Commons Sitting of 24 January 1996

Preamble
The House met at half-past Nine o'clock
PRAYERS
[MADAM SPEAKER in the Chair]

Women in Prison
Motion made, and Question proposed, That this House do now adjourn.—[Dr. Liam Fox.]
9.34 am
Mrs. Alice Mahon: Last week, at the very moment that the Home Secretary was announcing small changes to what many of us have described as the inhumane practice of shackling pregnant women prisoners while they are in labour, a woman prisoner suffering from breast cancer was lying in the Middlesex hospital manacled to two prison officers—one of whom was male—right up to the point when her radiotherapy treatment was due to commence.
One does not need much imagination to think of the scene—the woman in her white hospital gown waiting with other NHS patients for a sensitive and personal treatment while being shackled to a man. That is the reality, I suggest, of the policy that the Government now support.
Frances Crook, director of the Howard League, said when giving me information for the debate—information that I have checked out with the Prison Service and the hospital:
"The Home Secretary had given the clear impression that the shackling of women attending hospital would be discouraged."
She added that all hon. Members should question the Minister closely as to exactly who should and who should not be shackled.
Mrs. Audrey Wise: The Home Secretary has given way a little in relation to women who are in hospital to give birth, but does my hon. Friend agree that this half loaf—or one slice of bread—is totally inadequate? The Home Secretary has not addressed the issue of women who are breast-feeding, and has not addressed the issue of antenatal care. During pregnancy, all women are particularly vulnerable to stress and anxiety, and there is proof that that has an effect both on the foetus and on the baby for many years after birth. Does my hon. Friend agree that shackling should be discontinued during pregnancy?
Mrs. Mahon: I agree absolutely with my hon. Friend, who puts her case very well. I have some questions in a similar vein from the Maternity Alliance that I shall put to the Minister later in the debate. As joint chairman of the all-party breast cancer group, I have taken a considerable interest in women and how they feel. I have talked to many women who suffer from breast cancer, and I have listened as they described their terror at being
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told that they were suffering from the disease. I believe that shackling a woman who is awaiting radiotherapy is tantamount to the worst kind of cruelty, and there is no place for such treatment in a civilised society.
If such treatment is cruel, other cases of shackling that have been drawn to my attention border on the farcical or the downright dangerous. A report in the Daily Mirror gave details of patients who were chained to officers when attending hospital for treatment for pneumonia, cancer and other serious illnesses. But would you believe, Madam Speaker, that one case which was reported—and which I have pursued—was of a woman suffering from dysentery being shackled? As everybody knows, it is an infectious, notifiable disease. Some poor unsuspecting prison officer had to be shackled to someone suffering from it, so possible cross-infection is obviously considered a price worth paying to support the Government's "prison works" policy.
If the officer went down with dysentery, surely that would not be a price worth paying. The practice is mediaeval. When the woman was not chained to the prison officer, she was chained to the bed. We all know that people suffering from dysentery need to use the toilet frequently, so that woman would have been most uncomfortable hopping in and out of bed with chains on.
Except in the most exceptionally high-risk cases, the practice of manacling smacks more of the Home Secretary's Soviet style and gulag mentality towards the penal system rather than the policy of a Home Secretary in a modern democracy as it approaches the millennium. It is high time to end a shameful and degrading practice. High-risk women prisoners and other women who have simply been imprisoned because of a minor misdemeanour should not be treated in the same way.
The number of women imprisoned is not high. According to the latest figures that I received on 18 January, the current prison population stands at 51,584, of whom 2,024 are women. That figure peaked in December, when the highest female prison population, 2,150, was recorded. The latest published Home Office statistics about prison populations relate to 1993, so when we speak about the reasons for women's imprisonment and the percentage of women in gaol, we are working on old statistics.
In 1993, 37 per cent. of those imprisoned were fine defaulters, and 22 per cent. were in for theft and handling stolen goods. Those statistics also reveal that women are sent to prison mainly for minor offences. In June 1993, 39 per cent. of women in prison had no previous convictions. That seems to be the trend.
Women seem to get sentenced more often for first offences than men. During that year, just 26 per cent. of women who were held in prison on remand subsequently received prison sentences. The 74 per cent. released back into the community were either found not guilty or given a non-custodial sentence. I wonder whether any of those women were manacled or treated in an inhumane way.
Those statistics give the lie to the recent statement by the hon. Member for Gravesham (Mr. Arnold)—I am sorry he is not present—in a recent intervention on the Home Secretary:
"every one of those women is either a convicted criminal or has been remanded in custody by a court which considers them to be dangerous or likely to abscond".—[Official Report, 18 January 1996; Vol. 269, c. 898.]

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The figures show that that is nonsense. I do not believe that the 37 per cent. of women prisoners who are fine defaulters are dangerous, liable to abscond, or a threat to anyone. Anyone with an ounce of common sense would recognise that, and not make such a fatuous statement.
Fourteen prison establishments hold women, of which eight are closed prisons. It is current policy for girls as young as 15 to be held in prisons with adult women. The average cost of keeping a woman in prison is £541 a week—again according to the 1993 statistics. That figure does not include the cost of prison headquarters, so the total cost is higher.
Mr. Paul Boateng: On a point of order, Madam Speaker. Is it in order for a Conservative Back Bencher to seek advice from civil servants in the course of a debate? Will that facility be available to all hon. Members?
Madam Speaker: It is most unusual for a Back-Bench Member to seek information from civil servants unless, of course, that Member has been asked by a Minister to do so. That is not the case now, and therefore that Back Bencher should not be seeking information from Government civil servants. I had not noticed, and I thank the hon. Member for Brent, South (Mr. Boateng) for bringing it to my attention.
Mr. Boateng: I am much obliged, Madam Speaker.
Mrs. Teresa Gorman: On a point of order, Madam Speaker. I apologise for my action. I was checking the detail of an address with the civil servants, but I accept your reprimand.
Mrs. Mahon: A high percentage of women are in prison because they are fine defaulters or have not paid for a television licence. In 1993, 7.5 per cent., or 278 women, were imprisoned for the non-payment of television licence fees or fines related to that. I pay tribute to the hon. and learned Member for Montgomery (Mr. Carlile), who has tabled early-day motion 287 on the imprisonment of television licence fine defaulters. He should be commended on his campaign to argue that it is an absolute waste of time and shocking to imprison such people.
That early-day motion states:
"people prosecuted for TV licence evasion tend to be disproportionately poor, female, unemployed"
and single parents. It is impossible to quantify the harm and distress caused to a family when the mother, often the only parent, is taken away and incarcerated, perhaps for weeks, while the children are taken into care.
The Home Secretary has slickly informed the Tory party conference that prison works, but it does not work for the children of women imprisoned for fine defaulting, and whose only crime is to be poor. It does not work for the taxpayers, either; they might lose £86.50 on the television licence that goes to the Exchequer, but will fork out £541 a week for prison lodgings. That cost does not take into account the thousands of pounds extra that is spent on keeping children in local authority care.
The Home Secretary would be wise to start watching programmes such as "Coronation Street". West Yorkshire probation service has issued a news release noting:
"As Coronation Street's Trish is sent to prison after being caught without a television licence…many real life women are in prison for the same reason."
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Elly Phillips, the debts and benefits adviser for West Yorkshire probation service, has drawn attention to the absolute outrage revealed in that programme:
"A woman who cannot afford to pay her television licence is no more likely to be able to pay a Court fine. If she is then sent to prison the licence fee and the fine are still unpaid"—
on top of that, it costs the taxpayer money—
"When we are talking about a mother the result is even worse: her children are often taken into care, like Trish's son Jamie, so they become the innocent victims of the system."
The West Yorkshire probation service also notes:
"The Prison Reform Trust has reported that no fewer than 38 per cent. of all women prosecuted for all offences in 1993 were charged with using a television set without a licence."
That is slightly higher than the figure quoted in the Home Office statistics. According to the Home Secretary, that practice shows that prison works.
Ms Margaret Hodge: The population of Holloway prison has doubled in the past five years, but its budget for last year was cut. The Secretary of State is obsessed with the idea that the only thing that matters is to keep people locked up and that security is the issue of prime importance.
Does my hon. Friend agree that, in those circumstances, it is inevitable that the regime for women incarcerated in places like Holloway is bound to be dreadful? That will not make prison work, because we do not just want to lock people up while they are serving their sentence: we want to ensure that, when those people are released, we are secure in the community because they will be active, rehabilitated citizens.
Mrs. Mahon: My hon. Friend puts it eloquently. I was coming to that. I want to challenge the notion that prison works, especially for those whose only crime is poverty and civil debt. I want a criminal justice system that is linked with anti-poverty social programmes based on good rehabilitation practice. I want prison really to work.
If someone does end up in prison, the hallmark of success is whether they reoffend. In fact, 40 per cent. of women prisoners are re-convicted within two years of release. If their problem is poverty, that poverty will not go away while they are in prison. The taxpayer's bill goes up, but poverty does not go away. Prison has not worked for the 40 per cent. of women who are re-convicted.
Before there are any hysterical outbursts to the effect that I worry only about the prisoner and not about the victim, I should say that I am not in favour of early release for people who have been violent, such as muggers. I would never again trust a child murderer. I would never plead for someone who had murdered children. I am in favour of a civilised system, because I recognise that people who go to prison remain human beings, whatever crime they may have committed.
Mrs. Wise: On the question of rehabilitation, which is so important, does my hon. Friend agree that the time during which a woman is pregnant and gives birth, and immediately after, is a time of renewal? There is the possibility of a fresh start—indeed, it is inevitable—in a new life. If women are degraded and humiliated at that time, it can only harden them and make them less likely to use that opportunity—and impossible for the Prison Service to use it—for rehabilitation, which could be effective at such an important time in a woman's life.
Mrs. Mahon: Absolutely. I hope that the Minister took note of that.
I am told by prison reformers, the Prison Officers Association, the probation service and others who take an interest in prisons that conditions in women's prisons are not radically different from or better than those in most men's prisons. Women have little privacy, food is not good, and they have few chances to make decisions about their lives. Many people say that rehabilitation programmes are almost non-existent. The POA in particular is frustrated about prison officers being expected to act only as gaolers rather than doing useful rehabilitation work.
The present and previous chief inspectors of prisons have both made many relevant observations. When he visited Drake Hall in 1994, the previous chief inspector stated:
"The residential units were in a state of dilapidation."
Especially unsatisfactory were the small, dingy recreation areas, which were expected to accommodate about 80 inmates but could seat less than half that number. He went on to describe conditions in the communal wash areas, where there were no plugs in the sinks and most of the rooms were in a bad decorative state. People at the bottom of the pile, who have been subjected to poverty, especially first offenders and women in prison for civil offences, must have their feelings of rejection and hopelessness confirmed when incarcerated in such conditions.
In December 1995, the new chief inspector, Sir David Ramsbotham, took the unprecedented step of withdrawing his inspection team from Holloway. Other hon. Members will deal with that, and I mention it only briefly. According to The Times of 19 December, his team walked out of the prison because of
"over-zealous security, prisoners being locked in their cells 23 hours a day"—
the point made by my hon. Friend the Member for Barking (Ms Hodge)—
"poor health care, bullying, low staff morale, inadequate education and activities, and dirty conditions".
Nearer to home, two women from my constituency were sent to New Hall prison near Wakefield last year for non-payment of television licence fees. I got these statistics from the Library yesterday. Four years ago, that prison was condemned by prison inspectors, who made a total of 102 recommendations. I congratulate the prison on the many improvements that have been made since. I must put that on record, because, in the latest unannounced inspection, the Home Office report found
"notable improvements in facilities and an improved regime".
However, there were still 20 further serious recommendations for New Hall. Although the health care system had improved, the full-time medical officer was male, which is especially distressing for women from ethnic minorities, but seems to be the norm in women's prisons. Health facilities were not good. Prisoners did not get the same facilities that the rest of us get on the NHS. The Minister should address that.
The New Hall report also pointed out that bullying was a serious problem. Girls as young as 15 are held in women's prisons. The report stressed that an increase in bullying coincided with the increased use of class A drugs by prisoners, but there was no recognised anti-bullying
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strategy. That is desperately needed, and is recommended by the report. There was a high level of self-mutilation among prisoners. While improvements have been made, many more still need to be made.
What I found especially shocking about the report was that 86 of the prisoners in New Hall had been victims of sexual abuse. The probation service's figures are even higher. The majority of women prisoners have constantly been found to be victims of sexual abuse. In spite of that, they still had male medical officers. That is something that could be addressed. There should be counselling for women in that situation. Perhaps there should also be an in-depth study into why they end up in prison.
Women are strip-searched by female officers before going to court, and there are searches for drug testing. Random drug testing procedures involve strict searching, which is done in front of female officers. That has led to something even more disturbing, which I am sure that my hon. Friend the Member for Knowsley, North (Mr. Howarth) will mention. The probation service says that the system of searching and testing for drugs is making heroin more unpopular than cannabis. Drug taking is out of control in most of our prisons.
Mr. George Howarth: I think that my hon. Friend means more popular.
Mrs. Mahon: It is because heroin does not remain in the system for as long as cannabis, and is unlikely to be picked up by urine samples. This degrading process does not seem to have solved the problem that it was meant to address. We should examine that.
The Minister must seriously address the health care problems in prisons. Do we want prisons to stop people reoffending when they get out? That would mean that something must be done about the penal and criminal justice systems. The Home Office should be working on both. We must think of the poor old taxpayer, who has to pay out all that money because someone has not paid for a TV licence. It is, first, an obscenity that someone should be sent to prison for that offence, but the Minister must also consider the fact that our money is being wasted to satisfy some Tory prejudices.
I shall give the last word to Beatrix Campbell, who wrote a good article in The Guardian in December. She wrote of the typical offences for which women go to prison. The article is so good that it is worth repeating what she said. She stated that typical offences committed by women involved sex and shopping. The practice of women selling sex is as old as women's desperation. We all know that women end up in prison not for selling sex, but for where they do so and whether they are caught in the system.
Beatrix Campbell states:
"The organised shoplifter is no threat to public tranquillity, unlike the boy burglar whose business is as much about power as it is about poverty. Breaking and entering his neighbours' homes is a personal kind of piracy and the reward is both material and emotional—the pleasure of conquest. The 'shoppie' targets not her neighbours or private property but big business".
Beatrix Campbell suggests that, when women find themselves in such circumstances and are first offenders, the criminal justice system should not be tougher on women, but should try to find alternatives to custody, and should consider the poverty connection—linking crime and the penal system, and the woman's social conditions.

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We should try to do something to stop women getting into such circumstances, and we should stop locking up women simply because they do not have enough money on which to live.
Several hon. Members rose—
Mr. Deputy Speaker (Sir Geoffrey Lofthouse): Order. There about 35 minutes left for Back-Bench speeches before the Front-Bench teams wind up the debate. Five hon. Members are hoping to catch my eye, and, if everyone co-operates, I think that all those hon. Members may be successful.
10.1 am
Mrs. Jacqui Lait: Thank you, Mr. Deputy Speaker—I shall attempt to be brief.
I am sure that, when the hon. Member for Halifax (Mrs. Mahon) applied for the debate, she had in mind principally the repugnant case of shackling women while they give birth. All of us would agree that not only women, but men, had a very emotional reaction to that repugnant spectacle, and none of us could cope with the concept. I therefore welcome the Home Secretary's commitment to bring that practice to an end.
The hon. Lady detailed at length the number of women who go to prison, and many of the offences for which they do so. She said that there are only just over 2,000 women in prison; it is also worth while saying that 59 per cent. of women are cautioned for indictable offences, compared with 36 per cent. of males. Clearly, attempts are made to keep women out of prison where possible.
In addition, the average sentence for women is about half that of men, so the courts clearly recognise that, for most offences, women should be sentenced to prison for only a brief period. It has become fairly clear over many years that, by and large, courts do not like to send women to prison, and do so only when that is the only recourse left to them due to the nature of the offence or because the women themselves—
Mr. Boateng: Does not the hon. Lady realise that, on the Home Office's own figures, women are more likely than men to be sent to prison—and for longer—for minor offences? Does that not have implications, not only for her argument, but for sentencing policy generally? Should we not be doing something about it?
Mrs. Lait: Having sat in magistrates courts when women have come before them, and having talked to many magistrates about the lengths to which they go to try to avoid sending women to prison, I know that that is the key to the argument. When a court concludes that the only solution is to send a woman to prison, it is for very good and clear reasons, and I support the court's right to do so.
The hon. Lady spoke of the attempts made in prison to rehabilitate women. On the rare occasions on which I have visited women's prisons, I have been impressed by the way in which prison officers work with the prisoners to give them the life skills that so many of them lack. Those
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skills include how to manage budgets and how to look after children. Many of the women who unfortunately find themselves in prison are not as competent at managing their affairs as many of us would wish.
It is also reasonable to consider the history of escapes from hospitals, which is what prompted the debate. The figures are interesting: in 1991–92, there were 14 escapes by women prisoners; in 1992–93, there were 13 escapes; in 1993–94, there were nine escapes; in 1994–95, there were six escapes; and in 1995–96, there were just two. Escapes from hospitals over those same years are four, eight and five. In 1994–95, there were no escapes, and in 1995–96 there were none.
One of the principal policies of the prison service, whether the Home Office prison service or the agency, should be to prevent escapes—the prison service has clearly succeeded in doing so.
Ms Angela Eagle: Does the hon. Lady think that the brutality—which has been described and at which she expressed horror at the beginning of her speech—of chaining women prisoners is worth the saving in terms of escape figures, which are relatively minor, anyway? Does she think that the brutality and anger are worth that result?
Mrs. Lait: The hon. Lady will realise that the Home Secretary has said that women in labour will no longer be chained. Seven prisoners who were either pregnant or who had just given birth have escaped from hospital. It was not our decision or a Home Office decision to chain women: it was an operational decision, and the Home Secretary has now instructed that it should not happen again. Let us sincerely hope that we do not witness the spectacle of women who are pregnant or just about to give birth escaping from hospital. The Prison Service should look for the best way to meet that target.
I have mentioned the difference between operational decisions and Home Office decisions. On the subject of women in hospital, we all know that, while those in the Prison Service are hard-working and have tremendous commitment, they are not known for their imagination. It was probably the lack of imagination that led to the policy of chaining women. Now that that policy has been abandoned, I hope that more sensible and imaginative ways will be found to ensure that women do not escape.
Mr. Walter Sweeney: Does my hon. Friend accept that it has never been Home Office policy to shackle women in labour?
Mrs. Lait: It has never been Home Office policy, but an operational decision was made by the next steps agency to restrain prisoners outside prison from April 1995—I think that that is why many people have accused the Prison Service of lacking imagination, and I suggest that the problem arose there.
That problem has been remedied by an instruction from the Home Secretary, and, I hope, some imagination will now be applied to the issue of restraining prisoners effectively when they are outside prison, so that, while there are no more escapes, we are not faced with the repugnant spectacle of women in labour being chained to their beds. That is the key to ensuring that the Prison Service can make progress and achieve its aims and the targets that it has been set.

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The more often there are crises, the more often Ministers intervene in the agency's work. As a result, the agency finds it more difficult to follow the policy that we all wish it to follow—that of working effectively and efficiently, allowing it to deliver an effective service to prisoners, ensuring that the public are not affected by prison escapes, and providing an element of rehabilitation and training during a prison sentence.
10.10 am
Mr. Chris Davies: The debate must be placed in the context of the Government's recent problems concerning the care of pregnant women in prisons, which we all have in mind. What an embarrassment that matter has been for the Government. How costly it has proved. It was obviously a contributory factor in the decision of the hon. Member for Stratford-on-Avon (Mr. Howarth) and my hon. Friend the Member for Torridge and West Devon (Miss Nicholson) to cross the Floor of the House, giving the very strong impression of a Conservative party that was split and falling apart. That latter impression has not been corrected by the performance of Ministers at the Dispatch Box in recent weeks.
Having for months brazenly bluffed their way through with categoric denials of the allegations made by Opposition Members, Ministers have been exposed and humbled. I do not blame them for not knowing from personal experience what was going on. They were fed inaccurate information by the people on whom they relied. I assume that someone in the Prison Service continues to smart from the fury of the Minister of State, Home Office, the hon. Member for Maidstone (Miss Widdecombe), when she was forced to carry the can for their mistakes.
The question now is whether we can be sure that the official information that will no doubt be the basis for the Minister's response today is as good, as accurate and as reliable as it should be.
When the issue of pregnant women and new mothers was at its height, I was struck by the number of newspaper commentators who wrote, "What do those women expect? They did not go to prison for a rest cure." Those callous words from poisonous pens were revealed more starkly because, at that very time, the Government were conceding their errors. I should add, however, that those poisonous pens were not all directed at those who were in prison. Some of them were, and have been, directed at the Minister.
On Monday night, my wife telephoned me. She said, "May I read you a letter? I am incensed by an article that I read in the Manchester Evening News, attacking the Minister, and I hope that it will not cause you any political problems if I write in, defending her."
The Minister of State, Home Office (Miss Ann Widdecombe): Good.
Mr. Davies: I said, "All right. Read me the letter." The attack that was made on the Minister was indeed couched in the most personal terms, ignoring the political arguments entirely—an argument that would not have been presented against a male Minster. I said, "Fine; send it in."
When I spoke to my wife yesterday, she said, "I feel much better. I have sent it off. Sometimes I write these letters and never send them." I said, "That's fine. Are you
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going to start defending me against some of the attacks made on me in the papers?" She said, "No; you are attacked too often—day in, day out. I can't afford the pen and the paper to defend you."
We can be sure that some of those self-righteous authors will not retract their views, despite the evidence presented today by the hon. Member for Halifax (Mrs. Mahon).
There are more women in prison than ever before—about 1,800—yet, when one considers the reasons that they are there, and especially the enormous proportion, about 47 per cent., who are in prison for defaulting on fines, it is impossible not to question whether there are not more effective ways of ensuring that justice is done and the community served.
Neither I nor the Liberal Democratic party take a soft view toward real criminals. I share the concerns of the hon. Member for Halifax. Hon. Members will understand that, as the representative of Saddleworth, I have no problem with the idea that a woman sentenced to a life sentence for a crime that at other times would have deserved a capital punishment should indeed serve a sentence for life.
However, the obscenity must be ended of many women—many of whom are inadequate or impoverished, driven to extremes, but who have struggled to keep families together, making do on limited resources with no help from a partner, if any worthwhile partner exists—ending up in prison for fine default or for being unable to pay for a television licence.
A sentence in such cases may be only seven days, and to a judge that may seem nothing more than a slap on the wrist, but seven days to the person involved—especially if they have never been in prison—means humiliation and despair beyond belief. It means kids taken into local authority care, and costs to all members of the local community.
The Government may try to wash their hands of that by saying, "It is up to the courts to decide on the sentence," but it is up to the Government to ensure that the courts have a proper range of alternative, non-custodial, options on which they can call. The fact that Britain now has the fastest increasing—and, I believe, the largest—prison population in Europe, clearly demonstrates that it is failing in providing those non-custodial options.
For once, surely money cannot be used as a reason—not when it costs about £25,000 a year, for heaven's sake, to keep a woman in prison. For that money, each individual person sentenced instead to a non-custodial alternative might have a personal supervisor, probably with a chauffeur-driven car, to take them to their job each morning.
Mr. Sweeney: Does the hon. Gentleman agree that the vast majority of people who are ordered by the courts to pay fines pay those fines, that people who default and end up going to prison are volunteers, and that, were the possibility of sending such people to prison to be withdrawn, it would send entirely the wrong signal to people who are fined, and encourage them not to pay their fines?
Mr. Davies: I believe that the courts should sentence people when they are obviously in breach of the law, but we are debating what type of sentence it should be. I am

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suggesting to the House that non-custodial sentences offer sensible, practical options—and practical options for the courts—which should be explored more often than they are. The very fact that the number of women in prison is increasing so sharply shows that non-custodial options are not being explored properly.
Imprisonment is the right option if society needs protection from an individual. It is the right answer if the crime committed against another human being deserves the most serious punishment. It satisfies society's justifiable desire for retribution in some cases, but no one should pretend for a minute that it helps society.
Prison is a breeding ground for crime. It is an admission of society's failure. It solves nothing. People who have committed crime through poverty, and are imprisoned, return to poverty. Those who have committed crime because of alcohol or drug dependence return to that dependence. If crime in this country is to be reduced effectively, it is time we explored more realistic, practical, sensible ways of ensuring that our means of imposing that justifiable punishment, meeting the court's requirements and reprimanding the people involved does not result in the problem and its consequences for society becoming worse than they are already.
10.18 am
Mrs. Teresa Gorman: In the past few months, much more heat than light has been expended on the subject of the treatment of women in prisons. Not least, it has caused the hysterical actions on the part of two of my colleagues, who have changed heart over that issue, yet have not even bothered to turn up for this morning's debate. The hysteria appears to have died down almost as quickly as it flared up.
We all have 20:20 vision with the benefit of hindsight. The debate—to which my hon. Friend the Minister of State has responded in a sensible and a responsible manner—has focused entirely on the treatment of women who are allowed out of prison in order to use the public health service. I am sure that most hon. Members would have campaigned at some time to give women prisoners the right to receive the best medical treatment available. However, we must remember that such women are serving custodial sentences, and, as my hon. Friend the Member for Hastings and Rye (Mrs. Lait) pointed out, many are persistent offenders.
Perhaps the hon. Member for Halifax (Mrs. Mahon) is being a little sentimental when she suggests that there should be different rules for women. Women should not be judged by lower standards than men. It should not be assumed that, because they are women, we expect less of them in terms of obedience to the law. If women offend persistently—it has been pointed out that women are sent to prison not for non-payment of licence fees, but for refusing to obey a court order—they must be answerable to the law like everyone else in the community. Otherwise, what is to stop any woman saying, "I don't want to pay for my television licence, and I know that I can't be imprisoned for it, because I am a mother"?
I have experience in helping female constituents and their families with their problems. They receive an enormous amount of assistance from social services, which often includes financial help to settle immediate monetary problems.
Mrs. Mahon: I do not think that women should be treated differently from men—although perhaps women have different problems. Does the hon. Lady believe that it is a good use of taxpayers' money to incarcerate a woman in prison for a week or a fortnight and to take her children into care for default of payment of a television licence fine?
Mrs. Gorman: Like the hon. Lady, I deplore the fact that that occurs. However, my annoyance is rooted in the fact that women—who generally have more common sense than men—persist in committing the crimes that put them in that situation. I taught girls in London secondary schools for 10 years, and I know that it is silly to pretend that women cannot behave as badly as men. If they persistently refuse to obey the laws of the land, they must be dealt with accordingly. I stress that point to Labour Members who have sought to make enormous political capital from the issue.
As a Member of Parliament, I have been very interested in the plight of women who are charged with murder and who are unable to plead provocation as a defence—we do not need to go into the details of how provocation occurs. A few years ago, I visited Bullwood Hall prison at my request—unfortunately, my experience is not up to date—where I was permitted to interview 13 women who had been imprisoned for first degree murder. They included Sarah Thornton and Kiranjit Ahluwalia—whose name I can never pronounce, but I am sure that the hon. Member for Bristol, East (Ms Corston) will assist me.
I made an extensive tour of the prison, and what I saw does not match the descriptions of the treatment of female prisoners. I saw a family room equipped with toys which is used by children—who are separated from their mothers in those circumstances—when visiting the prison. I saw a gymnasium in a very large hall, and I was assured that tutors visited the prison to assist women with exercises. I saw the kitchens and the food that the women were served for lunch.
I also talked freely with the prisoners. At one point, I was alone with 13 prisoners, who expressed their grievances to me. I visited Miss Thornton, who was at that time in the prison hospital, in a very clean and neat room to herself. She sat curled up in the middle of a bed that was made up with clean linen. There was no attempt to restrain her, or to prevent me from speaking to her.
One can speak only about what one has seen. Of course, I was intimidated by the banging doors, the chains and the locks and keys, but the conditions in that prison were not offensive.
Ms Diane Abbott: I worked in the Home Office formulating prison policy in relation to women and young offenders. I assure the hon. Lady that most women prisoners are held in Holloway, not in Bullwood Hall. Is she aware that, when the new chief inspector of prisons visited Holloway, he walked out halfway through the day because he was so disgusted by the conditions there?
Mrs. Gorman: I am, of course, aware of those reports, and, like everyone else, I am concerned about them, and await more details. I find it surprising that an institution in which many women are incarcerated is allowed to get into a dilapidated state. In similar circumstances, I would want to clean up the conditions in which I was living.

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The cells that I saw—admittedly it was a small prison, but the women had been convicted of very serious crimes—were nothing like what the hon. Member for Hackney, North and Stoke Newington (Ms Abbott) describes. Perhaps female prisoners should be given the opportunity to contribute to the general maintenance of the prison, including the cooking and cleaning. I think that that would be excellent therapy.
That brings me to the amount of time, energy and taxpayers' money that the Government spend on rehabilitating prisoners. The Government have spent a phenomenal amount of money in an attempt to improve conditions for prisoners—who, I repeat, are incarcerated because they have committed offences against society, and society has demanded that they receive a custodial sentence. Government spending on prisons has doubled since 1979; more recently, it has increased from £1.35 billion in 1995–96 to £1.4 billion in 1996–97. The Government are doing their best to improve conditions within the Prison Service, not just for those who are incarcerated but for those who work in our prisons.
Even more important is the amount of time that is being devoted to ensuring that male and female prisoners learn skills that will prove useful upon their release from prison. I hope that that will include courses in simple accounting, which may help some women to balance their budgets.
Mr. Jeremy Corbyn: But they are locked up many hours a day.
Mrs. Gorman: The hon. Gentleman remarks that female prisoners are locked in their cells for long periods. However, 38 per cent. of all prisoners have their cells unlocked for more than 12 hours a day during the week. That compares with much longer periods spent in their cells 10 years ago. The prison regime is becoming much more humane, and is providing rehabilitation opportunities for male and female prisoners. Prisoners are able to exercise on outdoor pitches, and the prison library provides education opportunities.
Mr. Corbyn: While we agree that prisoners should have education opportunities, there is a serious problem in that regard in Holloway prison. Due to a shortage of prison officers, many women spend much time—sometimes up to 23 hours—in their cells every day. That is very wrong. There have also been enormous cuts in the budget of the education department at Holloway prison. Female prisoners' opportunities for education and self-improvement in prison have been wiped out by staff and spending cuts. In her response, perhaps the Minister will tell us how the Government intend to improve the education facilities at Holloway prison.
Mrs. Gorman: I am sure that my hon. Friend will do that.
Some 58 prisons run re-employment focusing courses and job clubs which prepare prisoners for a return to the work force, and 113 prisons provide advice on housing and employment issues. I am sure that such advice will prove especially helpful to women, whose problems are rooted in their inability to manage their budgets and pay the rent. It is very upsetting if women are constantly forced out of their homes and must seek new accommodation.
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Sentence planning is in place for all prisoners serving 12 months or more, so, while they are in prison, a prison officer can counsel prisoners to plan for the time that they are discharged. The Government's record of improving conditions in prisons, making them more humane and enhancing the chances of prisoners ending their sentences with a better attitude and of being more organised undoubtedly represents an advance on the conditions that once prevailed—and long may they go on improving.
There will inevitably be times when we can find cause for criticism. If we lived in a perfect world, we would not need to be here in the first place.
10.30 am
Ms Glenda Jackson: I apologise to you, Mr. Deputy Speaker, and to hon. Members on both sides of the House, for the fact that, due to a previous commitment, regretfully I will not be present for the wind-up.
I congratulate my hon. Friend the Member for Halifax (Mrs. Mahon) on securing this Adjournment debate on an issue of paramount importance.
Conservative Members have argued that women who fall foul of the law should not be treated any less leniently. No Opposition Members would argue against that—if women offend, they must be punished. However, I strongly argue that, as most women prisoners, who number more than 1,000 according to Home Office figures, are imprisoned for minor offences that do not involve harming an individual—such as defaulting on fines—they should not be incarcerated. It is entirely possible for an alternative form of punishment to be applied to women who are in the main mothers, and preponderantly single mothers. We are punishing not only them but their innocent children.
If the Government listen only to the argument that society is protecting the taxpayer by imprisoning such women, I remind Conservative Members that it costs more than £451 a week to keep a woman in prison, and that a child taken into care costs the taxpayer £45,000 a year.
Ms Jean Corston: When I visited Holloway prison nearly two years ago, women were faced with a terrible and stark choice once their babies reached the age of nine months. If a woman wanted to stay in Holloway, because, for example, she had other children in London, the baby was taken into care. If she wanted to keep the baby with her, she had to go to a prison in the north of England, thereby facing separation from her other children. Does my hon. Friend agree that that is an appalling way to treat mothers?
Ms Jackson: I agree absolutely. That is an appalling way to treat mothers and a ghastly lesson for their children to learn—that society has no care or feeling for them. The Howard League, for whose information I am most grateful, states that estimates lead it to believe that more than 8,587 children are left without a parent because their mothers are serving prison sentences for, in the main, minor offences. The league deems the true figure to be infinitely higher, as many women sent to prison for minor offences do not reveal that they have children, because they are afraid that they will be taken into care.
The issue of how society punishes mothers who have offended against the law must be reviewed. Currently, society is punishing not only mothers but their essentially innocent children.
10.33 am
Mr. George Howarth: I congratulate my hon. Friend the Member for Halifax (Mrs. Mahon) on initiating this debate, with the typical generosity of spirit that we associate with her, and in such a thoughtful way.
We should try to put the issue in the wider context of what has been happening and is happening in the Prison Service. The service has a contracting budget. Governors are expected to lower the unit cost per prisoner over the next two or three years, but there is a rising prison population. It currently numbers 52,000, but that figure varies one way or the other by 500 prisoners each month. Most experts agree that the figure will probably rise to between 56,000 and 57,000 by the end of this year.
That situation must be underwritten by the co-operation of the Prison Service, yet the morale of the people who work in it has never been lower in living memory. They have been confronted with privatisation and market testing, and they feel that the contribution they could make is constantly undermined by the Government, and by Home Office Ministers in particular. Even governors who occasionally get into difficulty, in some cases through no fault of their own, are scapegoated by Ministers.
Miss Widdecombe indicated dissent.
Mr. Howarth: Well, in that context, the co-operation that the Government need to implement any reasonable prison policy is not there, which cannot be ignored.
The hon. Member for Hastings and Rye (Mrs. Lait) must be the only hon. Member who maintains that one can readily define a split between policy, which is the prerogative of Ministers, and operations, which are allegedly the sole province of the Prison Service. I will, for the hon. Lady's further edification, quote directly from Hansard the Home Secretary's statement last Thursday:
"We are confident that the revised policy provides the correct balance without reducing security to unacceptable levels."—[Official Report, 18 January 1996; Vol. 269, c. 893.]
We have it from the mouth of the Home Secretary himself that handcuffing and chaining women during labour was a matter of policy. He conceded that in his statement.
Most sensible Members in all parts of the House accept that that practice was unnecessary and certainly barbaric, but I wish to distance myself from some of the more personal attacks made on the Minister of State.
Mr. Boateng: Hear, hear.
Mr. Howarth: However, the Minister cannot and must not maintain that she did not know about the practice. The chairwoman of Whittington hospital trust had written to the Prison Service about the practice. I mentioned the matter when I had a private meeting with the Minister and the Director General of the Prison Service, and voiced my concerns in early December.
Mr. Corbyn: Does my hon. Friend recall that, when we visited Holloway prison just before his meeting with the Minister, we met some of the women who had been handcuffed in Whittington hospital? It was clear to us both that Whittington had complained about the handcuffing of women entering the hospital for treatment,
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often for antenatal care, and that the issue had been raised with the board of governors and the prison governor. The concerns were well known by a range of people. I find it surprising that the only individuals who did not know of them were at the Home Office. I find that scarcely believable.
Mr. Howarth: I confirm my hon. Friend's observations. He has saved me having to make those points myself. When we visited the prison, I was concerned about the policy and the wider difficulties. I am not at all surprised that the chief inspector's staff walked out of Holloway prison during their visit. That is the sorry pass that we have come to.
On 30 November 1995, 2,072 women were held in prisons, as has been mentioned. Not all had been convicted—about 400 were on remand. The women's prison population has been growing, and we must be honest and admit that the offences for which women are held on remand or convicted are generally in a different class of criminal than those typically associated with men. The figures show that 37.1 per cent. of women are in prison for non-payment of fines, and only 7.6 per cent. are there for violence-related crimes.
Mr. Sweeney: Will the hon. Gentleman give way?
Mr. Howarth: I will not give way, because I have only a short time, and the Minister will have only a short time. The hon. Gentleman has intervened often enough.
The pattern of crimes committed by women is wholly different from that associated with men. The hon. Member for Billericay (Mrs. Gorman), in a typically eccentric contribution—
Ms Abbott: She is not eccentric.
Mr. Howarth: My hon. Friend is characteristically generous.
There is a difference between women in prison and men in prison, and that has been recognised since Victorian times. I do not know which history of women in prison the hon. Member for Billericay has read, but I am sure that she is a fan of the utilitarian, Jeremy Bentham. Even he accepted that there is a difference between women in prison and men in prison, and that the arrangements for them needed to reflect that.
I would like to say much more, but time forbids. It is necessary sometimes to pause in the operation of public policy, and if the great furore that has taken place over the past few weeks produces anything good, it should be a reassessment of what we want to achieve by putting women in prison.
I think that hon. Members on both sides of the House agree that the Prison Service has three aims. The first is to punish, which is a legitimate step to take on behalf of society. The second is to protect society by removing some people from general circulation to prevent them from creating more mayhem in the community. The third must be—I know that the Minister accepts it, because she has said so before—rehabilitation. Without rehabilitation, the whole process is a waste of time.
We must question whether the Prison Service is achieving those aims. It is not doing so in Holloway or in Styal, which has a high level of drug abuse among its

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women. Perhaps it is time to pause and ask what we are achieving for women in the prison system. Are those punishments for non-payment of fines the most appropriate ones?
Dr. Robert Spink: What would the hon. Gentleman do?
Mr. Howarth: I shall deal with that, if the hon. Gentleman will hold himself in patience.
Are there alternative ways of punishing and rehabilitating women that might be more appropriate and more effective? I wish to make an offer to the Minister. Will she set up an inquiry, not necessarily a high-profile one, to consider what alternatives may be available to punish women for non-payment of fines?
If the Minister was serious about that, and appointed the right people, who were prepared to consider the problem dispassionately and thoughtfully, we would be willing to co-operate—as, I am sure, would other parties in the House. If we could arrive at a formula for punishment that was acceptable to the House, was recognised as sensible by the general public, and, most importantly, was a more effective way to deal with the problem, we would all gain. Public policy, the Minister and the Opposition would all gain, and we would deal with the problem more intelligently.
If we could stop slinging abuse across the Dispatch Box—something I would never do to the Minister—and pause to give some thought to how we are dealing with the problems, we would reap the benefits. I make that offer to the Minister seriously, and I hope that she will take it up. I also hope that, after this debate, we shall start to deal with the problem more effectively and sensibly, instead of trading slogans all the time.
10.46 am
The Minister of State, Home Office (Miss Ann Widdecombe): I wish to start my reply to this debate by paying a tribute to the Prison Service. It has come in for much unfair criticism for some time, and it is right to put on record what it has achieved.
Escapes are now down by 77 per cent. compared with the figure when the Prison Service became an agency. No prisoners are now held three to a cell, and have not been since March 1994, compared with 1,053 in April 1992. At the end of December 1995, 17 per cent. of the prison population were held two to a cell for one, compared with 21 per cent. in April 1992. More than 96 per cent. of prisoners now have 24-hour access to sanitation, compared with 70 per cent. in March 1992. All that has been achieved against a background of a prison population that has risen from 43,400 in April 1993 to 51,300 in mid-January 1996—an increase of 18 per cent.
The Prison Service has provided more than 5,000 new and refurbished cells since it became an agency. Prisoners now spend 7 per cent. more time in purposeful activity than in 1992–93. At the end of December 1995, 36 per cent. of prisoners were unlocked for more than 12 hours per weekday, compared with 24 per cent. at the end of March 1993. All that has been achieved, not just against the rise in prison population, but against a reduction in the cost of a prison place of 2.4 per cent. in real terms.
The combination of the fall in escapes and the rise in purposeful activity, unlocked time and access to decent sanitation points clearly to a lack of any conflict between
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security and rehabilitation. It is often suggested that there is a natural conflict between the two, but, as the clear statement of purpose outside every prison demonstrates, we are committed to security.
Mr. Boateng: The Minister is arguing that there is no conflict between security and rehabilitation. Does she believe that Richard Tilt, the acting Director General of the Prison Service, was wrong when he said:
"The problem for the Prison Service is that we are trying to balance security with treating people humanely. They are often in conflict"?
Who is right, the Minister or Mr. Tilt?
Miss Widdecombe: There is no conflict between the two statements. It is clear that Mr. Tilt made that statement about a particular issue. He was explaining, as I myself have had to explain to the House, that sometimes there is a difficulty in balancing security against dignity. There is no conflict between the two purposes of the prison system—to hold people securely in custody and not let them escape, and to rehabilitate them and raise the chances of their being returned to society as law-abiding and useful citizens. The second purpose is also a major contribution to public protection, and there is no such conflict.
Now that I have said that rather fiercely to the hon. Member for Brent, South (Mr. Boateng), may I thank him for his sedentary intervention in support of his hon. Friend the Member for Knowsley, North (Mr Howarth), when he condemned the attacks on me? I also wish to pay especial tribute to the wife of the hon. Member for Littleborough and Saddleworth (Mr. Davies). I hope that he will convey to her my genuine thanks for what she has done.
I have listened with great care to the points that have been raised this morning. I regret that, because of the time constraints, I will not have the opportunity to answer them all. I shall, however, try to deal with some of the points raised in the time available.
I turn first to the opening paragraphs of the speech by the hon. Member for Knowsley, North, in which he said that I should not claim that I did not know what was going on. It is very important to put the record straight. I have never claimed, in the House or outside it, that I did not know what the policy was. Indeed, the hon. Gentleman will remember that, when he came to see me, the acting Director General of the Prison Service gave him, in my presence, a full exposition of what the policy was. I have never claimed not to know it.
What I said was that I did not know that concern had been expressed by the Whittington hospital about Holloway practice. That statement was utterly truthful, according to the knowledge I had at the time. When I came into the knowledge that had not been available to me, I took the earliest possible opportunity to rectify the situation. Will the hon. Gentleman confirm that what I have said is a truthful statement?
Mr. George Howarth: I would never accuse the hon. Lady of deliberately misleading the House or anyone else, but can she confirm that, when we met on 10 December in her office with the acting Director General of the Prison Service, I raised with her the fact that I was aware that Whittington hospital trust had been in touch, possibly initially with the Department of Health but certainly also

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with her office, to raise its concerns about the medical implications of what was going on? She was aware of that at the time. If I remember rightly, she said that she had had some dialogue with a ministerial colleague at the Department of Health about some of the issues that worried the Whittington hospital trust.
Miss Widdecombe: No, there is some confusion here. I had certainly had dialogue with my noble Friend Lady Cumberlege, but that was on the subject of health care throughout the Prison Service, not on this specific topic. That is where the confusion arises. I was assured, I queried the assurance, and I was reassured that there had not been any specific complaints about Holloway practice from the hospital to the prison. I do not think that there is any point in rehearsing the matter much further; I have stated the position as it was.
Ms Corston: Will the Minister give way?
Miss Widdecombe: No, I am pressed for time. I should like to give way; indeed, I have already given way twice in the course of my summing up. The hon. Member for Knowsley, North did not give way at all.
Mr. George Howarth: Yes, I did.
Miss Widdecombe: There have been claims by the Opposition throughout this debate that women prisoners and women in general, on being sentenced and convicted, are treated more harshly than men. It is worth recording that, in 1994, the last year for which complete statistics are available, 16 per cent. of adult males were sentenced and cautioned for indictable offences, and were given either an immediate or a suspended prison sentence. The number of adult women similarly treated was 6 per cent.
The use of community sentences for female prisoners has also been mentioned. I regret that we have no published figures later than the year 1993. Nevertheless, those figures show that 6,885 female offenders received probation orders, 2,998 received community service orders, 803 received supervision orders, 696 received combination orders—making a total of 11,382 female offenders who were the subject of community sentences. In the same year, the number of female receptions in prisons for immediate custody was 1,929. I therefore do not think it true to say that there has been a disproportionate use of prison.
We have also heard much from the Opposition about the imprisonment of fine defaulters. When they arrive with us, it is always because the courts have exhausted all other remedies. There has to be a final deterrent, but it is still worth keeping the problem in proportion. On 31 October 1995, there were 414 fine defaulters in the entire prison estate, of whom only 19 were women. So, at any given time, less than 1 per cent. of the female population is in prison for non-payment of fines.
The hon. Member for Halifax (Mrs. Mahon), who initiated this interesting debate this morning—on which I neglected to congratulate her at the beginning—brought up the problem of a Holloway female prisoner with breast cancer. As she has raised the matter, I think it worth pointing out that that prisoner goes to the Middlesex
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hospital four times a week. There are two officers on escort duty, and as far as operationally possible the prison makes every endeavour to ensure that both are female. I do not claim that they have always been female, but efforts are made to that end. Physical restraints are applied as a result of a risk assessment.
The Home Secretary made very clear our policy with regard to treatment in hospital. It is worth repeating some of it, although I do not intend to go into all of it, because it is important in respect of the essential point that the hon. Member for Halifax has raised: how we treat people who go to hospital for treatment for conditions other than pregnancy.
First, the Home Secretary made it clear that female prisoners who are admitted to hospital to give birth will not have handcuffs or other physical restraints applied to them from the time they arrive at the hospital until the time they leave. So, while a mother is attending to her child after birth, breast-feeding and so on, she will not be subject to restraints.
Secondly, female prisoners attending hospital for antenatal checks will not have restraints applied to them in the public waiting areas of hospitals. Restraints will not be applied at all during antenatal appointments. The hon. Member for Halifax expressed concern about the use of restraints when difficult treatment is being given, and I understand that point. Restraints may be applied if there is a particularly high risk of escape. Indeed, the hon. Lady herself conceded that restraints would be necessary in such cases.
For cases not associated with pregnancy, governors retain their discretion to decide what security measures are necessary. They must do a thorough risk assessment; following that, some female prisoners can go to hospital on temporary licence—in which case, they take themselves and bring themselves back. But in most other cases, physical restraints will be used.
If, following the risk assessment, the governor decides that restraints are unnecessary, they will not be used. In such cases, the prisoner will be accompanied and supervised by Prison Service staff. If there is a medical objection to the use of restraints at any time, the policy remains—it is not new—that restraints must be removed.
In the concluding minutes of this debate, I want to give a breakdown of the population of female offenders. There has been much talk today about the pettiness of the offences for which, allegedly, most female offenders are in prison. The precise statistics are as follows: violence against the person, 11 per cent.; sexual offences, 0.4 per cent.; burglary, 3.8 per cent.; robbery, 2.1 per cent.; theft and handling, 40 per cent.; fraud and forgery, 10.5 per cent.; drugs offences, 10.4 per cent.; other offences, 16 per cent.; offences not recorded, 5.8 per cent.
A specific point about the provision of education at Holloway was mentioned by the hon. Member for Islington, North (Mr. Corbyn). Education in the prison is provided by Kingsway college, and additional money has been put in the education budget for Holloway this year. Far from suffering a cut, therefore, it has attracted additional money.
I should like to say a few words about our overall aims—
Mr. Corbyn: And staffing levels.
Miss Widdecombe: The hon. Gentleman will be aware that, even preceding the inspector's report, we recognised

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that there were problems and had put in an extra £326,000, with a specific view to provide extra staff. Following the inspector's report, we drafted in some temporary staff to plug the gap before permanent staff were employed. I hope that that provides some reassurance to the hon. Gentleman. If he has worries about this, he is welcome to raise them with me at any time, as I am aware that he has a genuine constituency concern.
In the final minute of the debate, I should like to say something about our overall aims. I am committed, as the hon. Member for Knowsley, North admitted, to a rehabilitative regime in our prisons. I can think of nothing more—
Mr. Deputy Speaker (Sir Geoffrey Lofthouse): Order. Time's up.

