Beaconsfield)|
|Redwood, John||Speed, Sir Keith|
|Renton, Rt Hon Tim||Spencer, Sir Derek|
|Richards, Rod||Spicer, Sir James (W Dorset)|
|Riddick, Graham||Spicer, Michael (S Worcs)|
|Rifkind, Rt Hon. Malcolm||Spink, Dr Robert|
|Robathan, Andrew||Spring, Richard|
|Roberts, Rt Hon Sir Wyn||Sproat, Iain|
|Robertson, Raymond (Ab'd'n S)||Squire, Robin (Hornchurch)|
|Robinson, Mark (Somerton)||Stanley, Rt Hon Sir John|
|Roe, Mrs Marion (Broxbourne)||Steen, Anthony|
|Rumbold, Rt Hon Dame Angela||Stephen, Michael|
|Ryder, Rt Hon Richard||Stern, Michael|
|Stewart, Allan||Waller, Gary|
|Streeter, Gary||Ward, John|
|Sumberg, David||Wardle, Charles (Bexhill)|
|Sweeney, Walter||Waterson, Nigel|
|Sykes, John||Watts, John|
|Taylor, Ian (Esher)||Wells, Bowen|
|Taylor, John M. (Solihull)||Wheeler, Rt Hon Sir John|
|Taylor, Sir Teddy (Southend, E)||Whitney, Ray|
|Temple-Morris, Peter||Whittingdale, John|
|Thomason, Roy||Widdecombe, Ann|
|Thompson, Sir Donald (C'er V)||Wiggin, Sir Jerry|
|Thompson, Patrick (Norwich N)||Wilkinson, John|
|Thornton, Sir Malcolm||Willetts, David|
|Thurnham, Peter||Winterton, Mrs Ann (Congleton)|
|Townend, John (Bridlington)||Winterton, Nicholas (Macc'f'ld)|
|Townsend, Cyril D. (Bexl'yh'th)||Wolfson, Mark|
|Tracey, Richard||Wood, Timothy|
|Tredinnick, David||Yeo, Tim|
|Trend, Michael||Young, Sir George (Acton)|
|Twinn, Dr Ian|
|Vaughan, Sir Gerard||Tellers for the Noes:|
|Waldegrave, Rt Hon William||Mr. Sydney Chapman and|
|Walden, George||Mr. Nicholas Baker.|
|Walker, Bill (N Tayside)|
§ Question accordingly negatived.