Single Currency
11 am
Mr. Christopher Gill: I am extremely grateful for the opportunity to debate the consequences of abolishing the pound sterling. I appreciate that the debate is about the implications for the United Kingdom of a single European currency, but in plain language what we are really talking about are the consequences of getting rid of the pound. I hope that the sensibilities of right hon. and hon. Members will not be offended if I continue to express myself in those terms.
The debate takes place against the background of a round-table meeting in Brussels, hosted by the European Commission, to discuss the single currency. It will provide an opportunity for the 400 participants, who represent a wide range of interested parties from throughout the European Union, to discuss their expectations, concerns and ideas about the single currency.
There is absolutely no doubt where the European Commission President, Jacques Santer, stands on these matters. He is reported as having said to the European Parliament last Tuesday that a single currency was crucial in building a dynamic, strong and prosperous Europe. He went on to say that, with some member states devoting 20 per cent. of their budget to servicing their national debts, Europe would have to put its economic house in order anyway, regardless of whether it was introducing the single currency.
Indeed, as Europe's largest-circulation English language newspaper, the Europa Times, stated in March 1995:
"A single currency needs uniformly low inflation and stable exchange rates. But with low inflation and stable exchange rates who needs a single currency?"
That view was echoed in the business section of The Sunday Telegraph on 12 March 1995, which quoted the European Commission itself as saying:
"Since the empirical research has not found any robust relationship between exchange rate variability and trade it is not possible to estimate the increase in intra-EC trade that might derive from the irrevocable fixing of exchange rates."
I remind the House that both reports that I have just quoted came after 108 of my right hon. and hon. Friends signed early-day motion 581, tabled by my right hon. Friend the Member for Mole Valley (Mr. Baker) on 8 February 1995, which called on the House to congratulate the Prime Minister on making it clear on 8 January 1995 that it is not in the United Kingdom's interest to join a single currency in 1997, and on his confirmation that there are no proposals for legislation necessary for the purpose or for the United Kingdom to accept any changes at the intergovernmental conference that will impact on the constitution of the United Kingdom, and further noted his rejections of support for the principle of a single currency by the Leader of Her Majesty's Opposition and by Mr. Jacques Santer.
It is gratifying to see that the judgment of my colleagues was endorsed by the findings of the Henley Centre for Economic Forecasting, which reported in EP News, the newspaper of the European Parliament, in September 1995, that popular support in the United Kingdom for a single currency was only 31 per cent.—a figure which, broadly speaking, was endorsed by the

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findings of the Commission's private polling announced this Monday, which showed support for the abolition of the pound at 36 per cent. Clearly, no popular mandate exists for abolishing the pound. Nor, indeed, has one ever been sought.
It is my intention not to burden the House further with reports and opinions of other people in other places, but rather to turn directly to the facts that should concern us as Members of Parliament, answerable and accountable, as we will shortly be reminded, to the electorate whom we represent. The first fact concerns unemployment. In October 1990, when this country joined the exchange rate mechanism, unemployment totalled 1.67 million. Less than two years later—23 months—when we unceremoniously left the ERM, unemployment had soared to 2.85 million. There will be right hon. and hon. Members who will say, "Well, that was just the way the cookie crumbled on that occasion." Let me remind the House that that was precisely what happened when we were on fixed exchange rates between 1925 and 1931. I shall give the House the figures.
In 1925, when we joined the gold standard, unemployment stood at 1.25 million. By 1931, the figure had risen to 2.9 million. That has been the cost to this country of fixed exchange rates. The cost to my constituents has been the jobs that they lost and the consequential loss to many of them of their homes, because they could not keep up their mortgage repayments. In some cases, they lost their businesses.
Mrs. Teresa Gorman rose—
Mr. Gill: I can see that my hon. Friend wishes to intervene. I must make it clear that I shall not be taking any interventions, because I want to allow maximum opportunity for other colleagues to make their contributions to the debate.
Are the figures that I just quoted on unemployment a price worth paying for what is no more and no less than an economic theory? Even if they are, who in the House will vote for a single currency? Certainly not all hon. Members on the Conservative Benches, and definitely not all hon. Members on the Opposition Benches.
Mr. Walter Sweeney rose—
Mr. Gill: I am not giving way.
Indeed, there is increasing doubt that such a measure would command a majority in the House, even on a free vote. Why can we not simply conclude that a single currency is not in Britain's interest? Why must we keep up the pretence that, in spite of experience and all the political pain along the way, one day—miraculously—it will all come right? What the country needs is certainty. Decision makers in trade, industry and commerce need certainty, as do individuals, families, and—dare I say—politicians, particularly if they are seeking re-election, because in the final analysis there are no votes in equivocation, obfuscation and prevarication.
I hope that, when my hon. Friend the Economic Secretary responds to the debate, she will be able to provide the House with some sound and positive reasons
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for abolishing the pound. Before she does that, I remind her of yet another fact. Between 1925 and 1931, while the country was on the gold standard, economic activity stagnated, just as it did between 1990 and 1992 during our membership of the ERM. On each occasion, the abandonment of fixed exchange rates resulted in dramatically reduced interest rates—from 6 per cent. in September 1931 to 2 per cent. a mere nine months later, and from 12 per cent. on black Wednesday to 6 per cent. only three months later.
In both instances, the start of economic recovery coincided with the abandonment of fixed exchange rates, the effect of which had been to choke off exports due to an unrealistic and uncompetitive exchange rate, and to choke off investment due to the necessity to keep interest rates high to sustain a totally arbitrary rate of exchange. That was a vicious circle, the inevitable consequences of which were, as I have described, unemployment, economic stagnation and all the consequential effects on Government expenditure and the public sector borrowing requirement.
We should look at the situation today, now we are free of the straitjacket of fixed exchange rates. On 20 June 1995, The Daily Telegraph, in an article headed:
"Britain runs ahead of EU rivals"
said:
"Britain outpaced its main European rivals last year, achieving a growth rate of 3.8 per cent. against 2.9 per cent. for Germany, 2.7 per cent. for France and 2.2 per cent. for Italy."
The report then said:
"Norway, which decided to stay out of the EU, experienced a 5.1 per cent. rise in its gross domestic product last year."
Last week, The Daily Telegraph, in an article headlined,
"Britain shows the way on jobs"
said:
"On internationally agreed measures, the jobless rate in Britain, has fallen to 8.1 per cent. against a European average of 10.6 per cent. Unemployment has reached 11.4 per cent. in France and 9.9 per cent. in Germany."
If my analysis of the effect of fixed exchange rates on interest rates, unemployment and economic activity in Britain is wrong, I am sure that the House will be quick to correct me.
Another question arises from the proposition to abolish the pound. It is the associated costs of doing so—the costs to the Treasury, to banks and the financial sector, and to trade, industry and commerce, not to mention to the general public. Various bodies have made inspired guesses as to the overall cost, but one thing is for certain—Treasury Ministers, as evidenced by their written answer to me on 6 December 1995, do not know or will not tell. They will only say:
"there will be transitional costs to business and public authorities, associated with the changeover to the single currency. These potential costs would be one of the factors that would need to be taken into account, at the appropriate time, when the Government make their assessment of whether it is in the United Kingdom's interest to join a move to the third stage of economic and monetary union."—[Official Report, 6 December 1995; Vol. 268, c. 261.]
In other words, there will be no cost-benefit analysis because, as is all too plain to see, the decision to abolish the pound will be made, not for economic but for political reasons.
Without a shadow of doubt, the abolition of the pound, and all other national currencies in Europe, and the creation of a single currency, is the keystone to the

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completion of political union—the very apogee of the integrationists' dreams. The implication is that, by not ruling out the abolition of the pound, Her Majesty's Government are reconciled to the inevitability of political union. Again, if I am wrong, let my hon. Friend the Economic Secretary say so unequivocally, but I should perhaps warn her that many Conservative Members will need much convincing that political union does not follow monetary union as surely as night follows day.
I say to the House in all sincerity and with all due humility, this is not an enterprise to be entered into lightly. What we are talking about is the ending of 600 years of parliamentary democracy; the ending of the freedom of the British people to make their own laws in their own Parliament and according to their own preferences freely expressed in British ballot boxes.
Abolition of the British pound would be the final curtain call for the independent nation state. The issue cannot be fudged. The party managers cannot hope to finesse the outcome of a vote on a matter of such crucial importance. I call on our Government to dismiss the proposition for what it is—a mischievous and highly dangerous irrelevance which serves only to distract us from all that we might otherwise be more profitably doing.
11.14 am
Mr. Hugh Dykes: Thank you, Mr. Deputy Speaker, for calling me. I am grateful, as I am sure are other hon. Members, to my hon. Friend the Member for Ludlow (Mr. Gill) for initiating the debate, although they do not necessarily agree with most of the points that he has made.
If it does not offend anyone, I should like to follow my hon. Friend's excellent principle of not necessarily giving way to interventions because I am sure that that will allow more hon. Members to take part. I hope to be brief.
At the beginning of last November, the European Commissioner in charge of the EMU plans, the French Commissioner, Yves-Thibault de Silguy, confirmed yet again that the European Union is on target to commence the single currency by 1 January 1999, the expected date of commencement in Europe generally—at least in the rest of Europe.
That statement runs contrary to the superficial counter-propaganda that appears in some British newspapers—they have been growing in number slightly recently—that appear to be nervous and timid about the prospect. They constantly seek to undermine the plans, usually because of the reactionary attitudes of their non-British owners and short-sighted editors. The journalists have to follow suit because, after all, everyone is involved in the circulation battle.
The Commissioner's robust reaffirmation was welcome to those who are keen on this most exciting project and was particularly welcomed—it was mentioned specifically by a number of people—in what I would call financial and City circles. It also fits in with the optimistic and realistic expectation of the Commission President, Jacques Santer, who has now on three separate occasions emphatically reaffirmed his expectation that seven to nine countries could be in line to join in the unified currency system at, or close to, the target date without any impairment of the existing convergence criteria.
There is an interesting possibility that one of the best candidates for convergence criteria realisation will be the United Kingdom although, officially, the Government have
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our reserve on the opt-out, which seems to meet with the support of most of my hon. Friends for the moment. That is a reserve which in no way says that the United Kingdom is against monetary union or Britain joining it; it just says that we will make that crucial decision at a later date depending on the circumstances that are then emerging.
In the same November statement, Mr. Silguy reiterated, with enormous justification, once again the main objectives of the single currency system. The first is to boost growth and job creation in the future throughout the single market. My hon. Friend the Member for Ludlow is right to point up differences in unemployment figures because the member states' economies have not reached the full real economy convergence, aside from the statistical convergence that is necessary under the programme, that will gradually come as more and more intra-community trade develops. We know already how high our export ratio is to the other European countries.
Secondly, Mr. Silguy reiterated with great emphasis the need to eliminate the unnecessary bilateral and multilateral exchange costs that come from having different currencies in a single market. It is an interesting phenomenon, and a puzzle to me, that Conservative Members, and politicians and others in the United Kingdom generally, who are rightly keen on the single market in all its aspects, which are numerous, from specifications to measurements to trading conditions to standards—the whole edifice of the single market, which is more than just a trading area, as we know—are against the most essential lubricant of the single market; the need for currency harmonisation.
Those extra costs, which exist as a result of having differential currencies, aside from the disutilities of the fluctuations that occur, are estimated conservatively to be a minimum of 0.5 per cent. of combined European Union GDP. That is a vast amount of unnecessary expenditure. I should have thought that it was a good Conservative philosophy not to be in favour of unnecessary, expenditure and wasting of money.
Thirdly, the French Commissioner said that one of the crucial objectives was the cutting of costs for companies—the corporate sector is the most important aspect of that—to ensure that they are not burdened unnecessarily. Conservative Members are rightly keen, particularly with our deregulation policies—this is an aspect of that—to cut the unnecessary costs that companies face. During the past six to nine months, virtually all finance directors have probably expressed the view that the single currency is necessary.
Most important, however, is the need for the single currency not merely to satisfy keen pan-European politicians—regardless of the member state to which they belong—or, indeed, the central banking elites, but to be in the interest of consumers, who, under the Maastricht treaty, are now citizens of the European Union as well as of their own countries. European consumers—patriotic British, French, German and Italian consumers—are increasingly mobile: they want to move around the European Union in economic as well as social and holiday terms, and they rightly want the best possible bargain as purchasers of goods and services.
Boosting mass interest of consumers in the prices of consumer durables and all the available services—to be quoted in the same currency denomination or price expression—would be of enormous advantage to the

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public. They are slowly beginning to realise that, although—as has been said—they are understandably apprehensive because of false propaganda in the British papers.
I shall give an example of what I am describing, to calm the excited spirits of some of my colleagues who, as we know, wish to live in the past. It is generally recognised that, for some inexplicable reason, motor car final retail prices in Britain are generally higher than those in Belgium, France, Germany and other European countries. Apart from duty differences, no one really knows the reason for that. About four years ago, the Department of Trade and Industry carried out a wonderful investigation, but reached no conclusion other than blaming the sinister impact of some intermediaries—and even that was not properly explained.
We can imagine how the British public—Mr. and Mrs. John Citizen—would feel if car prices were expressed in the same currency denomination, in terms of the euro or whatever it will be called in the future. They would be able to compare the prices of many other consumer durables as well. That is the magic of the single currency and the single market. It is better to bear that in mind than to theorise about convergence criteria, low inflation rates and all the other matters that—understandably—preoccupy the central bankers.
The Commissioner's November statement was important because it provided the basis for Commission and European Union plans for Ministers' policies, and because it was accepted by member Governments at the time. The Commissioner rightly avoided any partisan comments about what the United Kingdom or Denmark should finally decide to do, equipped as those countries are with their reserve opt-out. However, he felt strongly—and I agree with him—that it would be in the United Kingdom's interest to remain an active participant in the detailed preparations for the commencement of the new currency on 1 January 1999.
I thank the Government wholeheartedly: although, for self-evident reasons, we have that constitutional, legal and political reserve, they have participated fully in all the working groups and other preparations as though we were going to join the single currency in any event. That is, of course, unavoidable; it would be very difficult for the Government not to participate, and no final judgment arrêté arises. The Government are simply being very practical. I believe, however, that their actions will in due course help to reassure the public that a single currency is an attractive proposition.
We are not talking merely of the practitioners in the financial markets, and all those who must deal with the increasingly old-fashioned syndrome of European currencies clashing and bumping against each other without any real rationale. Let me offer a chilling reminder of the behaviour of the United Kingdom's national currency. Since 1950, or the year before, when the deutschmark was established, the pound sterling has fallen by 90 per cent. against the deutschmark, which is the most successful currency in Europe.
The general perception is that, in broad output and production terms, the German economy overtook the British economy—sadly for this country—in 1955. Since then, the pound sterling has depreciated against the
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deutschmark by 79 per cent. Lest those of us who are consumed—as we all too often are—by huge prejudices against our friends in Italy think that the Italian lira has performed less well, I should point out that the difference is not great: the lira has depreciated by 84 per cent.
The sad reality is that that progressive depreciation of the pound has not built the United Kingdom up into a strong, high-output, dynamic economy. Economists never agree about anything, but if one factor can be singled out as the most important it is the rate of reinvestment in new assets. That must be the characteristic of the future strength of production, and of the balance between manufacturing industry and other services in significant economies.
I only wish that Britain were ahead of Germany now. We would have been if, in the 1950s, 1960s and 1970s, we had pursued different currency and reinvestment policies—but, for numerous reasons, that was not to be. Certainly, the latest devaluation of sterling has led to no long-term, durable improvement in the British economy, although I welcome the short-term cyclical improvement. It is good to see the economy recovering in a short-term statistical sense.
We should note the courage of the French in maintaining a high-currency policy despite the pain being experienced in Paris. The French franc is now higher against the pound than it was in December, despite what the British newspapers have said. That policy is now creating a high-production syndrome in France, similar to that in Germany. It will achieve the desired result in the longer term.
We need to exercise common sense in regard to the single currency. We must wait to see how convergence develops. I think that the United Kingdom will be a prime candidate, but we should show more self-confidence, and feel more excitement about the future and more willingness to explain the issue to the public. I am sadly, but understandably, reluctant to agree with my hon. Friend the Member for Ludlow.
11.26 am
Sir Teddy Taylor: Although my hon. Friend the Member for Harrow, East (Mr. Dykes) has been consistent in his views over the years, I think that, as a truthful person, he would accept that the opinions that he has just expressed are now held by a minority in the Conservative party. The party has woken up. I find it a tragedy that the Labour and Liberal Democrat Benches are virtually empty. We simply cannot persuade Labour and Liberal Members that monetary union is not a miracle, and will not bring benefits.
Mr. Sweeney: Does my hon. Friend agree that the almost complete absence of Opposition Members demonstrates that Labour is soft on European union, and soft on the causes of European union?
Sir Teddy Taylor: The last thing that I want to do is attack the Opposition parties. I want to persuade them that they are supporting a policy that will create unemployment, misery and degradation. I only wish that every Labour and Liberal Democrat Member would read the book by Mr. Connolly, the man who headed the department dealing with economic and monetary union in the Commission. He put at risk an easy, cushy number—

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a big job with big pay and big prospects—because he believed passionately that economic and monetary union would create mass unemployment and civil unrest. Unfortunately, however, there is nothing that we can do to persuade people.
Apart from my hon. Friend the Member for Harrow, East, few Conservatives would support monetary union. The Minister—she, too, is a truthful person—could help to involve the public by answering five brief questions. First, what about the tragedy of France today? France is one of the loveliest countries in the world, and contains the most fascinating people, but it is now creating more and more unemployment. It is putting people out of work and creating human misery solely for the sake of a mad policy of artificial exchange rates, which every Conservative wishes to have nothing to do with. Surely the Government must accept that our experience in the exchange rate mechanism, France's current tragedy and Germany's problem of 4 million unemployed demonstrate beyond a shadow of doubt that fixed exchange rates are simply a recipe for mass unemployment.
As for civil unrest, if Britain were involved in monetary union—if we had high unemployment and, for good European reasons, the central bank decided to raise interest rates—people would be outraged. They would protest. They would go to the politicians, and would find that they could do nothing. I wish that the Government—despite the sincere views of the tiny minority in our party who still support the crazy socialist nonsense of fixed exchange rates and monetary union—would just come out and say, "We will have nothing to do with it."
However, I move to my questions. First, is it true that, if we get involved with the euro, all our gold and other reserves must be handed over to the European central bank? People should be told the answer. I hope that the Minister will answer so that, through Hansard and through our wonderful press, people can be told the facts.
The second question is: is it true that, if Britain were involved in the euro, no Minister, no individual, no banker, not even my hon. Friend the Member for Harrow, East would be allowed to make representations to the bank about its policy? We all offer advice to the Bank of England and to the Chancellor of the Exchequer. It is appalling that we are going to have a central bank running a nation's economic affairs and that, under the Maastricht treaty, we will not even be allowed to make representations to it. Of course, that may just be silly Euro-sceptic nonsense, but the Minister knows the facts. Her splendid civil servants, who are running up and down to all these meetings all the time, know the facts. Is that true or not? We must be told everything about that matter.
The third question is important to the Conservative party. I was delighted—because I know that, if anyone can solve this problem, our Prime Minister will—to hear the Prime Minister say that Britain will not re-engage in a fixed exchange rate system such as the exchange rate mechanism. My reading of the Maastricht treaty—this is only as interpreted by the European Court of Justice—is that one cannot join the single currency in the first stage unless one goes through two years of fixed exchange rates.
During those two years, in which lots of money will be splashed around to try and create convergence, there will be lots of misery and unemployment, but is it true that, if one is to be one of the first participants in the single
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currency, one must go through two years of fixed exchange rates, which, unlike the ERM, will be irrevocable and irreversible? If so, it would seem from what the Prime Minister said that there is no way in which Britain could be one of the first participants in the euro. People should know about that.
Mr. Barry Legg: I am grateful to my hon. Friend for raising this important point. I would like to shed a small bit of light on this matter. When he returned from the Madrid summit, the Prime Minister said to the House that the convergence criteria under ERM conditions no longer applied. Does that not reinforce the fact that the decision to move to a single currency will be primarily a political rather than an economic decision?
Sir Teddy Taylor: My hon. Friend is expressing the sort of fears and worries that I have. It is exactly because of that that I should like the Minister to say what the truth is. If we are going to be one of the first guys in the euro, do we need two years of fixed exchange rates? If so, does the Prime Minister's statement mean that we will not be one of those chaps? That is a simple question; it is not complicated. It would be helpful if the Government would answer yes or no.
Mr. Tony Marlow: I regret breaking into my hon. Friend's speech, but he will know that, subsequent to the statement in the House, my right hon. Friend the Prime Minister answered a question on this issue from a prominent friend of ours among the Opposition, and the matter is not as straightforward as it appeared when he made his statement on his return from Madrid. I remind my hon. Friend that the criteria are set out in the Maastricht treaty, which is the law of Europe, and that, to have any change in the Maastricht treaty, there must be a treaty amendment, which would have to be ratified by every country in the European Union.
Sir Teddy Taylor: I am always grateful to my hon. Friend for explanations. He shows that the situation is confusing, but this is where the Treasury can help us. We want to know the facts. Is it true that we need two years of fixed exchange rates and, if so, does the Prime Minister's statement mean that we will not be involved?
The fourth question we must ask is: what are the conditions for countries that join at a later stage? It would be appalling if what happened under the then Chancellor of the Exchequer, Lord Lawson, were to happen again. I well remember how Britain unofficially joined the ERM without anyone knowing about it. This is meant to be a democratic House of Commons and assembly, and we became locked into that business without anyone being aware of it. We did not join officially; we joined unofficially. I hope therefore that the Government will help to clarify those four issues, which are terribly important. In particular, will they say what the conditions would be for joining at the second stage and whether the House of Commons would have an opportunity to express a view?
I have opposed the European Community from the beginning, and have believed passionately that it means misery for poor people, high prices and policies such as the common agricultural policy that cannot be changed. Of course, the Government will be aware that this year

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the CAP budget is £9 billion more than it was two years ago. We are all told that it will be reduced, but we know that all those assurances are absolute rubbish. It is terribly important that the Government answer this simple question: do they believe that, before any decision is made to contemplate joining the European Union, the people of the country must be asked?
Frankly, I do not think that most people are aware of the matter. It is not simply a matter of saying, "Do we have a currency that we can go to France and to Italy with?" Basically, if one accepts the single currency, in effect one is accepting a single European state without democracy. Mr. Deputy Speaker, you know that I am a well-behaved person, but the one thing that sickens me, and the only time that I feel like punching people—I really mean this—is when I hear a Conservative Minister say, "We are going to fight a federal Europe." There is nothing more sickening or misleading than that statement because a federal Europe would be infinitely better than what we have. It would at least have a democratic base and lay down guidelines on what belongs to the centre and what to member states. With a single currency, we are planning a single European state without democracy and, more important, a socialist state.
The whole principle of the European Union is artificial pricing, which unfortunately creates massive problems. The monstrous CAP policy, which my hon. Friend the Member for Mid-Kent (Mr. Rowe) supports so lustily, has meant that the average family in Britain spends an extra £28 a week in higher food prices and taxes. Nothing can be done to reform it—if only people would wake up to the fact that that simply cannot happen. The average family in Britain will pay an extra £5 a week for the net membership fee this year. Poor people are suffering and jobs are being destroyed.
Sadly, as Mr. Connolly rightly stated, across the whole of Europe, including dear old France, fixed exchange rates, where they are applied, are putting decent people out of work unnecessarily, and creating an appalling mess and misery. Question No. 5, as the Minister is aware, is: do the Government think that big countries or big organisations have a better future than small countries? Around the world today, all conglomerations of states are not doing well; small countries controlling their own affairs and applying Conservative policies are doing very well.
I shall give just two tiny examples. The first involves a little country called Switzerland. I am sure that my hon. Friend the Member for Harrow, East will have heard of it. How did its exports to the European Community do last year? Strange to say, they increased dramatically more than Britain's did, and that happened by Switzerland not being in the European Union.
Referendums took place in Sweden and Norway. In Norway and Sweden, in which I am interested and which I visit regularly because I am involved in the Ansvar insurance company which promotes temperance, all the people were told that they had to join the European Union to safeguard jobs. The same old Confederation of British Industry blokes we have here told them all that joining was vital. Poor old Sweden voted yes, although I told it not to, and Norway voted no.
What has happened since? Sweden is in an appalling economic mess. I have never heard of such devastating Treasury action taking place in any European country.
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Norway has never had it so good. If we look around the world—at little countries such as Japan and other countries—we will find that prosperity and growth are occurring in small and independent countries and not in ones that get involved with the big battalions.
Mrs. Gorman: What about that little country Great Britain, which is doing more trade with China than it does with any of our European partners?
Sir Teddy Taylor: As always, my hon. Friend is right. She showed great courage and determination in saying such things when we were laughed at and harassed in the party.
Mr. William Cash: Yes.
Sir Teddy Taylor: Yes, indeed. I know that my hon. Friend the Member for Stafford (Mr. Cash) has not had an easy time, but my hon. Friend the Member for Billericay (Mrs. Gorman) has had a terrible time with people attacking her. Her views are now accepted by the vast majority of the party, and I am obviously glad for her. Still, having said that, I should like to pay tribute to her courage and determination throughout this period.
We must remember that, if we are to survive as a small country off Europe we must go for world trade, low costs and the Conservative policy of getting away from artificial subsidy. I believe that the Economic Secretary to the Treasury is a straight and honourable person and I hope that, instead of voicing the usual Treasury nonsense, ambiguous words and things that mean nothing, she will tell people five simple facts. I have asked her for factual information. I know that we will receive that information from her and that it will be a major contribution to this desperately important debate.
In the next election, how great it would be if it was made clear to the people of Britain that the Conservative party will have nothing to do with this undemocratic, socialist job-destroying nonsense, and that the Labour party—sadly for the working class—will be supporting that nonsense, as will the Liberal Democrats, for reasons that I have never understood. If the people had a choice, they could vote for freedom and liberty and the end of all this nonsense. If the people could have a choice, it would be great, but it would require the Government to take a firm stand. I am sure that the Minister would be willing to do that; I hope that the Government will also.
11.40 am
Mr. Andrew Rowe: My friends and family sometimes tell me that one of the many reasons why I have never been asked to join the Front-Bench team is that I have an uncanny habit of naively exposing the fact that I am not as sophisticated or well informed as many people, and that I should keep my mouth shut when I do not know what I am talking about. I am not an economist and, unlike many of my hon. Friends, I feel insecure in talking about economic concepts. There is not a great deal of harm, however, in exposing to the House the type of difficulties that the ordinary punter faces in this debate.
I was brought up to believe that devaluation, on the whole, was to be avoided. As my hon. Friend the Member for Harrow, East (Mr. Dykes) has pointed out, however, we have been engaged in devaluing the pound since the

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time I was born, and certainly since the second world war, yet those who most passionately resist any attempts to devalue never seem to talk about any of the costs that are involved therein.
Mr. Bernard Jenkin: Everyone is against devaluation or debasement of the currency. It is important to realise that devaluation of the currency occurs when one has economic inflation and then resists the consequential adjustment of exchange rates, leaving an imbalance between the exchange rate and the real value of the currency which causes the economic dislocation. That is what occurred when we were in the exchange rate mechanism, and that is what occurred under the gold standard.
Mr. Rowe: I bow to my hon. Friend's superior knowledge, but his contribution does not explain the devaluations that occurred in the years before the European Union was even dreamed of.
National power is one of the main issues in the debate. The truth is that the world was once on the gold standard because it was the currency that the United Kingdom used. Worldwide, people wished to be linked with our currency to give their currencies credibility—a function of the enormous power that was wielded by this country. I have told the House before that we are no longer in a position to dictate to anyone in the world. That has marked consequences, shown most clearly in the Suez crisis when the world decided that it did not wish three sovereign states to continue a war and simply pulled the plug on them.
We are in no position to stand alone. Our armed services are so small that, with the exception of certain fire-fighting activities, there is no way that we can operate alone on the world stage. We require the sort of co-operation that is taking place—one hopes with happy results, eventually—in Bosnia. Except in certain cases, we do not even make our own armaments. We make bits of them because we are entirely dependent on our partnerships with manufacturers in other states. The process of gradually moving towards one another is accelerating.
As an ordinary layman, I become rather confused about why there is the tremendous imperative from above to drive us towards a single currency. A single currency will emerge during the years ahead, as sure as night follows day, as we do more and more business with our European partners. As my hon. Friend the Member for Harrow, East said, as more people travel through Europe and find that constant currency adjustments are expensive and tiring, we shall find that businesses increasingly wish to make use of a single currency unit. Big businesses will start the process, small businesses will follow, and tourists will follow that. In my lifetime, I do not expect to be able to buy a loaf of bread in my village bakery—should it manage to resist the supermarkets that long—with a single European currency unit.
Mr. Dykes: I am grateful to my hon. Friend for giving way. I did not give way at all, but he has kindly referred to me twice. Is it not interesting that consumers who go to other European countries are increasingly using credit cards rather than getting too much currency? The equivalent, therefore, is that the single currency becomes the credit card without any charges or expenses.
Mr. Rowe: That is entirely true.
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Having a national currency is no guarantee of independence. I have just returned from Nepal, which is desperate to preserve its national independence and have its own currency. The idea that it is not wholly overshadowed by India, its enormous neighbour, is nonsense. I do not believe that the preservation of our national currency is a guarantee that we will not lose our capacity to act independently. That capacity has been substantially diminished over the years, for the reasons that I have set out.
We are engaged in an extraordinarily acerbic debate about something that has been made more immediate than it should have been by the pressures from the European Union and the central bank. I should much prefer us to evolve towards the single currency which I am sure will follow.
Mr. Marlow: My hon. Friend is making a case, albeit not a strong one, for joining a single currency. Given that any single European currency would include Greece and Portugal—that would happen if he were to have his way—would it not be rather better to join with the dollar and the United States?
Mr. Rowe: I am reluctant to join any closer to the United States. I am fond of the United States and think that it is a fine country, but I should infinitely prefer to resist a great many of the influences that come from it. I do not wish to be closer to a country whose racial problems, for example, could be imported into this country. I do not want such a divide in the United Kingdom. The American culture seems to be destructive of many of the values that we in the House hold dear.
Mr. Charles Kennedy: I apologise to the hon. Member for Ludlow (Mr. Gill), who initiated the debate, for being elsewhere earlier and not hearing his speech. Does not the intervention by the hon. Member for Northampton, North (Mr. Marlow) tell us something interesting about that section of the parliamentary Tory party? The fact that the Americans have concluded a North American Free Trade Agreement in which, unless I have missed something, they did not expect the United Kingdom to participate speaks volumes. Does the hon. Member for Mid-Kent (Mr. Rowe) think that such an approach has any economic coherence given that we are part of a single market?
Mr. Rowe: It is fair to say that my hon. Friends do not stress the fact that we should also join Mexico, although they may prefer Mexico to Greece and Portugal.
It is important not to lose sight of the fact that the origins of the European Union arose from a passionate desire that Europe should not yet again plunge the world into war, the cost of which would dwarf any costs that might be incurred by joining a single currency. This country was ruined as a consequence of our incapacity to contain German expansionism. We have been provided with a mechanism for containing any possible future threat from such expansionism and I am extremely wary of taking steps to turn our back on that.
Mr. Legg: Will my hon. Friend give way?
Mr. Rowe: I think that I have given way enough. Other people wish to speak.

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The European Union must make an effort to contain precisely those pressures that have cost the western world enormous amounts of money, resources and anxiety in Bosnia, to take just one example.
We should therefore evolve towards a European currency, which will come about inevitably, without our having to make artificial efforts to create it. Our membership of the European Union is a partnership that stands by far the best chance of resisting the enormous internal conflicting pressures within the continent of Europe. I hope that we shall not try to bulldoze the Prime Minister and the Government off the strongest position that they can hold, which is that, if other countries adopt a single currency, the United Kingdom will then consider whether it would be beneficial for us to join. The pressure that some of my hon. Friends wish to put on the Prime Minister to say that, whatever happens in the European Union, we shall never consider joining a single currency, would weaken his position absurdly. I hope that they will cease to pressure him in that way.
11.52 am
Mr. Anthony Coombs: First, I congratulate and thank my hon. Friend and parliamentary neighbour, the hon. Member for Ludlow (Mr. Gill), for giving us an opportunity to discuss this important subject and for pointing out that a single currency enjoys not only minimal popular support in this country but dwindling support throughout Europe. The gulf between the political elite in Europe and popular opinion on this issue is increasing, which is extremely dangerous.
I was going to begin by saying that the single currency is an idea whose time has come and now, thankfully, gone. Far from moving smoothly towards its conclusion in 1999, as my hon. Friend the Member for Harrow, East (Mr. Dykes) would have us believe, its wheels are falling off as it moves forward. We have been told that the convergence criteria are being achieved. But only Luxembourg—not exactly a major player in Europe—currently meets those criteria. In 1993, the franc had to be loosened from its 2.5 per cent. band to a 15 per cent. band within the ERM.
It is interesting to read some of the comments of former Maastricht enthusiasts in France, quoted in The Economist this week. Julien Dray, a leading left winger and author in 1992 of a pro-Maastricht book, said that if the fight against the budget deficit was simply to meet the Maastricht criteria,
"our fellow-citizens will rightly soon be saying that they have had enough of this Euro-construction which requires nothing but sacrifices in the name of an Eldorado which no one is any longer sure even exists."
Even Martine Aubry, a former socialist Employment Minister, who happens to be the daughter of Jacques Delors, conceded that a single currency was
"not worth breaking the country to acquire".
Jacques Delors has argued that, if the French and German economies slow down, the deadline for European monetary union and a single currency will not be met. My hon. Friend the Member for Harrow, East would like us to believe that the French and German economies are not slowing down. The latest figures show that, for the past three months, German gross domestic product has been
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falling. In France, industrial production over the past three months declined by 6.4 per cent. If that is evidence of their moving smoothly towards the convergence criteria, those who argue it are living in cloud cuckoo land. Theo Waigel, the German Finance Minister, is also gradually distancing himself from the idea of a single currency by arguing for additional criteria and hinting that Italy and possibly France could not meet them.
The wheels of the single currency are undoubtedly falling off, and the reasons are obvious. First, the idea of a single currency is fundamentally flawed. At a time when European countries need to be more flexible in terms of dealing with the "challenge of global competitiveness", a single currency would impose a straitjacket on them by requiring unrealistic convergence criteria in fiscal terms. It would have no popular mandate in terms of the huge transfers of money from one country to another that would be required to make it work. For example, interest rate changes would have a far greater effect on Britain than on other European countries, for the simple reason that more people in Britain own their own homes. It has been calculated that, in Britain, the effect of interest on ordinary householders as a proportion of their household debt is 10.9 per cent., whereas in Germany it is only 3.9 per cent. and in France it is 3.2 per cent. So the effect of ceding decisions on interest rates to a supranational body would be far greater on British householders than it would be on French or German householders.
Secondly, the Maastricht criteria are, inevitably, heavily deflationary, especially if they are related to the strongest currency, as the Germans insist that they must be, through the exchange rate mechanism. As a result, as we have seen in France, Germany and other countries that have become constricted into preparations for the convergence criteria, our economy would probably gradually contract.
Moreover, budget deficits, the reduction of which is a major Maastricht criterion, will not be reduced as a result of cutting Government spending. That would be a virtuous way of achieving the criteria, especially for countries like Germany where nearly 50 per cent. of the country's resources go to the Government. Instead, they will be reduced by raising taxes, which will make the problem far worse in the long term. It will also worsen the problem of Europe's global competitiveness. So the criteria impose a fiscal straitjacket, whereas strenuous slimming is needed.
The third reason why it is becoming increasingly evident that a single currency is unrealistic is that it is not only anti-competitive but totally unnecessary. The Germans are so keen on it because they want to lock other countries into the very high social costs that they now endure. No less than one third of GNP in Germany goes on maintaining the welfare system, and the add-on to the average wage to cover welfare costs is no less than 80 per cent. As a result, the German economy is becoming increasingly sclerotic, and Daimler, Volkswagen and Siemens—companies that one would think of as paradigms of German competitiveness—have lost 150,000 jobs between them in the past few years.
It is small wonder, therefore, that even people such as the chief executive of the CBI, Adair Turner—he has never been exactly regarded as a Euro-sceptic—have described the inevitable concatenation of a single currency with the social chapter as "an employment-destroying disaster" here and throughout Europe.

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A single currency is also unnecessary, and even the EC is admitting that there is no particular correlation between exchange rate stability and investment or trade flows within the trade bloc. As for Britain being marginalised, I would frankly prefer to be marginalised if our economic performance continued to improve as it has done in the past few years when we have not been part of the ERM, as opposed to how constricted we would be were we a part of it. As evidence for that, the president of the German equivalent of the CBI recently said not only that Britain had attracted nine times as much inward investment as Germany in the past 15 years but that it was the European country best equipped to face the challenge of global competitiveness. That is a result of the flexible, free-market policies that we have been following in this country, away from the constrictions of European monetary union and the single currency.
The main flaw in the single currency enterprise is that its main aims are not primarily economic—however flawed the arguments may be—but political. Helmut Kohl talks about an
"irreversible process for which decisive steps will follow in the next two years".
Mr. Rowe: Does my hon. Friend agree that the Union between Scotland and England was primarily political?
Mr. Coombs: Precisely. My hon. Friend makes my point for me.
When one sees the vilification poured on Bernard Connolly for having the temerity to challenge the intellectual basis on which political union and the single currency are based, the concern felt by many in the EC and the Commission at the feebleness of their arguments becomes ever more evident. The irony is that a single currency will not work unless the conditions for political union are in place. It is obvious that the conditions for political union are not in place, and there is no public support for regarding Europe as a federal body or entity in the way in which a successful single currency would inevitably require.
It is time that the Government recognised that a single currency is a flawed and eventually disintegrating enterprise. It would be very much in their interests if they committed themselves to a referendum on a single currency, if it ever happens—although I do not think that it will ever come to that, and the matter will remain, happily, entirely hypothetical.
Contrary to the Labour party—which is six-sided and hypocritical on this matter as it is on so many policies—we would gain a great deal of political credit if we recognised the single currency as the chimera and myth that it undoubtedly is, and said that to the British electorate.
12.4 pm
Mr. Richard Shepherd: I am pleased to follow my hon. Friend the Member for Wyre Forest (Mr. Coombs). My hon. Friend referred to Bernard Connolly, who has been a good and faithful servant of the Community and has pointed out some of the inherent problems with the way in which monetary matters are managed.
The debate has focused on a subject which has consumed a great deal of the 20th century: the adjustment of exchange rates between one country and another.
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We can go back to the post-first world war settlement, Winston Churchill, the gold standard and the famous and wonderful pamphlet by Maynard Keynes, "The Economic Consequences of Mr. Churchill", the Bretton Woods settlement, through to the fixing of exchange rates by the mechanism that Europe developed. Unfortunately, we joined that system and had some very unhappy experiences in it.
My purpose is not to look at the economic side of the matter, although we know full well that only 44 per cent. of our total trade—visibles and invisibles—is with the continent of Europe, that the principal foreign currency in which we trade is the United States dollar and that we have a critical relationship with the US. Whether the proponents of the single currency or its opponents like it or not, our economic cycles seem to follow more closely those of the United States than those of the central European countries.
I wanted to look at the constitutional argument, which has divided part of our Government and Opposition Front Benchers, and particularly the Leader of the Opposition. Article 107 of the Maastricht treaty, which is justiciable, states:
"When exercising the powers and carrying out the tasks and duties conferred upon them by this Treaty and the Statute of the ESCB,"—
that is, the European system of central banks—
"neither the ECB, nor a national central bank, nor any member of their decision-making bodies shall seek or take instructions from Community institutions or bodies, from any government of a Member State or from any other body. The Community institutions and bodies and the governments of the Member States undertake to respect this principle and not to seek to influence the members of the decision-making bodies of the ECB or of the national central banks in the performance of their tasks."
That is reinforced in chapter 1, article 7 of the constitution of the European system of central banks.
I understand that to mean that no elected representative of the British people—including the present Chancellor of the Exchequer or, should Labour come into office, its Chancellor—may make representations to the central bank in respect of monetary policy, to cite one area. This is a huge constitutional change, and so profound. How is it possible for the Leader of the Opposition to say that he has no constitutional problem with that?
If the Leader of the Opposition becomes Prime Minister, what will he say to the millions who vote for Labour when our economy is out of joint with the central European economies? What will he say when interest rate policies pursued in Frankfurt are not appropriate for the British economy? What will he say to all those who elected him? Will he say that we no longer have the constitutional power? Is that what the present Chancellor of the Exchequer is saying by his promotion of the endeavour?
I suggest that it is a profound constitutional area and it startles me slightly to understand that, on the very basis of article 107 and the subsequent articles, any British Government could contemplate turning round to their people and saying, "I am afraid central European interest rates, although not appropriate for us, are the governing factor." We will then ask what the Government are doing about that and whether they are making the sternest, strongest representations to the government of the European central bank. The present Chancellor would no doubt reply, "Oh no. What does it matter? I no longer

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have authority as we signed it away by treaty without any consultation with the British people." I have not heard a reply from the Prime Minister on that subject, and we have great difficulty in pinning down the Chancellor to specific detail on such matters of great importance.
I had thought, and this may be based on the over-optimism of someone who watches things come and go, that the clear experience of joining a fixed exchange relationship, which ended so tragically and unfortunately less than three years ago, would have exorcised from the mind of the House the desire to enter into something even more absolute. Let us remember that exit from the ERM gave us the ability to make our interest rates more consonant with the needs of the British economy. That was the constitutional power of the British Government.
Now, under the Maastricht treaty, the Leader of the Opposition says that the Labour party has no constitutional difficulty about denying us, the people, the right to influence output, employment and all the necessary apparatus of sensitive management of an economy.
12.10 pm
Mr. Mike O'Brien: I hesitate to intervene in the debate lest I interfere in the private grief of the Conservative party. I suspect that all parties have their own reservoirs of private grief to entertain them. The Minister and I have agreed to be relatively brief, and for that reason I should prefer not to take any interventions as there is a lot to say on the issue.
I welcome the debate and I congratulate the hon. Member for Ludlow (Mr. Gill) on raising an issue of such enormous importance to the people of Europe in the coming decades. It will not surprise him when I say that I fear that the Labour party does not agree with him. The Labour party approves of the principle of economic and monetary union, but believes that questions about the practicalities still need to be resolved. In principle, we believe that in the long term a move towards economic and monetary union through the creation of a single currency would produce significant benefits for the people of Britain and Europe. In particular, a single currency would remove the cost of currency transactions, which have been variously estimated to cost in excess of £15 billion per year. The hon. Member for Harrow, East (Mr. Dykes) said that such transactions account for 0.5 per cent. of GDP of European currencies. It is also likely that a single currency would boost inward investment by reducing exchange rate risks, and in the long term it would create a more stable economic environment for industry by reducing currency speculation.
Unlike the Government, the Labour party has a clear principle to guide it when assessing the criteria and practicalities of entry into a single currency. Getting the circumstances right is important to the Opposition. We will take a hard-headed, businesslike view of the costs and benefits of a single currency. If approached wrongly, a single currency could do enormous damage to the British economy; if approached correctly, it could be a great stimulus to trade expansion, new jobs and prosperity.
The Opposition's criteria for judging the issue are clear. We believe that the convergence of the real economic performance of member states is a vital precondition of
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economic and monetary union. Convergence must be based upon improved levels of growth, jobs and productivity, and not just on monetary objectives alone. That is why we have long argued that the Maastricht convergence criteria need to be applied flexibly and that real economic convergence is of primary importance. Indeed, the hon. Member for Milton Keynes, South-West (Mr. Legg) said that the Prime Minister had suggested that the Maastricht criteria no longer applied at all—I hope that the Minister will tell us whether that is the case.
I was pleased to see that page 1 of the report from the European Monetary Institute on the circumstances for EMU contained the following sentence:
"For there to be a successful European currency area, a high degree of sustainable convergence of economic performance in the participating area is a pre-requisite".
We in the Labour party agree with that. I was also pleased to note that during a recent debate in European Standing Committee B the Paymaster General agreed that Labour's policy that economic convergence was a prerequisite of entry to a single currency had now been accepted by the Government.
The Labour party also believes that, on entry, we should be confident that British industry will be able to compete effectively within the single currency area. Furthermore, and in response to the hon. Member for Aldridge-Brownhills (Mr. Shepherd), the Labour party has always said that it wants the Council of Economic and Finance Ministers to be developed as the political counterpart of the proposed European central bank to give the public a voice in shaping economic policies. The move towards a single currency must also be based upon the consent of the British people.
The Labour party's first commitment in Europe is to jobs for our people. That is why we back the Swedish proposal to write into the Maastricht treaty a clearer commitment to full employment. Labour's vision is not of a Europe for bureaucrats or politicians, nor is it just a Europe for business—although we want business to succeed and prosper—our view of Europe is a community for ordinary people. We want workers to have better rights at work. That is why the Labour party will sign the social chapter and join our European partners in setting a minimum wage. We also want the unemployed to have jobs, which is why we put economic convergence before monetary criteria for joining the EMU.
The Opposition want a Europe in which Britain has a central role—where it is, in the Prime Minister's own words:
"Where it belongs, at the very heart of Europe".
Under the Tories, Britain has been reduced to the sidelines in Europe. The Prime Minister has sacrificed the interests of Britain to the interests of the Tory party.
The Tories are now so divided that they cannot agree the agenda for Britain's future in Europe. Some of them would crawl forward; some of them would go into reverse. I have made the analogy before and I will repeat it today. The Prime Minister reminds me of the driver of a stalled, clapped-out old bus marked "Conservative party". He sits there watching his passengers squabble while he tells them that he is not going to start the engine. The reason is that he is unable to move. He knows that if he starts and moves either way some of his passengers

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will get out. Two of them have already vacated the old bus. The Prime Minister dares not move, so he spends his time inventing excuses for doing nothing.
Mr. Graham Riddick: Will the hon. Gentleman give way?
Mr. O'Brien: The hon. Member was not present for the entire debate, so I will not give way to him.
Because of the Government's policies, Britain is marginalised and isolated. We do not know whether the Government support the principle of European monetary union. The Prime Minister has been quoted as saying:
"There is no more important issue facing the European Community than the path we choose towards economic and monetary union. We are all committed to this goal."
Does that remain the Government's position? Who knows, least of all, I suspect, the Prime Minister? The Deputy Prime Minister has said:
"No truly unified market can exist without a single currency. A close association of monetary policies will be needed if the single market itself is not to be put at risk."
Is that Government policy? Who knows, least of all the Deputy Prime Minister? Are the words of the former Conservative Prime Minister, Baroness Thatcher, the policy of the Conservative party? Is it based on the words of the Secretary of State for Defence? He has said:
"Economic and monetary union are a long way to political union and no Government can give up the government of the UK."
Who knows whether that is Government policy, least of all the British people? We simply do not know the Government's principles on this matter. As a result, as the right hon. Member for Old Bexley and Sidcup (Sir E. Heath) recently said, so simply but accurately:
"Our partners in Europe do not listen to us."
They do not listen because the Tories continue to play the British hokey cokey—in, out, in, out, shake it all about. They are having a pointless little dance, which is played to placate the egos of the Euro-sceptics on the Conservative Back Benches, but which, by turns, now simply irritates or amuses our European partners.
It is fair to say that over the years all political parties have had their internal disagreements about Europe. It is also fair to say, however, that historically there has always been leadership from the leaders of both parties, whether Macmillan or Gaitskell, Alec Douglas-Home or Harold Wilson, the right hon. Member for Old Bexley and Sidcup, Lord Callaghan or Baroness Thatcher. In each case, leadership was displayed—a sense of direction was clear for the Government of the day. Today, we have a divided, disorganised and disunited Cabinet, which fails to provide the sort of vision that Britain needs on the European issue.
The decision to publish a White Paper on the intergovernmental conference was dictated by internal struggles within the Tory party. It was a victory for the Europhobes. It is vital that British interests in Europe are determined not by parties' internal problems but by a genuine appreciation of where those interests lie.
The hon. Member for Southend, East (Sir T. Taylor) asked the Minister five questions. Let me put our five questions about the White Paper and Government policy. Do the Government agree with the Chancellor of the Exchequer, who said that a single currency is not
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"a threat to the nation state"?
Do they agree with the Deputy Prime Minister that a single market needs a single currency? Can they say whether, in the unlikely event of their re-election, a single currency is a possibility in the next Parliament, if the economic conditions are right? If the economic conditions were right, would the Government in principle favour persuading the country that it was right to join a single currency? One must ask whether they are prepared to agree with the following statement:
"Some observers hope—and others fear—that economic and monetary union as set out in the Maastricht treaty will be a step in the direction of a federal Europe… I believe that such hopes or fears are unrealistic".
Do they agree with that statement by the Prime Minister? Of course they do not.
The Government do not know what they want on Europe. In a sense it does not matter, because by the time the decisions have to be made, the Government will be gone. The divisions in the Tory party will be played out, as we have seen in this debate. The Tory party is taking up positions from which to fight its civil war in the long period that it is about to undergo in the wilderness. Meanwhile, there will be a Government with a clear vision, sense of direction and agenda for Britain's future in Europe, and it will be a Labour Government.
12.20 pm
The Economic Secretary to the Treasury (Mrs. Angela Knight): I thank my hon. Friend the Member for Ludlow (Mr. Gill) for obtaining this important debate. It shows the importance that the Conservative party attaches to European matters that so many of my hon. Friends are here. It also shows the absence of concern on the part of Labour Members about a matter of vital importance for Britain that they feel that they have better things to do elsewhere.
Mr. Jenkin: They are beating up Harriet.
Mrs. Knight: I should not like to speculate about that, but we shall find out at lunchtime what happened.
I suppose that the hon. Member for North Warwickshire (Mr. O'Brien) should be congratulated on his efforts to find a fig leaf to cover the absence of a Labour party policy on Europe. He spoke about clear principles. Perhaps I may remind him of statements made by three of his Front-Bench colleagues recently. We shall be interested to know with which of these statements he agrees.
Perhaps the hon. Member for North Warwickshire agrees with the right hon. Member for Kingston upon Hull, East (Mr. Prescott), who said of a single currency:
"Yes we are against a single currency".
Perhaps he agrees with the right hon. Member for Copeland (Dr. Cunningham), who said that he was
"Personally…in favour of a single currency";
or with his party's Members of the European Parliament, who are in favour of a single currency within the time limits and timetable. Or does he agree with the hon. Member for Livingston (Mr. Cook), who said some time ago that setting such a timetable was "irresponsible"? Those clear variations exemplify a party with no policy on this vital topic.

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I consider all the points made by my hon. Friends in this debate to be important and I will answer as many of them as I possibly can. On those points that I do not reach, I will write to my hon. Friends giving full and detailed answers.
The Government have consistently said that the United Kingdom would join a single currency only if it was in the national interest to do so, given the circumstances at the time. It is because the Prime Minister secured our right to opt out that Parliament and the Government can take a decision at the appropriate time in the light of all the circumstances.
I remind the House of the answer that my right hon. Friend the Prime Minister gave to my right hon. Friend the Member for Witney (Mr. Hurd) when he said:
"I can certainly reassure my right hon. Friend that, for a decision of such magnitude, we shall keep in mind the possibility of a referendum, if the Cabinet were to recommend British entry. That has been in my mind, as my right hon. Friend knows, for a long time and it remains there. I think that it is right to keep that before us for consideration."—[Official Report, 18 December 1995; Vol. 268, c. 1225.]
I am sure that all my hon. Friends will agree with that.
It is clear that it would not be in the national interest of any European country to proceed with a single currency—or in Europe's interest for any country to do so—before conditions were right. A premature economic and monetary union could be disastrous for the future of Europe. Given the importance of the United Kingdom's trade with the rest of Europe, and the rest of the world, we have a strong interest in making sure that such a disaster does not occur, whether or not we take part.
The convergence criteria set out in the Maastricht treaty aim to ensure that economies are moving in the right direction towards economic convergence, a necessary condition for economic and monetary union. However, the criteria of reducing debt and low inflation are sensible economic criteria in their own right.
Growth rates in many European countries are relatively sluggish at present, a point made by many of my hon. Friends. The problems that France is experiencing spilled over into the streets at Christmas. Its economic activity has slowed substantially, strikes have destroyed jobs, unemployment is 3 million and rising, and a high percentage of the work force is unemployed. Germany also reports economic difficulties, with new investment plans being directed to former eastern European countries or to lower-cost countries such as Britain.
Fulfilment of convergence criteria, while necessary, is still an insufficient condition to ensure successful economic and monetary union. The criteria represent nominal convergence. That is important but only alongside proper convergence, which requires economic liberalisation to encourage economic growth—the sort of measures that we have already enacted. If Europe wants proper convergence to make a single currency obtainable, it will have to follow suit.
Integration of markets is important for assessing whether countries are ready for EMU. That is illustrated by unemployment, which was mentioned by my hon. Friends the Members for Southend, East (Sir T. Taylor) and for Ludlow. High unemployment is a problem for many of our European partners. It is rising in Germany
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and high in France. In Italy it is 11.5 per cent. and in Spain over 22 per cent. In the United Kingdom, it is at 8 per cent. and falling. Of the five largest European economies, Britain is not just doing well but doing substantially better than the others. It is worth looking at the reasons why that is so.
In Britain, for every £100 spent on wages, an employer has to add an extra £18 for non-wage costs. That same employer would have to add £32 in Germany, £34 in Spain, £41 in France and £44 in Italy. Those are substantial additional costs.
The head of the German CBI recently said that German labour laws were "too rigid" and that social costs and taxes were "too high". He added that Germany worked
"the shortest working week in Europe"
and that
"the German Government spends 50 per cent. of GDP as opposed to 34 per cent. in Britain".
He went on to say:
"No wonder Germany has a problem".
The Germans' proposals to help reduce their economic problems include reducing employers' social costs—a policy that has been followed by the British Government. In addition, they are talking about cutting income tax—precisely what the British Government are doing.
In a week in which hypocrisy has hit an all-time high, is it not grossly hypocritical of the Labour party to want to introduce a European jobs tax into Britain by adopting the social chapter and thereby, at a stroke, increasing unemployment in Britain? Hypocrisy is saying one thing when another is in fact true. We all want Europe to follow the more flexible wage markets, lower tax burdens and lower non-wage costs that we have in Britain. We have the basis of an enterprise economy, and foreign investors recognise that.
My hon. Friend the Member for Ludlow asked about the pros and cons and costs and benefits of a single currency. It is too early to judge the costs and benefits, as the Prime Minister said in the debate on 1 March. That illustrates the value of the United Kingdom's opt-out, because it is impossible to judge something until one gets closer to it. The views of industry vary considerably. The business world has mixed views on the subject, but UK businesses are sure that if the single currency goes ahead it will have important implications for them whether or not Britain participates, so it is important that it is well planned. One reason why Britain is participating in the negotiations is to ensure that practical issues such as that are properly considered.
The City of London is also a subject of vital concern. It is a centre for international financial excellence and innovation and it is the overwhelming choice as the European headquarters for major international banks. It handles more currency than all the other European Union centres put together and I am confident that it will remain competitive and rise to the challenges, whether or not the United Kingdom participates in the single currency.
My hon. Friend the Member for Southend, East raised five issues, which I shall address one by one—
Madam Deputy Speaker (Dame Janet Fookes): Order. I am afraid that we must move to the next topic.

ROM-Data Corporation
12.30 pm
Mr. David Jamieson: I am pleased to have been granted this short debate, as there are important questions to be answered about the ROM-Data Corporation and the way in which the Department of Trade and Industry grant aid has been given to companies in the south-west. I am happy to allow the hon. Member for Falmouth and Camborne (Mr. Coe) to have some time to speak in the Adjournment debate that I have initiated.
The south-west is in great need of economic regeneration; there has been a rundown in defence industries and many of the primary industries that used to exist in Cornwall and parts of Devon. As you will know, Madam Deputy Speaker, unemployment is high, not only in Plymouth, but in Falmouth and Camborne. That is why inward investment is essential to create new jobs and improve the long-term economic conditions of the south-west.
I welcome the regional office that has been set up in our area, which has helped to make improvements in some of those sectors. I fully appreciate that there are limited and finite resources available for that assistance, which is why those resources must be used well and effectively. I also appreciate that, when those grants are given to companies, spotting winners is difficult, that only some companies can benefit from those funds, and that no Department can ever guarantee success. It is sometimes easier to spot losers and guaranteed failure.
The Department of Trade and Industry has an absolute responsibility to undertake the most careful checks before large sums of taxpayers' money are given to any company. At least two factors must be considered: the first is that a proper, skilled assessment of business plans must be conducted by an independent authority. Secondly, careful checks into the financial background of directors should be carried out to discover any former bankruptcies, liquidations or even fraud.
In the case of the ROM-Data Corporation, various questions are raised. The first involves the competence of the advice given to the DTI. The second relates to the DTI's policy when giving grants to people with dubious financial backgrounds. Were checks made of the ROM-Data Corporation? Was there a full and proper scrutiny of the company's business plans before the grant was made?
I shall give a brief history of the ROM-Data Corporation. It was set up in Falmouth in 1991 to do the job of data processing. In that year, it received regional selective assistance of £825,000 of taxpayers' money—a substantial sum. It is the sort of sum that many companies in the south-west would like to enjoy, and they would welcome receiving a fraction of it. A promise was made that many jobs would be created.
Early in 1994, wages and value added tax were unpaid, and, I believe, the company approached the hon. Member for Falmouth and Camborne, who assisted it to obtain more time to pay the VAT. That is what any Member of Parliament would have done in those circumstances.
Later that year, the company received £250,000 of loan guarantee—another substantial sum of taxpayers' money—despite the fact that it had not been paying wages, and was clearly experiencing financial difficulties.
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At the end of 1994, not only were wages and bills unpaid, but the company went into liquidation. It left many creditors; the wages of many workers in the Falmouth area, Cornwall and Devon were not paid. Many small businesses suffered as their bills were not settled.
The question must be asked: what checks were made in 1991 by the DTI into the directors of the ROM-Data Corporation, particularly Mr. John Dawson? Mr. Dawson was a former Bath Conservative councillor whose firm, John Dawson (Motor Holdings) Ltd, in 1981, suffered a spectacular bankruptcy—one of the largest bankruptcies in the south-west at that time. Mr. Dawson left more than £2 million of debts. Wages were unpaid; there were many creditors—many of which were small businesses—who were hurt when the company went into liquidation. I believe that Mr. Dawson fled to the West Indies on his yacht, and a warrant was issued for his arrest.
What checks were made into Mr. Dawson's background, and, more importantly, what did they reveal? The DTI Minister, Baroness Denton, wrote a letter to the hon. Member for Ryedale (Mr. Greenway), who had quite properly inquired why one of his constituents had not received his money from ROM-Data. On 12 January 1992, the Minister wrote to the hon. Gentleman saying:
"all applications for Regional Selective Assistance are rigorously appraised by officials within this Department."
The hon. Gentleman must have pressed the matter further on behalf of his constituent, as the same Minister admitted on 2 April 1993 in a further letter to the hon. Gentleman:
"Mr. Dawson may have made a commercial mistake in his past."
She was presumably referring to the liquidation that amounted to more than £2 million and the fact that the police were looking for Mr. Dawson in 1981.
On 2 March last year, I asked a question of the former President of the Board of Trade, now the Deputy Prime Minister, about what checks were made. The answer that I received stated:
"A range of inquiries were undertaken by the Department and others into the background of ROM-Data, including checks on the directors of the company through the Companies House and the insolvency service".—[Official Report, 2 March 1995; Vol. 255, c. 716.]
On 19 July 1995, I asked a further written question of the President of the Board of Trade. I asked him whether the Department was aware of the previous bankruptcy of the director, John Dawson. The reply that I received stated:
"The Department made certain inquiries into the background of the directors prior to the offer of grant in 1991. However, the bankruptcy record referred to did not come to light at the time."—[Official Report, 19 July 1995; Vol. 263, c. 1562.]
The bankruptcy did not come to light, despite the checks that had been made with the Insolvency Service, but, in 1993, Baroness Denton had had the information at her disposal—she said that Mr. Dawson had
"made a commercial mistake in his past."
She must have known then the information held by the DTI, so why was that not made clear in the answer before the House in July 1995?
When pressed on the matter of the checks, the new President of the Board of Trade came clean in a written answer to me on 19 December last year. He said:

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"although some checks may have been made…the subsequent investigation has revealed no documentary evidence that these checks were made."—[Official Report, 19 December 1995; Vol. 268, c. 1091–92.]
In a further letter to the hon. Member for Ryedale, the President of the Board of Trade said of the answers given to me earlier in the year:
"Answers which had been given earlier this year…were misleading."
In his letter, he underlined the word "were".
The answers given to me in the House were indeed misleading: they were untruthful and incorrect. The President of the Board of Trade said that checks were made, but in December he said that there was no evidence that those checks were made. The President of the Board of Trade has therefore admitted that the previous President of the Board of Trade misled the House on that important issue.
I shall now discuss the way in which those grants are assessed. A panel has been set up by the DTI, composed of people employed by the DTI, to inquire into those matters. I have not received answers from the President of the Board of Trade, which were due on 15 January 1996, to questions about the role of a Mr. Kenneth Holmes. I believe that he was an accountant. He was appointed to the DTI, I believe in the late 1980s, to help assess grant applications to decide whether they were the right type of applications to be eligible for substantial grants.
I ask the Minister today, because he has failed to answer that question so far in written questions that I have tabled: was Mr. Holmes involved in the vetting of the ROM-Data application for grant in 1991? The answer needs to be given to that, and I shall return to that later.
Was it known that Mr. Holmes, as it is alleged, has been involved with other companies that have had financial difficulties? I quote the company H. Bear and Sons, which he bought in 1987, which I believe went into liquidation in 1989.
If Mr. Holmes vetted the ROM-Data application, was he given permission by the DTI to become, on 21 November 1993, not only a director but the chairman of the ROM-Data Corporation? Only 12 months before ROM-Data went into liquidation, the man who had approved the grants had become a director and a chairman of a company that subsequently went into liquidation. The company has left unpaid the wages of constituents of the hon. Member for Falmouth and Camborne, and has many creditors for more than £2 million. I am pleased to note that the Serious Fraud Office is now inquiring into those matters.
Does the Minister approve of employees of the Department of Trade and Industry, who are carrying out the extremely sensitive work of vetting grants of substantial sums of taxpayers' money, becoming directors of companies that have benefited financially from their own decisions? How does he feel about a DTI official approving a grant and later becoming a director of that company, which then owes the DTI that money? Is it a coincidence that Mr. Holmes, like Mr. Dawson, is a member of the Conservative party? I believe that his wife is vice-chairman of the Totnes Conservative party. In spite of his liquidations, Mr. Holmes carries on in a very comfortable life style.
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The DTI should have conducted a searching internal investigation, and a careful analysis of what went wrong. I have been told by the President of the Board of Trade that those investigations are now complete. They are so detailed that, I believe, the two most important players, Mr. Dawson and Mr. Holmes, have not even been interviewed. I want to know from the Minister why those two people have not been interviewed in connection with that important matter.
I am sure that the hon. Member for Falmouth and Camborne, in whose constituency the events occurred, has acted honourably in this matter throughout. He played a part in helping the ROM-Data Corporation to defer payments of VAT, as any hon. Member would have done for a time.
I believe that the hon. Member for Falmouth and Camborne also helped the company obtain the loan guarantee. I question whether that was entirely wise. I notice that, in July 1995, the hon. Gentleman was quoted in the Daily Mail. He said that he had not investigated Mr. Dawson's background
"because I am only an MP and cannot be expected to rush off to Companies House to check out track records every time a business wants help".
[Interruption.] A quick check with the House of Commons Library would have given him the information he wanted.
Even if that was not good enough, the hon. Gentleman may also have read the Western Morning News, which, as early as 3 June 1992, published an article entitled "£2m debts that haunt high flier". If the hon. Gentleman had read that, he would have known that that man was extremely dubious. Was not the hon. Gentleman slightly suspicious that Mr. Dawson was not paying his constituents' wages? He nevertheless helped him to obtain further assistance.
I called the debate with some reluctance. [HON. MEMBERS: "Nonsense."] I had to call it, because we are not receiving satisfactory answers from the President of the Board of Trade to questions. [Interruption.] I believe that the previous President of the Board of Trade has seriously misled the House in that matter. [Interruption.]
Madam Deputy Speaker (Dame Janet Fookes): Order. The debate is becoming a little cantankerous. I ask hon. Members, however provoked they feel, to observe the highest standards of courtesy.
Mr. Jamieson: Thank you, Madam Deputy Speaker. I hope that the Conservative Members who appear to be disturbed by the truth coming out about this matter will make their own contribution to the debate, and tell us what their part was in the matter.
We need a thorough investigation into the way in which those grants were made in the south-west. I am sure that any hon. Member representing the south-west would agree that we need to help genuine companies, those that can create real jobs and buy from other companies to create other jobs. That will not be achieved until the DTI makes known its plans to improve.
The case of ROM-Data shows what happens if one mixes together a solution of taxpayers' money, incompetence by officials, obfuscation by Ministers, a large handful of people in the same political party and

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a generous supply of greed. A rich soup is created, in which taxpayers' money may be misappropriated and corruption may thrive.
12.45 pm
Mr. Sebastian Coe: I resent being limited to barely a few seconds in a discussion that centres on my constituency.
It is a matter of record that I drew attention to most of the issues that have been mentioned in the debate well in advance of the hon. Member for Plymouth, Devonport (Mr. Jamieson). More than a year ago, I expressed my anxieties about the way in which the company had operated, and its subsequent liquidation, to one of my hon. Friend's predecessors at the Department of Trade and Industry, the Member for Bexhill and Battle (Mr. Wardle).
It is a matter of record that ROM-Data was given a grant to set up in my constituency in 1991—a year before the general election, a year before I was honoured with the stewardship of that constituency. The hon. Member for Devonport mentions the way in which the vetting procedure may or may not have taken place, and I know that that is the subject of a full and thorough inquiry within the DTI, which I instigated and asked for more than a year ago.
Several issues have been raised, but I do not wish to enter into those, as they will be the basis of that inquiry and the President of the Board of Trade has promised to report back to the House.
I want to tease out two or three issues. It would be odd for a Member of Parliament representing a constituency with higher levels of unemployment than in most parts of the country, to sit on his hands when confronted, in the space of three or four days, with the potential loss of 170 jobs in his constituency. I very much doubt that the hon. Member for Devonport would have acted differently in those circumstances.
No local Member of Parliament has the ability to rubber-stamp or hand out a Government grant. There is a lengthy application process, in which many agencies in the constituency—and in this case the county—are involved. That is what happened in the case of ROM-Data. All types of agencies were involved, including economic development organisations. Jobs are important. No Member of Parliament will sit and do nothing when there is the potential for job losses on that scale in his or her constituency.
Broader issues should be discussed. The hon. Member for Devonport spoke of the need to vet grants. Of course that is paramount in any process. However, he has failed to say that, in my constituency, like his, and in much of the south-west, our lifeline is regional selective assistance and grants. That assistance should be provided.
I recently met an all-party group of councillors and local business men in my constituency. They said that they were aware of the way in which the ROM-Data case has been dealt with, and the way in which the hon. Member for Devonport has made mischief and slowed the process dramatically. I am delighted to be joined in the Chamber today by my fellow Conservative Members of Parliament from Cornwall and the south-west, who know that those delays have not been helped by the actions of the hon. Gentleman.
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It is a difficult issue, and we must tease out and examine various points. However, the manner in which the hon. Gentleman raised the matter this morning leaves something to be desired.
12.49 pm
The Parliamentary Under-Secretary of State for Trade and Industry (Mr. Phillip Oppenheim): I have listened carefully to the points made by hon. Members this morning, and I shall attempt to deal with them in the short time available.
I refer at the outset to the allegation by the hon. Member for Plymouth, Devonport (Mr. Jamieson) that Mr. Holmes was a Department of Trade and Industry official. I state categorically that that was not the case.
I shall continue with some general remarks about the way in which the Department has approached the case. First, I make it absolutely clear that Ministers accepted from the beginning that it was important that the facts of what occurred should be investigated fully and properly, and that the results should be made known. My hon. Friend the Member for Falmouth and Camborne (Mr. Coe) and others have been active in raising concerns about the case, and Ministers have been equally anxious to discover what has happened.
That is why the Department set up a formal investigation into the handling of the case as soon as problems became apparent, and why the Department drew the case to the attention of the Serious Fraud Office. Above all, it is vital that we know what happened and why, so that we can take effective action to ensure that there is no repetition.
Secondly, we have made it absolutely clear that we shall be open about what went wrong, both to ensure that we get to the bottom of what has been a lengthy and complex sequence of events, and, more importantly, to ensure that nothing is done to impede or prejudice in any way the investigation of the events by the Serious Fraud Office. That investigation is continuing, so I am limited in what I can say today about the company's actions, or about particular individuals who might be the subject of further proceedings. I also must not prejudge the further inquiries that are being made under the Department's internal disciplinary procedures.
However, I assure hon. Members that we intend to be open about the matter. That is why, as soon as it became clear that answers to earlier questions from the hon. Member for Devonport might have been based partly on inaccurate information supplied by officials, my right hon. Friend the President of the Board of Trade warned the House of that possibility. When, following further investigation, it became clear that that had occurred, he informed the House immediately. It is in that spirit of openness that my right hon. Friend has undertaken to report the findings of the Department's investigation to the House as soon as he is able to do so. That will not be long delayed.
The Department's internal report on its handling of the ROM-Data case has now been completed. Ministers have received the report only in the last few days. It deals with a series of complex events which must be considered carefully. However, Ministers remain committed to making the Department's findings public as soon as possible. The Department will also consider taking further action under its disciplinary procedures. That latter aspect,

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together with the continuing investigations by the SFO, makes it difficult to say much about the role of individuals at this stage.
The DTI has rigorous procedures for handling public money, which are communicated to staff in extensive written guidance. The Department's financial procedures and systems are regularly checked by its internal auditors and the National Audit Office. My initial impression of the common theme running through the report's findings is that the main problems resulted from failings in the way in which the specific ROM-Data case was handled, rather than major deficiencies in the Department's overall systems and procedures—although clearly improvements can, and will, be made in a number of areas.
We shall consider how to implement the report's various recommendations for improvements in existing procedures once we have had the opportunity to consider them properly. They are essentially concerned with detailed additions to the existing systems and procedures. In light of the findings, the DTI will also pursue the necessary further inquiries under its internal procedures in order to establish whether and what disciplinary action should be taken against any staff members.
I had intended to run through the chronology of events at ROM-Data. However, as time is limited, and as most hon. Members are aware of that chronology, I shall not do so. I turn instead to the role played by my hon. Friend the Member for Falmouth and Camborne.
My hon. Friend was obviously concerned about the failure of an important local employer and a company which had received substantial sums of public money. As the constituency Member of Parliament, he had quite properly and assiduously supported the company's application to secure a loan guarantee scheme loan which offered an opportunity to protect jobs in his constituency. In so doing, he acted in the same manner as any hon. Member seeking to fulfil his proper role in this place. I find it difficult to believe that the hon. Member for Devonport would not have done the same thing in similar circumstances.
Mr. Jamieson: I would have checked.
Mr. Oppenheim: If the hon. Gentleman is saying that directors' backgrounds should be checked every time that Labour Members lobby for regional selective assistance or a loan guarantee scheme grant, I suggest that he conduct a poll of his right hon. and hon. Friends. I will be amazed if he can find one Labour Member who has done such a check.
Mr. Jamieson: Will the Minister give way?
Mr. Oppenheim: No, I will not give way. The hon. Gentleman had quite enough time to put his case.
I pay particular tribute to my hon. Friend the Member for Falmouth and Camborne, because he contacted Ministers as soon as he became aware of possible irregularities in the case. I make it absolutely clear that he was the first person to contact Ministers following the company's liquidation. He immediately passed all his
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information to Ministers, and he has kept in close touch with Ministers since then. He has acted properly and constructively throughout.
Ministers want to get to the bottom of the matter, put right any failings by the Department and be as open as possible about the circumstances. As soon as Ministers heard about the ROM-Data case, they asked the Department for an urgent report. The contents of that initial investigation, which was conducted in February 1995—shortly after the meeting with my hon. Friend—led to the decision to establish a full internal inquiry into the Department's handling of the case.
The inquiry's terms of reference were extended subsequently in light of emerging concerns—for example, concerns about earlier ministerial answers that were given on the basis of inaccurately supplied information, to which I have referred already. Parallel work by the Department on the circumstances of the ROM-Data Corporation led to the establishment of a separate SFO inquiry after the Department had referred the case to the SFO in August 1995.
The Department aims to find out what happened, where, and how any mistakes were made in its handling of the case, and to suggest ways of preventing such failings occurring again in future. I attach particular importance to that last point, as will be apparent from what I have said about the important action that the Department will take. It is clear that there have been procedural failings, and, if we find that DTI officials have breached the Department's rules of conduct, they will be held to account through the Department's disciplinary procedures.
Mr. Jamieson: Will the Minister give way?
Mr. Oppenheim: With respect to the hon. Gentleman, he has taken up half the time available for debate. He raised a series of complex issues, and I am doing my best to address them. I must add that most of those issues had already been raised separately by my hon. Friend in whose constituency the problem occurred. I do not believe that the hon. Member for Devonport has any constituency interest.
The SFO must determine whether others have acted improperly, and its inquiries are continuing.
Mr. Anthony Steen: Will my hon. Friend give way?
Mr. Oppenheim: I hope that my hon. Friend will excuse me, but I have only a few minutes in which to conclude my speech.
Finally, I shall put the unfortunate events into context. As my hon. Friend the Member for Falmouth and Camborne pointed out, regional selective assistance is a highly successful and popular scheme. Last year, the DTI offered grants of £159 million, which are expected to result in £1.3 billion in new investment and the creation or safeguarding of 36,000 jobs. In the same year, we wrote off less than £2.5 million. That is too much, as no one likes to see public money lost. However, some failures are inevitable and the RSA failure rate is extremely low. We must learn the lessons from this case, in order to prevent any repetition in the future.

Rest Homes
Madam Deputy Speaker (Dame Janet Fookes): Before the House debates the next topic, I want to point out that although the Adjournment debate embraces different topics, technically it is one debate, so that any right hon. or hon. Member who wants to speak twice should seek the leave of House. That is the case for the hon. Member for Hastings and Rye (Mrs. Lait).
1 pm
Mrs. Jacqui Lait: I am grateful for that guidance, Madam Deputy Speaker and I hope that, with the leave of the House, I may be permitted to speak again. I am grateful for the opportunity to raise the subject of rest homes for the elderly, and to the Under-Secretary, my hon. Friend the Member for Battersea (Mr. Bowis), for kindly taking time out from a busy day to respond to my concerns.
I have long taken an interest in rest homes for the elderly, and the debate was provoked by a document from the Centre for Policy on Ageing, "Home Life II", to which I shall refer later. First, I refer to the bed blocking that occurred over Christmas because social workers, for all sorts of valid reasons including flu, were not available to ensure the appropriate care. Many of my constituents involved in the rest home sector made the sensible proposal that in such cases, there is no reason why a hospital could not discharge into a rest or nursing home, for respite-type care over a brief period, people who could so benefit. Hospital beds would not be blocked, but available for more crucial cases, and social workers would have adequate time to make an assessment. I should be grateful if my hon. Friend the Minister could throw that suggestion into the melting pot of ideas when his Department considers the matter.
Dame Elaine Kellett-Bowman: Does my hon. Friend's constituency encounter the same problem as Lancashire, where the Labour-controlled county council keeps open expensive county homes rather than use more efficiently run and cheaper private homes?
Mrs. Lait: My hon. Friend anticipates my next point. That problem exists in East Sussex, as in other counties. Sometimes it is caused by people being inappropriately allocated to nursing homes, rest homes or domiciliary care. General practitioners have reported seeing bed sores of considerable size and complexity on elderly residents in rest homes who should be in nursing homes. Similarly, there are people in domiciliary care who should be in rest homes. At one stage, Lancashire county council was maintaining people in domiciliary care in their homes on packages costing £1,000 a week. I understand that that practice has come to an end, but in Hertfordshire, payments to private sector nursing homes have reduced from £370 to £350. Some nursing homes have been allowed residential care beds, with an insistence on the same staffing levels, and are paid only £250 a week. It is not difficult to anticipate the problems as county pressure increases on the private sector to reduce nursing home fees to £250 to cater for Hertfordshire residents, while county-owned beds will be considerably more expensive.
As my hon. Friend the Minister knows, East Sussex is currently wasting £4 million a year by overpaying itself to the extent of £100 per week per bed. The solution is to
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split the purchaser from the provider. As long as the present system remains—whereby social service departments are providers and inspectors and they let the contracts—we shall continue to receive justified criticisms from the private sector.
The Centre for Policy on Ageing was instrumental in producing the Government-sponsored report "Home Life", which set out rest home care standards that are generally accepted and agreed. Subsequently and under the same chairman, Lady Avebury, the centre established a further working party to produce "Home Life II". In fairness to the working party, Lady Avebury and the centre's director, Gillian Dalley—who has been helpful in advising me—I shall quote from a letter that Gillian Dailey wrote to me, referring to
"the draft which has been circulating without the Advisory Group's authorisation."
She wrote also to everyone who commented on the draft:
"The draft of the revised document which many of you have seen was an interim draft not intended for public circulation because further work and editing was going on."
I completely accept that explanation, but when the draft entered the public domain of the rest home sector, it caused those of my constituents who are rest home owners and others throughout East Sussex promptly to contact me, because of the history of Government sponsorship of "Home Life". The fear was that the Government had sponsored "Home Life II" as well.
The interim draft included the recommendation that every rest home room should measure 12 sq m, excluding bathroom facilities, and that 15 sq m would be better. In Hastings and St. Leonards, we are in the process of raising a large sum to help our local voluntary association for the blind to provide rooms that measure 10 sq m—the current standard. It does not take a big leap of the imagination to appreciate the effect on the private, public and voluntary sectors of a requirement for rest home rooms measuring 12 sq m or 15 sq m.
The interim draft's other recommendations include:
"Residents should not be thought of as objects of charity to be entertained through carol singing or children's plays, or be recipients of harvest festival goods or Christmas presents."
That is one of the draft's more ludicrous suggestions.
Dame Elaine Kellett-Bowman: And patronising.
Mrs. Lait: My hon. Friend is right.
One of the interim draft's more impractical suggestions is:
"Commodes should only be used as a last resort. Portable chemical toilets are a better option."
I am sure that many hon. Members are aware of the down side of chemical toilets.
Dame Elaine Kellett-Bowman: Certainly those of us from rural areas.
Mrs. Lait: Those of us from rural areas are well aware of the down side of portable chemical toilets, and I am sure that we would not want many of them in rest homes.
Rest home owners anticipate problems with recommendations such as:
"The window cill should be low enough so…resident can see out when seated or lying down. There should not be horizontal bar obstructing vision."

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Many rest home residents are a bit dodgy on their pins and it does not take much imagination to realise the risk of nasty accidents in the absence of window bars. That apart, many rest home windows are of Victorian or Edwardian design. Their replacement would not only involve expense but require extraordinarily long and complex planning negotiations. Further, the document states:
"Annual accounts should be readily available to residents, relatives, inspection units and other organisations involved."
In one sense, I have no difficulty with that. I just hope that local authority homes could provide that information, because one major criticism from the private sector is that local authorities cannot do so.
The recommendation in the document that strikes terror into hearts of my local rest home owners is:
"Homes which fail to meet these standards will be required to make changes in order to meet them."
That is the most draconian requirement that I have come across in the guidelines. The National Care Homes Association, the East Sussex Registered Rest Homes Association and many others to whom I have spoken point out not only that the recommendations are expensive, but that they are inappropriate in a number of cases and are not suitable for many residents of rest homes. They are prescriptive and coercive. They do not allow for innovation, change and local interpretation by the people who run the rest homes and who are expert in providing good standards of care, as most people involved in the sector know.
The document is a motherhood-and-apple-pie wish list. I am told by the Centre for Policy on Ageing that it is amending the list. If anything like it was ever to emerge into the light of day officially, that would not just kill off the private sector, but the voluntary sector could not comply with its requirements. The public sector in its present state certainly would be unable to comply in most cases. I rather suspect that the public sector would try to comply at enormous cost to the public purse. That might mean a wider provision of beds by it. It would not utilise the expertise of the private sector, which would be forced out of the business.
If one is a conspiracy theorist, one can perhaps work out some of the thinking behind the document. However, I believe in a broad and wide provision of rest home and nursing home care and I do not wish to see anything done that would make the private or voluntary sector less competitive and less able to offer the high standards that those sectors now offer.
I am conscious, because of the research that I have done, that alternative work is being down by bodies such as the Residential Care Forum, which may produce some standards that people will find more compatible and easier to provide. We know from the past that, when guidelines come out, they are treated so often as law. Registration officers and social services insist that the guidelines are met. Too often, the guidelines are entirely physical and do not take into account elements such as the friendliness of a home and the involvement by owners and staff in ensuring that residents feel that they are living in their own homes. That is one of the keys to providing the best standards of care in the rest home sector.
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I should be grateful if my hon. Friend the Minister could repudiate the report and ensure that the Government will not in any way encourage such guidelines to be used in the rest home sector. If any further standards are to be encouraged by the Government, they should be produced in collaboration with the key people in the sector—the owners.
Dame Elaine Kellett-Bowman: My hon. Friend referred to the voluntary sector. I am sure that she is aware of the superb work done by the Abbeyfield Society. In Lancaster, we have been fortunate for some years to have a go-ahead chairman, Mr. Chirnside. Many Abbeyfield homes are doing a superb job, but they would find it very difficult to comply with those guidelines, even the modern ones.
Mrs. Lait: My hon. Friend makes an extraordinarily good point. I was tempted to mention all the people who provide such good care, in both the voluntary and the private sector. Many organisations, some very large and some small, have helped me in my research, but I was conscious that I would like the Minister to have as much time as possible to reply. Therefore, I am afraid that I refrained from commending many of the people who produce such good care in that sector.
1.14 pm
The Parliamentary Under-Secretary of State for Health (Mr. John Bowis): I thank my hon. Friend the Member for Hastings and Rye (Mrs. Lait) for raising this subject. In another place, this would be called the dinner-hour debate, and it is perhaps appropriate that we take this half-hour to consider care for some often vulnerable people in our society who need to be looked after safely and of course with common sense. That is the flavour of the debate and of my hon. Friend's speech.
I have noted the comments of my hon. Friend the Member for Hastings and Rye and of my hon. Friend the Member for Lancaster (Dame E. Kellett-Bowman) about bed blocking and the inefficient use of the independent sector by some social service departments in providing or obtaining good-quality care for people who need residential care.
The debate gives me the opportunity to put the record straight on a matter that I know has been brought to the attention of and exercised the minds of a number of hon. Members in the House and one or two in another place. As I have said, I have noted the comments that have been made today, and my hon. Friend the Member for Plymouth, Sutton (Mr. Streeter), who is in his place, has also written to me about the subject.
I can assure my hon. Friend the Member for Hastings and Rye that the draft publication known as "Home Life II", which has so upset owners and managers of residential care homes, is nothing whatever to do with my Department. The publication is the work of a group set up by the Centre for Policy on Ageing, which is a wholly independent organisation. The document is not the result of a Government working party, we are not funding it and we are not associated with any of the draft recommendations in it. I hope that that is clear. There has been some misunderstanding because of the origins of the original document, "Home Life".
My hon. Friend the Member for Hastings and Rye has quoted sensibly from the draft document and has drawn to our attention some of its absurdities. There are others.

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The requirement that residents' bedrooms should have not only television and radio, but music centres strikes me as strange for a residential home. My hon. Friend referred to the mention of carol singing and Christmas presents. She might also have referred to the fact that the document claims that
"An objective measure of food acceptability is to weigh and record plate waste."
The requirement on window sills and horizontal bars has been mentioned, but the document also suggests that every room, irrespective of personal need, should have a remote control system for closing windows and drawing curtains. As my hon. Friend said, the document is a wish list that goes beyond sensible borders.
The document also contains a glossary, which includes such gems as
"gender—all words indicating one gender must always include both genders"
and
"singular/plural—words indicating singular or plural always include the other".
And again:
"Life is always taken to include all aspects of life, physical, medical, social, cultural, spiritual, economic".
The term "relatives" is primarily used to describe people living outside the home
"whether they are related or not. It certainly includes friends".
Perhaps my favourite quotation is:
"Positive/negative—statements often have an equivalent negative/positive statement. The opposite is always assumed to hold even if it is not stated."
If you can work that out, Madam Deputy Speaker, I congratulate you.
We know that this is a draft, not a final document, but it has caused unnecessary concern among home owners and people living in homes. That is unfortunate. As I said, the document has nothing to do with our Department; I hope that it is now being revised in accordance with the commonsense response from my hon. Friends, among others.
There are some things in the document with which we would all agree and many others that are unexceptional—but I share the concerns about some of the contents. A number of statements in the document are far too prescriptive. They attempt to play nanny or to interfere in the lives of residents in an unnecessary way. There are some ludicrous examples, too, of political correctness. We have not been asked to endorse the publication and there is no question of that endorsement being given to the sort of ideas that we have heard discussed today.
If there is a "Home Life II", there must have been a "Home Life I". There was: it, too, was produced by the CPA, and that one we did endorse. It subsequently became widely used as a standards document by homes and regulatory authorities. But that was in 1984 when the Registered Homes Act was being introduced, and there was a widely recognised need for standards in homes to be improved.
Since "Home Life" was first published, a number of other, similar documents have been published. I could cite a range of them, including "Homes Are For Living In" and the "Caring For Quality" series published by the social services inspectorate. Any successor to "Home
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Life" will need to find its own place among those and other new publications being planned, for example, by the Residential Care Forum.
Whether or not we endorse particular documents that try to define standards for homes, we all recognise how vital it is that homes provide quality care. But I believe that that can be done while avoiding unreasonable and costly demands—of the sort my hon. Friend has highlighted—being placed on homes, and unwarranted interference occurring in the lives of residents. Homes, after all, are for living in. Moreover, the wish to see quality care should not lead us to too much prescription. We are committed to keeping the regulatory burden on homes to the necessary minimum, without loss of safeguards for residents.
We believe that much can be done to maintain and improve the quality of care by a sensible dialogue: a partnership between homes and authorities—and above all, between homes and authorities on the one hand and residents and families on the other.
Local standards for homes should be drawn up by authorities only after full consultation with providers, and those standards should be published. Such a process means that homes know what is expected of them and authorities have a clearer appreciation of what it is reasonable for homes to do. It also means, in accordance with the citizens charter principles, that potential residents will be provided with more and better information about homes.
Guidance about the local development of standards and other regulatory matters was issued to all authorities by my Department last September.
Dame Elaine Kellett-Bowman: Does my hon. Friend agree that while we are always seeking information from private homes, it would be no bad thing to get rather more information from the county homes?
Mr. Bowis: My hon. Friend is right. As she will know, we require county homes to be inspected against the same standards as are expected of the independent sector.
Critics of our determination to improve regulation of homes have, I believe, been proved wrong. We did not abandon the law. We took steps to restore a sense of appropriateness to regulation—keeping things in proportion, cutting paperwork, seeking consistency in enforcement practice within and between authorities, and targeting enforcement effort. All that will benefit everyone. Residents will benefit by not having their homes unnecessarily examined or invaded in an unco-ordinated way by a range of bodies. They will also benefit from care staff not having their attention unnecessarily diverted; and of course taxpayers will benefit from better value for money.
I am not suggesting for one moment that we should go soft on poor homes in any sector: far from it. We expect regulatory authorities to take all necessary steps to bring low-standard homes up to scratch. The law provides authorities with all the powers that they need to take enforcement action in the light of the evidence concerned. We expect them to take similar action—this answers the point made by my hon. Friend the Member for Lancaster—when their own homes are not up to scratch.
Our community care reforms are now in place. Our community care development programme is about moving on from consideration of structural changes.

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I hope that this will reassure my hon. Friends. We now want to concentrate on improving the quality of life of the people who rely on services. That is certainly true of care homes. Better outcomes for residents mean listening to what they say, involving them as far as possible in decisions about their care, and allowing them to exercise choice and control. Residents must be valued and their needs not subordinated to the needs of the home or the opinions of local authorities or inspectors.
Mrs. Lait: My hon. Friend referred to the need for residents to be given choice. Is he confident that all social service departments are giving residents and prospective residents the widest possible choice of homes to go to? Is he aware that social services still exhibit some restraint when offering choices to prospective residents?
Mr. Bowis: The answer to the first question is no, and to the second question, yes. The problem is that they do not offer enough information about all the options that are available. I should like some improvement in that area. Assessment and care plans should ensure that residents get the care that they need. Privacy, confidentiality and sensitive treatment are all essential. Much can be achieved by the idea of partnership between the home and its residents.
Mr. David Hinchliffe: I came to the debate to listen to a speech by the hon. Member for Hastings and Rye (Mrs. Lait) about standards of care in homes, but the debate might have been better entitled, "The business interests of private care home owners". I was saddened to note that, in a 14-minute speech, the hon. Lady did not mention residents' interests once.
We are talking about vulnerable people, and I am pleased to hear the Minister, at least, talking about their interests. The current review of the 1984 legislation is worryingly underpinned by a belief in deregulation that
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forgets the fact that people in care homes—I have talked to some of them—feel demeaned when they receive third-hand apples and oranges at harvest festival.
Madam Deputy Speaker: Order. I am sorry, but this is a short debate—and interventions should in any case be short.
Mr. Bowis: I am sorry that the hon. Gentleman did not go on to criticise the nonsense in the draft document—unlike my hon. Friends—but I suppose that that shows the differences between our parties.
My hon. Friend the Member for Hastings and Rye did talk about the interests of residents. As the hon. Gentleman knows, the SSI recently published a report—"Responding to Residents"—based on an inspection of local authority homes. There are many important lessons in it for all homes in respect of providing individualised care for residents. For many elderly people, it is important that homes do not become too restrictive—as the document under discussion seems to be—or lead to a loss of continuity or contact with their past lives. Relatives and friends should be encouraged to participate in the life of the home and how care is provided. A friendly, domestic environment should be maintained, and there should be opportunities for contacts with the wider community to be developed in accordance with residents' wishes. They should be allowed to have their own possessions around them. There should be sensible policies on risk taking, and encouraging residents to pursue leisure activities or to go outside if they feel that they can and wish to do so.
Many good homes provide such care now, and others are working to get there. A review is under way on inspection and regulation. I believe that it will open up some of the debates on how we should seek those qualities and standards in the future. We have seen considerable growth in the independent sector in recent years. One of the concerns that the review has is that we do not wreck the quality of the homes with a whole panoply of regulation. We are exploring that area in the review so that providers can be treated even-handedly.
I believe that I have had the opportunity to clarify our stance on the CPA's draft and to emphasise our concern to see standards in care homes maintained and improved, in full collaboration with providers—
Madam Deputy Speaker: Order. We now come to the next topic for debate.

Health Provision (Bradford)
1.30 pm
Mr. Gerry Sutcliffe: I am grateful for the opportunity to raise my concerns and, more importantly, those of my constituents, about health provision in Bradford. I know that my hon. Friend the Member for Bradford, West (Mr. Madden) will wish to comment on this important matter.
It is my belief, as I hope to prove today, that Bradford people are losing confidence that their national health service will be able to meet their medical needs when they require it. I have no intention of talking down the health service. I am proud that it was a Labour Government who set up the national health service based on need. Indeed, I pay tribute to the doctors, nurses and health workers, who are acting above and beyond the call of duty. I shall read an extract from a letter that one of my constituents, Mrs. Jean King, whose mother is in hospital, wrote to the chief executive of Bradford hospitals trust. She says:
"I am writing both to compliment and complain. The compliments are directed at your nursing staff and the complaints are directed at your organisation. All credit must go to the staff, they never complain they just get on with their duties as best they can. They look tired, stressed and they are definitely overworked. I am sure that they know they have not got the time to give the sort of service they used to give.
My mother has become depressed and distressed, not because of her illness but because nobody has the necessary time to give her the sort of care which used to be available for patients.
My mother is only one of many needy patients on that ward who try not to trouble the nurses because they can see how busy they are."
In another letter, one of my constituents, Mr. Key, makes further mention of the shortage of staff. Unfortunately, his wife passed away in hospital. He said that, in the last few days of her life, she was concerned about being moved into a side ward, as she feared that she might not be heard because the staff were so busy. Eventually, to benefit her family, she agreed to go into a side ward. She died with the alarm button in her hand.
There are many other cases that I could quote, but the constant theme remains the same: grateful thanks to the doctors, nurses and health workers, but harsh criticism of the system.
Bradford nurses still have not received their pay rise in their pay packets, due to the financial crisis facing the hospitals trust. That crisis is based on the faltering relationship between the purchaser, Bradford Health, and the provider, Bradford hospitals trust. The evidence is that, in the past, both parties had to go to arbitration to confirm their financial settlements, as Bradford hospitals trust claimed that it was not receiving the appropriate funds. To balance the books, the trust has had to make efficiency savings, which have resulted in savage cuts in the number of staff, the closure of wards and the loss of beds. That in turn has affected morale among hospital workers, who have seen the quality of their service deteriorate and the number of skilled and qualified staff reduce. At the same time, the number of administrators has increased, due mainly to the bureaucratic relationships and complexities of the purchaser-provider split.
In Bradford, we have seen an increase in the need for charitable donations to provide much-needed equipment, particularly in the care of cancer and heart patients.
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The death two weeks ago of my constituent, Mr. Geoffrey Cranswick, was a great tragedy, not only for a loving family who lost a special person but for Bradford. Mr. Cranswick collapsed in his doctor's surgery. His general practitioner tried to save his life, and hospitals in the area were contacted for an emergency admission to intensive care. Bradford royal infirmary has only five intensive care beds, four of which were in use at the time. The fifth bed was unavailable because of staff shortages. Eight other hospitals were contacted in the region until a spare bed was found, in Scarborough. Sadly, Mr. Cranswick died just after arrival in Scarborough.
Bradford's population of 485,000 deserves more than just five beds. Following the announcement of Mr. Cranswick's death, the director of nursing services commented:
"For the size of our population we look to be lacking in Intensive Care beds at the moment".
That is somewhat of an understatement. In December, 19 people needing intensive care had to be transferred outside the Bradford area.
The irony is that Mr. Cranswick was a tireless worker for the British Heart Foundation. I believe that a full inquiry is needed into the circumstances of his case. I hope that his family's pleas for extra intensive care beds will be heeded as a fitting memorial to him. I have a relevant quotation from our local evening paper in Bradford, the Telegraph and Argus, which said:
"There is obviously a nationwide problem. It is hard to work out whether the crisis is the result of a shortage of funds—or due to mismanagement of resources and bad planning."
The Secretary of State for Health is the man ultimately responsible for sorting out the mess. The Government created the new-look NHS. They must ensure that it stops failing people when they are in desperate need. The indications are not good. When I raised a question in the House about the problems of purchaser-provider splits, I was told that it was a matter for the chief executive of the trust and for the commission. I believe that to be an abdication of responsibility. The Government should and must act when things go wrong.
Again in December, the hospitals trust had to subcontract more than 1,000 patients to other private and NHS facilities because it did not have the capacity or the notice to make arrangements. Some £1.9 million was found by the regional health authority out of "unrenewable resources" to meet the backlog of cases that had been waiting almost 12 months. There were 516 general surgery cases; 322 orthopaedic cases; and 278 urology cases. Operations were carried out in the private sector at premium rates by consultants who would have carried out the same operations within the NHS. I urge the Minister to investigate how it was possible for such a situation to occur.
Bradford hospitals trust has shut down its capacity to match its budget provision. The trust's chief executive raised concerns with my colleagues and me about the seriousness of the financial situation. In the contracting year 1994–95, the trust was required to carry out 76,500 finished consultant episodes from a budget of £80.5 million. In 1995–96, it has been requested to supply 79,500 FCEs for £82.1 million—an increase of £1.6 million for a further 3,000 operations. In effect, it is a 4 per cent. increase in requirement, but with an increase of only 2 per cent. in funds.

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Needless to say, the health commission does not accept the figures and makes the case that the trust is the provider and that it must be competitive on its prices to win contracts. That would be understandable if we were talking about a business, but we are not. Nor are we comparing like with like. Bradford hospitals trust depends on Bradford health commission for more than 90 per cent. of its budget. The trust forecast that it is heading for a finance deficit this year of £5 million. It says that further financial pressures are unavoidable on issues that have been agreed by the Government—the cut in junior doctors' hours, and more medical education—but have not been budgeted for.
The only method of retrieving the shortfall is for further cuts to be made in an already beleaguered service. The trust maintains that it is cost-effective, low priced, and an efficient production unit. It points to several local and national indicators to prove the point. What is clear to all of us in Bradford who use, and depend on, our hospitals is that we cannot afford more cuts. Yet we discover that the new formula funding for the regional health authorities means that Bradford will receive £5 million less next year, on top of the £5 million shortfall for this year.
Taxis ferry patients across the city, because the trust operates on two major sites. X-rays and scanners are available only at one site. We need more money and more investment, not less money and further cuts. Staffing levels on the wards are the lowest in West Yorkshire. On most wards, 19 staff provide 24-hour cover seven days a week. On others, there are six nurses—three qualified from the Royal College of Nursing and three auxiliaries—to 51 patients. When there is absence through sickness, the staff have to go to the management to arrange cover instead of using agency nurses.
All training courses have been stopped until the end of the financial year as the training budget has been used up. Nurses and staff are not allowed time off to attend courses to develop their skills. They have to pay for the courses themselves and attend them outside working hours. Staff working on Christmas day had to pay for taxis to get to work because there was no public transport and when they applied for a refund they were told to deduct the amount of the bus fare. That is outrageous.
In 1994, a document was launched in Bradford outlining the strategy for health until 2000. It pointed out Bradford's medical requirements and all the agencies involved gave a commitment to make Bradford a healthy place with healthy people able to depend upon first-class health provision. If present trends continue, that will become a worthless piece of paper to put alongside the patients charter. We do not want more words; we want a health service that provides for us when we are in need.
The trust recognises that it has a problem. It forecasts increased waiting times and says that current contracts will mean that people will be on waiting lists for more than 12 months. It believes that a cost reduction programme will make matters worse, putting the trust at greater risk of complaints and litigation. Bradford people cannot afford that. I urge the Minister to investigate and put matters right. If he does not, the Government cannot continue to say that the health service is safe in their hands. This is not a matter of the numbers of patients being treated; it is a fundamental question of providing an effective, efficient and caring public service.
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In 1991, the Bradford hospitals trust was launched as a flagship of the new approach to health provision. It saddens me to say that it is floundering and in danger of sinking. The casualties will be the decent people of our city, people who cannot afford to buy their way out through the private sector if they are in trouble.
It is a great privilege and responsibility to represent Bradford, South. I hope that the Minister will take the issues seriously and not respond by quoting statistics showing the throughput of operations. I hope that he will show a genuine desire to get to the heart of the issues and to put matters right.
Doctors, nurses and health workers in Bradford deserve better support. People in Bradford know what the problems are and they deserve better treatment. I hope that the Minister will investigate all the matters that I have raised and ensure that Bradford receives proper and appropriate health care.
1.44 pm
Mr. Max Madden: I congratulate my hon. Friend the Member for Bradford, South (Mr. Sutcliffe) on securing the debate and allowing me a brief opportunity to participate.
The Under-Secretary of State for Health is new to his portfolio, but I am confident that the briefing material given to him before the debate will have said that concerns about the NHS in Bradford have been put to the House by different Members of Parliament representing the city during the past 10 years or so.
I do not want to be alarmist—what I have to say is substantiated by what my hon. Friend said—but the NHS in Bradford is in deep crisis and unless the Government intervene decisively, that crisis will deepen. Those who depend on the NHS in Bradford are clearly not receiving the quality of service to which they are entitled and all the prospects are that that quality of service will deteriorate unless decisive action is taken.
As the House has been told on numerous occasions, Bradford suffers from deep poverty. That poverty is endemic and breeds all sorts of health demands. Clearly, Bradford NHS is incapable of meeting those needs at present and, as time goes by, without the injection of additional funding, it will continue to be unable to meet those growing and important needs. We suffer particularly from high rates of heart disease. Thankfully, our infant mortality rates have improved substantially in recent years, but there is continuing concern about infant mortality and the health of children in our district.
As my hon. Friend said, the NHS in Bradford is grotesquely underfunded. That has been the case ever since the NHS trust was first established there. Public warnings were consistently given about that underfunding, which were reaffirmed by the Select Committee on Health which visited Bradford at that time. Those warnings were never heeded, but I appeal to the Minister to do so today and to take action.
The morale of nursing and medical staff is at an all-time low. There is gross understaffing. As my hon. Friend said, the nursing staff-patient ratio is not only below the regional average but way below the national average. Considerable burdens are imposed on staff, who experience great stress and there is unacceptable dependence on temporary or so-called bank or agency nursing staff.

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There is also considerable anxiety about the need to increase the number of consultants, in comparison not only with Airedale but with the rest of Yorkshire. My hon. Friend rightly spoke about the language that we now hear so much of in the health service—for example, throughputs and activity rates. We are dealing not with supermarkets but with those who are desperately trying to provide the best quality of care and service in Bradford, as is the case throughout the rest of the country. That is not being delivered in Bradford today and the main reason for that is the underfunding.
As my hon. Friend has already said, it is no good the Minister saying, as he may well do, that the funding is adequate and that the matter is one for the trust and the health commission—once better known as the health authority. Despite the new name, the reality remains the same, and that is that there is serious underfunding, which is historical. Unless action is taken, the consequences of that underfunding will continue and there will be more unfortunate cases, such as that of Mr. Cranswick, which has illustrated the need for urgent action now.
Some particular incidents have caused considerable concern recently. My hon. Friend referred to the decision to spend nearly £2 million on reducing the number of those who have been on waiting lists for nearly a year which, as the Minister will have heard, has resulted in that money being spent primarily within the private sector. It is unacceptable that nearly £2 million of taxpayers' money should be spent within the private sector.
The absurdity of that is compounded because most of the operations were carried out by NHS consultants who should and would wish to carry out those operations within the NHS. That decision was politically driven. The Government clearly said that they wanted to reduce waiting lists and did not care how it was done. In Bradford, the result was that money that should have gone into the NHS went predominantly into the private sector.
I hope that the Minister will give us more than sympathy today. I hope that he will call urgently for information about the situation. If he agrees with the views expressed not only by me and by my hon. Friend today but continually by many others who are desperately concerned about health in Bradford, I hope that he will find a way of injecting substantial funds into the NHS in Bradford and do so urgently.
1.48 pm
The Parliamentary Under-Secretary of State for Health (Mr. John Horam): I am glad to have the opportunity to respond to the hon. Member for Bradford, South (Mr. Sutcliffe). I congratulate him on securing time in the House to debate the important matter of health care in Bradford. I acknowledge, too, his long-standing concern and his local knowledge. I well understand his feelings following the sad death of Mr. Geoffrey Cranswick, his constituent. He made an eloquent plea not only on the general question of health care in Bradford but on the particular question of intensive care beds, which are a material factor. I also acknowledge what the hon. Member for Bradford, West (Mr. Madden) said. He too has a great deal of knowledge about, and concern for, health matters in Bradford. I promise not to give too many statistics, but we must include a few facts in dealing with this case.
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Before referring specifically to Bradford, let me say a little about the position in the country as a whole in order to put the matter in context. The number of available intensive care beds has increased by nearly 90 in the past four years. We recognise that the lack of intensive care provision has provoked criticism. It is sometimes claimed that the problem is due to a shortage of qualified nurses; retaining highly qualified nurses can be a problem, but—as my right hon. Friend the Secretary of State confirmed only last week in Health questions—we now have 1,000 more qualified nurses than we did in 1990. Indeed, the number of qualified general intensive care nurses increased by more than 18 per cent. between 1990 and 1994.
It must be stressed that intensive care is precisely that: it is a very intensive business. Between five and seven highly trained nurses are required to deal with one bed in an intensive care unit. That is one reason why we are encouraging the development of high dependency units, which can take some of the strain off intensive care provision.
In response to the claims of shortage in provision, the Department of Health commissioned a study from the London School of Hygiene and Tropical Medicine, led by Professor McPherson. His report, which was published last year, identified considerable variation in provision; it also found a significant number of inappropriate admissions. It must be recognised that what capacity we have must be used sensibly: it should not be misused in the handling of cases that do not necessarily justify intensive treatment. Following the publication of the McPherson report, a working group of medical and nursing professionals was formed to draw up guidelines for admission to, and discharge from, intensive care. It is expected to complete its work early this year.
Both the hon. Member for Bradford, South and the hon. Member for Bradford, West said that this should be a matter for the Government. In fact, the Government—or, rather, the professionals whom they have commissioned—are examining the whole business of intensive care, including intensive care in Bradford. Last year, we also asked local health authorities to review local intensive care provision in the light of Professor McPherson's report. We are also supporting the Intensive Care National Audit and Research Centre with a grant of £400,000. Both performance and outcome are being examined. I agree with both hon. Members, however, that we should consider not merely short-term but medium and long-term benefit.
Let me now deal with the position of local health commissions, and Bradford health commission in particular. It is the responsibility of district health commissions, or authorities, to use their resources to meet the health needs of their populations. The hon. Member for Bradford, South expressed the fear that resources for Bradford might be insufficient, but let us look at the facts. In 1995–96—the current financial year—Bradford health commission received over £200 million, an increase of £9.6 million in cash terms, including an increase of £1.6 million for development. Furthermore, in the next financial year, beginning in April, Bradford is to receive £210 million—another substantial increase in cash terms, including a real terms increase of £1 million. While the hon. Gentleman clearly believes that Bradford's health service is underfunded, the fact is that it is receiving substantial amounts each year in addition to what it already has.
Mr. Sutcliffe: The worries that we have expressed are not merely our personal worries; they have been substantiated by the hospital trust management, which says that it faces real shortfalls.
Mr. Horam: I hear what the hon. Gentleman says, but the fact remains that we are increasing funds for Bradford in real terms.
Let me be more specific. One of the ways in which Bradford has benefited from the extra money is through improvements in its accident and emergency department. After Bradford health commission had completed its own review, the results of which were published last September, it was able to assist with A and E services at Bradford royal infirmary, which is part of Bradford Hospitals NHS trust. The commission also provided an extra £140,000 for A and E staffing. This year, the trust has increased the number of staff in its A and E department by one consultant, four senior house officers and eight nurses. It has invested a total of £420,000, and a new computer system has been installed.
The hon. Gentleman, however, is concerned about not just A and E but wider health matters. The trust has also appointed eight additional consultants, including three anaesthetists and a general surgeon. As recently as the end of 1994, my hon. Friend the Minister for Health opened a new wing at St Luke's hospital in Bradford, which is part of the trust. The development cost £25 million.
The hon. Gentleman raised the sad case of Mr. Geoffrey Cranswick. I shall not go into that tragic case at length, because it has already been dealt with exhaustively, and we probably agree about what happened. Following the case, however, Bradford health commission's chief executive visited the trust—I believe that he did so the day after the events with which we are dealing—to discuss the need for more intensive care beds. To that, extent prompt action was taken, as it should be in such cases.
As I explained earlier, the health commission's contract allows for the funding of five intensive care beds, so the recent difficulties are not related to funding. In this case, as the hon. Gentleman admitted, they were due to staff shortages. Two people were not available because of flu, and there were four more shortages because of the inability to attract properly trained nurses. That is a problem, but it does not relate specifically to funding.
Mr. Madden: I am sorry to interrupt the Minister when he has only a few more minutes in which to speak. May I ask, however, whether he has received any representations from either Bradford health commission or Bradford Hospitals NHS trust regarding the allocation of resources and the need to increase those resources?
Mr. Horam: No, I have not. What I have received is a report on the position. I looked into it after the hon. Gentleman raised the issue in an Adjournment debate.
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I am assured that much joint work is now being done to bring about a better understanding of the pressures on the service in Bradford. That involves more co-operation between the commission and the trust—the specific point about which the hon. Gentleman complained.
As the hon. Gentleman will be aware, the commission and the trust have been working together on a programme called "Making Bradford Better". He did not mention it, but I am sure that he knows of it. The project evolved from joint discussions and work, and is intended to effect early improvements in specific patient services. Specific programmes include dealing with emergency admissions and the Bradford eye service. Whatever may have obtained in the past, the relationship and level of understanding between the commission and the trust are improving. I acknowledge that great effort is needed to ensure the continuation of that joint work, which clearly benefits Bradford.
On the occasion in question, only four intensive care beds were in service. There should have been five, and it is clearly vital for that fifth bed to be returned to service as soon as possible. It is accepted, however, that five beds are not enough to serve the 500,000 people who live in the Bradford area. Six beds should be available as early as possible, and the commission and the trust assure me that every effort will be made to achieve that.
I mentioned high dependency beds, which can take the pressure off intensive care beds. There are plans to fund an additional four such beds.
The hon. Members for Bradford, South and for Bradford, West may never accept that Bradford has enough money, and I would probably feel the same if I were in their shoes, but funds have been increased substantially. Moreover, as far as I am aware, co-operation between the trust and the commission is becoming better and better. Such co-operation must exist if the problems are to be solved. Specific attention is being paid to the question of intensive care and high dependency. I hope that all those factors will lead to an increase in Bradford's health provision, and I join both hon. Members in paying tribute to the work done by the professionals.
It being Two o'clock, the motion for the Adjournment of the House lapsed, without Question put.
Sitting suspended, pursuant to Standing Order No. 10 (Wednesday sittings), till half-past Two o'clock.

BILL PRESENTED
  EDINBURGH ASSAY OFFICE
  Mr. Secretary Forsyth presented a Bill to confirm a Provisional Order under the Private Legislation Procedure (Scotland) Act 1936, relating to the Edinburgh Assay Office (to be presented under section 7 of the Act): And the same was read the First time; and ordered to be considered upon Tuesday 30 January and to be printed. [Bill 47.]
Oral Answers to Questions
  EDUCATION AND EMPLOYMENT

    School Discipline
    Mr. Evennett: To ask the Secretary of State for Education and Employment what measures she is taking to help schools enforce firm discipline; and if she will make a statement. [9415]
    Mr. Jacques Arnold: To ask the Secretary of State for Education and Employment what measures she is taking to help schools enforce firm discipline. [9420]
    The Parliamentary Under-Secretary of State for Education and Employment (Mr. Robin Squire): Last September, my right hon. Friend announced a range of initiatives to help schools combat the problem of disruptive pupils. They build on guidance on pupil behaviour and discipline sent in May 1994 to all schools, as part of the "Pupils with Problems" pack. She has also asked the consultative group on school standards for advice on what else can be done to help schools maintain and improve discipline.
    Mr. Evennett: I thank my hon. Friend for his reply and welcome the additional resources provided by the Government to help schools deal with disruptive pupils, but does he agree that better teacher training in classroom management would be one way in which to help improve discipline in the classroom?
    Mr. Squire: I agree with my hon. Friend who, as a former teacher, speaks with considerable authority. Initial teacher training should equip all new teachers with the skills to create and maintain a disciplined environment in the class. It is also fair to say that the increased emphasis that we are placing on school-based teacher training will assist in that respect. Separately, funding is available for training for existing teachers so that they also may improve their skills.
    Mr. Arnold: I agree that teachers are the key to discipline, but they can be effective only if they receive proper back-up from local education authorities. As we well know, too many local education authorities, especially Labour-controlled ones, can be categorised as being soft on indiscipline and soft on the sources of indiscipline—basically, on badly behaved pupils. The Government were right to set up pupil resettlement units—the well-known sin bins—but bearing it in mind that their policies are implemented by the same Labour education authorities that are soft on indiscipline, what checks are made on those sin bins to ensure that they have tough discipline and get these yobs right?
    Mr. Squire: My hon. Friend has put his finger on a significant point. There is no question but that we must ensure that the vast majority of school pupils are able to be educated in a proper and ordered environment. That will sometimes mean the exclusion of disruptive elements, but it is not sufficient that those elements are then left to drift—they must be educated too. The Office for Standards in Education inspection of the first 12 pupil
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    resettlement units was revealing and worrying. From this September, it will inspect all 300 pupil resettlement units with a view to ensuring that standards are high enough.
    Mr. Barry Jones: Would not providing real jobs for young school leavers help?
    Mr. Squire: The hon. Gentleman has not considered the unemployment figures for the past three years. The figures for unemployment and for the proportion of people employed in this country are among the best, if not the best, in Europe. Rather, the problem is that some of our pupils suffer from a poverty of expectation, which goes back to the quality of teaching.
    Mr. Kilfoyle: The Minister mentioned exclusions. Given the threefold increase in exclusions in the past three years, will he explain why his Department could not even be bothered to send a representative to the recent Runnymead Trust seminar, at which Sir Paul Condon was reported to have said that the majority of street criminals in London were excluded from school?
    Mr. Squire: I do not know about the seminar to which the hon. Gentleman refers, but I know beyond argument that the Government are deadly serious about equipping teachers, schools and local education authorities with the full range of powers they need to cope with indiscipline in schools. The hon. Gentleman mentioned permanent exclusions. We have made it clear that that is a last resort, not a first resort. In September, my right hon. Friend the Secretary of State set out a number of ways in which we are seeking, through discussion—particularly with the teaching unions—to extend the scope of alternatives open to schools.

    Grammar Schools
    Mr. Congdon: To ask the Secretary of State for Education and Employment how many pupils are currently educated in grammar schools. [9416]
    The Secretary of State for Education and Employment (Mrs. Gillian Shephard): In January 1995, approximately 123,000 pupils were being taught in maintained grammar schools in England.
    Mr. Congdon: Does my right hon. Friend agree that grammar schools provide not only an excellent education but a real choice for parents, particularly in inner-city areas? Does she also agree that parents who are fortunate enough to be able to send their children to such schools should have the courage to fight for the survival of grammar schools rather than to support policies that would ensure their destruction?
    Mrs. Shephard: We are in favour of selection. Selective schools have a distinguished record of providing a high standard of education and increased choice, which many parents want for their children. Indeed, such parents are emerging in increasing numbers from the Opposition Benches. The events of the past few days have revealed that the Labour party's policy on choice, diversity and selection is a basic contradiction at the heart of its

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    thinking—choice and diversity for some, but policy intentions to remove choice, diversity and opportunity for selection from everyone else.
    Mr. Beggs: Does the Secretary of State agree that in Northern Ireland we have managed to maintain a high standard of education for our children by maintaining a selective system, but that in good secondary schools and comprehensive schools—in which teachers are dedicated and committed and pupils are streamed and educated according to their age and ability—youngsters achieve as much as they do in grammar schools?
    Mrs. Shephard: What is important is that parents should have a range of schools from which to choose: selective, non-selective, grant-maintained, specialist schools, city technology colleges and, of course, access to the independent sector through the assisted places scheme. Sadly, such variety would be crushed out of existence by the Labour party's policies, should it ever have the chance to put those policies into practice.
    Sir Malcolm Thornton: No one doubts the excellent record of many grammar schools in this country and the contributions they have made to many children's education. Does my right hon. Friend agree that what is perhaps more important than the label which is put on a school—the name it is given—is what happens within it? Does she agree that those schools that are targeting the real needs of pupils will achieve the best for them and provide parents with the diversity and choice that is central to the Conservative party's attitude and approach to education?
    Mrs. Shephard: There is no doubt that all schools are capable of providing an excellent education and good results. Schools, of course, depend very much on the quality of the head and teachers in them. That is why we are introducing a qualification for head teachers. I think that my hon. Friend will agree that a range of schools from which to choose, and the very existence of choice, help to drive up standards.
    Mr. Skinner: Is the Minister aware that grammar schools are not all that they are cracked up to be? I went to one and they taught me Latin—amo, amas, amat, amamus, amatis, amant. They also taught me the Archimedes principle—when a body is weighed in air and then in a fluid, the upthrust or apparent loss in weight is equal to the weight of the fluid displaced. But none of that equipped me for life. I went down a coal mine, which is where I got my real education. Do not believe all that rubbish about selectivity. Let us give every child in Bolsover and the rest of Britain the chance to do as well as one another.
    Mrs. Shephard: It is not part of the Government's policy to impose on our education system the dead hand of uniformity, as the Labour party would seek to do. The hon. Gentleman is the most wonderful advertisement for the selective system. He should be used in publicity.
    Mr. Patrick Thompson: In the 1960s, I was a physics teacher at Manchester grammar school, teaching the Archimedes principle, and I am impressed by the knowledge of the hon. Member for Bolsover
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    (Mr. Skinner) on that subject. Does my right hon. Friend recall those direct grant selective grammar schools which provided a good education for people of all backgrounds in Manchester and throughout the country? Does she also recall that it was a Labour Government who pushed those schools out of the state system and thereby took away the opportunities for young people?
    Mrs. Shephard: It was indeed the Labour party which, in the 1960s and 1970s, sought to use education as a tool for social engineering. If we read the lips of Opposition Members, see that they continue to want to do that. Did not a Labour predecessor of mine say that he would not rest until he had got rid of every blank grammar school in the country?
    Ms Estelle Morris: The Secretary of State's comments on this issue are interesting. If the Conservatives think that selective grammar schools are so good, why did Baroness Thatcher close so many and why has the Secretary of State no plans to open more?
    Mrs. Shephard: As I have already said a number of times, we are in favour of selection because we believe in diversity and choice for parents, as do some Opposition Members, particularly on the Labour Front Bench. As the hon. Lady knows, we are currently consulting on proposals to broaden selection. Although that has not been received with three cheers by all Opposition Members, I am sure that the hon. Member for Peckham (Ms Harman) would welcome it. Given the welcome boost to the issue provided by Labour Members' activities, we shall consider what further developments might arise from that consultation exercise.
    Dame Elaine Kellett-Bowman: Does my right hon. Friend agree with the comment in the "Our View" column of Monday night's Lancashire Evening Post, which said:
    "Many parents still believe we are paying a high price for…comprehensive education."?
    Does not the fact that so many people apply to the two grammar schools in my constituency confirm that view?
    Mrs. Shephard: Indeed. As I said, it is not part of the Government's policy to impose the dead hand of uniform comprehensive education across the country. We need choice and diversity, and selective schools are an important part of that.

    Temporary Employment
    Mrs. Mahon: To ask the Secretary of State for Education and Employment what estimate she has made of the number of people currently in temporary positions because they cannot find a permanent job. [9417]
    Mrs. Gillian Shephard: Around 650,000.
    Mrs. Mahon: Is the Secretary of State aware that, when the Courage brewery in my constituency closes, with a loss of 200 jobs, only part-time insecure jobs will be on offer to those workers—and not to many of them? Has she any idea how devastating it is for people who

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    want to make a stake in society by buying a house or engaging in social activities when they have only temporary, low-paid work? What will she do about it?
    Mrs. Shephard: Of course I agree that unemployment is a very unpleasant experience, but two thirds of all those who become unemployed find work within six months. I hope that the hon. Lady's constituents will find some comfort in the fact that the Employment Service has placed a record 2 million unemployed people in work this year.
    I must correct the hon. Lady's apparent belief that there is a problem with temporary or part-time jobs. In 1994, only 6.3 per cent. of the work force were in temporary work, compared with more than 10 per cent. in France and Germany and a massive 33.6 per cent. in Spain. In case the hon. Lady has missed the connection, I should point out that socialist Spain—where the proportion is a massive one third—embraces both the social chapter and the national minimum wage. I believe that I am right in thinking that the Labour party wants to subject the people of this country to both of those policies.
    Mr. Viggers: Is my right hon. Friend aware that I have some special knowledge of the employment situation in France, as my daughter has lived there since her marriage? Is she aware that unemployment among the under-25s in France has now reached the appalling figure of 27.3 per cent.? Is she further aware that, to avoid the rigours of the national minimum wage, it has become normal for employers to offer young people unpaid work—the so-called "stage"—for three or even six months, and the expectation of a chance of getting a paid job at the end of that period is held out to them? Is not that a scandal? Can we expect a similar situation in this country if we embrace the social chapter?
    Mrs. Shephard: There is clearly a direct correlation between France's embracing a national minimum wage and its regrettably high rate of youth unemployment. Youth unemployment in this country is below that in Spain, Finland, Ireland, Italy, France, Belgium, Greece, Sweden and Portugal. I think that that speaks for itself.
    Mr. McAvoy: Is the Secretary of State aware that, in 1994, the unemployment rate among graduates six months after graduating was 10 per cent.? They were thereby forced to look for any kind of job—particularly temporary jobs—to try to get along. Does she agree that that is a complete waste of their time and of the taxpayers' money invested in them? Does she have any suggestions or helpful comments for people in that situation?
    Mrs. Shephard: The employment rate among graduates in this country is very much higher than that in the European Union, and unemployment among graduates here has halved in the past year. We do not want anyone to be unemployed, but unemployment is falling further and faster in this country than in any of our major competitor countries in the EU.

    Older Workers
    Mr. Stephen: To ask the Secretary of State for Education and Employment what provision is being made for the employment of older workers. [9418]
    Mr. Stewart: To ask the Secretary of State for Education and Employment what progress is being made in the campaign for older workers. [9422]
    The Parliamentary Under-Secretary of State for Education and Employment (Mrs. Cheryl Gillan): The Government's economic and labour market policies have led to an increase in employment of 600,000 over the last two and a half years. Thirty-nine per cent. of those jobs have been filled by people aged 50 and above.
    Mr. Stephen: Does my hon. Friend agree that older people very often make reliable, experienced and knowledgeable workers? Is not it a tragedy that so many of them are thrown on the scrap heap when they can be most productive? Is there any evidence to suggest that the attitude of employers is shifting towards older workers? Are the Government doing anything to ensure that the attitude does shift?
    Mrs. Gillan: The Government are doing something. Our older workers campaign continues apace, particularly with the recent publication of the third booklet in the series entitled "Age Works". It makes no economic or business sense to exclude people because of their age, and many companies—such as B and Q and the Nationwide building society—are now welcoming older workers and older job applicants. I received a letter from a recruitment consultant this week, who wrote:
    "We currently have temporary staff in their 50's and 60's working for us. They are reliable and conscientious and as an agency we have no hesitation in promoting the mature worker".
    Mr. Stewart: My hon. Friend has reported considerable and welcome progress to the House, but would she comment on international examples of apparently succesful legislation to ban age discrimination in employment procedures?
    Mrs. Gillan: My Department has carried out a study of approximately 20 countries, including the United States where such legislation exists, and no conclusive evidence suggested that it helped older workers when they tried to find a job. I have found that persuasion and our campaign is genuinely working. Richard Worsley, the director of the Carnegie Third Age programme, wrote just this month in People Management:
    "In 1995 I surveyed 500 employers in the United Kingdom about their advertising policies. Nearly 90 per cent. of them replied that they do not or will not use age limits in recruitment advertisements."
    That magazine has made it clear that, from January, it will no longer accept any recruitment advertisements that exclude some applicants purely on the ground of their age.
    Mr. Hain: Is the Minister aware that no progress has been made in many former coal-mining areas, such as my constituency, where 50 per cent. of over-50-year-old men are economically inactive? That is a staggering figure and has contributed to the hopelessness and despair that not only the young, but many middle-aged and older workers, feel. The Government's policies are, more and more, driving them to despair. What is the Minister going to do about that?
    Mrs. Gillan: I am very sad to hear that the hon. Gentleman has constituents who feel depressed and

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    are unable to get a job. All I can say is that, from the summer of 1994 to the summer of 1995, employment for the over-45s grew by 1.7 per cent. compared with 0.9 per cent. for the remainder of the work force. I very much hope that his constituents find jobs in the near future.
    Mrs. Helen Jackson: In view of the Minister's comments, why have the Government decided not to make student loans available to the over-50s?
    Mrs. Gillan: Our policy is well known—[HON MEMBERS: "What is it?] I am concerned to get older workers into jobs. The campaign that is being conducted by the Government is proving its success time after time.
    Mr. Rowe: I am pleased to hear about the progress that my hon. Friend has made. She will be as aware as anyone that a man of 50 has the expectation of a further 36 years of life during which he may have low pension expectations. Has she plans to improve the spread of the use of national vocational qualifications to enable older people to validate the considerable experience of life that they have so far gained?
    Mrs. Gillan: Opportunities should exist irrespective of age. Everyone with the ability and desire to participate in the labour market should be encouraged to do so for as long as they wish, regardless of age.

    Church Schools
    Mr. Jon Owen Jones: To ask the Secretary of State for Education and Employment what representations she has received from Church bodies on her proposals for fast-track opt-out for Church schools. [9419]
    Mr. Robin Squire: My right hon. Friend the Secretary of State has received 69 representations from Church bodies on the Department's consultation paper on self-government for voluntary-aided schools. A summary of responses has been placed in the Library.
    Mr. Jones: Contrary to the impression that the Minister seeks to give, is not it true that Church schools have overwhelmingly rejected proposals for grant-maintained status? What lessons have the Government learnt from that? Surely that rejection will speed up the rejection of grant-maintained status across the country.
    Mr. Squire: The inference to be drawn from the hon. Gentleman's supplementary question is rather strange. He seems to suggest that, via a press release from the Government, attempts have been made to hide the result of the consultation. We have always made it clear, as we did in the Chamber two days ago, that we would consult—the Prime Minister made that clear in his speech in September. We listened to the results of that consultation and responded. The difference between the Labour party and the Government is that, too often, the Labour party is not prepared to consult, or even to listen, when the majority of people tell it that they like selective education.
    Mr. Couchman: Has my hon. Friend had any representations from the Bishop of Southwark suggesting
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    that a Church school in Southwark should be opted out to replace St. Olave's so that the children of middle-class parents may be spared a 30-mile round trip to Orpington?
    Mr. Squire: While I cannot speak for the specific source mentioned in my hon. Friend's question, the obvious lesson from the events of the past few days for any voluntary-aided—let alone selective—school that has not yet opted out is to get going.

    Temporary Employment
    Ms Janet Anderson: To ask the Secretary of State for Education and Employment if she will make a statement on the proportion of employees currently in temporary employment. [9421]
    The Minister of State, Department for Education and Employment (Mr. Eric Forth): Latest figures from the labour force survey indicate that about 7.5 per cent. of employees are in some form of temporary employment.
    Ms Anderson: Is the Minister aware that, according to the latest labour force survey, the number of people who are in temporary jobs because they said that they could not find permanent jobs has increased by 140 per cent. over the past five years? Can the Minister explain that increase?
    Mr. Forth: The number in temporary employment fluctuates, depending on economic circumstances and the development of the labour market. The hon. Lady seems to have missed the point that my right hon. Friend the Secretary of State made earlier. If one regards temporary work as being undesirable—I in no way agree with that view; temporary work has its place in the economy—Britain has a much lower number, and proportion, of workers in temporary employment than nearly all of our major continental partners, especially those of a socialist bent who are imposing social chapter conditions and statutory minimum wages on their employees. The more restrictions one seeks to place on the labour market, the more likely there is to be a higher number of temporary workers. I hope that the hon. Lady will convey that fact to her Front-Bench colleagues.
    Mr. Marlow: Does my hon. Friend include in his statistics of those in temporary employment the hon. Member for Peckham (Ms Harman)—in view of the remark of the hon. Member for Bolsover (Mr. Skinner) that, if she has not been fired between now and later in the year, she will be voted out of the shadow Cabinet? If she loses her job, does my hon. Friend recommend that she become a teacher in a grammar school or that she go down t'pit, as suggested by the hon. Member for Bolsover?
    Mr. Forth: Perhaps I should arrange for a form from the next labour force survey to be sent to the hon. Lady so that we can be sure that her status is clear.
    Mr. Meacher: Does the Minister think it right and fair that, generally, temporary workers do not get sick pay or premium payments for working overtime or shifts, are excluded from occupational pensions and are paid less than full-time staff for doing the same work? I have with

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    me examples such as a double-glazing factory worker from north Wales on £1.75 an hour, a trainee hairdresser in Oldham on £40 a week who has to pay £5 a week in bus fares and lunch money and an advertisement from a jobcentre in Chorley for a landscape gardener for just £1 an hour. Is it not disgusting that Tory economics favour six-figure, fat cat executive share options on the back of the temporary worker sweatshop economy?
    Mr. Forth: I recommend to the hon. Gentleman that he listens to our replies before he reads out his prepared soundbites. If, as he seems to be, he is saying that temporary employment is undesirable and disastrous, he should examine his party's policy more closely and explain to the electorate and the work force why the policies that he seeks to impose would almost inevitably greatly increase the number of temporary employees to the sort of figure that is found in socialist Spain. When he has an explanation for that, he should come back to the House and give it.

    Commuters
    Mr. Barry Field: To ask the Secretary of State for Education and Employment what studies she has made of the average daily number of workers commuting into travel-to-work areas with a higher than average level of unemployment. [9423]
    Mr. Forth: The Department has not made any such studies.
    Mr. Field: A number of commuters travel from the mainland to the Isle of Wight every day despite the relatively high unemployment on the Isle of Wight. Will my hon. Friend consider including the island in a study at some future date to discover why the island's resident population are not taking the jobs that are filled by commuters from the mainland?
    Mr. Forth: My hon. Friend asks an interesting question. It is undeniable that a large number of people are prepared to travel extraordinary distances—for example, from Southwark to Bromley—to improve their family circumstances. I have even heard of family members travelling from Islington to Hammersmith. That illustrates that the labour market is a free market, and we encourage people to move to wherever they can better themselves.
    As for my hon. Friend's constituency, the only figures that I have been able to find show that local council planners in his authority estimate that, each day, 1,000 people travel off his island to work and about 500 people travel on to the island. There is a healthy awareness in the locality of my hon. Friend's constituency of the availability of jobs. My hon. Friend asked an interesting question and I shall consider his proposal as a prospective project for my Department's research budget next year.
    Mr. Ian McCartney: The Government have introduced a travel-to-interview scheme for travel-to-work areas. Under the scheme, unemployed workers are entitled to subsidies to help with the costs of travelling to interviews. Owing to the scheme's mismanagement, 88,000 people have been refused access to that resource. As we speak, a young gentleman called Chris Owen is
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    walking the 160 miles from Gwent to London for a job interview tomorrow. The Minister spent £74 million tarting up his headquarters with new carpets, curtains, tables and chairs, but he has refused the young man £11 to come to a job interview in London. Will the Minister review his decision, pay the £11 and, as a sign of contrition, buy the chap a new pair of shoes to compensate for the 160 miles that he has already walked? Is it not a disgrace that the Government can cause someone to lose a job simply by refusing the £11 bus fare for an interview?
    Mr. Forth: The hon. Gentleman displays his usual ignorance of the rules of the schemes that we introduce to help people who are out of work. Opposition Members—and certainly the hon. Gentleman—do not understand that each scheme and programme to help people who are out of work has to have its rules. I am sure that the hon. Gentleman would not have it otherwise, because taxpayers' money could be misdirected. It is for individuals and experts in the Employment Service to find the best way to help each individual. If someone wants to dramatise his position by doing what the hon. Gentleman has described, that is a matter for the individual involved. I will not be accused, and I will certainly not have the Employment Service accused, of not doing everything possible to help people in reasonable circumstances to return to work. Our track record on that is extraordinarily good.

    Expenditure (Somerset)
    Mr. Mark Robinson: To ask the Secretary of State for Education and Employment what additional resources will be provided for education in Somerset in 1995–96. [9424]
    Mr. Robin Squire: Somerset's education standard spending assessment increased by £3.5 million in 1995–96 and is set to rise by £7.4 million or 5.1 per cent. in 1996–97.
    Mr. Robinson: Does my hon. Friend share the outrage of parents, teachers and governors in Somerset and my constituency at the fact that the Liberal Democrat-controlled county council is thinking of not passing on up to £3 million of that £7.4 million to schools in Somerset? Is that not particularly disappointing given the excellent series of reports that the Office for Standards in Education has recently issued that show the quality of the schools in my constituency?
    Mr. Squire: I agree entirely with my hon. Friend. He will remember—as I suspect do all my hon. Friends—that throughout the past year the Liberal Democrats have been accusing the Government of underspending on education. Now, as my hon. Friend rightly said, as a result of the settlement announced, there is ample opportunity in Somerset for the Liberal Democrat council to spend that money on education. If it does not do so, to use a word in common usage at present, it will be being hypocritical.
    Mr. Don Foster: Further to the reply that the Minister has just given, will he confirm to the House

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    that the capping limit on Somerset is such that it may raise its cash limit by only 3.1 per cent.? Will the Minister confirm that Somerset has received only 20 per cent. of its request for capital allocation? Will the Minister confirm that service delivery increases in Somerset—through rising pupil numbers, inflationary prices and changes in legislation alone—will cost £10 million? Will the Minister confirm that Somerset is a prime example of why the report by the Tory-dominated Treasury and Civil Service Select Committee said of education spending that the Chancellor's Budget did not live up to the claims that he was making in it?
    Mr. Squire: The total increase in spending that Somerset can make next year is about £8.5 million—the type of figure for all services that most local education authorities would be delighted to receive. The hon. Gentleman will be aware that a restricted document has fallen into public ownership. I am a little unclear whether his contribution today should be described as naive, woolly or barmy—all words used in the document—but I would say to him that it is right and proper for the local education authority in Somerset to be able to spend that money overwhelmingly on education, and it has the means to do so.
    Mr. David Nicholson: Will my hon. Friend support the efforts made by Conservative Members and Conservative county councillors in Somerset to ensure that all the money budgeted for education this year goes to schools and is not retained by county hall? Apart from the resource argument, will he acknowledge that there must be constant pressure to improve teaching methods and standards in schools, which is why all Conservative Members welcome the motives of, and commend the example shown by, the hon. Member for Peckham (Ms Harman)?
    Mr. Squire: I agree with both the main points made by my hon. Friend. As he well knows, the Government are committed to raising standards in all our schools—including those in inner cities, which appear to be so unpopular at present among Opposition Members.

    Examination Results
    Sir David Madel: To ask the Secretary of State for Education and Employment what conclusions she has drawn from the 1995 A-level and GCSE examination results; and if she will make a statement. [9425]
    The Parliamentary Under-Secretary of State for Education and Employment (Mr. James Paice): 1995 was another year of which teachers and candidates can be justly proud. The GCSE and GCE results in 1995 were among the best ever achieved.
    Sir David Madel: Does my hon. Friend agree that A-level and GCSE results will continue to improve as long as schools maintain a vigorous policy of setting and streaming, subject by subject?
    Mr. Paice: I certainly hope and believe that there will be a continued improvement, as there has been for many years, in the success rates at GCSE and A-level examinations. As for setting and streaming, obviously the
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    structure of their teaching mechanisms is a matter for teachers and governors to decide, but I suggest that any means of grouping pupils according to ability or aptitude that enables teachers to focus their efforts more effectively must lead to better results for everyone concerned.
    Mr. Bryan Davies: Will the Minister confirm that, for the first time for very many years, the percentage of 16-year-olds staying on in full-time education has decreased this year? How on earth are we to attain the targets for achievement among 18-year-olds—the targets that the Government have set—if we are slipping back at this stage?
    Mr. Paice: The hon. Gentleman clearly does not understand what targets are, because they do not specifically relate to school-achieved qualifications. For example, the target at ages 18 and 19 relates to qualifications equivalent to NVQ3, and those qualifications may be an NVQ gained partly at work or partly at college, or A-levels. There is a range of ways in which those qualifications may be achieved. To equate staying-on rates with the ability to meet our targets is a complete misunderstanding of what targets are all about.
    Mr. Harry Greenway: Will my hon. Friend consider the examination results in those 11 schools—schools most of which I know well, and have known for 30 years—that are between the home of the hon. Member for Peckham (Ms Harman) and St. Olave's school in Orpington? Will he not find—I can assure him that he will—that more money is being spent on those schools now by the Government than was ever spent on them previously; that the Labour Inner London education authority and its predecessor, the London county council, for both of which organisations I have worked, also spent large sums on those schools; and that the present Lambeth and Southwark councils are also spending unprecedented sums on the schools?
    It cannot be said that those schools are underfunded. It cannot be said that they do not have the opportunity to achieve properly. If local parents would send their children to those schools, as they expect other parents to do in other areas, the schools would have a better chance.
    Mr. Paice: My hon. Friend has studied the statistics in great depth and I would not dream of dissenting from them. As he reminded the House, secondary level education in Southwark is better funded than ever before by this Government and, more important, it is better funded than in many other local education authorities in the area. More money is spent per secondary pupil in Southwark than is spent in Barking, Brent, Bexley or, yes, Bromley. If we look further afield, we will see that Southwark spends £400 more per pupil than Bradford.
    The important point is the way in which that money is used to maximum effect in the teaching of our young people. It is no coincidence that some of the authorities with the worse performance record are led by Labour, and have been for decades.

    Parental Choice
    Mr. O'Hara: To ask the Secretary of State for Education and Employment what new measure the Government will be taking to extend parental choice in education. [9426]
    Mrs. Gillan: Parental choice is being extended in many ways: by increasing the number of assisted places available in independent schools, by the continued expansion of the grant-maintained sector, by city technology colleges, by enabling more schools to become specialist technology and language colleges and by giving more schools and local education authorities more flexibility over their admission arrangements.
    Mr. O'Hara: If the Government are so proud of the so-called parental choice that is offered in the state education system, why do so many Conservative Members commit their children to the private sector? Is it because they do not have the courage to commit their children to the lottery of choice and opportunity over which they preside in the state education system?
    Mrs. Gillan: I was pleased to see that the question was not withdrawn, unlike a question in the other place earlier this week. The hon. Gentleman is absolutely wrong and I shall give him an example from the Government Front Bench. The Under-Secretary of State for Education and Employment, my hon. Friend the Member for South-East Cambridgeshire (Mr. Paice), has both his children in the comprehensive school system.
    Mr. Pawsey: What action does my hon. Friend intend to take to protect hon. Members who exercise their right to decide to which school they will send their children? In addition, will my hon. Friend join me in congratulating Labour Members on the courage that they have displayed in opting for selection and in sending their children to grammar schools?
    Mrs. Gillan: My hon. Friend is absolutely right. I believe that all hon. Members should be able to choose where they send their children, and several Labour Front Benchers have made an excellent choice of school for their children. However, we must remember that, under Opposition policy, they would not have that choice.
    Mr. Blunkett: Will the Minister confirm for the House and the country that last year the number of parents who failed to get their first preference for their children increased by more than 100 per cent, but, even so, more than four out of every five parents secured their first preference? Does that not compare very favourably with a selective system, which excluded four out of every five parents from their first preference? Is it not the comprehensive system, which allows parents to exercise their preference, that offers real choice and diversity in this country? It does not offer what the Secretary of State described earlier this afternoon as the "dead hand" of comprehensive education.
    Mrs. Gillan: The hon. Gentleman knows that it has never been possible to guarantee every parent a place for his or her child at a preferred school. Some schools have been oversubscribed for many years because they are so good and so popular. The hon. Gentleman should examine the dead hand of his policies. Labour would end grant-maintained status, abolish the option of self-government for schools, weaken the autonomy of Church schools and of their governors, abolish assisted places, and end selection. What choice would that give the parents of this country?

    Unemployment
    Sir Roger Moate: To ask the Secretary of State for Education and Employment what is the current figure for unemployment (a) in the United Kingdom and (b) in other European Union countries. [9427]
    Mr. Forth: On the International Labour Organisation measure, unemployment in the UK in November 1995 was 8.1 per cent.—lower than in any other major European country and well below the European Union average of 10.6 per cent.
    Sir Roger Moate: Those figures show again that Conservative policies are working in making Britain the enterprise centre of Europe and bringing unemployment down at a time when it is rising fast in Germany and France. Would not UK unemployment rocket even to the level in socialist Spain if Labour was ever in a position to sign up this country to the social chapter, impose a minimum wage and give in to every inflationary wage demand from its union paymasters?
    Mr. Forth: My hon. Friend is absolutely right. People are becoming daily more aware of the comparison that can be made between this country's success in establishing an enterprise economy, attracting inward investment, encouraging entrepreneurship and new businesses and reducing the unemployment rate for 28 successive months, and the policies of our continental partners and competitors on the mainland—who are experiencing rising unemployment because they have shackled their economies with the social chapter, statutory minimum wage and all the other restrictions that Labour would seek to impose on our economy. That comparison is well understood by people throughout the country.
    Mr. Pike: Will the Minister accept that it is not a good Government record to claim that they have reduced unemployment to the level that they have, when so many people in temporary or part-time jobs want full-time jobs? They are working in low-pay and, in many cases, poverty-pay jobs that are an absolute disgrace for Britain in 1996.
    Mr. Forth: I regret that the hon. Gentleman did not seem to be in the Chamber for earlier questions. We have tried to get it across to Labour Members—unsuccessfully so far—that temporary work accounts for a much lower proportion of our work force than in most continental countries. The hon. Gentleman may regard temporary work as some sort of evil, but his party will create the conditions to increase temporary work rather than the other way around. As to the other factors that the hon. Gentleman mentioned, it should be understood by Labour Members that the vast majority of people who work part time do so from choice as a result of their individual circumstances. We encourage individual choice, but obviously Labour Members do not.

    School Security
    Mr. Simon Coombs: To ask the Secretary of State for Education and Employment what plans she has to improve security arrangements for primary and secondary schools. [9429]
    Mr. Robin Squire: Following the tragic death of Philip Lawrence, my right hon. Friend has established a high-level working group to advise urgently on what more should be done to improve security in and around schools.
    Mr. Coombs: Does my hon. Friend agree that the appalling death of Philip Lawrence is a symptom of the wider problem of indiscipline in the classroom? What hope can he give the House that the Government are prepared to take the measures necessary to ensure that the 5 per cent. of pupils who are disruptive and unruly will not in future be allowed to disrupt the education of the 95 per cent. of pupils who want to learn?
    Mr. Squire: My hon. Friend draws attention to a subject that the House was discussing earlier. I reaffirm that the Government are utterly committed to all teachers and schools having a full range of measures open to them for tackling indiscipline. We are well aware of the urgency of the matter. The high-level group is discussing practical measures to improve school security, including updating and reissuing the Department's guidance on school premises.
    Mr. Madden: Does the Minister agree that large-scale temporary classrooms and crumbling old schools present an attractive target to vandals and criminals? Will he confirm that there are a large number of temporary classrooms and crumbling old schools in Bradford? Does he understand why we were gobsmacked when, in the latest capital allocations, Bradford received just £4 million of the more than £40 million requested to deal with the problem? Instead of denigrating Bradford children and their examination results as the Minister did again today, when will the Government give Bradford the resources to ensure that all our children are given the most decent start in life and the best facilities possible to maximise their performance?
    Mr. Squire: As the hon. Member well knows, the capital allocation formula is a universal one that is applied to all authorities, and the priorities were drawn up more than 10 years ago. Bradford is no more or less disadvantaged than any other authority. If the implication at the heart of his question is that in some way the state of a building is responsible for indiscipline or bad behaviour, I beg to disagree. There are clearly several causes, including a need for greater parental control and involvement, and—in some places—a need for greater teacher skills. I made reference earlier to the efforts that the Government are making, in partnership with local education authorities and the Teacher Training Agency, to ensure that those skills are more widely practised.
    Mr. Atkins: Will my hon. Friend examine the security arrangements and ancillary matters at Lostock Hall high school in my constituency? Labour county councillors and Labour activists are seeking to frustrate the wishes of the parents in the ballot on grant-maintained status that is being held at the school this week. Such are the antics that extreme disquiet has been expressed by parents and governors alike. Will my hon. Friend invite the Labour party to desist from involving its local members politically in what should be an educational decision that will affect the future of the children at that school and their parents?
    Mr. Squire: My hon. Friend will understand if I do not comment on the specific example that he has given,
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    especially as the ballot is in progress. I can say that, sadly, what he has described, if it is happening, is only too reminiscent of what colleagues have reported when either Labour or Liberal Democrat councillors seek to frustrate and disrupt a ballot on grant-maintained status. It is for that reason, if no other, that any comments from Opposition Members that they are truly and deeply supportive of GM schools must be dismissed as garbage.

    School Funding (Nottingham)
    Mr. Simpson: To ask the Secretary of State for Education and Employment what capital funding allocations have been made to local education authority schools in Nottingham for 1996–97. [9430]
    Mrs. Gillan: The annual capital guidelines for capital work in schools in Nottinghamshire local education authority in 1996–97 are £2.811 million.
    Mr. Simpson: Will the Minister explain to parents in Nottingham if there is any fairness in a system that makes available on average £5,000 in capital allocations to a local authority school, compared with £250,000 in capital allocations to grant-maintained schools? Will she also explain fairness in a system that made available four times the amount of capital allocations to the city technology college than to all the Nottinghamshire schools combined? Is that not an example of a Government committed, if not to capital punishment, to capital programme punishment of the state education system?
    Mrs. Gillan: The hon. Gentleman should know the answer to his question. Capital funding comparisons on the basis of central Government support alone are misleading. Local education authorities have access to capital receipts and revenue moneys, while GM schools are almost entirely dependent on Government grants. It is for the local education authority to decide what proportion of its capital spending is directed towards schools in Nottingham and whether to supplement borrowing sanctioned by its ACG from other sources, including capital receipts and revenue budget.
    I suggest that, as the Labour party has controlled the county council for 14 years, perhaps the hon. Member should address his questions to his own party members.

    Unemployment
    Mrs. Bridget Prentice: To ask the Secretary of State for Education and Employment what steps she is taking to tackle unemployment among those over 45 years old. [9431]
    Mr. Paice: We intend to continue the successful economic and labour market policies which, together with the campaigns to which the Under-Secretary, my hon. Friend the Member for Chesham and Amersham (Mrs. Gillan), referred, have reduced unemployment for that group by 21 per cent. in the past two years.
    Mrs. Prentice: Does the Minister agree that it is outrageous that people over the age of 45 should feel that they have been thrown on the scrap heap? Does he also agree that there is age discrimination in the workplace? If

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    he is not prepared to introduce legislation to resolve that, what evidence does he have that the voluntary scheme is working?
    Mr. Paice: I entirely agree that discrimination on the ground of age is unjustified and unfair. There is ample evidence, as my hon. Friend the Under-Secretary said earlier, that many businesses now recognise the greater skills and greater commitment—among other attributes—that older workers can provide. We have been running a number of campaigns, to which my colleague referred earlier, and we are conducting an evaluation process to discover the success of those campaigns and to establish the attitude of employers.
    I believe that the vast majority of employers—but not all of them—are beginning to recognise that older workers represent a tremendous resource which they ought to be tapping, to provide their future skills needs.
    Mr. Nicholas Winterton: Does my hon. Friend accept that the best way to help the over-45s who are unemployed—or indeed anyone who is unemployed—is to create the right economic climate for industry? The country to which we have all looked in the past as a superb example of this, Germany, is now finding out that the minimum wage and the social chapter are catastrophes. Unemployment in Germany is rising beyond 4 million, and it is exporting manufacturing capacity abroad, is it not, faster than any other European country?
    Mr. Paice: My hon. Friend is entirely right. The real way to deal with unemployment and job-search difficulties for any age group is to have real growth in employment created by the economy. That is what has been happening over the past few years under this Government and, as my hon. Friend rightly says, it is not happening in a number of European countries.
    My hon. Friend rightly reminds us of Germany. Only a week or so ago, I met some German industrialists who were bemoaning Germany's situation and the imposts of taxation and of regulation of their labour market—and the increasing unemployment that they are causing. It means that they are being forced to look abroad to continue investing. I am delighted to say that these particular industrialists were investing in my constituency, but they would usually prefer to invest in Germany. They do not do so because of the imposts of the social chapter, the minimum wage and the sort of regulation that we would have again if the Labour party was ever given the chance to implement its policies.

    School Admissions
    Dr. Wright: To ask the Secretary of State for Education and Employment what consultations she undertook before proposing to amend school admission arrangements. [9432]
    Mrs. Gillan: The consultation on my right hon. Friend the Secretary of State's proposals for giving schools and local education authorities more flexibility over school admissions does not finish until 22 February.
    Dr. Wright: I am grateful for that answer. Can the Minister explain to those of us who are serious about
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    extending and exercising parental choice how a proposal to increase schools' ability to choose children and reduce parents' ability to choose schools contributes to parental choice? In particular, how does it do so when combined with the proposal to withdraw the right of the parents of children in voluntary-aided schools to ballot on those schools' futures?
    Mrs. Gillan: I am very pleased to note that the hon. Gentleman supports the Government's education policies so robustly by sending his children to selective schools. I am delighted that he has made the right choice as a parent.
    At present, all schools can select 10 per cent. of their intake; our consultation is looking at increasing that to 15 per cent., thereby providing more choice and diversity in the education system.
    Mr. Neil Hamilton: Is my hon. Friend aware of the impact on social cohesion of the Government's policies on parental choice? Is she aware of the conflict to which this can give rise between middle-class and working-class parents—for instance, in the Labour party, in which it is largely the middle-class Blair glitterati who have chosen to send their children to grant-maintained schools? What can we do to improve the consciousness of people like the deputy leader of the Labour party concerning the benefits that the policy can bring about for working-class parents of working-class children?
    Mrs. Gillan: My hon. Friend is absolutely right. We have had much publicity over the past few days, as a result of Opposition Members, on the choice in education that is provided by the Government, and that will bring it forward. I do not understand why Opposition Members oppose the choice that we put into the education system—for example, assisted places, the very existence of which allows a wider socio-economic spread of children within the independent sector. The Conservative party provides real choice in the education system for all parents.

    Cycling
    Mr. Robathan: To ask the Secretary of State for Education and Employment what plans she has to put cycling and cycling proficiency on the curriculum of primary schools. [9433]
    Mr. Paice: Schools are free to offer lessons in cycling and cycling proficiency, but the Government have no plans to include cycling in the national curriculum.
    Mr. Robathan: When, Madam Speaker, you and I were at school—not so long ago in your case—a great many children cycled to school, and as a result there was much less congestion on our roads in the mornings and afternoons. Does my hon. Friend agree with hiscolleagues in the Department of Transport that we should encourage cycling and discourage congestion? Does he agree with his friends at the Department of Health that we should discourage child obesity and encourage healthy child activities, such as cycling? Does he agree with his colleagues at the Department of the Environment that we should decrease pollution and vehicle emissions? If so, will he also make it his Department's policy to encourage

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    schools to make cycling facilities available to encourage cycling to and from school? Does he further agree that it is a long way to cycle from Peckham to Bromley or from Islington to the Oratory school?
    Mr. Paice: I am sure that when my hon. Friend was at school there were a lot more cycles and a lot more cycle sheds, behind which he no doubt learnt something. What
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    the Government have done is to slim down the national curriculum, as a result of requests from teachers, to give teachers far more flexibility in how they organise their school days. We would like them to use that flexibility as they think most appropriate. Clearly, the opportunity for young people to learn about cycling and to take cycling proficiency tests would be one of the things to which I hope they would give some priority.

Northern Ireland (Mitchell Report)
3.31 pm
The Prime Minister (Mr. John Major): With permission, Madam Speaker, I shall make a statement on the report of the international body on the decommissioning of illegal arms, which was published earlier today.
The key to progress in Northern Ireland is confidence—confidence to enable the parties to sit down together without threat of force. The retention of arms by the paramilitaries on both sides is the biggest single factor in holding back that confidence. It has so far prevented the holding of all-party talks. That is one of the reasons why we and the Irish Government established the international body, to provide an independent assessment of the decommissioning issue as one track of the twin-tracks initiative that John Bruton and I launched last November.
The body's remit was to identify and advise on acceptable methods of verifiable decommissioning, and then to report on the commitment of the paramilitaries to work constructively to achieve that. We set the body the challenging target of reporting by mid-January. I am extremely grateful to Senator Mitchell and his colleagues, the former Prime Minister of Finland, Harri Holkeri, and General John de Chartelain, for the energy and determination with which they have completed this difficult task.
The body's main conclusions are: first, that the total and verifiable disarmament of all paramilitary organisations has nearly universal support and must continue to be a principal objective; secondly, that to reach an agreed political settlement and take the gun out of politics, all parties should commit themselves to, and honour, six principles embodying the path of democracy and non-violence. These principles include the total and verifiable disarmament of all paramilitary organisations; the renunciation of force and the threat of force; agreement to abide peacefully by whatever agreement is finally reached; and an end to so-called punishment killings and beatings.
Thirdly, the body concludes that there is a clear commitment on the part of those in possession of illegal arms to work constructively to achieve full and verifiable decommissioning as part of the process of all- party negotiations. The body makes a series of recommendations on the modalities of decommissioning of illegal arms. It emphatically declares that there is no equivalence between such arms and those held by the security forces. It rightly emphasises the need for independent verification.
Fourthly, the body concludes that other confidence-building measures are needed, such as an end to targeting of potential victims by the paramilitaries, information on missing persons and the return of those previously intimidated out of their homes.
The body also records its conclusion, on the basis of its discussions, that the paramilitaries will not decommission any arms prior to all-party negotiations. The House will note that the body did not conclude that they cannot decommission; the body concluded that they will not, and the House will draw its own conclusions. Although the body makes no formal recommendation on this point, it suggests an approach under which some decommissioning would take place during the process of all-party negotiations.
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The Government welcome the body's endorsement of the seriousness of the decommissioning issue. We welcome and fully endorse the six principles that it sets out. We call on each and every one of the parties to do the same, speedily and unequivocally.
If all concerned were to accept those principles, and honour them, as the international body also rightly emphasised, that would be a significant step forward. Even more significant would be if, in addition, all parties, particularly Sinn Fein, also joined the two Governments in supporting the wide principles of consent set out in the Downing street declaration.
The Government also welcome the body's broad recommendations on the modalities of the decommissioning process. We are ready to implement them. It is now for those in possession of illegal arms to say whether they will accept and act upon them. We look forward to an early and definitive response from the paramilitaries on both sides.
We welcome, too, the emphasis on other confidence-building measures. If the paramilitaries give up their present practice of keeping themselves ready for a return to action, that will be a most welcome sign of real commitment to peaceful methods. Otherwise, gun law continues to hang over the heads of the people in Northern Ireland.
There is therefore much in the report that we can welcome and endorse. But the practical problem remains—how to bring all the parties together. Self-evidently, the best way to generate the necessary confidence is for the paramilitaries to make a start on the decommissioning process. We see no reason why they should not do so.
There can be no justification for the maintenance of private armies by those who claim to be committed to exclusively peaceful means. Opinion polls in both Northern Ireland and the Republic of Ireland have shown overwhelming public support in both communities for decommissioning before talks. We shall therefore keep up the pressure for an immediate start to the process.
However, I am not prepared to accept that any one group should, through its intransigence, stand in the way of peace and a comprehensive settlement for the people of Northern Ireland. We will not be deflected from our aim. It is now apparent that there may well be another way forward, consistent with the basic principles to which we have always adhered.
One of the confidence-building measures taken up by the international body is the idea of an election. The body made it clear that a broadly acceptable elective process, with an appropriate mandate and within the three-strand structure, could contribute to the building of confidence.
The Government believe that such an elective process offers a viable alternative direct route to the confidence necessary to bring about all-party negotiations. In that context, it is possible to imagine decommissioning and such negotiations being taken forward in parallel.
The election proposal originated in Northern Ireland and, as recent opinion polls have shown, has widespread cross-community support there. A number of parties, including those led by the hon. Members for Upper Bann (Mr. Trimble) and for North Antrim (Rev. Ian Paisley), as well as the Alliance party, have put forward proposals for some form of elected body as a means of getting all parties talking together, even if the paramilitaries persist in their refusal to decommission prior to negotiation.

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It is true that other parties have registered their concerns; they will certainly need to be addressed. We will discuss urgently with all the parties how to overcome them. But, in a democratic system such as ours, I cannot see how elections could be regarded by any of the parties either as a side issue or as a block to progress.
As the Mitchell report says:
"Elections held in accordance with democratic principles express and reflect the popular will".
So let me make it quite clear to the House that we are ready to introduce legislation, and to seek both Houses' urgent approval for it, in order to allow such an elective process to go ahead as soon as may he practicable. I hope that this will attract support right across the House.
To sum up, we believe that, in the light of the Mitchell report, there are two ways in which all-party negotiations can now be taken forward. Both are fully consistent with the six principles set out in the report. The first is for the paramilitaries to make a start to decommissioning before all-party negotiations. They can—if they will. If not, the second is to secure a democratic mandate for all-party negotiations through elections specially for that purpose.
Those are two routes to all-party negotiations and to decommissioning. The choice between them is ultimately for the parties themselves. I believe that the people of Northern Ireland have every right to expect that one or other of those routes will be taken, and taken soon. For our part, we, together with the Irish Government, will intensify our discussions with the parties. I intend to meet the Taoiseach again in the middle of February to review progress.
The people of Northern Ireland are enjoying today's peace. They wish it to be permanent. They also want and deserve political progress. It is time to put the old enmities to one side, and to allow the people of Northern Ireland and their representatives once again to have a normal say in their future and their affairs.
The proposals that I have put forward today require all concerned to take risks for peace. We have done so before, and we will do so again. Consistent with our principles, we will pursue this process. That is what is needed if we are to build on the achievements of the past two years.
Let us never forget that we are dealing here with the lives of innocent men, women and children. We are dealing with their future, and with the future of Northern Ireland. In the end, our obligations as politicians—as the House of Commons—are to the people whom we govern.
I pledge that I will leave no stone unturned to deliver to the people of Northern Ireland, on a permanent basis, the precious privilege of peace that they have enjoyed for the past 17 months.
Mr. Tony Blair: I join the Prime Minister in welcoming the report produced by Senator Mitchell and his colleagues, who have been subject to a punishing schedule to produce the report in just eight weeks. I know that the whole House will be grateful to them.
I consider the report constructive and helpful, although it leaves a number of difficult questions unanswered. Those questions will be addressed in the no doubt
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intensive discussions between the two Governments and all parties. The report provides certain important elements that can help to move the peace process forward.
I, too, endorse the six principles set out by Senator Mitchell, and hope that other parties will as well. In particular, I endorse the commitment to democratic and exclusively peaceful means of resolving political issues, and to the ending of punishment killings and beatings, which should stop at once. They have no legitimacy. They are simply terrorism in a different form, and they damage the process of peace.
I spell out our firm belief that, if trust is to be established, it must and it should be made clear by all parties that any final settlement will be dependent on the consent of the people of Northern Ireland, and the more that that is emphasised, the better. Senator Mitchell's report has set out in some detail the modalities of decommissioning paramilitary weapons, including a recommendation that it be verified by an independent body, and we, like the Prime Minister, endorse that. Will the Prime Minister perhaps explain how the Government propose to move forward on the creation of an international commission to verify decommissioning?
At the heart of this issue is how we now move to all-party talks. For that to happen, there must be confidence—in particular, confidence among all parties—that violence has gone for good and been replaced by democratic debate. May I therefore reiterate our support for the view that that confidence cannot arise unless there is tangible evidence of the commitment to democratic means?
We remain of the view that the simplest way of providing that tangible evidence is indeed the decommissioning of weapons. It is right in itself. People in all communities want it. It will strike any reasonable person as sensible. Senator Mitchell says that it will not occur, in his view, before talks. May I stress that, if that is so, it is incumbent on those making it so to engage with other means of building confidence? We accept the ways forward proposed by the Government. Perhaps the Prime Minister can assure us that the Government will consider, of course, other options put forward by the parties themselves.
The report makes reference to the possible role of an elective process—perhaps I can say a word about that. We agree that this proposal deserves serious consideration. Will the Prime Minister tell us what, in his view, would be the nature of the mandate and the time scale of such a process?
Will the Prime Minister confirm that an elective process would be a mechanism for substantive negotiations? If it is, how will it fit in the three-stranded process to which the British and Irish Governments are committed? How does he intend to deal with what he accepts are the concerns of other parties about the elective body? As the Prime Minister mentioned in his statement the issue of legislation, may I say that, if legislation is forthcoming and there exists the broad agreement necessary for it to work, for our part, we will be happy to co-operate in putting that legislation through Parliament?
The Labour party has adopted a bipartisan approach to the peace process. We have consistently supported the Government on it because we believe it to be right and we believe that the issues connected with it should transcend normal party politics. I reaffirm that bipartisan approach today and our belief that the Government must, of course,

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make every effort to carry all parties with them. As each day passes, the benefits of peace in Northern Ireland become clearer. Although formidable obstacles remain—of course they do—peace is the only sane path to take for the future. We have offered, and we offer again today, our unqualified support in pursuing it.
The Prime Minister: I am grateful to the right hon. Gentleman for his support for the international body and the report and for the specific points that he has made in the past few moments. He said that the principal Opposition party, the Labour party, has adopted a bipartisan approach to this process. That is most certainly so, in public and in private. I am grateful for that, and the process itself has been the stronger for that bipartisan approach.
On the specific points made by the right hon. Gentleman, I am pleased at his endorsement of the six principles, and I concur with the points that he made about them. He shares my firm belief that any final settlement must have the consent of the people of Northern Ireland.
In response to the right hon. Gentleman's question, let me reaffirm again to the House that, at the conclusion of the talks process, the outcome of that talks process will be put, by means of a referendum, for endorsement by all the people in Northern Ireland. I announced that some time ago, and I reaffirm yet again that that is the case. I think that, in these circumstances, that consent will be necessary.
The right hon. Gentleman is correct to talk about the need for verification of decommissioning. The international body's report deals specifically with that. We will need to discuss with the Irish Government the mechanism for establishing an international commission, but I see no great difficulties with it. I think that we would look for distinguished individuals, who would act as an independent body, to verify the manner and certainty of the weapons decommissioning.
The right hon. Gentleman is right to say that confidence requires tangible evidence of democratic views. He is right also to share my view that there is no justification for decommissioning not starting now, and that, in the event that it does not, those who have refused to do so have a special obligation to see how the process proceeds.
As we proceed, of course we will look at other options that are brought before us. We have always made it clear that we have an open mind to consider options that will carry the confidence of all the parties and people of Northern Ireland towards getting people together in talks—leading to negotiations, to a settlement, to a referendum and to the House's approval of the outcome.
As for the election and the purposes for which it could be used, I see it being used to determine which parties would participate in the talks, and to give each party with elected representation a fresh electoral mandate—testing the extent of its democratic support in current circumstances. I see the election providing a pool of representatives from which party delegations to the talks could be drawn, and a means to index the strength of the parties' delegations in the talks process. Apart from that, of course, I see the election providing, by weighted majority vote, an initial mechanism for testing widespread acceptability within Northern Ireland of the outcome of any talks process.
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We will, of course, consider people's concerns as we do that. Again, I am grateful to the right hon. Gentleman for his confirmation that, when the time might be appropriate to introduce such legislation—I hope that it will not be too long delayed—the official Opposition will co-operate in its swift and comprehensive passage.
Mr. David Trimble: In order to establish the necessary confidence, the Mitchell report sets out six principles, which we accept. It also sets out certain confidence-building measures, such as the elected body, which, in view of the refusal of Sinn Fein-IRA to make the necessary moves in relation to weapons, we regard as the only way forward. Does the Prime Minister realise that, in an opinion poll published in Belfast last week, the concept of an elected body was endorsed by 70 per cent. of the people of Northern Ireland—and, indeed, by 68 per cent. of the supporters of the party led by the hon. Member for Foyle (Mr. Hume)?
We welcome the Prime Minister's reference to urgent discussions to overcome any difficulties there may be about this proposal. Does the Prime Minister know that, in recent weeks, our party has been engaged in a series of meetings with other parties, including the SDLP, on this and related issues, and that our belief is that those problems can be overcome if there is the necessary will?
We also welcome the statement by the Leader of the Opposition about assistance for the necessary legislation. We believe that such legislation can be carried through the House very quickly, and that we should set the target of elections in April and May this year so that the elected body can get down to work as soon as possible, and thereby open the way to decommissioning and substantive negotiations.
The Prime Minister: I am grateful to the hon. Gentleman for his response to what I had to say, and to the report before the House. I am pleased at his unequivocal support for the six principles. I hope that such unequivocal support will come from all the parties that are concerned with these negotiations.
I was, of course, aware of the opinion poll to which the hon. Gentleman referred. I am also aware of similar opinion polls that have been conducted in the Republic of Ireland on similar matters, which produced broadly similar majorities for an elected body and decommissioning. I was aware that the hon. Gentleman and his party had been considering this approach, and were discussing it among themselves, and I welcome his confirmation that he would be prepared to take part in discussions about this proposal in the future.
It is my wish that we shall be able to take all parties with us and move forward with this process. If decommissioning does not take place and it is necessary to use that route, I hope that the hon. Gentleman and his party and others will be able to move forward swiftly so that we can make early and tangible progress, for that is what people of both communities in Northern Ireland urgently wish to see.
Mr. Tom King: Does my right hon. Friend accept that many of us recognise that it was an act of courage to entrust that task to the independent body? If people thought that its task would be easy, the chillingly blunt refusal that it received of the suggestion of any decommissioning will have made them realise how difficult this issue is.

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May I endorse what the Leader of the Opposition said: that that blunt refusal makes much more difficult Sinn Fein-IRA's task of persuading people of their adherence to the six principles and of building the trust which the independent body says is so essential to this process? Does my right hon. Friend accept, however, that his determination to build on the positive aspects of this report, despite some disappointment with it, and to seek to continue, with the courage that he has shown, to carry forward his determined effort for lasting peace, must receive the support it deserves?
The Prime Minister: I am extremely grateful to my right hon. Friend. As he said, we asked the international body to undertake a difficult job, with no certainty that it would be able to make progress. I believe that it has done so comprehensively and well. It is fair to say—indeed, Senator Mitchell would acknowledge this—that the report does not offer a single party connected with the negotiations everything that it might have wished. There is something uncomfortable in the report for every party to the negotiations. We need to use the report as part of the structure to take the present process forward. That is what I seek to do in the response that I have made this afternoon, and I am grateful for the support that has already been provided for that.
As my right hon. Friend said, that raises difficult questions also for the paramilitaries—Sinn Fein-IRA and the loyalist paramilitaries. If they are committed to democracy, they must make it perfectly clear why they will not start to decommission. They must make it clear whether they accept that there is no equivalence between illegal paramilitary arms and the arms of the security forces, as they previously said. They must also make it clear whether they accept the principles on democracy set out in the Mitchell report as well as other matters. They must accept not just the principles of democracy but, as the Mitchell report makes clear, the honouring of the principles of democracy.
Mr. John Hume: May I agree with the Prime Minister's comment that we are dealing with the lives of innocent men, women and children in Northern Ireland? Does he agree that it would be utterly irresponsible for any party to play politics with the lives of those people? It would be particularly irresponsible for a Government to try to buy votes to keep themselves in power. Does he also agree that the commission recommends no form of election? It made it clear that that proposal was outside its remit, and that it was making no recommendation, but simply reporting what was said to it.
May I take this opportunity to express my deep appreciation to the commission for the intensity and urgency with which it has perceived its objectives? Although its members come from three different countries, it has spent Christmas and the new year urgently dealing with its track. I invite the Prime Minister to read paragraph 18, which points out that similar urgency is needed on the political track. Will he accept that advice and now fix a date for all-party talks, rather than waste time as he has for the past 17 months? [HON. MEMBERS: "Disgraceful."] I live with it—you don't!
May I make it clear that my party fully and unequivocally supports the six principles in the document, which call for total commitment from all parties to the
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democratic and peaceful process, and to the total renunciation and rejection of violence? Does the Prime Minister feel that, if all parties committed themselves to those six principles, he could fix a date for all-party talks?
The Prime Minister: Let me say to the hon. Gentleman that there cannot be all-party talks unless there is confidence that encourages all parties to attend those talks. There is no point in the hon. Gentleman saying, "Let us have all-party talks," when he knows that, without confidence, neither the communities nor the political parties in Northern Ireland would be able to come to such talks.
The hon. Gentleman has for many years played a leading role in Northern Ireland in trying to bring people together and trying to ensure that we move towards peace. It would be a tragedy of enormous proportions if he himself put a barrier across our progress towards peace in Northern Ireland at this stage.
The hon. Gentleman talked about buying votes in this House. If I had been concerned about short-term electoral matters on this issue, I probably would not have embarked upon the process in the first place. From the outset of the process, I have made it clear—and, from time to time, I have taken risks in order to demonstrate—that what I care about is trying to prevent the killing, the bloodshed, the hatred, the abuse and the sheer nastiness that has dominated too much of the lives of British citizens in Northern Ireland for far too many years.
I am prepared to take risks for that, but I am not prepared to buy votes for it. I will stand upon the principles upon which I have stood since the beginning of the process, and I do not intend to be shaken free of them by the hon. Gentleman's remarks or by any other circumstance. What matters to me is carrying the process forward.
The hon. Gentleman has been engaged in the battle for peace in Northern Ireland for longer than I have—I acknowledge that—but I care about it as much as he does, and I am engaged in it as much as he is. I am approaching the matter, as I hope the hon. Gentleman is, with good will, and my prime concern is that we move the process forward. We must not allow old hatreds, old enmities and old stupidities to prevent the progress from now until we secure peace.
Hon. Members: Hear, hear.
Mr. Peter Robinson: I welcome the statement by the Prime Minister, and the sensible remarks from the Leader of the official Opposition. The Mitchell commission recognises that it would be impossible for those who believe that decommissioning should take place first to have any confidence unless the six principles outlined are not only accepted by the paramilitary organisations, but honoured. As one of those principles is the total decommissioning of their weaponry, cannot that honouring take place only after decommissioning has occurred? That being the case, the Prime Minister is right to recognise that the only real way forward is through an election.
May I state unequivocally that, while I might have liked some further principles to be added to the six that the Senator and his team have laid down, I can give my support to those six? I will work with the Prime Minister in his

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efforts to bring about an election, so that the people of Northern Ireland can put forward their negotiators in an attempt to get a real and structured peace in Northern Ireland.
The Prime Minister: I am grateful to the hon. Gentleman for what he has to say. I agree with the analysis of why the route forward is the democratic route, and we must bring into play the views of the majority of people in all communities, who I believe wish to see the process continued. I see no route other than the one I have outlined, unless decommissioning takes place prior to talks, which, of course, would remove the need for an elective route.
The paramilitaries may be intransigent or unwilling to begin decommissioning, which—I remind the House—is what is asked for. No one has asked for the total decommissioning of all weapons before talks begin. We have told Sinn Fein and the loyalist paramilitaries, in order to provide confidence for the people of Northern Ireland and the political parties and their representatives in Northern Ireland, "Show your determination to seek peace by beginning to decommission." We have said not that they should totally decommission, but that they should begin to decommission before we get into talks and negotiations. In the absence of that, I see no route available at present—unless a fresh one, as yet unknown, is suggested—other than the process I have set out before the House.
Mr. Paddy Ashdown: I warmly welcome the commission report from Senator Mitchell. It was a very tough job, but it has been done thoroughly and deserves support. I warmly welcome the fact that the Government have been able to provide such a welcome for it as well. Frankly, that cannot have been easy, because the report did not fulfil all that the Government had wished for. I am sure that the Prime Minister is right to welcome it. I was also extremely pleased to hear the welcome that the report has received across the political spectrum in Northern Ireland. That has shown—we have heard some of it today—some considerable statesmanship.
The Prime Minister should be clear—I do not need to stress it too much to him—that the Liberal Democrats take the view that those who have terrorised Northern Ireland through the bomb and the gun, on all sides, in the past 25 years need to show a concrete example of why they are now moving to democracy. It remains our view that the best way to do that would be through the decommissioning of weapons. It has for some time been argued that, should that not prove possible, approaching the process through an elected convention is a right and proper alternative route to take. We have proposed that to the Prime Minister and the Secretary of State for Northern Ireland on previous occasions.
Nevertheless, I am sure that the Prime Minister would agree with me—we have heard some evidence of it today—that that idea produces peculiar and legitimate sensitivities on the part of the nationalist community in Northern Ireland, for whom words like "assembly" have chilling and unacceptable reverberations of failure in the past. Matters such as the size of such a body, its remit, its nature and its time limitation, are absolutely vital. We will submit some thoughts on that to the Prime Minister in the near future.
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I should like to touch briefly on one other matter relating to confidence-building measures. In December, when I was in Dublin to see the Taoiseach, I proposed to him that there might be case for a limited cross-Ireland amnesty for the surrender of Semtex. I understand that much is held, and that many of those in possession of it would like a chance to get rid of it.
Semtex is unique, because it is a purely aggressive weapon, with no defensive purposes and no forensic history. Does the Prime Minister believe that, as part of the confidence-building measures, such an offer, made by both Governments and unconnected with the peace process, could nevertheless contribute greatly to building confidence around that process in the future?
The Prime Minister: I am grateful to the right hon. Gentleman for his support, and for his kind words about Senator Mitchell and his colleagues. I am pleased that he concurs with our view—one that I know he has expressed—that, first, the right approach would have been decommissioning by those who hold weapons, but, in the absence of that, the right way to proceed is the way that we have proposed.
As the right hon. Gentleman has said, the details of the election and the body are crucial. Those will need to be discussed with the parties, and we will wish to remove sensitivities wherever we can. I will, of course, be pleased to receive any representations from the right hon. Gentleman, the official Opposition or any other colleagues in the House.
On the question of an amnesty, our aim is to take terrorist weapons out of circulation. That is what matters. There could not, of course, be an amnesty for the murders and violence of the past.
Mr. Ashdown indicated assent.
The Prime Minister: The right hon. Gentleman did not suggest that, but I am making that point so that there is no misunderstanding that that could be on offer at any stage. The issues raised in the right hon. Gentleman's earlier comments will be among those that we will have to consider and examine.
Mr. Andrew Hunter: Will my right hon. Friend accept that, in contrast to the remarks of hon. Member for Foyle (Mr. Hume), on the Conservative Benches and further afield there is widespread and the strongest possible support for the statement that he has made, and for his entire handling of the peace process?
Will my right hon. Friend comment on the proposition that what we are seeking by various means, one of which may be an elective process and decommissioning in parallel, from IRA-Sinn Fein and others is an irrefutable and irrevocable demonstration that they are committed exclusively to peaceful means? Does he also agree that we are seeking evidence that they accept the principle of consent, which means acknowledging that Northern Ireland is part of the United Kingdom, and will remain so as long as that is the wish of the majority of the people of Northern Ireland?
The Prime Minister: Yes, I can confirm that to my hon. Friend. Indeed, the House will have been familiar with the specific formulation that he used. I am grateful

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for his support for the line that we have proposed to take. I know that my hon. Friend has taken a great interest in Northern Ireland, and is a frequent visitor to Northern Ireland. I think that his support for this approach is warmly welcomed.
Mr. Clive Soley: If the Prime Minister is obliged to go down the route of an elected assembly because the paramilitary groups are not prepared to surrender weapons, he will know from what has already been said that there is acute concern, especially among the nationalist community in Northern Ireland, that any assembly should not represent a return to some of the structures that have failed in the past. His problem is to carry with him the elected republican parties in Northern Ireland. What guarantees did he give them and other people that their fears about the past will not come true in future?
The Prime Minister: I understand the point that the hon. Gentleman makes. When I made my statement to the House some time ago, I acknowledged that not every party in Northern Ireland had advocated this approach, that there would be some sensitivities about it, and that we would seek to see what could be done to meet those sensitivities.
I have made the point consistently that, if we are to achieve peace successfully in Northern Ireland, we are going to have to achieve consent across the political divide in Northern Ireland. That has been our approach from the outset, and it remains our approach. Of course, we will try to take on board the sensitivities that people have as we take this matter forward.
Mr. David Wilshire: Does my right hon. Friend join me in deploring yesterday's selective leaking and briefing by the Dublin Government and the Irish ambassador, and agree that, while remaining opposed to all-party talks before decommissioning, it would be utterly irresponsible simply to reject the report? Does he accept that this Tory at least is prepared to consider elections in Northern Ireland, because he believes it to be right, not because it might buy support? I find it deeply offensive for people to suggest that elections might be such a tactic. This issue is far, far too important to play gutter politics with.
The Prime Minister: I am grateful to my hon. Friend. I share his view about the selective leaking of the Mitchell report, and, indeed, the selective leaking of any report on any occasion. It does, sadly, happen from time to time. Many people's lives would be easier were that not to be the case.
Mr. Ashdown indicated assent. [Laughter.]
The Prime Minister: One does not have to be in government to realise that leaking, whether total or selective, can sometimes be difficult.
I know my hon. Friend's strong feelings about Northern Ireland, but it would not have been at all responsible to reject this report because there are things in it that do not accord wholly with the previous position of the
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Government. I think that what we are doing is accepting, as every party to these negotiations has to accept, that, within the Mitchell report, there is something that each and every party will like and something that each and every party will not like.
But what we must not do is get ourselves in the position that we have so often been in in Northern Ireland, in which, because there is something one party does not like, it brings the whole process to a juddering halt. I am prepared to operate within the principles we have set out with a degree of pragmatism in order to reach the conclusion that this House wishes to see reached, and I believe that will be the view of most hon. Members.
On the other point made by my hon. Friend, I think perhaps I could do no better than to quote from paragraph 56 of the Mitchell report:
"Elections held in accordance with democratic principles express and reflect the popular will".
That is entirely true. That is how all of us arrived here in this House.
Mr. Robert McCartney: Does the Prime Minister agree that, while all welcome his statement on the commission's report, and while paragraph 20 sets out the six principles, with which the whole House agrees, it omits to mention the principle of consent that governs all democratic proceedings? Does he accept that the principle of consent would have to govern not only any agreement that may emerge from any substantive negotiations but the possibility of disagreement or failure to arrive at an agreement?
The Prime Minister: The hon. Gentleman is right about the consent principle. The report makes it clear that all the parties should accept democratic and exclusively peaceful means of resolving issues, and should agree to abide by the terms of any agreement. As I said earlier—I suspect that the hon. Gentleman may share my view—it would be a significant additional step if Sinn Fein were to join the two Governments and the other parties in supporting the principle of consent in the Downing street declaration.
Mr. Peter Bottomley: I do not need to remind my right hon. Friend that among the more than 3,000 who have lost their lives in the past 25 years are Ian Gow, Anthony Berry, Robert Bradford and Airey Neave. Is it not a proper memorial to them and to all the others that we should go beyond bipartisanship to non-partisanship, that every party that takes part in the process, which we hope we will be able to start, should try to overcome any past obstacles, and that those parties should talk, not only to the Mitchell group, but to each other? That requires each of them to create the conditions under which the others will come.
The Prime Minister: All the former Members of the House mentioned by my hon. Friend were democrats. I think that all of them, were they here today, would have been urging us to take a risk for peace. In my judgment, all the people who have suffered in Northern Ireland over the past 25 years, were they able to be here today—on either side of the House—would be saying the same thing: peace is worth a risk—take it.
Mr. Kevin McNamara: I congratulate the Prime Minister on his good fortune in having a tangential advantage in the statement announced today—that of keeping his Government in power.

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Will the Prime Minister inform the House whether the Taoiseach has agreed with the Government's proposed course of action? I am not suggesting that he can veto anything that the right hon. Gentleman does, but has he agreed with the proposal? Does the principle of consent, as outlined in the Downing street declaration and the framework document—which we all support—amount only to British sovereignty over Northern Ireland, not to the imposition of any arrangements that do not have the support of a majority in both communities?
The Prime Minister: The principle of consent relates to the agreement, and that is set out clearly in the documents before us. I do not propose to respond to the first part of the hon. Gentleman's statement. It is unworthy; I have responded to it once this afternoon, and see no purpose in responding to it again. I spoke to the Taoiseach last evening; he was well aware of what I was going to say, and we both look forward to meeting and to discussing the subject at a forthcoming summit.
Mr. Hugh Dykes: Not only is the report a tribute to the people who created and wrote it, but it is the culmination of the long-standing forbearance, patience and courage of both my right hon. Friend the Prime Minister and my right hon. and learned Friend the Secretary of State for Northern Ireland, who have liaised with the senior Irish Ministers involved.
As a member of the British-Irish Parliamentary Association, I thank my right hon. Friend the Prime Minister for his earlier forthright mention of the fact that any delicate election process or system that is to be constructed, in whatever way it may emerge—in itself a difficult matter—would not be a return to the old Stormont paralysis or the Ulster assembly system, which was, I vividly and painfully remember, sabotaged by Protestant militants two decades ago.
The Prime Minister: It is certainly not a return to the past; I see it as a step to the future. I think that that is how it has been viewed by all those who have examined the proposition over recent months and put their name to it.
Mr. Thomas McAvoy: I wish to associate myself with the gratitude expressed to Senator Mitchell and his team for their work, and with the tributes to the Prime Minister and the Leader of the Opposition for their responsible attitude to that issue.
The Prime Minister must know, however, that, when one adopts an idea that has emanated from one side or the other in Northern Ireland, suspicion is immediately aroused on the other side, as has happened in connection with more than one issue in Northern Ireland of late. Bearing that in mind, to keep the SDLP and the other parties on board, will he listen carefully to their representations about the nature and modality of the proposed assembly, and about the possibility of a time scale for its existence?
The Prime Minister: The answer to the hon. Gentleman's question is yes. I think I may say that, in the past three or four years, I have gone to enormous pains, as have my right hon. and learned Friend the Secretary of State and my right hon. Friend the Minister of State, to try to ensure that we can remove misunderstandings, and that we can take on board the views and sensitivities of all the parties. I have made that point clear repeatedly.
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I am as well aware as any hon. Member that we need to carry people with us—all the people with us, if we can—if we are to achieve a satisfactory outcome to the negotiations that we are embarked on. That has been our position in the past, and it remains our position today.
Mr. Graham Riddick: Although the Mitchell commission says that decommissioning would take place "during the process" of all-party negotiations, it does not say how those negotiations and decommissioning would interact. Can my right hon. Friend confirm that we will never allow a position in which Sinn Fein-IRA are allowed to take part in negotiations if there is even the vaguest implicit threat that violence may be resumed if they do not get what they want?
The Prime Minister: My hon. Friend makes a valuable point. Perhaps I may refer him especially to paragraph 34 of the Mitchell report, which says:
"The parties should consider an approach under which some decommissioning would take place during the process of all-party negotiations, rather than before or after as the parties now urge. Such an approach represents a compromise. If the peace process is to move forward, the current impasse must be overcome."
That is precisely the way I see it.
Obviously, at the beginning of such talks, I would suspect that the parties themselves will wish to erect a series of staging posts, but it is not for me at this stage to set out precisely what they would do or how they would agree it. I believe that they would wish to discuss that matter at the beginning of their talks. I think Senator Mitchell envisages that that is what they would do, and so do I.
Miss Kate Hoey: I welcome the Prime Minister's statement and the statement by the Leader of the Opposition. I say to the Prime Minister that I personally do not believe that either the Prime Minister or the Leader of the Opposition would be prepared to play politics with the lives of the people of Northern Ireland.
I repudiate the insinuations made by my hon. Friend the Member for Kingston upon Hull, North (Mr. McNamara), and I wish to dissociate myself from those remarks.
Can the Prime Minister tell me any possible reason why, if the proposals for an elected body were taken up—as they might be—any democratic party that believes in democracy would refuse to get involved in an election for that body with a very narrow mandate?
The Prime Minister: I am grateful to the hon. Lady for what she said, which I deeply appreciate.
As to the second part of her question, I can give the hon. Lady no good reason why any democratic party would refuse to take part in an election for the narrow purposes set out in my statement today. I cannot conceive that there is a credible reason for refusing to take part in that, and I very much hope that no one will.
Mr. Nicholas Winterton: I congratulate my right hon. Friend on his outstanding commitment to a lasting peace in Northern Ireland. It was his initiative, he has driven it, and it should not be overlooked. As a Conservative and committed Unionist, I also congratulate

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the official Unionist party, its leader and his predecessor on their enlightened and constructive attitude to the peace process.
Paragraph 19 of the report says:
"there must be commitment and adherence to fundamental principles of democracy and non-violence."
Because confidence is so important, can my right hon. Friend tell the House this afternoon that it is his belief that Sinn Fein-IRA are prepared to accept those fundamentals, which they have never done in their history?
The Prime Minister: We wait to hear from them. The statement that they have produced so far has not covered that point. Clearly, we wish to hear from them and from the loyalist paramilitaries—from both sides—precisely whether they accept those principles and that commitment. We hope that they will accept them, and that they will state that unequivocally. I look forward to hearing them say so. They now have the opportunity to argue the case and to say directly, on television and on radio, that they accept those principles. I hope that they will use the opportunities that are open to them.
Mr. Dennis Canavan: Does the Prime Minister accept that the Mitchell report does not recommend immediate elections, but recommends a compromise between those who demand decommissioning before all-party talks and those who maintain that decommissioning can take place only at the conclusion of all-party talks? Will the Prime Minister accept a staged process of decommissioning in parallel with immediate all-party talks, with elections to be held on a new constitutional settlement after the all-party talks agree to such a settlement?
The Prime Minister: We must get all the parties to the table in order to have all-party talks. To do that, we need the confidence of the people and all the parties of Northern Ireland. That is the ingredient that is missing from the hon. Gentleman's proposition. That is why we are seeking an electoral position that will enable all parties to have that confidence and to have a direct mandate to enter into talks. The election is the mechanism that will allow that to occur. On that basis, I hope that the hon. Gentleman will understand why we have proposed it, and what it will achieve.
Mr. Richard Spring: My right hon. Friend has spoken about the need to boost confidence in order to develop the political processes in Northern Ireland. Does he agree that a significant step toward improved confidence in Northern Ireland would be the immediate cessation of killings and punishment beatings?
The Prime Minister: Yes, I certainly agree with that. My hon. Friend has some direct experience of Northern Ireland, and I am grateful for his support. He is entirely correct. If that were to happen, it would certainly increase the feeling of confidence across the communities in Northern Ireland, and, as such, would be a very welcome development.
Mr. Tony Benn: Is the Prime Minister aware that many people who hoped that the ceasefire
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would lead to early all-party talks have been strengthened in that view by the peace process in South Africa, the agreement between Israel and the Palestinians, and the Dayton accord—not one of which required the decommissioning of weapons? In the latter case, President Clinton said that the arms embargo could be lifted a few weeks after the Dayton accord was agreed.
Is the Prime Minister aware that the process began when my hon. Friend the Member for Foyle (Mr. Hume), Mr. Adams and Albert Reynolds advanced a proposition to end the fighting based on the idea that the people on the island of Ireland—north and south and in the two communities—should be able to determine their own future? If there is a newly elected body and a referendum in the north that underlines the division of Ireland, it is no more likely that peace will be secured now—whatever the parties' intentions—than in the past hundreds of years.
The Prime Minister: If the right hon. Gentleman were to look more carefully, he would see that the report refers to "north and south respectively". The right hon. Gentleman ran them together, and referred to the "north and south", which gives a rather different impression of the view at that stage. Northern Ireland is already a practising democracy, and therefore is different from some of the examples that the right hon. Gentleman gave.
The underlying point remains the same. We have sought to gain the confidence of both communities from the outset. If we do not obtain their confidence, we cannot carry the process through to a conclusion. That point cannot be ducked if we are to reach a settlement.
Mr. Tony Marlow: May I congratulate my right hon. Friend on his approach and achievements to date? Could he confirm that there are two alternative approaches to all-party talks: one is through the acceptance by the parties of the six principles, and therefore confidence-building measures; and the other is through the election? Does the election require that the people standing for election should adopt the six principles first?
The Prime Minister: No, the two routes are not quite as my hon. Friend set out. The first way to obtain the confidence that would lead to all-party talks would be some prior decommissioning by the paramilitary bodies. On that basis, I think that all parties would come together and talk without an election.
The second way would be the elective basis that I set out this afternoon. If that is to be successful, we would hope and expect all parties to declare their support for the six principles. Those are the two options—either some prior decommissioning, or, through the process of an elective body, to determine who would take part in the negotiations.
Mr. John D. Taylor: Does the Prime Minister accept that, like the hon. Member for Foyle (Mr. Hume), all right hon. and hon. Members on the Ulster Unionist Benches live in Northern Ireland? They have suffered as well, and they speak for a large section of the community that has been severely hit by terrorism for 25 years. We are equally anxious to ensure that peace prevails in the long term in Northern Ireland.
Does the Prime Minister recognise that, although we accept the six principles in the report, we do not agree with other elements in it? We welcome the

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Prime Minister's statement to the House, and we emphasise that we welcome also the thoughtful response by the Leader of Her Majesty's Opposition.
As to the forthcoming election in Northern Ireland, will the Prime Minister correct the hon. Member for Harrow, East (Mr. Dykes), who does not understand the difference between an assembly and an elected body? If that hon. Gentleman is in the British-Irish Parliamentary Association, he ought to know the difference.
Will the right hon. Gentleman assure the House that we are talking not about an assembly but about an elected body, having no legislative or administrative powers in Northern Ireland? Can the Prime Minister tell the House that, in co-operation with Her Majesty's Opposition and other parties, he will expedite the election to ensure that it does not coincide with other possible elections—for example, a general election in the Republic of Ireland?
The Prime Minister: I am pleased to have the right hon. Gentleman's support. The whole House knows of the time when the right hon. Gentleman was badly wounded as the result of an incident in Northern Ireland, and of the courage that he has shown in his career in politics since then. Many Northern Ireland politicians on both sides of the divide have shown great courage. I draw no distinction in the difficult circumstances of politics in Northern Ireland. I hope that those politicians will show the same moral courage to move forward as they have shown physical and moral courage in the past.
I know that the right hon. Gentleman cannot agree with every point in the Mitchell report. I dare say that no one does. Over time, it may turn out that one of the report's greatest strengths is that everyone will find something in it with which he can agree, and something with which he is not quite so happy to agree.
As to the proposed elections, the right hon. Gentleman is concerned that they would establish a body that had no legislative or administrative powers. I hope that it will be of assurance to everyone across Northern Ireland that it is a mechanism for getting into all-party talks and finding a proper solution, following which I hope that we can ensure that politicians in Northern Ireland are able to take a greater share of responsibility than they have been able to do in the past.
Rev. William McCrea: I welcome the Prime Minister's statement. I am sure that the right hon. Gentleman agrees that real, genuine and lasting peace is a rich prize for the people of Northern Ireland—and something that they do not want in any way to see thrown away.
I am sure that the Prime Minister recollects that two years ago, in 1993, the leader of my party, my hon. Friend the Member for Belfast, East (Mr. Robinson) and myself presented a document proposing a constitutional convention for Northern Ireland. Bearing it in mind that at least 70 per cent. of all the people right across the community in Northern Ireland support such a body, surely the matter should be moved upon with utmost urgency. Surely no one in a democracy should be afraid of the will of the ballot box.
The Prime Minister: I am extremely grateful for the hon. Gentleman's support. I recall the proposals for a constitutional convention that the hon. Member for North
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Antrim and his hon. Friends presented to me some time ago. I have not yet mentioned Mr. Alderdice of the Alliance party, who has also played a constructive role. I hope that, as a result of all those proposals, we will be able to move forward.
Mr. Seamus Mallon: May I assure the Prime Minister that we fully support the six principles, unequivocally and without any reservations? I also wish to point out that people should read the fifth principle—paragraph 20(e) as it is in the document—carefully before they start talking about the absence of the principle of consent from the document.
I wish to refer the Prime Minister to a section of the document that he mentioned earlier—paragraph 34 of Senator Mitchell's report. That paragraph recommends that all parties, including the Governments not "might", not "may", but "should" follow a course of action in terms of decommissioning as part of the talks process.
Is not the reality of the situation that the Prime Minister and the Government are actually rejecting that core element of Senator Mitchell's report, and that, not only on that but on all the key political elements of the report and the recommendations, the Prime Minister is at odds with Senator Mitchell, his commission, and the Irish Government? Is not the Prime Minister creating a situation in which the consensus that will be required in any democratic experiment simply will not be there, because he is at odds with those with whom he should be working closely on the central, fundamental elements?
The Prime Minister: The hon. Gentleman knows that I have worked very closely with him and his hon. Friends over the past three years, and I look forward to doing so in future.
On the specific points that the hon. Gentleman raised, if he considers paragraph 20(e)—or principle five, whatever one wishes to call it—he will see that at best it means limited consent, not full consent, in the terms of the documentation that we have seen in the past. Limited consent I concede: full consent I emphatically do not concede. That is most certainly not the case.
I have two points to make to the hon. Gentleman about paragraph 34, and both are accurate and pragmatic. First, paragraph 34 is not a recommendation, and is not put forward as a recommendation. Secondly, it does not get everyone to the table. We have to get everyone to the table in order to advance, and that is the purpose.
The right hon. Member for Strangford (Mr. Taylor) mentioned the elections. The purpose of those elections is not to produce some body that would return to the concerns that the nationalist community has had in the past. The purpose is to enable a process to take place so that people can be elected to a body that does not have legislative powers, and to ensure that there is a democratic mandate for negotiations, and everybody can sit down together.
The hon. Member for Newry and Armagh (Mr. Mallon) has been as passionate as any Member of the House over the years about getting everybody to sit down together and discuss the future. All I would say to him is that here is a way of achieving that, and he should not turn away from it.
Several hon. Members rose—
Madam Speaker:Order. We are now going to move on.

Registration of Immigration Advice Practitioners
4.37 pm
Mr. Nirj Joseph Deva: I beg to move,
That leave be given to bring in a Bill to establish a system of registration for approved immigration advice practitioners; and for connected purposes.
I am grateful for the opportunity to introduce the Bill to the House. My Bill seeks to establish a system of registration to improve the standards of immigration advice practitioners. It is designed to help their clients—sometimes the most hapless victims and most vulnerable people in our society, and drawn largely from the ethnic minorities. Those clients are occasionally, and more and more frequently, at the mercy of unqualified and incompetent immigration advisers.
Those so-called advisers, or cowboys as I prefer to call them, operate by exploiting the ignorance of applicants and to reap large fees for poor-quality—and sometimes deliberately false—advice. In so doing, they extend and complicate the immigration application procedures, prolong the duress on the applicants, make them pay large fees at regular intervals and clog up the entire system of processing applications, to the detriment of genuine applicants.
Those people build up a large case load of work, which the taxpayer pays for, and embark on appeals, tribunals, judicial reviews and so on, funded by legal aid. In parallel, they charge their clients exorbitant fees at every stage.
If we are serious about stopping bogus applications, we must address the source of the problem: bogus advice given by bogus advisers who exploit applicants for reward.
It is not in the interests of bogus advisers to settle applications swiftly and satisfactorily. It is in their interests to prolong the process—until it fails, at which point their hapless clients are either prevented from entering the country or are removed from the country, erasing at a stroke any future action against them for negligence or complaint.
The scale of the problem is difficult to quantify, but from a small survey in the London area I have enough evidence to claim that between 70 and 80 per cent. of immigration advisers are of doubtful provenance. That of course excludes qualified solicitors, citizens advice bureaux and other reputable advisory services, and Members of Parliament.
My Bill is designed to license the cowboys who set up shop, advertise, charge fees and then move on, leaving chaos and despair in their wake.
At this point, I should like to quote the authority of Mr. Justice Stephen Sedley, chief immigration liaison officer in the High Court. On 31 March 1995, in ex parte motion Miranda he said, obiter dicta:
"I want to say that this court sees a sorry trail of applicants whose rights have been forfeited or lost or garbled or injured by putting themselves into the hands of unqualified advisers in the immigration field."
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Other countries have faced this problem and set out to resolve it. Three years ago, Australia passed a statute—the Migration (Amendment) (No. 3) Act 1992, which confined the right to give advice to lawyers or to registered agents. In order to secure registration, proof has to be given of competence and some financial security. The Australian migration agents registration scheme has an independent board appointed by the Immigration Minister, which has the power to register aliens, to investigate complaints received about an agent and to impose disciplinary sanctions on an agent.
Voluntary workers are required to register, but are exempt from paying registration fees. Criminal penalties exist for unregistered practice. So far, 1,800 agents are registered under the Australian scheme; 307 have been refused registration; 270 have been deregistered; and 741 complaints have been received.
As some of my colleagues know, I am strongly committed to deregulation, but I also recognise, just as the Deregulation and Contracting Out Act 1994 recognises, the principle of necessary protection, as defined in the 1994 Act and in Standing Order No. 124(A). I do not believe that self-regulation will work. The cowboys will not register. They will operate by word of mouth and client ignorance. Under self-regulation, the relevant bodies will not have the power to monitor and police themselves. Cowboys are mobile and can set up shop at any time under assumed names. They then charge their clients arbitrary fees.
My Bill is designed to set up a council of licensed immigration advisers, whose duty will be to maintain and ensure standards of conduct and professional competence among those who practise as immigration advisers. The council will issue licences and will maintain a register, under the direction of the Secretary of State. It will also have powers to investigate and to make rules. It will be an offence to pass oneself off as an immigration adviser without a licence. It will be an offence liable to summary conviction and/or imprisonment for someone to practise as an immigration adviser in return for payment or material reward without holding a licence.
My Bill will protect the most vulnerable. It will make the application process more efficient. It will save the applicants who are now exploited a considerable amount of money. Most important, it will save the public money, by reducing the cost to the taxpayer of the legal aid that is being used because of the poor quality of advice that is given by unqualified or incompetent immigration advisers.
Question put and agreed to.
Bill ordered to be brought in by Mr. Nirj Joseph Deva, Sir Ivan Lawrence, Mr. James Pawsey, Mr. Jacques Arnold, Mr. Harry Greenway, Mr. Julian Brazier, Mr. Robert G. Hughes, Mr. D. N. Campbell-Savours, Mr. Piara S. Khabra and Mr. Simon Hughes.

Registration of Immigration Advice Practitioners
  REGISTRATION OF IMMIGRATION ADVICE PRACTITIONERS
  Mr. Nirj Joseph Deva accordingly presented a Bill to establish a system of registration for approved immigration advice practitioners; and for connected purposes: And the same was read the First time; and ordered to be read a Second time upon Friday 8 March and to be printed. [Bill 48.]

  Points of Order
  4.46 pm
  Mr. David Shaw: On a point of order, Mr. Deputy Speaker. Would it be in order to suspend the House for 10 minutes so that Opposition Members can have a cup of tea, because they have been banned from the Tea Room?
  Mr. Deputy Speaker (Mr. Michael Morris): No suspension is called for for anything at the moment.
  Mr. Charles Hendry: On a point of order, Mr. Deputy Speaker. I am extremely concerned—[Interruption.]
  Mr. Deputy Speaker: Order. The House will listen to an hon. Member who has an important point of order.
  Mr. Hendry: I am extremely concerned that, on an Opposition Supply day, some 220 Labour Members are missing. Will you check, Mr. Deputy Speaker, that the annunciator screens are working, so that all the Labour Members who might want to support their health spokesman know that the debate has started? [Interruption.]
  Mr. Deputy Speaker: Order. I had hoped that the hon. Gentleman had a genuine point of order.
  Mr. Ronnie Campbell rose—
  Mr. Graham Riddick rose—[Interruption.]
  Mr. Deputy Speaker: Order. The hon. Member for Easington (Mr. Cummings) will stay behind the red lines.
  I hope that the hon. Member for Colne Valley (Mr. Riddick) has a genuine and honourable point of order I know that he wants to speak in this afternoon's debate.
  In that case, we shall move on.

Opposition Day
[2ND ALLOTTED DAY]
Opposition Day

  National Health Service
  Mr. Deputy Speaker (Mr. Michael Morris): I have to announce that Madam Speaker has selected the amendment in the name of the Prime Minister.
  4.47 pm
  Ms Harriet Harman: I beg to move,
  That this House views with alarm the mounting evidence of inadequate patient care and of overstretched staff and facilities in the NHS; deplores the relentless cuts in NHS beds; condemns the increased amount of money spent on internal market bureaucracy rather than on front line services and staff; and calls on the Government to announce an immediate moratorium on bed closures; nominate someone in each health authority to identify bed shortages and take appropriate action locally; monitor and publish a weekly report on the number of beds and staff available; and issue clear national guidelines to end the uncertainty about who pays for continuing care.
  The debate is about the crisis in our national health service. It is about the hundreds of patients who wait on trolleys for emergency treatment. It is about the thousands who are denied the treatment that they need. It is about the millions of people throughout the country who no longer feel that they and their families can rely on our NHS.
  The people of Britain want to know the answer to some very simple questions. Why is our great national health service being torn limb from limb by the Tory Government? Why is the NHS, which the Conservatives claimed would be safe in their hands, being savaged in their hands? Why have one in six NHS acute hospital beds been cut since 1990? Why are there 20,000 more managers and accountants in the NHS, but 50,000 fewer front-line staff on the wards?
  The British people have a clear decision to make and that is what today's debate is about. It is a decision between a unified national health service with Labour and an NHS that is simply being frittered away under the Tories; a decision between more money on doctors and nurses with Labour and wasted money on accountants, form filling and bureaucracy under the Tories; and a decision between a strong public service for the next century with Labour and an NHS that is privatised, broken up and sold off to the highest bidder under the Tories.
  Mr. Robert Atkins: I would just like to ask the hon. Lady one question. Is it still Labour party policy to abolish fundholding?
  Ms Harman: We have said that we are absolutely concerned that access to hospitals should be on the basis of clinical need, that everyone in primary care should work towards a local health strategy, agreed locally, and that there should be the minimum of duplication and bureaucracy. The right hon. Gentleman will understand from that that there are many problems with GP fundholding. We are concerned to ensure that there is fair treatment for every patient and a fair say for every GP in our renewed national health service.
  Mr. John Sykes: How much extra money would the hon. Lady pour into the hospitals? Is

  375
  not it a good thing that there is no such thing as a grant-maintained hospital, otherwise would not she have been in more trouble?
  Ms Harman: I am surprised that the hon. Gentleman did not rise to complain to the Secretary of State about the fact that, in his health region, 7,546 hospital beds have been closed. That is what his constituents want him to be speaking up about in the House rather than making cheap points. [Interruption.]
  Today's debate is important because the NHS is at a crossroads. The importance of the NHS cannot be overstated. [Interruption.]
  Mr. Deputy Speaker: Order.
  Ms Harman: The NHS is the public institution that the British people cherish more than any other. It remains, despite the Tories, one of the few public services that bind the nation together. People want to have the confidence that the NHS will be there for them and their families. But today, under the Tories, they cannot have that confidence.
  Dame Elaine Kellett-Bowman rose—
  Mr. Quentin Davies rose—
  Ms Harman: I give way to the hon. Gentleman.
  Dame Elaine Kellett-Bowman: Sexist.
  Mr. Davies: Is not it extraordinary that a party that has the pretension to be an alternative Government simply does not know the answer to the question whether it wants to abolish GP fundholding?
  Ms Harman: Perhaps the hon. Gentleman was not listening or he cannot understand. We have set out our concerns and how we shall address them.
  Whatever the Secretary of State says, people know what is really happening. They know that each and every day seriously ill people are being turned away from casualty. They know that treatments that used to be available on the NHS are simply no longer available in some areas. They can see from their own daily lives the growing reality of privatisation of our health services.
  The Tories' strategy for the NHS is clear. They are allowing the NHS to fail and that is privatisation by the back door. Up and down the country, they are withdrawing many services so that people have to go to the private sector for treatment. They are changing what is left of the NHS so that it becomes less and less a public service and more and more a private business run on the basis of cost, not on the basis of need.
  Mr. David Tredinnick: Given the hon. Lady's commitment to the Conservative principle of choice in education—[Interruption]
  Mr. Deputy Speaker: Order.
  Mr. Tredinnick rose—
  Mr. Deputy Speaker: Order.
  Mr. Tredinnick rose—
  Mr. Deputy Speaker: Order. Is the hon. Gentleman deaf? [Interruption.] Order. There will be freedom of speech on both sides of the House.
  Mr. Tredinnick: Has the hon. Lady ever taken advantage of private health care?
  Ms Harman: No. But let me make something clear to the hon. Gentleman, who has spoken of choice in relation to private health care. For many people, it is no longer a question of choice; they feel that they are refugees, driven out of the national health service because it is no longer available to them. We want the national health service to be available, so that people do not feel that they must pay again to obtain private treatment.
  Nowhere is the rundown more devastatingly clear than in casualty departments. A fundamental principle of the NHS is that it will always be there for people in an emergency; at least, that used to be a fundamental principle, but it does not apply any more. Casualty departments have been closed, and critically ill patients are being turned away. It is happening throughout the country, as every hon. Member will know.
  In London, at the St. Helier hospital, Carshalton, the casualty department was closed for 22 hours on 27 November. All ambulances were turned away. On another occasion, in the same hospital, patients had to be treated in the ambulances outside the casualty department because there were not even enough trolleys in the department; they were all full. On 14 January, at the Royal Hallamshire hospital in Sheffield, patients waited for 19 hours on trolleys in casualty. Many personal tragedies are occurring throughout the country.
  Nine-year-old Nicholas Geldard was playing at his Stockport home just before Christmas when he fell ill. The emergency services searched hospital after hospital for an intensive care bed, but none could be found. Eventually, an ambulance had to take him across the Pennines in the small hours of the morning, in freezing fog, with his parents following by car. When they finally arrived at Leeds general hospital, they were told that their son had died on the way. No one can say whether he would have lived, but we know that he never had the chance of life that an intensive care bed in the NHS could have given him.
  Consultant physician Professor J. D. Ward of the Royal Hallamshire hospital in Sheffield warns:
  "For God's sake, do not get ill…to be taken as an ill patient into an acute casualty or admissions ward is now a major danger in life."
  It is not that the Government have not been warned; they will not listen. They have ignored the advice of the British Medical Association, which has told them that hospital emergency services are at breaking point because of a
  "severe and prolonged crisis in the acute sector".
  They have ignored the Royal College of Nursing, which has warned that nurses' morale is now so low that 37 per cent. say that they would leave nursing if they could.
  The reason for the crisis in our hospitals and for the plummeting morale of doctors and nurses is obvious: more than one in six NHS hospital beds have been closed. When sick patients are turned away from hospitals, the Government are betraying the basic principles on which the NHS was founded.
  Mr. Anthony Coombs: The hon. Lady cannot get away with being so evasive about GP

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  fundholders. As of next year, 100 per cent. of the people in my constituency will be treated by GP fundholders and, as a result, they will receive a far better standard of primary health care than ever before. They will want to know, just as we do, whether the Labour party would abolish GP fundholding for those who are gaining so many benefits from it. Is the answer yes or no?
  Ms Harman: I am glad that the hon. Gentleman is so interested in the policies that will be pursued under a Labour Government, and he will certainly hear of the discussions that we are having with GPs, both fundholders and non-fundholders, to sort out the mess that the Tory Government have created. I am surprised that he has not risen to his feet today to complain about the problems caused to his constituents in the west midlands because, in that region, one in five hospital beds have been closed in the past five years, the number of nurses has been cut by 12 per cent. and the number of managers has gone up by 310 per cent.
  Mr. Coombs: What is the answer? [Interruption.]
  Mr. Deputy Speaker: Order. It is no good the hon. Member for Wyre Forest (Mr. Coombs) saying, "What is the answer?" when the hon. Lady is giving her answer. He may not like the answer, but that is not my responsibility.
  Ms Harman: It used to be a fundamental principle that NHS patients would be entitled to the best medical treatment, irrespective of where they lived, but now managers in each region are deciding on the ground of cost what will and will not be available on the NHS.
  Two years ago, only four health authorities were excluding treatment from the NHS. Now 40 health authorities, one third of all the authorities in the country, are rationing, so people have to be careful where they become ill. Do not get brittle bones in Dorset, because the health authority is stopping screening for osteoporosis there. Do not get infected wisdom teeth in Hertfordshire or Kingston and Richmond, because the health authority will not take them out there. Health care has become a lottery, depending on where people live.
  Dame Elaine Kellett-Bowman: On a point of order, Mr. Deputy Speaker. Is it in order for the hon. Member for Peckham (Ms Harman), the Labour Front-Bench spokeswoman, to practise sex discrimination—in the debate, she has given way only to men and not to women?
  Mr. Deputy Speaker: That is not a matter for the occupant of the Chair, but I am sure that the hon. Lady's point of order will have been noted by Madam Speaker.
  Ms Harman: It was not sex discrimination that made me not respond to the hon. Lady's intervention: it was kindness.
  The problem is that, when people cannot get the treatment that they need on the NHS, they have to go private or go without. Again, we see the Government strategy of creeping privatisation at work. Again, it used to be a fundamental principle that the NHS provided not just for illness, but for a wide range of health care needs, but now services are being pushed one by one into the private sector.
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  Take dentistry. When people go to an NHS dentist, they pay so much, now that the charges have gone up, that they think they have gone private anyway. First, charges are pushed up so high that people can hardly tell the difference between the public and the private sector; then fewer and fewer dentists do NHS work, so more and more people end up having to go private.
  Take long-term nursing care. The Government close long-stay wards and force people into the private sector. People used to receive treatment free and now they have to pay. It is no wonder that private health care is growing. These are the facts. There are now 28 per cent. fewer NHS hospital beds than there were 15 years ago, but there are 66 per cent. more private hospital beds than there were 15 years ago.
  That, however, is just the start. The Government want to go further. They are handing public health services over to private organisations through market testing, the private finance initiative and making the NHS buy services in the private sector. Their privatisation strategy is about not just putting out services to the private sector, but changing the basic ethos of what is left of the NHS, so it is no longer doctors and nurses who decide how people are treated: it is accountants and bureaucrats put in by the Tories.
  If people want to know where so much NHS money has gone in the past five years, I shall tell them. It has gone on accountants, on senior managers, on their company cars and on their form filling. The number of managers has increased from 5,000 five years ago to 23,000 today. At the same time, 50,000 staff have been cut from our wards. These are the Tory priorities for our health services: more people to count the cost of care, fewer people to provide that care. They are not, however, the priorities of the British people, who are totally opposed to the privatisation of the NHS.
  The Secretary of State for Health, for all he protests—as he will, no doubt, today—that he is the friend of the NHS, is nothing more than the presentable face of privatisation. I should like to ask him some simple questions about where he stands. First, on the casualty crisis, does he agree with this statement:
  "I believe that it is unacceptable that people entering the hospital through the accident and emergency unit should be kept waiting for hour after hour on a trolley"?
  Does he believe that that is unacceptable? That statement was made by the former Secretary of State for Health, the right hon. Member for Sutton Coldfield (Sir N. Fowler). If the Secretary of State agrees with that statement, which he says he does, and I welcome that, why does he not implement—
  Sir Norman Fowler: The hon. Lady has just quoted my words, so I think that I am entitled to ask her the further question: does she welcome the steps that the Government have taken to create new emergency wards at Good Hope hospital, to provide new nurses and to modernise the accident and emergency unit?
  Ms Harman: No, I do not—[HON. MEMBERS: "Oh."] Will hon. Members listen? I do not welcome those steps

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  because they are a sham. If hon. Members will listen, I received a letter from the chief executive of Good Hope hospital today, who said:
  "I can tell you there are no new beds being opened. We are simply re-opening beds that have been closed through lack of staff resources."
  Mr. Robin Corbett: I thank my hon. Friend for coming to Good Hope hospital in north Birmingham. May I confirm that none of the so-called beds opened when the Secretary of State for Health was walking down the corridor is new—they are reopened beds? There is no money available for an admissions ward alongside the accident and emergency unit. It will be a year before building on that ward can be started, even if it can be funded. May I confirm that the money that is now being spent on refurbishing the accident and emergency unit is not new or extra money, but money that the regional health authority already had and had allocated for that purpose?
  Ms Harman: My hon. Friend's points demonstrate that the Government's response to the crisis facing patients is to produce bogus statistics and false solutions. Why does not the Secretary of State produce a real solution to the casualty crisis and act now?
  There are many ways in which the NHS could improve the service that it provides. New technology offers unprecedented opportunities so that, for example, a doctor in Sheffield can examine a patient in London. New drugs and treatment, such as hormone replacement therapy for brittle bones, offer new hope to many women. New screening techniques can prevent and detect serious diseases, such as cystic fibrosis, and new ways of delivering care to people in their own homes can revolutionise medical treatment.
  Rebuilding the NHS after the Tories will be a challenge, but its staff—the doctors, nurses and all the other staff—have repeatedly shown their commitment to the NHS as a public service. They have shown their ability to deliver high-quality care, despite the Tories. Labour will bring together staff, patients and the community to draw on their views, to create not division but consensus and to plan for the future of health care.
  We will transfer the £1.5 billion that the Government waste on bureaucracy to front-line services—to doctors and nurses and not to accountants and managers. We will end the unfair system whereby treatment is dependent on which GP is purchasing the health care rather than on the clinical needs of the patient. We will end the lottery of long-term nursing care, which means that the care received and the price paid depend on where one lives. Our NHS will concentrate on the patient, not on the costs.
  The NHS has great potential, which Labour in government will unlock. The next general election will decide the future of our health service. Already we have an NHS in which there are hospitals without trolleys, patients without beds and wards without nurses. The Tories have a hidden agenda for a fifth term that will destroy our NHS for good. The Secretary of State's friends give the game away. Roy Lilley, Tory health expert, called the NHS
  "the rump of the remaining nationalised industries and an overburdened bureaucracy".
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  David Green, of the Institute for Economic Affairs, said that the NHS
  "breeds a childlike reliance. It has to go."
  The NHS is simply not safe under the Tories.
  In their hearts, members of the Tory party hate the NHS. Its only safeguard is the party that created it—the Labour party.
  5.13 pm
  The Secretary of State for Health (Mr. Stephen Dorrell): I beg to move, to leave out from "House" to the end of the Question and to add instead thereof:
  "believes that the NHS is a great British success story which delivers health care of international quality, which is and will remain available free at the point of use on the basis of medical need and provides excellent value for money for taxpayers; congratulates all NHS staff for their hard work and dedication, particularly during the exceptional period of increased demand for NHS services over recent weeks; welcomes the increasing number of qualified nurses and midwives over the last seventeen years and looks forward to the NHS continuing to flourish under the policies of a Government which has backed its commitment to the service with year-on-year increases in real resources.".
  This week, we have seen a completely new political principle being put into action by the Labour party. It used to be true—there was general recognition of its effectiveness—that the best way to express support for a political colleague was to go on to the media, write an article, give an interview and offer a public endorsement for the sort of policies that we have heard espoused from the Labour Benches. That is, of course, the old-fashioned method.
  This week, the Labour party has found a completely new way to express the warm fraternal solidarity for which it is famous. The hon. Member for Hartlepool (Mr. Mandelson) has told us that the Labour party has expressed its support this week for the hon. Member for Peckham (Ms Harman) by remaining silent. The right hon. Member for Kingston upon Hull, East (Mr. Prescott)—that not normally taciturn individual—has not been anywhere near a studio this week. There has been no sign of the hon. Member for Holborn and St. Pancras (Mr. Dobson) or the hon. Member for Oldham, West (Mr. Meacher). They are all biting their tongues, restraining their natural urge and containing their generous instincts to support the hon. Lady. It has been the chorus of the Hebrew slaves in mime.
  Conservative Members say that the hon. Lady's friends should have supported her. This week, we have seen the irresistible force of parental obligation meeting the immovable object—
  Ms Hilary Armstrong: On a point of order, Mr. Deputy Speaker. I wonder what you can do to help the House. The Government have clearly sent in the wrong Secretary of State. This is meant to be a health debate, but the Secretary of State does not seem to know that.
  Mr. Deputy Speaker: The Secretary of State's speech has been entirely in order so far.
  Mr. Dorrell: This week, we have seen the irresistible force of parental obligation meeting the immovable object of political correctness. The reason why the hon. Lady is right, and virtually all of her Back-Bench

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  colleagues are wrong, is that she has shown by her actions that she endorses the principles and values of a free and open society. That is important in education, and it is equally important in health care.
  Mr. Deputy Speaker: Order. I have yet to hear the word "health", but I have every confidence that it is coming.
  Mr. Dorrell: I fear that noise from Labour Members might have drowned out my point. I said that the principles for which the hon. Lady is standing are just as important in the management and development of the national health service as they are in education and much more broadly in our society. She is standing for the principles of choice and diversity. The sadness in the House this afternoon is that her rhetoric on the health service does not reflect her actions in the education sector.
  We have argued that we need the NHS to deliver a service which empowers local people and allows them to make choices, and which allows the managers who are in charge of trusts to manage the trusts for which they are responsible.
  Several hon. Members rose—
  Mr. Dorrell: As many of my hon. Friends have pointed out in interventions, we need a national health service that allows fundholding doctors to make decisions in the interests of their patients and, by so doing, to raise the quality of care throughout the NHS. Those are the principles on which our health policy is built. The hypocrisy of Labour Members—
  Several hon. Members rose—
  Mr. Deputy Speaker: Order. It is clear that the Secretary of State does not intend to give way now.
  Mr. Dorrell: The hypocrisy of Labour Members is demonstrated by the gap that has opened up this week between their rhetoric and their actions. That is what makes my hon. Friends angry.
  Several hon. Members rose—
  Mr. Dorrell: I am spoiled for choice. I shall give way to the hon. Member for Liverpool, Walton (Mr. Kilfoyle), who I believe is an education spokesman.
  Mr. Peter Kilfoyle: I am indebted to the Secretary of State. He has said a great deal about principles. Will he explain how his Government's principles helped the 38 people who, two weeks ago, were kept overnight on trolleys in Fazakerley hospital in Liverpool, which led to surgical and medical cases being kept in beds in the maternity unit? Is that a reflection of his principles? Where was their choice?
  Mr. Dorrell: I started my speech by pointing out the Government's commitment to the principle of local management in the health service to ensure that the health service responds to patients' needs as they arise. I shall
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  now demonstrate how those principles in action have delivered the emergency service, which all national health service patients are entitled to expect.
  The problem for the hon. Member for Peckham is that she is willing to endorse the principles by her actions but not to endorse those principles being put into effect within the national health service.
  Mr. George Howarth: On the Secretary of State's principles on the national health service, will he explain why Fazakerley hospital, to which my hon. Friend the Member for Liverpool, Walton (Mr. Kilfoyle) has already referred, is generating so many problems that two or sometimes three people contact me every day to complain about the service there? When I wrote to the Secretary of State and asked him to investigate what was going on there, he refused to conduct an investigation. If he has nothing to hide and there are no problems, why will he not hold an investigation? Is he more content to play politics than to sort out the health service?
  Mr. Dorrell: I am content with a system that vests in local managers and clinicians the power to make decisions in the interests of patients in their area.
  Several hon. Members rose—
  Mr. Dorrell: Before I deal with the background to the two points raised about Liverpool, I shall give way to my hon. Friend the Member for Lancaster (Dame E. Kellett-Bowman).
  Dame Elaine Kellett-Bowman: I tried to make this point to the hon. Member for Peckham (Ms Harman), who would not listen. Does my right hon. Friend accept that all patients in my constituency will shortly be in fundholding practices and that the GPs in charge of those practices will be able to send their patients to the most up-to-date hospital north of Watford, with all the latest facilities, including a good day hospital that carries out cataract and varicose vein operations? Fewer hospital beds will be needed because the hospital has all the latest equipment, which is as good as anywhere in Europe.
  Mr. Dorrell: My hon. Friend is right. The fundholding system benefiting her constituents would be under threat if the hon. Member for Peckham put into effect her rhetoric on the national health service, which is in sharp distinction from her actions in her own family.
  Mr. Graham Riddick: Will my right hon. Friend confirm that all doctors must take the Hippocratic oath? Is it not clear that the hon. Member for Peckham (Ms Harman) has taken that to heart, but misunderstood it?
  Mr. Dorrell: My hon. Friend makes his point compellingly. What makes Conservative Members angry is the distinction between what Labour Members say and what they do.
  I shall outline the background to the stress and pressure on the emergency services, which we have seen over the past few weeks.
  Several hon. Members rose—
  Mr. Dorrell: What I am about to say lies behind all the questions that Opposition Members have asked me. If it does not answer their questions, I shall give way further.

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  Over the past two months, there has been an unprecedented peak in the emergency work load placed on the NHS emergency services. I can illustrate that simply by a few facts: in the week commencing 8 January, emergency admissions in the city of Birmingham rose by 35 per cent. on the normal seasonal average; in Shrewsbury, they were 29 per cent. above the normal seasonal level; and in Winchester they were 50 per cent. above the normal seasonal level. So, throughout the health service, since the middle of November, there have been examples of unprecedented peaks in the emergency work load. The best overall measure was that, in the whole of London in December 1995, emergency calls increased by 11 per cent. compared with December 1994.
  The background against which this debate takes place is of an unprecedented increase in the NHS's emergency work load. The fact that the hon. Member for Peckham does not like to face is that the more flexible local management in the health service that she likes to denigrate has responded to that increase and ensured that, in the overwhelming Majority of cases, it has been met. That has been done by increasing the bed space available to the emergency services. She decries that and says that a hospital that is not using all its beds should leave beds closed rather than reopen them to absorb the emergency work load. New bed space has been opened throughout the health service and existing bed space has been redesignated to ensure that the emergency work load is met.
  The position is clear throughout the country: in Consett, 26 beds; in Sunderland, 26 beds; in Grimsby, a whole ward; in the Good Hope hospital, 39 beds; in the West Middlesex hospital, 12 beds; in Newham general hospital, two wards creating 32 beds. Furthermore, not just new bed space is being created but existing bed space is being redesignated to ensure that the emergency work load is met. The Birmingham Heartlands hospital has 60 extra beds from that source and in the North Staffordshire trust, 70 surgical beds have been redesignated as medical to meet the emergency demand.
  The hon. Member for Peckham is therefore right to identify an increase in the health service's emergency work load, but she is profoundly wrong to denigrate the management system that has ensured that the health service has responded to that increase in emergency work load and, in the overwhelming majority of cases, delivered the emergency service that NHS patients need.
  Ms Glenda Jackson: The local flexibility to which the Secretary of State referred operates at the Royal Free hospital trust in my constituency. One of my constituents, a cancer patient, was given a day for admittance to the hospital but his admittance was cancelled at 5 o'clock on the day that he was due to go in. He went in one day later and went through the entire pre-operation medical procedures, only to be told that the operation had been cancelled. At that time, the hospital could not give him an alternative date. Instead, it has allowed him to go home every day but he must return to the hospital at 6 o'clock in the evening. He believes, and I have had that belief confirmed by others, that during his absence his bed is used. That is not redesignation of beds but hot bedding.
  Mr. Dorrell: It is well known that, if an hon. Member wants a Minister to examine a specific case, he or she will
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  do so. I shall not seek to respond off the cuff to a specific case. I remind the House that, over the past two months, the national health service has done what it is there to do: treat priority cases first. In the overwhelming majority of cases, it has delivered the emergency service that we want to see.
  Sir John Gorst: How does my right hon. Friend reconcile all that he has said and the principles that he correctly outlined at the beginning of his speech with the intention to close the accident and emergency unit in my constituency and replace it with a miserable alternative that is of no consequence when compared to the original?
  Mr. Dorrell: My hon. Friend knows that we are currently engaged in consultation on the shape of services to be delivered at Edgware hospital in the future, and part of a state-of-the-art accident and emergency service for his constituents will be delivered through Edgware hospital. The precise nature of the total service to be delivered at Edgware is the subject of current consultation.
  Mr. Hugh Dykes: Will my right hon. Friend give way?
  Mr. John Marshall: Will my right hon. Friend give way?
  Mr. Dorrell: I shall give way to one of my hon. Friends—my hon. Friend the Member for Harrow, East (Mr. Dykes).
  Mr. Dykes: I am grateful to my right hon. Friend. Does he agree that a perfect example of his point about the increase in treatment figures and in the accident and emergency figures is Northwick Park hospital—a big district general hospital shared by my constituency and that of my hon. Friend the Member for Harrow, West (Mr. Hughes)—where the figures have risen enormously recently, but where treatment has improved, as all of its patients say, without any reasoned exception?
  Mr. Dorrell: My hon. Friend is exactly right, and that has been the overwhelming experience of patients of the emergency services of the NHS. I must move on, because the hon. Member for Peckham said in response to my arguments—
  Mr. Simon Hughes: Will the Secretary of State give way?
  Mr. Dorrell: Later. The hon. Lady said that the shift to meet the emergency work load has led to a reduced service for those on elective waiting lists, with the result—she claims—that there has been an increase in the proportion of elective surgery done by the private sector. I have heard her make that claim several times since I took up my present responsibilities, so I have had it examined. I have looked at the evidence to see whether it is true that there has been a dramatic increase in the share of elective surgery conducted in the private sector.
  The fact is that, in the past 14 years, the share of elective surgery done in this country on people resident in this country by the private sector has risen from 14 per

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  cent. of the total to 15.3 per cent. of the total—an increase of 1.3 percentage points. The House will not recognise from that statistic the rhetoric of the hon. Lady.
  That brings me to another element of the choice and diversity for which the hon. Lady has made herself famous this week—the application of that principle within the NHS. Many of my hon. Friends have raised the issue of GP fundholding, and they are right to do so. The Government have made it clear that we are determined to develop the primary health care service of the NHS because—[Interruption.] Opposition Members appear to have lost interest in the NHS. So much for their passionate interest in the development of primary care in the health service. They seem to be more interested in their private internal bickering. No doubt they are all discussing the performance of the hon. Member for Peckham. We know from the lunchtime news what Labour Members think of her performance, and we can see them all plotting their next move in the battles that are going on within the Labour party.
  When Opposition Members have concluded their private discussions, perhaps they would like to turn their attention for a moment to the future of the NHS and the delivery of high-quality primary health care. The fundholding system has been described by the chairman of the Socialist Health Association, Julian LeGrand, as the biggest success story of the health service reforms. Perhaps more tellingly, the hon. Member for Peckham's predecessor as Opposition health spokesman, the right hon. Member for Derby, South (Mrs. Beckett), went to the National Association of Fund Holding Practices—
  Mr. Henry McLeish: This is old hat.
  Mr. Dorrell: Old hat? This happened last October. How long does a policy last in the Labour party? Last October, the right hon. Member for Derby, South went to the National Association of Fund Holding Practices conference, and thought that she had better curry favour from the audience. She said that Labour understood and welcomed the advances fundholding has brought to many patients. The hon. Member for Peckham has shown us this week that she thinks services should be determined by—in her case—the interests of the son. I would argue that the same principle should apply to the patient.
  There is, in the words of the right hon. Member for Derby, South, clear evidence that fundholding brings benefits to patients. I look forward to hearing from the hon. Member for Peckham how she justifies her policy of replacing fundholding. How can a party which espouses the true interests of patients be committed to sweeping away a system that its own previous health spokesman has recognised serves the interests of patients?
  Mr. Jerry Hayes: Does my right hon. Friend recall that the right hon. Member for Derby, South (Mrs. Beckett) went on to say that she hoped that fundholding would be abolished in the first year of a Labour Government? Does that still stand?
  Mr. Dorrell: The right hon. Member for Derby, South's line on fundholding was reminiscent of the line taken by Anthony Crosland on selective schools. Her line was, "We shall get rid of fundholding." The hon. Member for Peckham's words, however, are slightly more
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  honeyed. She says, "We shall replace fundholding." What does that mean? The patients of fundholding practices—they will make up more than half of the patients in the NHS this April—want to know what the hon. Lady would do, were they ever misguided enough to put her in charge of the NHS.
  Mr. Nicholas Winterton: Fundholding has brought immense benefits to the patients in the large village of Poynton in the north of my constituency. I had the privilege to open a new medical centre there that provides, on the doorstep of patients, facilities that hitherto would not have been available and for which local people would have to have gone to the district general hospital. The fundholding practice is working closely with the district general hospital and is providing additional, technologically advanced services right on the doorstep of patients.
  Mr. Dorrell: My hon. Friend is precisely right. He quotes a good example where service has been enhanced, and that has happened not just in the practice in the constituency of my hon. Friend, but across the NHS. When one fundholding practice makes such a breakthrough, others—fundholders and non-fundholders—want to apply the same principles.
  I said that I applaud the hon. Member for Peckham's endorsement of the principles of choice and diversity, and so I do. What I deplore is double standards and two-facedness. This week, the hypocrisy of the Opposition has been exposed. The hypocrisy of choosing selection for themselves while denying that right to others is just the tip of the iceberg. The hon. Lady can be excused for that, but not for the other hypocrisies for which she is personally responsible—the hypocrisy of talking about underfunding, while promising no more money; the hypocrisy of paying tribute to fundholders, while maintaining a commitment to abolish them; the hypocrisy of bewailing management costs, while voting against the abolition of regional health authorities; the hypocrisy of supporting a health authority's right to choose where to commission health care, while arguing that the internal market is wrong; the hypocrisy of arguing that the private finance initiative is right in principle, while arguing that it represents the privatisation of the health service.
  Mr. Stephen Byers: On the question of hypocrisy, the Secretary of State says that he is to launch an attack on bureaucracy in the health service. Can he tell the House why, compared with five years ago, there are 50,000 fewer nurses and 18,000 more administrators?
  Mr. Dorrell: I am getting rather fed up with people taking statistics that they know to be dishonest and misrepresenting them—
  Mr. Byers: Answer the question!
  Mr. Deputy Speaker: Order. The hon. Member for Wallsend (Mr. Byers) asked a question—he should stay silent and wait for the answer. That is a courtesy of the House. We need ordinary and decent manners, and I would be grateful if the hon. Gentleman kept quiet.
  Mr. Dorrell: The hon. Gentleman knows very well that the figures that he quotes rely for their effect on, first,

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  ignoring the build-up of practice nurses in general practices, and secondly, pretending that nurses in Project 2000 are not in training and therefore do not count. As the hon. Gentleman knows very well, like-for-like comparison shows not a cut, but an increase in the nursing work force.
  It has not escaped notice that the loudest cheer this week was that for the hon. Member for City of Durham (Mr. Steinberg) in the Members' Dining Room on Monday night. The simple reason for that is that he spoke for the majority of Labour Members. Those Members are now discovering what stakeholding means for them. It means what the hon. Member for Warrington, North (Mr. Hoyle) said on the lunchtime news about the parliamentary Labour party meeting this morning:
  "We called the meeting. Let us hear the opinion of the parliamentary Labour party.
  "He might have added, "and then ignore it." Labour Members are discovering precisely what stakeholding means for them. It means do what Tony says. "Get up," says Tony, and they get up; when Tony says, "Sit down," they sit down; when Tony says, "Turn right," they turn right and when Tony says, "Turn left," they turn left. Where once there was commitment and passion there is now simply the grin on the face of the leader—a leader who likes to talk about standards in public life.
  Mr. Ronnie Campbell: On a point of order, Mr. Deputy Speaker. Are we debating the health service or the Leader of the Opposition?
  Mr. Deputy Speaker: Order.
  Mr. Dorrell rose—
  Mr. Deputy Speaker: Order. We are debating the health service.
  Mr. Dorrell: We are indeed debating the health service.
  I made the mistake of assuming that the leader of the Labour party was interested in the future of the national health service. It is to him that the difficult questions must how be addressed. He cannot hide behind the hon. Member for Peckham. What we need to know from the leader of the Labour party is whether he will authorise more money for the NHS. Will he support choice and diversity in general practice? Will he wind up fundholding in general practice?
  Mr. David Shaw: Hypocrite.
  Mr. Dorrell: Will he support local managers—
  Mr. Deputy Speaker: Order. Did I hear the hon. Member for Dover (Mr. Shaw) suggest that an hon. Member was a hypocrite?
  Mr. Shaw: I would not want to suggest that at all; it must have been a mistake.
  Mr. Deputy Speaker: The hon. Member did say that. Is the hon. Member withdrawing that remark here and now?
  Mr. Shaw: I certainly would withdraw it if you thought I said it, Mr. Deputy Speaker.
  Mr. Deputy Speaker: Order. I heard the hon. Member say it. Does the hon. Member withdraw it or not?
  Mr. Shaw: I certainly shall withdraw anything that you are not happy with, Mr. Deputy Speaker.
  Mr. Deputy Speaker: Order. Does the hon. Member withdraw the word I heard him say—that the Leader of the Opposition—
  Mr. Shaw: I do—
  Mr. Deputy Speaker: Order. Does the hon. Member withdraw his comment that the Leader of the Opposition was a hypocrite? Does the hon. Member withdraw that?
  Mr. Shaw: I withdraw it.
  Mr. Deputy Speaker: I am most grateful.
  Mr. Dorrell: The questions remain for those on the Opposition Front Bench and most importantly for the leader of the Labour party. Those questions require him to face one way. They require him to convert soft-focus rhetoric into hard commitments. If he fails to do so, we must draw the conclusion that warm words are simply hot air. Today, another opportunity to do that has passed. Yet again, Labour has failed the test.
  5.42 pm
  Mr. Sam Galbraith: I was somewhat disappointed that the Secretary of State spent so little time talking about the health service. I now realise why it is that more and more people within the NHS—
  Mr. Deputy Speaker: Order. I hope that the hon. Gentleman is not criticising the Chair. The whole of the Secretary of State's speech was about the health service.
  Mr. Galbraith: Thank you, Mr. Deputy Speaker.
  I now realise why fewer and fewer people in the NHS listen to the Secretary of State. I was also disappointed that once again he raised the issue of choice under the Government as a result of their changes. The right hon. Gentleman should be aware that, before the Government changes, any doctor, be it a general practitioner or a hospital consultant, working anywhere in the health service, could send any patient anywhere in the United Kingdom at any time.
  The Minister for Health (Mr. Gerald Malone): That was the theory.
  Mr. Galbraith: That was the practical reality. That fact is so. That is no longer the reality and I wish that the Secretary of State would stop going on and on about choice within the NHS.
  Dr. Keith Hampson: What the hon. Gentleman suggests is simply not what happened in fact. For years and years, all hon. Members who represented Leeds, including Opposition Members, complained bitterly about how Leeds general infirmary was swamped by patients. They were sent to it from all over the area, to the point where our constituents in Leeds

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  could not get treatment at our hospital. The hospital received no financial recompense for that. That is not the case now. One thing is for certain; the Labour party will not do any better than the Conservative Government, who, in the past three years, have raised the capital spending of LGI from £8 million to £20 million.
  Mr. Galbraith: The hon. Gentleman reinforced my point by saying that people came from all over to his hospital. That reinforces my argument that choice always existed. Nowadays choice does not exist; one goes to where the contract is made. That is the reality.
  Being a good Presbyterian, I want to start my speech today with a text from the Secretary of State. In The Guardian on 11 January he was reported as saying:
  "It is no good continuing to provide treatment which is out of date, nor rushing to carry out new procedures before they have been clinically evaluated."
  That is an appropriate text, to which I shall return partly in relation to the changes within the NHS. I should like to start by relating it to beta interferon, once again. That drug is at the heart of much of the controversy in the NHS—the controversy does not specifically relate to the drug but concerns treatment rationing and effective treatment.
  When the right hon. Gentleman has considered the subject before, he has sought to make a distinction between rationing and non-use of ineffective treatments. I am extremely happy that he has done so, because he has probably read some of my speeches on the matter.
  In The Herald of Glasgow, of 5 October, I discussed the rationing of health care. I said that the definition of rationing was important and that rationing meant
  "the denial to a patient of treatment that would benefit their physical or mental health, treatment the patient wishes to have and which, in the doctor's judgment, is considered to be medically appropriate. Unnecessary treatment, by which I mean treatment that is of no benefit to the patient, is not included within this definition."
  It is therefore not indicated—that means, to requote the Secretary of State, one should not rush
  "to carry out new procedures before they have been clinically evaluated."
  In that respect, and given the Minister's view, I am really surprised that he is not taking a harder line on the handling of the drug beta interferon.
  Let me explain briefly that beta interferon has been put forward as a treatment for multiple sclerosis—a debilitating disorder for which there are really no effective treatments. It is a disease that in part is considered possibly related to the immune system and slow viruses. One of the possible treatments put forward recently has been beta interferon.
  The drug has been extensively evaluated, and as a result two studies were reported. The first of those appeared in an expedited publication in Neurology in 1993, volume 43, 655–81. A follow-up study was published in Neurology in 1995, volume 45, 1277–85. Those studies have been used as justification for the prescription of beta interferon—an extremely expensive drug. Those studies are what are known as phase 2 trials—a term that I am sure the Minister understands. Those trials do not use definitive end points but are studies used for looking at dose regimes and possible efficacy. They do not prove the worth or value of any treatment. They use surrogate end points such as remission rates and nuclear magnetic resonance scanning and different types of imaging of the brain.
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  Those phase 2 trials showed that, as a result of the drug, there may be an improvement, initially, in the remission rate, or at least a reduction in the exacerbation rate, but that it has no effect on disability at any stage. It is also a stage 2 trial and it is therefore not surprising that the authors, in their 1995 paper, conclude that their results do
  "not establish an effect…in limiting progression of disability. This study was not originally powered to demonstrate a treatment effect on disease progression. At these levels of disability, more patients or longer follow-up, or both, would be required. Accordingly, additional clinical trials will be necessary to evaluate the role of IFNB in preventing disability."
  It is a drug of unproven value.
  I return to the Minister's comment that we should not rush to carry out new procedures before they have been clinically evaluated. This is an expensive drug that has not been clinically evaluated. We should not rush into allowing its general use in the national health service.
  I have raised that point before with the Secretary of State. He says, as do Scottish Office Ministers, that such matters should be decided locally. That is their first line, but it is a dangerous road to go down. The Secretary of State himself recognises that fact; The Independent on 9 January reported his speech to the Manchester business school in which he made the point that there should not be variations in treatment and practice in different areas. He said:
  "We must recognise, in the first instance, that this is a national health service"
  and prevent variations. I agree. Guidance on the matter must come from the centre. That principle should apply to all treatments in the national health service.
  It is not appropriate for separate authorities to make differing decisions about treatment or its allocation. It is not appropriate that people who live on one side of a street are deemed to need treatment but that people who live on the other side are not. The system to decide whether treatment is necessary must be national.
  The Secretary of State will say that different areas must decide on their own priorities. If an area requires increased resources for some disease such as, in my area, carcinoma bronchus ischaemic heart disease, it requires additional resources and not to start cutting back on other necessary treatments. I implore the Minister to consider the matter and give national guidelines.
  The Secretary of State will also say that doctors must be left to make their clinical judgments. I accept that. On a day-to-day, face-to-face, eyeball-to-eyeball basis, doctors should make clinical judgments. However, we do not give doctors total freedom in their clinical judgment. That has never been appropriate and has never been the case. When cardiac surgery came in, we did not make it universally available to anyone who wanted it. It was evaluated nationally and properly. When it became clear that it was of use, we set up, using national guidelines, units throughout the country. That is the way forward.
  Beta interferon is a test of the way in which the NHS works at its best. In other words, we respond to need; we evaluate that need; consider the methods of dealing with it; and, if a treatment is shown to have an effect on that need, we provide it. We must not get into the situation that exists in the United States, where the system is demand led. There, a drug, merely because it has become available and is being pushed by a drug company, suddenly acquires a demand and is prescribed all over the place. The NHS faces a test

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  with beta interferon to ensure that it is prescribed only if it is shown to be effective. We should not duck that through doctor's choice or local choice. It is a decision that only the Government can make.
  Mr. Norman Hogg: I am grateful to my hon. and technically qualified Friend. How can we deal with people who suffer from dreadful illnesses such as multiple sclerosis who are hoping for some remedy? I have seen a great deal of written information that seemed to make claims for beta interferon, but he says that they have not been substantiated by tests. How can we get over the problem of information being published in what seems to be a learned way when it is not true?
  Mr. Galbraith: In this case, we can get over it by allowing it to be prescribed only in the context of a clinical trial. The authors of the Neurology study said that the drug required further study. That would mean a phase 3 study which would be a proper double-blind, crossover controlled trial with proper end-point evaluations. If it were done in that way, we would discover whether the drug was effective. That is the way forward.
  The Secretary of State realises that that is part of what is known in the current phrase as evidence-based medicine. Most people thought that we have always had evidence-based medicine and that it was good medicine. Not everyone practised it; some people practised bad medicine. Evidence-based medicine is not new. If we are to use evidence-based medicine in clinical practice, we must use it in managerial practice in the national health service. We have singularly failed to do that, and it has led, in large measure, to the beds crisis that has occurred this winter.
  The Minister pretends that somehow the beds problem is different. Every year, from time to time, there are beds crises in the NHS. The Minister maintains that it is worse this year than it has been in others. I am not sure about that. I am always wary of figures. Patients get redesignated and reclassified. I have been around several hospitals and I have seen no greater crisis than usual. There simply were not enough beds available.
  That is not a problem by which we should have been surprised. Everyone predicted it because, in making managerial decisions, we had not considered the evidence properly and had made too many snap judgments. We should not have had a winter crisis, because hospitals are usually especially quiet at that time. Patients are decanted from beds over the holiday period and are not taken in for elective procedures. There ought to have been plenty of beds, yet we failed patients. We should examine the reasons behind that. We have closed far too many beds—a decision that was based on a model of bed numbers that was flawed and never subject to decent analysis but propagated on the one principle that we must close beds. Anything that challenged that assumption was ignored.
  It is proper to consider how we can improve the model. That is happening in the Scottish Office and I hope that the Secretary of State will undertake to consider it for the whole United Kingdom. Let me suggest some of the things that went wrong. We have reached the stage where there are not enough beds. It is no good talking about redesignation and having bed managers.
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  Please save us from Philip Hunt of the National Association of Health Authorities and Trusts who came on radio to say that the way to solve the problem of the lack of beds was to appoint another manager. That is the last thing that we need. We need another manager like we need a hole in the head. We need someone to examine the problem. Does the Secretary of State realise what redesignation of beds means? It involves moving patients around the hospital over two or three days. They are often taken out of the ward in the middle of night and placed elsewhere. That is bad medicine for patients and doctors.
  Let us return to the possible causes of the mistake with the beds. First, we did not properly take account of the demographic shift and the fact that older patients suffer more disease. Those diseases add to the number of emergencies.
  Secondly, we did not take account of the effect that community care would have on emergency admissions. The principle of community care is right; I am not going to challenge that. However, many people in care in the community fall sick who would previously have fallen sick in hospital beds, where they were attended by surgeons and physicians in their hospitals and managed in their beds. Now, however, those people present at hospitals as emergencies, which is another factor that was not taken into consideration in the bed model.
  The third factor that was not taken into consideration was early discharge from hospitals. The re-admission rate was simply not included in the calculation.
  Mr. Malone: There is no evidence for that.
  Mr. Galbraith: I hear the Minister of State saying that there is no evidence for that, but I should like him to present me with the facts.
  I am not opposed to early discharge from hospital, which is correct and proper, but we must consider the re-admission rate that is associated with it.
  The fourth factor that was not taken into account was the changing nature of the practice of medicine. In the past, myocardial infarctions and strokes could be managed at home; now they are not and, instead, the patient is taken to hospital. We should have taken all those factors into account.
  The current crisis has come about not because of a lack of emergency beds but because of a lack of beds generally. In our acute strategies, we forgot to take into account all the necessary procedures. There is a similar shortage of intensive care beds. That shortage is not simply due to the fact that there are too few intensive care beds; there are too few acute beds. The way to free an intensive care bed is to move its occupier into a second-line bed. If there are no second-line beds, the patient cannot be transferred from the intensive care unit to a second-line bed. We must reappraise the number of beds; we cannot continue to close them.
  The Government should have a moratorium on all bed closures until we reconsider the bed model and decide on the number of beds in the national health service. In that period, we should undertake a proper study in which we listen to everyone involved and base our decisions on evidence, and only evidence. We shall not base our decision on any prejudice, on managerial diktat or simply on financial grounds. We shall make our decision on the

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  evidence. If evidence is good for clinical practice, it is good for every practice in the NHS and we should follow it through to its limit.
  6.1 pm
  Sir Norman Fowler: I have been taking part in health debates for the past 20 years or so. The speech of the hon. Member for Peckham (Ms Harman) was one of the nastiest speeches on health that I have heard during those 20 years. When the hon. Lady says that the national health service is being "torn limb from limb" by this Government, she is talking the most contemptible nonsense—what is more, she knows it. The hon. Lady's allegation that the health service is being "privatised" and sold off to the private sector is ludicrous, and known to be ludicrous.
  The hon. Lady has succeeded in showing us something else entirely: that the words of the Labour party do not match up to its action—its present action, its action when it was in power or future action that it might take if it were in power. I talk specifically about health, as I believe strongly that the sort of attack the hon. Lady pursued on the Government this afternoon was not only inaccurate, but hypocritical.
  When we debate health, the public are not impressed when the political words do not meet the needs. The pubic want frankness about health care, and a recognition of the problems encountered in any health service system. The public want an explanation of constructive policies. The public wanted more this afternoon than the same depressing mixture of scare and stridency that we received. All we were given was the unappetising sight of the hon. Lady trying to work her passage back into her own political party.
  The hon. Lady was trying, once more, to exploit the health issue. Despite the denials over the past 15 years by successive Secretaries of State for Health, the hon. Lady attempted to suggest that the Conservative party wants to privatise the health service. Attacked for her own double standards, she ascribes double standards to others. I reject that claim, and I return to the division between the Labour party's words and its actions. Let us compare the words that the Labour party now uses on health with the action that it took when it was in power.
  Mr. Michael Connarty: Will the right hon. Gentleman give way?
  Sir Norman Fowler: I am glad that the hon. Gentleman has strolled in. I shall not give way to him, as he has not listened to the argument—I doubt whether it will affect his argument much, but it affects the House.
  I accept that today there are problems involving the accident and emergency units and the demand they face. As my right hon. Friend the Secretary of State and my hon. Friend the Minister of State know, I have raised that issue in the House, as well as the subject of the Good Hope hospital in Sutton Coldfield, to which I shall turn in a moment, as it was raised by the hon. Member for Peckham. I have made criticisms of the current position, and I have welcomed the action that has been taken—including the creation of new operating theatres and the modernisation of the unit. I hope that, in due course, there will be a new admissions unit, provided by the Government.
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  When I intervened in the speech of the hon. Lady, she appeared to cast doubt on the importance being set on that issue at the Good Hope hospital. She quoted a few words from what Tom Dean, the chief executive at Good Hope, had said. As it happens, I have with me the press statement that Tom Dean issued on 12 January, when the Secretary of State and I were at the hospital. The Secretary of State will confirm that his words were not part of our press release, but his own.
  The headline in the press release is "More beds opening at Good Hope". It continues:
  "Tom Dean…said: 'We are continuing to take positive steps to deal with the rise in emergency medical admissions by opening more beds on various wards at Good Hope.
  'Thanks to our recruitment drive for more nurses, we have been able to open another 18 medical beds and six surgical beds this week.
  'Building on the recruitment drive, we expect to open a further 39 beds next month to assist with meeting the emergency needs and to help us catch up on non-urgent surgery.
  'We are looking at ways of increasing yet further our operating lists, particularly for those patients for whom day case surgery is appropriate."
  That press release gives the flavour of what Good Hope hospital and its chief executive seek to do much more than the selective couple of words used by the shadow Secretary of State for Health. We shall want to see the full letter, from which she took just three or four words.
  I hope that hon. Members on both sides of the House will accept that I find it difficult to take the implication or charge that came through in the hon. Lady's speech this afternoon—that the problems of the health service and of the Good Hope hospital have all emerged during the lifetime of the Conservative Government. Anyone who knows the position knows that that is not true.
  In the 21 years that I have been Member of Parliament for Sutton Coldfield, the most agonising health meeting that I have attended—and that I ever hope to attend—was when a consultant at the hospital gathered together his entire waiting list in a local hall to confront the authorities. The authorities that he confronted to protest about waiting lists were not the Conservative Government, but the last Labour Government.
  The biggest problem we have faced in the past 21 years in Sutton Coldfield has been what happened over the much-needed hospital buildings. Those buildings were cancelled because of the capital cuts made by the last Labour Government, which were brought about by the economic crisis. It is all very well to call—as the motion does—for new beds to be opened, but if the Labour party's practice had prevailed, there would have been no question of bringing back beds, because those beds would never have existed. The wards would not have been built. The Conservative Government built the wards in Good Hope hospital.
  That is only one local hospital, but it illustrates the general position. Those of us who remember the health policies of the last Labour Government remember perfectly well that their actions did not remotely match the words that Labour Members use today.
  What about future action? I listened to what the hon. Member for Peckham said this afternoon, and I listened to her in Birmingham town hall in a debate with my right hon. Friend the Secretary of State—and many other people, as it happened—and an audience of about

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  1,000 people. Naturally, the hon. Lady was asked about resources. The only answer she gave was one similar to that which she gave this afternoon—an assault on managers in the health service.
  I am the last person to defend bureaucracy. Indeed, I believe that removing the regional health layer, which my right hon. Friend the Secretary of State is doing, is probably the best way of tackling bureaucracy. Although I oppose bureaucracy, I am emphatically in favour of strong management.
  The general managers that I introduced in the 1980s, following the report of the late Roy Griffiths, were the real start of the health reforms of the present Government. I shall tell the House why those reforms were important.
  In the summer of 1984, there was an outbreak of food poisoning at the Stanley Royd hospital near Wakefield. Perhaps one or two hon. Members remember it. It affected more than 800 elderly patients, and caused 19 deaths. I appointed a public inquiry into the outbreak, and the crucial message that came back was that we needed more hands-on management.
  There was a gulf between those who were meant to be in charge and those who were carrying out the work. According to the report, the so-called managers at the time
  "passed through rather than spent time in the kitchen".
  In other words, what were needed were managers who took responsibility for securing the best service for the patients and who could be held to account if there was failure. That was the overwhelming logic of the Griffiths report.
  At the time, we were opposed all the way by the Labour party on that proposal. We were told that the health service was different from business, and therefore did not need the benefits of management techniques that had been developed in business and in industry.
  Of course the delivery of health care is different from producing cars or selling food, but there are very many common problems that any manager shares. He must be concerned with the quality of service and productivity. He must motivate and involve all his staff, and he must live within his budget. The health service should not be run in any way on a commercial basis, but it certainly must be run in a businesslike way, because that is the sensible way to manage a service of that size.
  Mr. Simon Hughes: I wonder whether the right hon. Gentleman's experience leads him to the conclusion that, however much one might devolve management, the only person publicly accountable by election for the health service in this country is the Secretary of State, so it is the Secretary of State who ultimately must ensure that, when the health service is needed, for example to respond to emergencies, the services are provided—the buck stops there, not with the local management.
  Sir Norman Fowler: The buck ultimately does stop with the Secretary of State. As someone who was Secretary of State for six years, which I believe is longer than most, I bear the scars of the buck stopping with the Secretary of State.
  Mr. Ronnie Campbell: You can see them.
  Sir Norman Fowler: Indeed you can.
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  I agree with the hon. Member for Southwark and Bermondsey (Mr. Hughes) that the buck stops with the Secretary of State, but, before general managers were introduced, we had the totally unsatisfactory position in which, all too often, no one was in charge at the health authority level or the hospital level. That is not the way to run anything, let alone a health service as important as ours.
  I predict with certainty that, if by some mischance there were a Labour Government, they would not abolish general managers. Labour Members have opposed them, but they would continue with them, because no serious figure inside or outside the health service wants us to return to the old system.
  It is not only in the past or the future that the words of members of the Labour party do not match their actions. The Secretary of State was at the Good Hope hospital when it was announced that more beds were being made available. However—this really is an argument for the hon. Member for Peckham—a couple of miles away, in another part of Sutton Coldfield, the Labour-controlled Birmingham city council is closing altogether a 40-bedded, purpose-built residential home for old people, the Frances Withers home. It is transferring to other accommodation, if it can, residents aged, on average, in their late 80s and 90s.
  The read-across from that is quite clear. Elderly people account for more than 40 per cent. of the cost of the national health service. If the council takes such facilities out of operation, we all know what will happen—sooner or later, the strain will be taken by the national health service.
  I am not the only one who opposes that policy. It is opposed by the residents, it is opposed by the relations of the residents, and, perhaps most vociferously of all, it is opposed by the trade union Unison on behalf of the staff.
  Why is the home being closed? Birmingham city council has a budget of about £1.2 billion. It spends almost £190 million on social services, yet it cannot find a small cost to keep that home open. It has wasted millions of pounds—there is no doubt about that—on maladministration in the housing benefit system. It is unable to find the modest resources necessary to keep open a purpose-built home, built only 20 years ago, with good single rooms for residents, an exceptionally quiet and safe position, and an excellent sheltered garden, which is in every respect an excellent place for elderly people.
  I find the arguments for that policy extraordinary. The council says that, together, Sutton Coldfield and Erdington constituencies have the second greatest provision of residential accommodation in the city of Birmingham, and that has become an argument for closing down the home. The council cites the cost of refurbishing the home, yet—I toured the home myself again last Friday—there is considerable doubt whether any refurbishment is required.
  The television cameras and the media have camped outside Good Hope hospital, and I make no complaint of that. I have, as the Secretary of State knows, been outspoken on behalf of my local hospital. I hope that the same television cameras will portray what is happening in the Frances Withers home. I hope that they will portray a home being broken up. I hope—
  Mr. Connarty: Will the right hon. Gentleman give way?
  Sir Norman Fowler: I will not give way, as I am just ending.
  I hope that the cameras will portray how old people are being transferred from one part of the city to another, often far from their relations. I hope that they will portray the way in which a purpose-built home is being vacated. Let no one ever forget that that policy is being instituted and carried out by a Labour-controlled council.
  So the hon. Member for Peckham—
  Mr. Connarty rose—
  Sir Norman Fowler: I will not give way.
  If the hon. Member for Peckham wanted to interrupt me, she might have remained in the Chamber. I regret very much that she has not done so.
  The hon. Member for Peckham has succeeded in opening a debate. It may not be the debate that she intended to open in the glad morn of last Wednesday, when the subject was decided for today's debate. The debate that she has opened is about the difference between the Labour party's words and its actions. Conservative Members look forward with enthusiasm to joining that debate.
  6.19 pm
  Mr. Simon Hughes: The first two speeches in the debate today have shed much heat but very little light on the subject. The hon. Member for Peckham (Ms Harman) moved the Opposition motion on the national health service. It contains some good ideas, including the suggestion that each health authority should nominate a person to identify bed shortages, that there should be a regular report on bed numbers, and that national guidelines should be introduced to clarify who pays for continuing care. The motion is strong, according to the hon. Lady's own diagnosis, but we know that we seek a diagnosis only in the hope that we shall receive a prescription, and the hon. Lady certainly offered very little in that regard.
  The Opposition have many questions to answer. For example, the hon. Lady referred to the difficulty that people have securing dental treatment, but she did not tell us whether Labour is committed to restoring free dental checks. The hon. Lady and her colleagues regularly refer to the difficulties facing opticians, but she did not announce that the Labour party is committed to providing free eye tests. The Opposition complain every year when prescription charges increase, but they never confirm that they would freeze or reduce those charges.
  The Secretary of State is correct when he says that we do not know whether the Opposition are for or against fundholding, the private finance initiative or increased money for the health service. Until Labour Members answer those questions, there will be no prescription—which is always more difficult to provide than a diagnosis.
  The Secretary of State conceded that the health service has experienced some problems recently. He conceded that the demands on the health service have increased during the winter months, but he did not tell us whether the health service is coping with that demand, and he certainly did not tell us how he will ensure that it copes
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  in the future. The Government amendment congratulates NHS staff on their hard work and dedication. The staff are certainly working hard, but I intend to cite some facts which show that they are not very happy about their status or about the work they are asked to perform.
  The number of practitioners has increased in some areas, but decreased in others. In some areas, there is a dearth of people who are ready and willing to do the necessary work. The Government's figures show that their commitment to a year-on-year increase in real resources—we have debated the subject twice in this place in the past few months—will be barely attainable in future years.
  The health service needs to develop three fundamentals in order to secure its future. It needs a working structure which will hold the health service together; it needs adequate funding to do the job; and it must be run effectively in order to improve staff morale. Although we do not need many further significant administrative changes within the health service, many areas that are clearly unsatisfactory could be vastly improved without uprooting or disrupting the service as a whole.
  For example, from April we shall have regional outposts and regional civil servants, but no regional health authorities. The Liberal Democrats have long argued against separate regional health authorities. We believe that elected regional representatives should operate the strategy that determines the health service at a regional level. At a local level, the health authorities are appointed by the Secretary of State. That is not a democratic process, and my party has now agreed that health commissioning should be carried out by local government, in the same way as it carries out the commissioning and practice of social services.
  Change is necessary in order to democratise the health service. I make it clear to the Minister that that does not mean any alteration in the purchaser-provider split; nor does it signal an end to fundholding. We believe that everyone should be a stakeholder in the fundholding and a partner who is able to buy the service—
  Mr. Charles Hendry: Barmy.
  Mr. Hughes: It is not barmy, and it is not a new idea. It has been advocated for a long time by eminent people on both sides of the House, and by others such as J. K. Galbraith.
  Having improved the structure of the NHS, we must then address the question of funding. Whatever the complex causes may be, the perception on the ground is that the funding and resource needs of the health service cannot be met only by the redistribution of resources within the service. It is not sufficient to cut the high salaries and the perks of managers, although that should be done. It is not sufficient simply to reduce the number of managers and put more staff on the front line, although that must occur also. The health service has a more fundamental need, as has been evidenced in the past few weeks by a shortage of doctors, nurses and support staff.
  Elements of the recent crisis have been publicised in the newspapers, which carried stories about people being flown around the country in search of hospital beds—in one case, it involved an airman from the east coast. It was clear that emergency services were not available. I was told at the beginning of the week that Guy's hospital in my constituency needs 40 intensive care nurses.

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  In practices all over the country, people are being told that the resources are simply not available, and that they cannot be recruited.
  Mr. Hayes: I accept that the hon. Gentleman is totally sincere. However, I refer him to his suggestion that persons elected from local authorities should serve on health authorities and trust boards. That idea was declared unworkable by Nye Bevan, and the leaked document describes it as "barmy". I suspect that it was declared unworkable and barmy because, under the present system of appointment—there are many Labour and Liberal Democrat as well as Conservative appointees—party politics is buried once the parties are around the table taking decisions. That is good for health care.
  Mr. Hughes: I know that the argument is not cut and dried. No one wants to see health authority policy hijacked for party political aims. I shall conclude my speech by suggesting how we can behave slightly more intelligently in that area than we have of late. We should not shout at each other across the Floor of the House. The people are not well served by party political appointees who seek to advance an imperfect manifesto. No one has the benefit of complete wisdom.
  However, I do not accept that no one should be elected, and that all members should be appointed by the Government. Of course they will appoint people of different political persuasions in order to make it appear a balanced exercise, but at the same time they will continue to appoint their own people and those who are politically neutral. That gives the Secretary of State enormous power and leads to a lack of accountability to the patients, which is entirely inadequate in the case of a public service. The service is funded with taxpayers' money, and people expect to have some control over that expenditure.
  Many problems remain in the family doctor service, including inadequate out-of-hours service and inadequate deputising services in many areas. Doctors cannot be recruited in many urban areas, and the quality of doctors is also an issue. People often find it difficult to register with a doctor, and they may be thrown off a doctor's list even though they have not found a replacement GP. We have not yet resolved the controversial issue of how often doctors should be allowed to dispense.
  Doctors certainly believe that they are under increasing pressure. My colleagues have surveyed doctors around the country, and I shall refer to the views of doctors in three areas. My colleagues in Hazel Grove—an area south of Manchester, which I know well—conducted a survey of general practitioners in the autumn, and discovered that 70 per cent. of those who replied wanted to change profession or take early retirement. Eighty per cent. of GPs said that they were unhappy with the state of their profession.
  Colleagues in Cornwall made a similar survey, and in Devon morale among GPs was so low that new jobs in Torbay are attracting only two out of three applications, compared with 40 out of 50 a few years ago. In Cornwall, the county of the hon. Member for Falmouth and Camborne (Mr. Coe), the local medical council chairman, Dr. Andy Stewart, said in response to a survey by the hon. Gentleman's prospective Liberal Democrat opponent,
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  Terry Jones, that 20 out of 320 GPs surveyed were receiving psychiatric care because of the stress caused by long hours and other work-related problems.
  My colleague in Liverpool, who is a prospective candidate, also undertook a survey.
  Mr. Malone: Was it a similar survey?
  Mr. Hughes: Of course, and it comprised straightforward questions. I shall willingly show the Minister the results. When all the results are collected, I will let him have those because the issue is hugely important. Thirty per cent. of Liverpool's doctors are thinking of earlier retirement. Morale among GPs at the front line of the health service is severely low; that bodes ill for the future unless immediate action is taken to remedy it.
  Mr. Sebastian Coe: I hope that the survey by one of the hon. Gentleman's colleagues in my constituency had slightly more intellectual and numerate rigour than the Liberal Democrat survey in Devon and Cornwall. Under scrutiny in a debate in this Chamber only a few weeks ago, the Liberal Democrats had to accept that the response rate barely bordered on 25 per cent.
  Mr. Hughes: I am perfectly happy to deal with the figures. I remember that debate, and I have read it. Various surveys have been undertaken in large areas, if not throughout the country. The response rate varied. In some places it was one quarter, and in others well over 50 per cent. There is no secret—I can give the hon. Gentleman the figures. I hope that he shares my concern that the trend, which is identical or similar throughout, is for large numbers of general practitioners to say that they are overworked, over-stressed and thinking of retiring early, and cannot recruit to their practices.
  A practice just around the corner from my house is having great difficulty recruiting. I asked another practice in my constituency today, so that I could not be accused of giving outdated information. It stated that it is under huge pressure because of lack of resources. It was told that there would be adequate resources for care in the community, but there are not.
  The practice informed me, for example, about a lack of bathing facilities and care assistants. It knew of more than one person who has been waiting three years for a bath seat. Standards of care are often considerably reduced because there are not the people to deliver them.
  I do not rejoice in that situation, but state facts rather than speak rhetorically. Those facts suggest that something is substantially wrong. We all have a responsibility to respond.
  Mr. Ray Whitney: We all want facts, not rhetoric. Does the hon. Gentleman have any comparable statistics of that claimed low morale in the medical profession during the Lib-Lab pact, when morale was distinctly low? I do not have any such figures, but it would be interesting to compare them. Is the hon. Gentleman aware that, in the past 10 years, the average GP list has been reduced by 9 per cent, which is difficult to square with the high stress to which the hon. Gentleman referred.
  Mr. Hughes: I was not here in the time of the Lib-Lab pact, but I remember the issues and debates. The former

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  Secretary of State, the right hon. Member for Sutton Coldfield (Sir N. Fowler), said that the health service suffered significant cuts and waiting lists under the Labour Government at that time. That is a matter of record, and I remember it well. I do not doubt that the health service in the late 1970s was badly sapped of morale. We are debating the health service today, and I want to respond positively because we have an obligation, between us, to prepare the service for the next century, when there will be more demands than now.
  There will be no bottomless pit, no matter which party is in government and who is Secretary of State, any more than there is now. The Secretary of State was right to point out that there will always need to be rationing of health care, and we would be fools to ignore that fact. Rationing has always happened—at some times by long waiting lists, at others by clinical choices. We owe a duty collectively to our citizens to resolve three questions—as the hon. Member for Broxbourne (Mrs. Roe), who chairs the Health Select Committee, knows.
  First, what are the health service's boundaries of responsibility? The original legislation and current legislation do not accurately define them. The right hon. Member for Sutton Coldfield gave an example of care in the community, where free service at the point of delivery may no longer be available. We may enter the area of community care or social services. Redefinition is a difficult debate, but we must address it.
  Secondly, we must address how we make choices among competing priorities for funds that will always be insufficient to meet the needs to which the NHS would like to respond. We may need to be rigorous about eliminating work that does not have proven clinical value. If I may be controversial, the famous case of Jennifer's ear was probably an example of work that did not have proven clinical value.
  Thirdly, we should seek to agree the minimum public funding needed to guarantee a comprehensive health service in all four countries of the United Kingdom that is free at the point of delivery and accessible to all our citizens.
  Those difficult-to-answer questions are ideally suited to the exercise of that which, from this week, I am required to call partnership politics. The people—patients, actual and prospective, professionals and politicians—should begin a dialogue to reach agreement. Just as there used to be bipartisan agreement on pensions policy, if we are to hold on to a national health service we will require a bipartisan or multi-partisan agreement on health service policy.
  The best guarantee for the future of the health service in the next century, with more older people to be treated and more high-cost medicine, is renewed commitment to the service's principles and agreement on paying for its practice in a way that accommodates those greater demands. I hope that the Secretary of State and his colleagues, and those who speak on health matters for Labour, agree that they should have such a dialogue with me and my colleagues and others in the House. Otherwise, we shall have the same sort of shouting match as we have seen this afternoon, which does not advance the cause of patients one jot.
  6.37 pm
  Mrs. Marion Roe: I am pleased that the House has the opportunity to debate the state of the national health service because I want to draw attention to the work
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  that the Select Committee on Health, which I have the honour to chair, is currently undertaking in respect of long-term care—an issue of enormous importance in future policy and direction and to the public.
  How the disabled elderly are to be cared for and who is to pay for that care is a question that affects us all potentially. Last November, the Committee published the results of phase 1 of its inquiry, which considered the implications of Department of Health guidance on NHS responsibilities for meeting continuing health care needs. That report was unanimous, and I thank all my colleagues on the Committee for the constructive way in which that topic was discussed. It was a very good advertisement for the Select Committee system. We are now well into phase 2 of our inquiry, which is considering the potential demand for long-term care in the future and the possible consequences of funding arrangements.
  I shall begin by outlining the main conclusions in our report and the main points of the Government's response, which was published yesterday. The Select Committee has not yet had an opportunity to discuss the response, so I shall give my own personal view. I will also touch on the main issues that we are considering in phase 2 of the inquiry.
  The Select Committee was pleased that the Department of Health had recognised the need to clarify NHS responsibilities for continuing health care services. We commended the Department for the extent to which it was able to accept views expressed during its consultation period. Nevertheless, there were some areas where we thought that further clarification would be helpful for the NHS, for local authorities and also, of course, for the users of those services.
  The guidance calls on health authorities to develop local policies for purchasing continuing health care services. All the members of the Select Committee were struck by the desire of witnesses that health authorities should not focus solely on the important question of defining eligibility criteria for NHS continuing health care, but should also ensure that the full range of high-quality continuing health care services is available to support people in their own homes for as long as possible. I am pleased to note that the Government strongly agree with our sentiments.
  The Select Committee shared the concerns of many witnesses who argued that locally set eligibility criteria might create unacceptably wide variations in the provision of NHS services. We recognised that the Department of Health's guidance provided a framework which went some way towards meeting those concerns, but on the grounds of equity we recommended that the nationally set framework should include eligibility criteria for long-term care so that it is absolutely clear what the NHS, as a national service, will always provide.
  I am also pleased that the Government, in their response to our report, agreed that the current variation in continuing health care arrangements needs to be addressed. The Government have also committed the national health service executive board to reviewing, during the coming year, how eligibility criteria are operating in practice and to issuing further guidance on priority issues relating to eligibility criteria, which may, in effect, lead to the national criteria that we called for in our report.

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  The Select Committee felt that it was important that patients, together with their families and carers, should be left in no doubt as to the circumstances in which health authorities rather than local authorities will be responsible for purchasing continuing care services, especially nursing home care which, as the House will be aware, can be purchased both by health authorities and by local authority social services departments. We were not convinced that the Department of Health's refusal to provide information on the types of cases that might be expected to come within the eligibility criteria was justifiable. We therefore recommended that the Department of Health should prepare illustrative case studies and widely disseminate them.
  I am pleased that the Government have recognised the strength of our case by accepting in their response that there is value in health authorities testing their eligibility criteria against case studies. I fear, however, that the members of the Select Committee will be disappointed that the Department of Health is still only considering whether it would be helpful to issue the kind of illustrative case studies that we call for. In our view, those are clearly necessary to help members of the public to understand their position.
  Our report also recommended that the Department of Health should introduce a national long-term care charter, which would specify the minimum levels of provision that people could expect from health authorities, NHS trusts, GP fundholders and local authorities. It would also specify access to a named range of services, a minimum list of specialist equipment and home aids, time limits for assessment, and provision of services where need is identified.
  The Government have told us that they have not reached a final decision on whether to issue such a charter, which would cover some of the ground already covered by the forthcoming local community charters, but that before April they will issue a national leaflet on long-term care. We look forward to seeing that.
  The guidance issued by the Department of Health also deals with hospital discharge arrangements for patients who are assessed as not requiring further NHS-funded continuing health care. The Select Committee recommended that health authorities and NHS trusts should not discharge patients home without a package of care being prepared, which can be demonstrated to meet their assessed needs fully and, as far as possible, agreed in advance with them and their informal carers. We also called for NHS-funded patients entering a nursing home to have the right, subject to the necessary clinical and financial conditions, to choose their nursing home—a right which currently exists for local authority-funded patients in nursing homes.
  The Select Committee welcomed the proposed establishment of independent panels to which patients being discharged from hospitals, who are not to be funded by the NHS, can appeal. Those panels will provide an extra safeguard for patients facing important and sensitive decisions about their future. We also urged the Department of Health to clarify the arrangements under which those panels would seek independent clinical advice. We also recommended that the right of appeal to the review panel should he extended to all patients
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  assessed as requiring nursing home care, wherever they live, when that care is not to be funded by the NHS, and that the right of appeal should not be restricted to those being discharged from hospital.
  I am pleased that the Department of Health's further guidance on the review procedure makes it clear that patients, families and their carers have the right to request a second clinical opinion, which should be offered routinely before their case reaches the independent review panel. However, it is disappointing that the Department of Health has not clarified our concerns about how the provision of independent clinical advice to the review panel can be conducted fairly from the patient's point of view, if an opinion is to be given only on whether the clinical judgments made match the health authority's eligibility criteria, rather than on the clinical diagnosis, management or prognosis of the patient.
  The Select Committee warmly welcomed the decision that implementation of the new guidance should be one of the six national priorities set by the Department of Health for the NHS over the next three to five years. We called upon the Department of Health to set firm target dates for the completion of NHS reinvestment programmes by all those health authorities whose reviews indicated a need for such a programme. We also considered that to aid public confidence in the equity of access nationally to NHS-funded continuing health care, the Department of Health should publish the outcome of its review of individual health authorities' policies and eligibility criteria and outline the action that it would take against any authority which significantly departed from the national framework. I welcome the Government's assurance that health authorities will have to publish plans clearly setting out the target dates for completion of any necessary reinvestment programmes; and the Committee will look to the NHS executive to monitor health authorities closely to ensure that the policies are fully implemented.
  I should like now briefly to outline how the Select Committee is taking forward its work on long-term care in phase 2 of the inquiry. Many of our witnesses have commented on the need for the Government, Parliament, providers and the public to participate in a far-reaching debate about the future of long-term care provision and funding. We hope that our Committee is currently stimulating that debate. We are considering what models of care exist for long-term care services, and we are further examining the differing models of care which can meet future demand for long-term care.
  Some of our earlier witnesses stressed the potential impact that health promotion might have on reducing demand, while others drew attention to the potential offered by further investment in rehabilitation services. We are also considering who should manage long-term care.
  An aging population is a widely recognised phenomenon throughout most of the developed world, including the United Kingdom. The state of health of older people is also a key determinant of the need for, and hence the cost of, long-term care. We shall therefore be considering the cost implications of long-term care, given projected demographic trends, and whether talk of a demographic time bomb is realistic or alarmist.
  We have been exploring the question of whether longer life expectancy is likely to lead to longer periods of illness and disability, in addition to other factors which may impact on the demand for long-term care, such as changing social and demographic conditions.

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  Whatever the scale of the likely increase in demand for long-term care, one thing is clear: it will have to be financed from one source or another. Where the balance of responsibility for funding as between the individual and the state should lie is being debated in just about every western country, as well as in many Asian countries. It is probably true to say that this issue potentially eclipses in its future importance every other issue that we daily discuss in this House. I hope to be able to address the House on this subject again in the near future, when the Select Committee has produced its final recommendations.
  6.52 pm
  Mr. Joe Benton: I begin by thanking the shadow Secretary of State for Health for her excellent exposé of the state of the health services as they affect my constituents in Bootle and Merseyside. She particularly drew attention to the shortage of beds—a factor highly relevant to my part of the world.
  I could not help pricking up my ears when I heard the hon. Member for Broxbourne (Mrs. Roe) refer to case studies. As she is Chair of the Select Committee on Health, I would like her to consider three case studies that I shall offer the House tonight, if the House will bear with me. I shall use them to illustrate and identify what is going on in hospital care in my part of the world. That is why I am asking the hon. Lady to take my case studies forward.
  The first concerns Mrs. K. Larkin, who was diagnosed as having cancer and taken to Fazakerley hospital on 26 October. She was admitted at 2 pm and remained in the reception area until 8 pm without food or drink. Her daughter had to ask for a blanket to cover her up. Only after repeated requests from her family was she even given painkillers. She was later discharged and eventually died at home.
  The second case relates to Mr. J. Molloy, another constituent of mine. On 16 January 1995 he was taken by ambulance to Fazakerley hospital, to which he was admitted at 1620 hours suffering from internal bleeding due to a duodenal ulcer. He was kept waiting in the reception area on a trolley for some seven hours and 10 minutes, before being transferred to a cubicle where he was later visited by a doctor, some eight and three-quarter hours after being admitted. He was then taken to a ward at 0320 hours the following morning.
  The third case will take a little longer to deal with, but I should like the House to hear it. Mr. Barlow, now unfortunately deceased, was terminally ill with cancer. He was admitted to Fazakerley hospital, following a referral by Dr. Krasner, for the purpose of alleviating a restriction in his throat. He arrived at the hospital at 1.30 pm and proceeded to ward 12 as requested, where he waited for a doctor. After an hour, he asked the nurse when he would be seen and was advised that the doctor was on his way. Much later, because there was a bank holiday pending, he was advised that there was little point in his staying because he would not be seen until after the bank holiday.
  Mr. Barlow arrived back after the bank holiday and was admitted to the ward at about 8 am, only to be told that no bed was available. A computer breakdown was blamed. He was given a trolley bed and placed in the store room of the hospital among boxes of syringes, dressing packs and other medical appliances and equipment. That afternoon he was taken to theatre and given a general anaesthetic. He was assured that he would be placed on a
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  ward on his return from the theatre. Mr. Barlow came round from the anaesthetic somewhat disoriented and found himself back on a trolley bed in the same store room—aware that he still had a blockage in his throat. He could get no clear information about what had happened from nurses or ward doctors.
  Those are three real cases: they actually happened. The situation in Liverpool's hospitals has been rightly described as critical. Indeed, so bad is it that my hon. Friends the Members for Liverpool, Walton (Mr. Kilfoyle) and for Knowsley, North (Mr. Howarth) went with me to meet the trust. Earlier, the Secretary of State talked about referring cases to Ministers individually. All Merseyside Members have referred individual cases to the Minister, but we have had no satisfactory response: we are always referred back to the trust.
  This has caused a terrible crisis of confidence throughout Merseyside. The sad fact is that the older one gets, the less confidence one feels about going anywhere near a hospital. I should be grateful if the Minister would answer today the questions that I tried to put earlier in the debate. The Secretary of State today mentioned certain parts of the country where new beds have been created. Exactly what beds have replaced those lost by the closure of Walton hospital in Liverpool? Will he also say why, when we refer individual cases to the Department of Health—contrary to what the Secretary of State said earlier—he will not deal with them as a matter of urgency, but simply refers us back to the trust, which is self-defeating and gets us absolutely nowhere?
  It is clear that there is a crisis in the health service. I am not a dinosaur. I am quite prepared to listen. I know of the problems of funding, and I am prepared to look at that and to have an open mind. What I and my colleagues insist upon, however, is that we have a national health service of which we can be proud. I remember its inception when I was a young boy, and I remember the great relief that it brought to families such as mine. Instead of having to pay for doctors and services, we had the national health service. It is one of the greatest treasures that this nation has and justifies our putting the adjective "Great" in front of Britain. That is what I think of the health service. I am prepared to look at all sorts of ideas so that we eventually come up with a national health service which provides the necessary service at the point of delivery and does not mean people being stuck on trolleys for nine hours at a time in hospitals up and down the country.
  Before the hon. Member for Broxbourne leaves the Chamber, I ask her to take to the Select Committee the case studies that I have given. Let us see what the Committee has to say. If any Government fail to provide a proper national health service at the point of delivery, they will bring the country down. I believe in the framework of a Christian state, and that framework means a wholesome national health service that is available to everybody.
  When the Minister replies, I very much hope that he will answer the questions that were posed by my hon. Friends earlier. We are dealing with a very serious matter, and we shall be failing many people if there is any further deterioration or exacerbation of the crisis that exists in the health service.
  7.1 pm
  Dame Jill Knight: The hon. Member for Bootle (Mr. Benton) is not the only one who seeks to have a Christian basis in life. Nor does any party,

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  on either side of the House, have any right to suggest that it is the only party with a Christian base. It is extremely unfair to expect the Minister for Health, or, indeed, the Secretary of State, when he has had no warning whatever about Mr. Jones or Mrs. Brown having received this or that kind of treatment, to know instantly the circumstances surrounding the case, when there must be hundreds, if not thousands, of hospitals in this country. That would be totally absurd. I understand that the hon. Gentleman has not had the experience, but surely a little thought would have shown him that it is simply not reasonable to expect the Minister, who is in charge of the biggest business in the whole of Europe, to know every last detail about every patient in every hospital. He simply could not do that.
  Mr. Benton: Of course, I do not expect the Minister to be able to reply in detail to every individual case, but it was the Secretary of State who said earlier that individual cases should be referred on an individual basis. I presume that by that he meant, referred to him. I—and my colleagues who represent constituencies in Merseyside—am tired of referring individual cases. I thought that I made that point clearly and lucidly. We are getting nowhere.
  Dame Jill Knight: The hon. Gentleman is not being realistic at all. Obviously—I wish that he would listen to what I am saying—no Minister or Secretary of State for Health could possibly be expected to know all the details of all the patient cases in all the thousands of hospitals in this country. When a single case is referred to a Minister, he has no alternative but to make inquiries of the health authority that covers the hospital where the patient is having treatment. There is no other possible way to deal with the matter. I suggest that the hon. Gentleman is being a little unreasonable to suggest otherwise.
  I did not, although many hon. Members did, seek to intervene during the opening speech of the hon. Member for Peckham (Ms Harman). It was not because I was not burning to do so—indeed I was—but because I did not know which point to pick her up on. A clear reply could have been given to every single one of her questions. I shall not prolong my speech by answering all the points that she raised, but I wish to raise a particular point.
  The hon. Lady poured scorn on the Government's interest in involving the private sector and competition in the health service. Only last week—this is not old hat, either—I tabled a question, which, sadly, was not reached during oral questions, and how many of us have had to deal with that disappointment? My question read:
  "To ask the Secretary of State what estimate he has made of the annual saving to the NHS arising from compulsory competitive tendering."
  The written reply was:
  "As a result of market testing, it is estimated that since 1983 the national health service has been saved a total in excess of £1 billion".—[Official Report, 16 January 1996; Vol. 269, c. 548.]
  That saving is the result of competition being introduced and the private sector being utilised. What interests me about that is that every penny of that sum has gone to patient care. Had that action not been taken, there would have been £1 billion less for patient care. We can assume only that were, God forbid, a Labour Government to be elected and to take control of our health service, we would no longer have such savings. I have no doubt whatever
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  that patients would suffer badly. It should be clearly on record that the Government's determination to save money and to use every sensible method of competitive tendering is a good idea.
  Mrs. Anne Campbell: Will the hon. Lady give way?
  Dame Jill Knight: Other hon. Members want to speak, so if the hon. Lady will forgive me, I shall hurry along.
  I am putting this on record, because it is true. Our health service has never been as good as it is today. For every one of the cases that the hon. Member for Bootle mentioned, I can tell him of 10, 20 or 30 patients who were very satisfied with the care that they received. Many of them have written to me about it. I have a file from people who wished to tell me how satisfied they were with the care that they received. Never in our history have so many doctors treated so many patients for so many ills with so few failures. Indeed, they are carrying out miracles, when I look at some of the cases of tiny babies being operated on today who would have died only a few years ago.
  There are such cases not just in Birmingham, but throughout the country. Hip replacements are now carried out as a matter of common practice. Twenty years ago, transplant surgery was unheard of on its present scale, but it is now widespread. Consider how miraculous that is and the benefits that it gives. Nowadays people have not one heart bypass but triple or quadruple heart bypasses in one operation. Our clever doctors have never served the people so well. Our health service has never been as miraculous as it is today.
  The second basic truth to which Opposition Members should listen carefully is that no Government of any political colour will ever be able to ensure that every single patient is treated for every single ill, in the hospital of his choice, by the consultant whom he prefers, the instant that the need arises. That may be a good goal for which to strive, but it ain't gonna happen because it is impossible. We can work towards it, but it is unlikely to be achieved, whoever is in power.
  In Birmingham, we are grateful for the excellent health care available. However, Opposition Members have taken care to dwell on the few times when things do not go right rather than the thousands of times when they do. The newspapers are the same. I am aware that editors believe that only bad news sells papers, but I wish that they would not lie. A recent story in Birmingham referred to the huge loss of beds in Birmingham hospitals.
  Incidentally, I was worried to deduce that the hon. Member for Peckham must have misled the House when she read a portion of a letter this afternoon. I know that my right hon. Friend the Member for Sutton Coldfield (Sir N. Fowler) will have been disappointed that she was not present during his speech, because he also had information from the same official. The information that my right hon. Friend gave me was almost directly opposite to that given by the hon. Lady, so one of them must be wrong and we should be told which one. My right hon. Friend, who has been a Secretary of State, had the information in front of him and he read some of it.
  I do not believe that the Birmingham health authorities are lying when they say:
  "Claims in the local press and elsewhere, that there has been a huge loss of beds across Birmingham hospitals are not true."

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  We should at least have the truth, and the authorities that are in charge say that such claims are not true.
  It is right to recognise—nobody referred to this when talking about the lack of hospital beds—that many patients today are dealt with in day care facilities. Surely we do not need the same number of beds when thousands of patients are dealt with in the course of a day. I also welcome that advance, which medicine has given us.
  The substantial investment in our Birmingham hospitals should be acknowledged. The Queen Elizabeth hospital has had a new neuro-science unit at a cost of £7.2 million, a cancer centre will open shortly at a cost of £8.5 million and there is a £30 million budget for improving theatres and wards. At Selly Oak hospital, £7.5 million has been spent on a new accident and emergency trauma unit and £2 million has been allocated for upgrading the outpatients' department. That was certainly needed, but £2 million is a lot of money. City hospital has had £7.2 million for a high-tech eye unit and £1.4 million for the upgrading of the accident and emergency unit, and it is also to have a new dermatology unit. Such figures are exceedingly encouraging.
  Birmingham Heartlands, Good Hope and the Children's hospital have had £34.7 million between them. We also have a miraculous new women's hospital costing £17 million, for which we in Birmingham are grateful. All in all, Birmingham health authorities now have a budget of £600 million. That is one city—an important city, but one city.
  Why will the Opposition never tell us whether they will put any more money into the health service, or even whether they will put as much money in? We just do not know. But those are the cold, hard facts and they are true. Of course, difficulties and problems can arise and they do, but there could not be a better sign of Government commitment to the health service than the fact that one city alone has had £600 million for the improvements that are needed.
  I am rather tired of the unjustified criticisms made in the debate, which are constantly made, for reasons that can only be political. A favourite grumble is that too much is spent on management. My right hon. Friend the Member for Sutton Coldfield pointed out that inefficient management in the health service leads to bad patient care. However, I want to put on record the fact that Birmingham spends less than 3 per cent. of its resources on management—less than 3 per cent. That is not a waste of money on large cars and all the rest of it. In addition, there is no trace of self-congratulation when Birmingham says:
  "We know there is further room for further improvement and we will go for it."
  I am sure that the Government feel the same.
  Finally, I want to make two suggestions for the improvement of health care, particularly for the elderly. Too often in hospital, the elderly are robbed of their dignity. That occurs in two particular ways, which have been brought home to me, about which the previous Secretary of State tried to do something.
  Many people hate being in a mixed ward. We understand that intensive care is a different matter because people are often unconscious. But men and women do not want to be mixed up in an ordinary hospital ward, and they should not be. It takes away their dignity and it is wrong.
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  There is also far too much taking away of elderly people's dignity by immediately referring to them as Betty, Jim or Bill. That may seem a small thing, but it is not. That surprises younger people, but I have known many elderly people—hon. Members know that there is validity in what I say—who feel a loss of dignity if they are addressed by their Christian name, often by nurses and doctors young enough to be their grandchildren, if they are not used to it. That is hurtful and there is no need for it. Surely to goodness we could recognise that every scrap of help that we can give our patients to preserve their dignity as well as their health should be made available.
  With those two suggestions, I strongly support the amendment and I hope that it is carried.
  7.18 pm
  Mr. Ronnie Campbell: Listening to some Conservative Members, one would think that the health service was safe in their hands, but the complaints that I have received and the troubles about which I have heard during a number of years under this Administration suggest otherwise. As a member of the Select Committee on the Parliamentary Commissioner for Administration, I know that there has been a large increase in the number of complaints about the health service.
  I recognise that more operations are carried out now than ever before as a result of improved techniques. A person can go into hospital one day and come out the next, whereas a few years ago, he might have had to stay for a week. That, however, does not account for some of the horror stories that my hon. Friends have told. I have heard such stories myself, particularly in relation to a hospital in my area, the Cheviot and Wansbeck hospital.
  Originally, a hospital was built in the constituency of my hon. Friend the Member for Wansbeck (Mr. Thompson), at considerable cost. Another hospital existed on another site, but, although still operational, it was run down and in a decaying state. The new hospital became a trust shortly after being opened, despite suggestions that it should not take that step too quickly. Lo and behold! In that first year of its existence, it was in debt to the tune of £2.5 million. That is when the problems started.
  Two mothers are currently taking legal action against the hospital because they lost their children, which was undoubtedly due to neglect on the part of the hospital and, in particular, the maternity ward. I do not know what progress their cases are making, as legal action is a lengthy process. One of those patients is a constituent of mine; the other is a constituent of my hon. Friend the Member for Wansbeck. My constituent was left in the maternity ward. After her waters broke, she was left again. Although obviously in labour, she was left for hours with no one to tend her. Finally, someone came along and found that she was in labour—as she had been for some time. As it was her first child, she did not realise what was happening. The child was born, and taken from her; when she woke up, the doctors told her that it was very ill and that there was not much hope. The baby subsequently died.
  The moral of that story is simple. As I said, the hospital had been advised not to become a trust yet, but it did so under pressure from the Government. It was £2.5 million in debt. It had cut the number of midwives on its staff to save a few bob: it had to save money in some way.

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  Because of the cut, the midwife who was looking after my constituent was having to do 32 other things at the same time. She was under enormous pressure.
  The chief executive, chairman and finance officer of that hospital have all left. I thank God for that, because it was they who made a mess of things. I must admit that those who took over are doing a pretty good job at present: at least they have clawed back £1 million, and patients to whom I have spoken seem fairly satisfied. I have not received many complaints.
  I see that the hon. Member for Rugby and Kenilworth (Mr. Pawsey), who chairs the Select Committee on the Parliamentary Commissioner for Administration, is present. The Committee often investigates the health service, and we repeatedly find that trust managers and chief executives are not taking seriously their responsibility to deal with complaints. When serious complaints are made, they ignore them. The health service ombudsman is said to have renewed his attack on national health service managers' handling of complaints, and the way in which they ignore the necessary procedures. I wonder how many complaints are received by the Parliamentary Commissioner, and whether any of the complaints cited by my hon. Friend the Member for Bootle (Mr. Benton) have been investigated.
  My local practice in Blyth Valley has 12,000 patients. The practice, which is one of the biggest in the area, refused to adopt fundholding, although other local practices have. I have heard stories and tried to gather evidence, and I questioned the Parliamentary Commissioner some time ago when he was giving evidence to the Committee. I had an inkling that fundholders were beginning to receive preferential treatment, although that has always been denied. I asked the Commissioner whether, if someone told me that a patient in a fundholding practice had been seen before them, that would constitute a legitimate complaint. The Commissioner said that he would investigate the matter.
  I am examining the position carefully, and I have written to the executive at the Cheviot and Wansbeck hospital to that effect. Of course, those involved may have smartened themselves up because they know that I have my eye on them. I ask other hon. Members who obtain any relevant evidence to write to the Commissioner, and to inform my hon. Friend the Member for Rugby and Kenilworth and me. As I said, however, the hospital is getting back on its feet, and I hope that phase 3 will proceed successfully.
  Only last year, Gallup conducted a survey among NHS workers. I doubt that the Minister has seen the results, but I shall provide him with a copy if he would like one. The survey found that nurses were leaving the NHS in droves, piling pressure on those who remained. I remind hon. Members that Gallup is entirely independent.
  When workers were asked whether they would consider leaving the NHS if they could obtain another job, 62 per cent. said that they would—an increase of 48 per cent. since the last survey in 1993; 75 per cent. of ward sisters and charge nurses said that they would leave, and 74 per cent. of staff nurses, 70 per cent. of health visitors and 69 per cent. of midwives said the same. When asked for their reasons, they cited falling standards: 62 per cent. mentioned having to compromise in regard to standards
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  of care, while 63 per cent. referred to acute staff shortages and 75 per cent. said that they felt undervalued. If that is the reaction from health service workers, no wonder my hon. Friend the Member for Bootle and others are receiving complaints. Sixty per cent. said that their reason was the treatment by management. Of course, management is hard on the heels of the poor unfortunate people working in the health service. The service is being cut and those people are under pressure, understaffed and under great stress, and they are doing more work now than before. Of course, they are sick of it, and managers are always on their back—that is what they are for.
  Fifty-one per cent. of nurses said that their reason was level of pay. They were concerned about the Government's policy of breaking the national agreement and bringing in local pay. Many of them thought that that was just another way of devaluing their pay in different regions, so a nurse in one region would get less than a nurse in another region doing the same job. If nurses want to work in a rich region, they are "Okay, mate," but if they want to work in a poor one, they are not.
  There was a good article on health in one of the national newspapers in the north-east. Newspapers are newspapers, but I have heard this before and it was not far from the mark. In the north, the number of nurses has fallen by 4,000 in five years. It was interesting to read that Scottish and Newcastle Breweries is luring nurses to pull pints. One of its executive members said:
  "In our experience, trained nurses make superb pub managers".
  That is obviously because nurses are tolerant and understanding—that is all people want in a pub manager. Breweries are luring nurses and nurses are going to work for them.
  This year, the Nursing Times and Nursing Mirror carried 1,000 job advertisements for nurses—there were five pages of them. More than 100 nursing posts are vacant in the north-east of England. There must be something wrong, unless all nurses go to a bank—as an agency is called. Apparently, nurses who use them get more money. A hospital or a trust can sack a nurse tomorrow and she can join a bank, come back to that hospital and cost the hospital more. I cannot fathom that out for my life, but it happens.
  There are short-term contracts for nurses now. When a nurse is employed, she is put on only a one or two-month contract, so she has no job security. In the health service, hospital trusts can float people out and float them in at a whim. It is a pity that we cannot do the same with some of the executive members and chairmen of the trusts, although I must admit that I did pretty well in achieving that in the Cheviot and Wansbeck NHS trust, getting rid of three of them in almost one go.
  Staff shortages and a growing work load cause great stress. At least 87 per cent. of nurses interviewed in the Gallup poll said that they were overworked and under great stress. That says a lot. I hope that the Minister will take note of the fact that people are under stress. We must ask why that is happening. It might be because they see all these people on trolleys. They might be seeing the things that my hon. Friend the Member for Bootle has made complaints about, and they cannot do anything about it because they are overworked and overstressed.

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  In the past few years, complaints about the health service have increased by 55,000. There is a serious fault somewhere. If we do not get to grips with it, and if we do not give nurses a decent wage and make the job worth their while, problems will pile up.
  How many times have we heard a patient say how wonderful it was being in hospital, seeing nurses at work and seeing their dedication to the people whom they are there to serve? I have heard that many times in hospital, yet nurses' wages have fallen and, as the survey showed, many want to leave the health service. That counteracts all that. If those things are happening, big accidents will occur and complaints will be made.
  In relation to the case involving my constituent—the mother who lost her child—it was not the midwife's fault. I do not blame her. It was the fault of the system. I forgot to mention before that the trust brought the nurses back after making them redundant, when it found that it could not do without them—I do not know for how long. That is the system that we have now. That is what causes deterioration in the health service.
  The health service is a wonderful thing. There is no doubt in my mind that the Government's idea is to have a two-tier health service, whereby some people pay and some people wait in the corridor. That is the service which the Government want. I say to the Minister that, if the survey means anything, it means that people who are working in the health service are as sick as we are at the state of it.
  7.34 pm
  Mr. Ray Whitney: What the hon. Member for Blyth Valley (Mr. Campbell) says about the health service in the north-east bears no relation to my experience in the health service in Buckinghamshire and in many other parts of the country. For example, he referred to nurses' pay declining. That is contrary to the facts. If my memory serves me well, since 1979 nurses' pay has increased in real terms by 45 per cent. Nurses' pay dropped only once in real terms and that was during the time of the Labour Government.
  The hon. Gentleman seems to have trouble with the service he gets from his trust. He does not like fundholding. He suggests that nurses are leaving the health service in droves. The South Buckinghamshire NHS trust gives excellent service to my constituents. GP fundholders give excellent service too.
  The hon. Gentleman seems to get no proper answers when investigating complaints about his chief executives. Again, that is contrary to my experience and, I suspect, to that of most hon. Members.
  Mr. Ronnie Campbell: Will the hon. Gentleman give way?
  Mr. Whitney: Very briefly. The hon. Gentleman had a pretty good innings.
  Mr. Campbell: I did not say that I did not get proper answers; I said that the health service ombudsman said that he did not get proper notice from health executives.
  Mr. Whitney: I can repeat only that that is certainly not my experience and I would be surprised if colleagues had a similar experience.
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  What the hon. Gentleman produced was on a par with that produced by his hon. Friend the Member for Peckham (Ms Harman). As someone who has been interested in the health service for many years, I have grown accustomed, over the years, to hearing a litany of complaints and—as the cliché has it—to seeing this shroud waving. We have had that this afternoon, particularly from the hon. Member for Peckham, who always—she, too, has been involved in the health service for a number of years—comes to the House and reads out her essay, which is one long dismal dirge quoting individual cases.
  Invariably, Conservative Members become deeply angry about that misrepresentation of the health service and about the total farrago of misinformation. It is based sometimes on ignorance and sometimes, one is moved to believe, on malice. The standard attacks are normal. Sadly, part of the reason for that is that the national health service has become a political football—a lamentable feature of British politics. I may not have agreed with many of the things that the hon. Member for Southwark and Bermondsey (Mr. Hughes), the Liberal Democrat spokesman, said, but I join him in this: if only the Labour party grew up and stopped believing in the myths that it has created about what did or did not happen in 1948, we could have a genuinely adult approach to tackling the challenges of health care.
  Everyone knows what those challenges are. With the discovery of new treatments, the aging of the population and the wonderful opportunities that are available, added to the inevitable and inescapable pressures of funding, there are and will always be challenges, but we shall get nowhere as a nation while we have the pettifogging, narrow-minded and idiotic approach that was personified by the performance of the hon. Member for Peckham. It is a matter of great regret that her participation in the debate and her presence in the Chamber seemed to be of such brief duration. We have seen little of her. She would have at least learnt something if she had stayed.
  Mr. Alan Milburn: What about the Secretary of State for Health?
  Mr. Whitney: My right hon. Friend was here a great deal longer than the hon. Member for Peckham. She is in much greater need of learning what is happening in the health service than is the Secretary of State.
  The approach of the hon. Member for Peckham seemed to be based on one or two minimal propositions. The first was the usual litany of individual cases—we heard the same from every other Labour Member who has contributed—in which the NHS may or may not have failed. As up to 1 million patients a day are treated by the NHS in hospitals or GP surgeries, it is not surprising that there can be one or many more mistakes. Of course, that is not the story of what is really happening in the NHS. The lie is given to those statements by Labour Members—or would be if they thought, for only a moment—by the situation into which they plunged what they are so fond of calling their national health service.
  In relation to other issues, such as what happened in 1979 and before, I am almost prepared to let bygones be bygones—but not about the NHS. The Labour Government's record was criminal, and Labour Members should never forget it or be allowed to forget it. They speak as if they are completely ignorant, which is the most

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  charitable thing that I can say. They do not know how bad it was when they ran it. They seem to have no idea of the fact that we have increased spending on the NHS in real terms by 66 per cent.
  The average spend has increased from £433 to £697 a head, which is a terrific achievement. Of course, any fool can spend money badly; the great challenge is to spend money sensibly. That is what is happening. It has not been universally successful, because that is not in the nature of life, or certainly not in an enterprise as big as the NHS. We heard no recognition of that fact from the hon. Member for Peckham.
  We heard from the hon. Lady that fatuous attack on management. As my right hon. Friend the Member for Sutton Coldfield (Sir N. Fowler) said, Conservative Members, far more than Labour Members, would lead the charge on bureaucracy. When one is dealing with £41 billion of taxpayers' money and when there are more than 8 million hospital treatments every year, one needs that money and that enterprise to be managed. To spend 3 per cent. on management charges strikes me as entirely reasonable.
  The one concrete point—if it can be so dignified—made by the hon. Member for Peckham was that, in relation to resources, she had allegedly discovered £1.5 billion that was spent on management that she would transfer to front-line care. How will she manage that? What will she do? If 3 per cent. for management charges is too much, is 1.5 or 2 per cent. the right figure? We never hear anything like that from the Labour party, and least of all from the hon. Lady.
  There was some suggestion that the NHS was being privatised, which of course is complete nonsense. It is true that we do not share the hon. Lady's opposition to private medical care. We believe in choice. I shall not go over the issue of choice, which has been so familiar over the past few days in relation to the hon. Member for Peckham, but it should be recognised that the private medicine sector is not in competition with, but is an adjunct and addition to, the health resources of the nation. I hope that the Labour party is clear about that.
  The Member for Peckham seemed to object strongly to any increase—she greatly exaggerated what it has been—in private medical provision. I must tell Opposition Members that the final years of the previous Labour Government were one of the bonanza times for the private medical industry. They were the great recruiting sergeants for private medicine because the health service was in such a mess. The hon. Member for Blyth Valley would have had something to complain about then. That was when people, including the unions, flocked to sign up by the cartload for private medicine. Union leaders were working hard, and why not, to provide private medical services to their members in case it was needed.
  We heard that great litany, which completely disregarded the achievements of the NHS which include the fact that 3 million more people receive treatments every year in NHS hospitals, and we have thousands more doctors and tens of thousands more nurses. It was the same old litany that we have heard so often.
  I believe that a great disservice is constantly done to the 1 million people, or whatever it may be, who are now working in the health service and giving a first-class,
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  international-quality service. The litany has completely devalued and debased that service. I hope that the Labour leadership will look at itself and try to adopt a more positive attitude and constructive approach. Perhaps then we will be able to conjure up some meaning out of the term "stakeholding". That would be better than a diatribe, of which the hon. Lady gave us the most classic example.
  The hon. Lady said, for example, that some treatments were no longer available. Does she not know that there are vastly more treatments available now than were dreamt of in 1979, not because of the Conservative Government but because of medical advances? The Government have generated an economy that is successful and strong enough to bear the necessary increase in resources that are devoted to the NHS to bring those new treatments to the service of our constituents. The hon. Lady's statement that treatments are no longer available is a grotesque misrepresentation of reality.
  The hon. Member for Peckham, finally, tried to attack the private finance initiative, and again she seemed to be at odds with her leader and protector, the Leader of the Opposition. In the Budget debate he said:
  "The PFI is right in principle. We have supported it, and in many ways we have been advocating it."—[Official Report, 28 November 1995; Vol. 267, c. 1077.]
  Not so the hon. Lady.
  The PFI has great benefits to bring to the NHS. I am delighted to say that Wycombe general hospital and Amersham hospital in my constituency and the constituency of my hon. Friend the Member for Chesham and Amersham (Mrs. Gillan) are benefiting as some of the first examples of funding from the PFI. They are benefiting to the tune of £35 million. Because of the PFI, a wonderful hospital development is coming to us much more quickly than it would have done. There is a great story to be told. A great record has been achieved. It is one more great British achievement that the Opposition concentrate on denigrating. They should stop.
  7.47 pm
  Ms Janet Anderson: The speech we have just heard from the hon. Member for Wycombe (Mr. Whitney) accused my hon. Friend the Member for Peckham (Ms Harman) of peddling misinformation about the NHS. I was present for both the opening speeches in the debate and was impressed by my hon. Friend's detailed knowledge of the problems facing the national health service, unlike the Secretary of State for Health, who devoted a great deal of his speech to matters that had nothing to do with the NHS. In fact, he seem to be much more concerned to find out what we were going to do in government rather than to tell us what he had done in his post.
  The hon. Member for Wycombe talked about the number of patients being treated in the health service and I think that he said something like, "It is hardly surprising that there is a mistake a day when millions of patient are being treated." That is not much consolation to my constituent, Mr. Craig Yates of Darwen, who is fighting for his life in hospital because he was denied a brain scan at Blackburn royal infirmary.
  I put it to the hon. Member for Wycombe that, if one out of 10 planes that land at Heathrow airport were to crash, we would not say that that was all right because nine out of 10 had landed safely; we would find out why

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  one had crashed and do something about it. It is a great pity that Conservative Members do not apply the same test to the national health service.
  I am grateful to you, Mr. Deputy Speaker, for calling me to speak in this debate. I shall concentrate on the future of the hospital in my constituency. I say "the" hospital because we have only one hospital, the Rossendale general. It is situated high on a hill, partly still housed in what was once a workhouse, with beautiful views over the Rossendale valley. It is dear to all our hearts, and is part and parcel of our valley community.
  At times, Rossendale general has seemed to be under threat of closure and some of the services that we wanted retained have now gone. We have no accident and emergency facilities and no maternity unit. If people need accident and emergency facilities or want to have a baby, they must go to Bury, Burnley, Rochdale or Blackburn. We fought hard against those changes at the time, but when we lost the fight we consoled ourselves with the thought that at least we still had our hospital. We were further encouraged when antenatal facilities were restored and the Burnley Health Care NHS trust decided to invest £5 million in the hospital over the past four years.
  Our satisfaction at having retained the hospital, however, may be short-lived. The bombshell was dropped last week by Mr. David Chew, chief executive of Burnley Health Care NHS trust. A week ago today, he met staff at the hospital and told them that 31 beds would be axed, a ward would be mothballed and 60 to 70 staff, mainly nurses, would go. He said:
  "I hope that we can find jobs for everyone and that no staff will go".
  The local Unison representative, Susan Holmes, said:
  "We are concerned about job losses. In spite of management assurances, there are a number of people on temporary contracts who are very worried about their position. Mr. Chew tried to assure us that this was the way forward".
  It may be the way forward for the trust, but it is not the way forward for the people of Rossendale, whom I am proud to represent in the House. Nor is it the way forward for the 60 to 70 staff who stand to lose their jobs, or for those patients who, according to nursing staff, have been sent packing because of insufficient beds.
  The proposals also mean that elderly women will be forced to endure the indignity of mixed wards, to which the hon. Member for Birmingham, Edgbaston (Dame J. Knight) eloquently referred. She is right. Many patients, especially the elderly, do not want to be forced into mixed wards and I am deeply saddened that that will happen to my constituents to save money.
  Anne Parkinson of the Royal College of Nursing said of those proposals:
  "The beds we have been operating with have been full and we have been turning patients away recently. Goodness knows where they have gone. This seems a drastic step at a time when there is a national shortage of beds.
  I am sure the trust will handle redeployment sensitively but they cannot promise there will not be any job losses. Staff are worried about losing their jobs. Some who have not got any transport are also worried about where they will be redeployed. Fewer beds will also force more and more people to travel further afield for treatment. There has been a gradual decline in in-patient facilities here during the past 10 years and there is a real feeling among staff that the hospital is being run down."
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  Patients are being turned away through lack of beds, yet the trust is axing 31 beds. Hospital staff whom I met last weekend told me that someone turned up at the hospital last week claiming that he had bought 18 beds from the hospital and was there to collect them.
  If the proposals are not the way forward for my constituents, hospital staff and patients, why should it be the way forward for the trust? Mr. Chew made it plain last week that the decision was to do with cash, not patient care, and claimed that it would save the trust £200,000 a year. I wonder why the trust seeks to save that sum of money. Just over a year ago, my hon. Friend the Member for Burnley (Mr. Pike), who was present earlier in this debate, secured an Adjournment debate on the state of chaos in the Burnley Health Care NHS trust. He read out a headline from the Lancashire Evening Telegraph:
  "Scapegoat: 'Health chairman asked me to resign to save his own neck'.
  The chairman and chief executive of the troubled Burnley Health Care Trust each called for the other's resignation today in an astonishing bust-up."
  We learned from the Minister's winding-up speech in that debate that, because the chief executive had fallen out with the chairman and wanted rid of her, the pay-off was no less than £245,000, which is the sum that the trust seeks to save today.
  A moving article appeared in my excellent local newspaper, the Rossendale Free Press, which many of my constituents read. It sums up the position by saying:
  "Desperately sick and dying people are shunted all over the country in search of hospital beds and Burnley Health Care NHS Trust's reaction is to close 31 beds at Rossendale General Hospital. How can it possibly make sense?
  They are not the right sort of beds, says Burnley Health Care Trust. There's no emergency intensive and coronary care back-up at Rossendale, which is to be turned into 'an important out-reach post for minor surgery', catering for short-stay and day cases.
  You'll get your ingrowing toenails, your hernia or your piles fixed at Rossendale and be home again in a jiffy. But who wants to be home again in a jiffy, walking wounded and thrown on the mercy of that well-known euphemism, Care in the Community? Try telling Rossendale's old people, stripped of their home-helps by financial cuts, what a marvellous service that is.
  A mixed-sex ward will replace the existing male and female general medical wards despite public inhibitions and sensibilities. When a woman is stripped of her dignity, in pain, and sitting behind a curtain on a bedpan, the last thing she wants is a bloke in the next bed. And vice versa.
  Letters heaping praise on Rossendale General and its superb nurses and doctors appear regularly on the Free Press Viewpoint page.
  The maternity unit was closed in the face of massive opposition. Ante-natal clinics were clawed back after public outcry. Trust chiefs are at pains to stress, yet again, the hospital is not in any danger of closing;… Yet they can hardly be surprised that Rossendale folk"—
  and their Member of Parliament—
  "are unable to resist the doubts and now will be even more perplexed, agitated, defensive, protective.
  Must we now stand by while more excellent services are amputated like limbs, until the trunk is no longer a hospital, but becomes an 'out-reach post'?"
  It is vital for the patients and staff of Rossendale general and the whole community of Rossendale that there are no further cuts. I hope that when the Minister responds to this debate he will tell us how the Burnley Health Care NHS trust's latest proposals will improve health care for my constituents.
  7.58 pm
  Mr. Jerry Hayes: I begin by declaring an interest. I am an adviser to the Western Provident Association, which, as the hon. Member for Fife, Central (Mr. McLeish) should know, is a non-profit-making organisation.
  Mr. McLeish indicated assent.
  Mr. Hayes: I am glad to have the hon. Gentleman's nod of approval.
  When I first saw the Leader of the Opposition sitting next to the hon. Member for Peckham (Ms Harman), I thought, "There is decency in the man after all. He is there to protect the hon. Member for Peckham. God bless him, what a brave man he is." Then I realised that I had got it wrong because she was there to protect him, and to act as his human shield. They are the Siamese twins of British politics, but I suspect that, even now, the hon. Member for Hartlepool (Mr. Mandelson) is working on a surgical separation. The hon. Member for Peckham should be very careful.
  I was having a drink the other day with a member of the shadow Cabinet, who said, "We have a saying in the Labour party—beware of left-wing toffs." Looking at the Opposition motion today, one sees that he was right. It could have been cobbled together by guests at a Pinter soirée discussing their view of the health service while being served Nicaraguan coffee by Filipino maids.
  The hon. Member for Fife, Central must, I am afraid, pick up the wreckage from the speech of the hon. Member for Peckham later tonight, and we expect some answers from him. The hon. Lady's speech was not so much a policy statement as a cry for help. The speech from the hon. Member for Blyth Valley (Mr. Campbell), however, was remarkably honest—although he did go off the rails towards the end. The hon. Gentleman admitted that we now have the lowest number of people waiting for treatment in the history of the health service. He also admitted that he had no evidence that there is a two-tier system, although he is investigating the matter. If the hon. Gentleman finds some evidence, I hope that he will report it to the House. I suspect, however, that he will find no such evidence.
  I spent a little of this morning reading through all of the speeches that the hon. Member for Peckham has made on health. The hon. Member for Fife, Central saw me do it. It was not a happy task. One interesting thing that the hon. Lady did say was that in vitro fertilisation was a lottery and that, "It depends on where you live." Oh dear—that has a familiar ring.
  One of the points that cropped up over and over again in the hon. Lady's speeches since 1987—I have listened to many of them in the House—was that the health service reforms that had been put into operation would have to be abolished. She has also said that GP fundholding was a wickedness that led to a two-tier system, and that, too, would have to go. NHS trust hospitals and the internal market would also have to go. It is all very different now, however.
  We just do not know precisely what Labour's policy on health is, and there is tremendous confusion. About 41 per cent. of the population are now covered by GP fundholding, and more than 10,000 GPs have voted with their feet because they know that the scheme provides
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  good service. [Interruption.] The hon. Member for Fife, Central is making a gesture with his fingers—a pleasant one, as one would expect from him—to indicate money. He is right. The fundholders are getting more money to spend on patient care, and that is quite apart from the money coming from the Government. I can give the hon. Gentleman an example—the £64 million made from efficiency savings has gone directly to the patient to provide services that have never been seen before.
  Mr. McLeish: Would the hon. Gentleman like to extol the virtues of the 59 per cent. of fundholders throughout England that are commissioning groups?
  Mr. Hayes: The hon. Gentleman refers to commissioning groups, but I understand that one of Labour's policies is that the internal market, or the split between purchaser and provider that has been denounced over the years at the Dispatch Box from which the hon. Gentleman will shortly address the House, will continue. Does the hon. Gentleman deny that? Of course not, because he knows that it works.
  GP fundholders have been a great success, offering more services than ever before. There are now some 10,000 of them, covering 41 per cent. of the population, and it is expected that there will be an additional 660 by next year. If there is—heaven forbid—a Labour Government, the majority of people in the country will be covered by GP fundholders that work. According to GP fundholders in my constituency and elsewhere, it would be a grave mistake if they were not to continue.
  That is why the fudges are beginning. I mentioned in an earlier intervention on my right hon. Friend the Secretary of State that the right hon. Member for Derby, South (Mrs. Beckett)—Labour's previous health spokesman—extolled some of the virtues of GP fundholding in October 1995, but had added that she hoped that they would be abolished in the first year of a Labour Government. I assumed that that would again be a Labour manifesto commitment as it was in 1992, but oh no. We now hear something totally different from the hon. Member for Peckham. The policy is now shrouded in secrecy, and I hope that the hon. Member for Fife, Central—as this is an Opposition Supply day—will tell us what that policy is.
  What is a "comprehensive health care agreement", and how would it differ from the contract that we have at the moment? The hon. Gentleman knows that the contract system works because it gives incentives. Clive Wilkinson, chairman of the Wolverhampton NHS trust, said on BBC television:
  "You do have to have in the final analysis, don't you, the ability to take the contract away. Otherwise, if you don't have that, then all the incentive to the provider to deliver what they are asked to deliver disappears. We know from past experience that just cajoling public servants to do better is not effective".
  I cannot see how the hon. Gentleman can possibly disagree with that.
  There is total confusion among Opposition Members about the private finance initiative. On the day when the virtues of the PFI were extolled by the Opposition Treasury team—I can give the hon. Gentleman the quotations, although I am sure my hon. Friend the Minister of State will do so when he winds up—the hon. Member for Peckham

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  was calling it "creeping privatisation". Yet the PFI was extolled by the hon. Member for Rother Valley (Mr. Barron), who said it was a Labour party invention. Again, there is confusion and division in the Labour ranks.
  Hon. Members should cast their minds back to before the reforms, to the time when no one knew the price of anything at all. If one does not know the price of a treatment, a medicine or a bandage, how on earth can one plan for the future? We must spend the money wisely. My right hon. Friend the Member for Sutton Coldfield (Sir N. Fowler) reminded the House that the Government were castigated when we introduced sensible management programmes.
  I shall deal now with the Labour accusation of bureaucracy. The hon. Member for Fife, Central nods his head, and I suspect that he will later speak against bureaucracy with the eloquence of Satan denouncing sin. What does Labour want to do? It wants another tier of regional health authorities, which some of us have been trying to get rid of for years. That would cost £100 million, money that would be removed from patient care. The hon. Gentleman would have to get that £100 million from the Treasury if Labour were in government. The hon. Gentleman also wants a minimum wage— [Interruption.] Perhaps he does not want a minimum wage.
  Mr. McLeish: I do want it.
  Mr. Hayes: According to the hon. Member for Livingston (Mr. Cook), the minimum wage would cost the health service £500 million, and that money will all be taken away from patient care. The Opposition's policies are all about centralisation, whereas the Government's policies on health are very simple—we have decentralised, and brought better patient care to ordinary people. Since the introduction of the "wicked" reforms, 1 million more people have been treated, and the House will have heard my hon. Friend the Member for Wycombe (Mr. Whitney) give the figures. Some £4l billion is being spent—66 per cent. above the rate of inflation. We have the lowest waiting lists ever, and we have the citizens charter. Did one hear anything about a citizens charter under the previous Labour Government? It was derided by the Opposition as a rather sick joke—[Interruption.]—as a citizens anthem, I am grateful for the correction.
  Mr. Edward O'Hara: Is the hon. Gentleman aware that the citizens charter concept was invented by Labour local authorities long before the Prime Minister ever dreamt it up?
  Mr. Hayes: I am grateful to the hon. Gentleman. I wish that he had told that to his hon. Friends on the Front Bench at the time, who were so vehemently opposed to the concept. That is yet another division in policy in the Labour party.
  Under the patients charter, we set down clear times for operations and for when ambulances should arrive at the scene, and we introduced checks and further checks.
  Mr. O'Hara: The Labour party criticised not the concept of the citizens charter, which it applauds and preceded the Government in thinking about, but the lack of resources to implement the set targets, which were utterly unrealistic.
  Mr. Hayes: The hon. Gentleman has highlighted the exact problem I was about to consider. In the past, all the
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  speeches from the Opposition, including those from the hon. Member for Peckham, which I read over again this morning, concentrated on the underfunding of the health service over the years. They claimed that hospitals had been starved, and promised £1 billion for them in their manifesto at the last election. Of course, the Treasury gave us an extra £1.3 billion just for 1996–97. Expenditure has greatly exceeded that manifesto pledge within just the first year of the present Parliament.
  How much money will the hon. Member for Fife, Central pledge for the NHS? How much extra money will it take to get people off the trolleys? The Opposition have not pledged to the British people one single extra penny for the NHS. How do they intend to improve the health service, apart from the added bureaucracy of which we have heard, if they do not intend to spend any more money? Will they claim to be better managers of the NHS than the Conservative Government and NHS experts?
  Let us destroy another little myth. We hear that the health service is overmanaged, but for every 26 front-line staff, there is one manager. Opposition Members should compare that with the relevant figures in France, Germany, the United States and the rest of Europe. They should check those figures and note that those managers account for just 4 per cent. of the NHS wages bill. We are very lucky to have such a management in the health service. Of course the Secretary of State is absolutely right to ensure that there is no waste and inefficiency.
  Ms Janet Anderson: Is the hon. Gentleman aware that in North East Thames region, which covers his constituency, in the past five years, the number of managers has increased by no less than 260 per cent.? Does he think that that represents an efficient use of resources?
  Mr. Hayes: If the hon. Lady looked at the figures, she would understand why that has happened. There has been an increase in managers all over the country because we happen to believe in a good role for women in management.
  Mr. McLeish: Oh, come on!
  Mr. Hayes: I thought that Labour was a politically correct party. Because we recognise the value of women and the value of nurses, we have re-registered many of them as business managers.
  Ms Anderson: Is the hon. Gentleman talking about nurses or about managers? Is he saying that all the extra managers are women?
  Mr. Hayes: There are nurses of both sexes. The hon. Lady can check the accepted facts in the Library, which show that many nurses have transferred to management posts. That is all that has happened. I note that the Minister of State, Scottish Office is nodding in agreement. The figures can be sorted out another time, but I promise the hon. Lady that what I say happens to be the truth.
  If anyone wants to see decent health care, he should come to my constituency. I spent a long time fighting with respective Ministers because Harlow was genuinely underfunded under the RAWP—resource allocation working party—system. It was desperately unfair to my

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  constituency because so much of our money was sucked into London and elsewhere. We had some of the longest waiting times in the country and the three accident and emergency departments did not operate terribly efficiently. The service was a catastrophe because we were constantly in debt.
  I am not saying that health care in Harlow is perfect—it never will be anywhere because people's expectations are, rightly, so high. Errors will always be made. It is no use hon. Members shroud waving. [Interruption.] It is true. We all have dreadful cases that we all want to see investigated; they have arisen under every Government, and will continue to do so as long as the health service is run by human beings, not by robots. Mistakes are made, and all that we can do is institute various checks such as medical audits and clinical directorates to try to ensure that the minimum amount of errors are made in the future.
  It is not particularly helpful to read out constituency cases in the House. The best thing to do is to deal with one's NHS trust chairman or chief executive. If one does not get satisfaction then, there is always the ombudsman and, if that fails, that is when one goes to see a Minister.
  Mr. McLeish: What happens if people do not get satisfaction from anyone?
  Mr. Hayes: Hon. Members who have constituency cases should deal with local managers first. If Members go to a Minister, all that happens is that the Minister asks for a report from the region, which then asks for that report from the local hospital. It is much quicker to go direct to the manager. Every time I have had a problem, I have always had a full and frank inquiry, and I have always been able to get the answer for my constituent.
  I hope that the hon. Member for Fife, Central will come to Harlow in the run-up to the next general election, whenever that might be. He will see that in the last few years we have got a new computerised tomography—CT—scanner and a new MRI scanner. A new day surgery centre has just opened, along with a brand new £10 million accident and emergency centre. All that is good news for my constituents, but it is indicative of what is happening all over the country.
  Mr. McLeish: I am grateful to the hon. Gentleman for his invitation and I will certainly take it up if I am successful and become a Minister, but the problem is whether the hon. Gentleman will still be in Harlow to see me.
  Mr. Hayes: I look forward to welcoming the hon. Gentleman, when I hope he will be number two in the shadow health team as opposed to number three.
  Health care has improved not just in Harlow but throughout the country. Every week, a multi-million pound capital project is announced for the health service. Compare that with the record of the Labour Government, who cut capital expenditure by one third. The hon. Member for Fife, Central should consider that.
  8.16 pm
  Mr. George Mudie: The hon. Member for Harlow (Mr. Hayes) spoke about money. I want to talk about the necessity of doubling the number of acute
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  beds for youngsters in Leeds. Those beds are desperately needed, and they would cost £2 million to provide. They could mean the difference between life or death to youngsters in Leeds and West Yorkshire, but the hospitals cannot use those beds because they are in debt. They cannot find the necessary £2 million because of a £12 million debt between the two trusts. To the disgust of other doctors, fundholders in Leeds, at the end of the financial year, are sitting on £2.5 million. That surplus is lying in a bank, doing nothing but earning interest for those fundholders while seriously ill children are being bussed hundreds of miles by ambulance from Leeds to Newcastle for operations. That £2.5 million is sitting in the bank for dogmatic purposes and it is not being used in my city.
  Let us talk about money for the health service. This seems to be a debate in which we are accused of waving shrouds, but Conservative Members wave capital receipts. We know where those receipts have come from as we go through Leeds and see hospital after hospital closed, asset stripped and beds closed.
  Sir Ivan Lawrence: That is not true.
  Mr. Mudie: Not true! Let me tell the hon. and learned Gentleman about Killingbeck hospital and the actions of the Government and the regional health authority. Two years ago, it was decided that that much-loved hospital in my patch should be closed down. It was decided to transfer its facilities to the city centre at the multi-storey Leeds general infirmary. Once opposition from the public became apparent, the community health council decided to shift just the heart unit to LGI and to continue using Killingbeck for other NHS purposes. The people of Leeds still believe that Killingbeck is open. However, behind the scenes, the region—presumably with the Minister's knowledge, before the hospital has even shut and despite the pledge that it will continue to be used for national health service purposes—has sought planning permission for houses and industrial development for the whole 46 acres.
  When the Government talk about fresh money and wave capital receipts at Labour Members, we know how they were got—by asset stripping other resources in the city. There is the evidence. The hon. and learned Member for Burton (Sir I. Lawrence) is not growling at me now because those are the facts from my own hack yard.
  This is an intriguing and disappointing debate. It is intriguing because hon. Members seem to come from two different worlds. The hon. Member for Birmingham, Edgbaston (Dame J. Knight) made that point earlier when she said that the shadow Health Secretary was saying one thing and the right hon. Member for Sutton Coldfield (Sir N. Fowler) was saying the opposite. Someone is not telling the truth.
  Our motion talks of "overstretched staff", "inadequate patient care" and the
  "relentless cuts in NHS beds".
  It goes on to condemn
  "the increased amount of money spent on internal market bureaucracy".
  In their amendment, the Government congratulate themselves on the "NHS continuing to flourish".
  Dame Elaine Kellett-Bowman: It is.
  Mr. Mudie: Before the hon. Lady gets over-excited, let me say that I do not for a minute think that Members

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  such as the hon. Member for Wycombe (Mr. Whitney) do not see the health service in their patch. However, I wish that Conservative Members would not accuse us of shroud waving when we quietly, and in debates such as this, legitimately, explain the details.
  Sir Ivan Lawrence indicated dissent.
  Mr. Mudie: I hope that the hon. and learned Gentleman will have the patience to hear my speech out. He will have the opportunity to respond.
  Which flourishing health service are the Government talking about? It is intriguing that we seem to have two health services, but it is also disappointing. I was always disappointed when legitimate complaints about the health service were made and the previous Secretary of State used to go into her trance and recite all the statistics of buildings built, staff here and staff there, but pay no attention to the complaints. That that disappointment continues is clear both from the motion and from the performance of the Secretary of State today, when he took five minutes to mention the health service.
  The Secretary of State is one of the most intelligent and caring Ministers in the Government, but if he cannot support the motion, thinks that he lives in a Britain with a flourishing health service, has little time for my hon. Friend the Member for Bootle (Mr. Benton) describing the ordinary human cases that happen day in, day out and accuses Opposition Members of shroud waving, it is a disappointing day.
  Dame Elaine Kellett-Bowman: Will the hon. Gentleman give way?
  Mr. Mudie: I shall give way in a moment. We are not all villains; when I look across the Table of the House, especially at those Conservative Members who are present, I have to say that they are not all villains.
  Dame Elaine Kellett-Bowman: Will the hon. Gentleman give way?
  Mr. Mudie: I shall give way when I finish my peroration. Conservative Members are not villains, but I wish that, for one minute, when we are discussing a sensitive and important matter—it is no exaggeration to say that it is a matter of life and death—we would listen to one another. I concede that there have been improvements in the health service under the Government, but I wish that some Ministers would listen to the case for some of the improvements that are needed to make it an even better health service.
  Dame Elaine Kellett-Bowman: Nobody would suggest that Labour Members are villains. We merely suggest that some hospitals are more efficient than others. The hon. Gentleman may be right that there are two health services: those that are exceptionally well run and those that are not. In Lancashire as a whole, the expectation of life is a year below the national average. In my city, the expectation of life is a year above the national average. We are steeped in hospital care. We have the finest hospital in the country. It is funded in the same way as everybody else, but we run it extremely well. The nurses' mothers or fathers were probably nurses as well, male or
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  female. Those families have been in the hospital service for the past 100 years and they care for it. Our services are exceptionally good and they make the best use of every penny that is given to them.
  Mr. Mudie: I accept that. I live in a city with good hospitals, especially the two that I am going to discuss. I wish that the hon. Lady would listen to their problems. I do not say this of the hon. Lady, but the Secretary of State has been inclined to steamroller them. The previous Secretary of State made a habit of steamrollering genuine problems.
  The Secretary of State pointed out that there was growing concern during the winter about intensive care beds. The problem is that he suggested that it was a seasonal difficulty and gave me the impression—in which I hope that I am mistaken—that the Government think that they are well on top of it.
  I am delighted to see the hon. Member for Leeds, North-East (Mr. Kirkhope) here. As a colleague from my city, he will be able to confirm everything that I say. I am sure that he has come to the Chamber just to do that. This is an important matter. The Secretary of State accepted that, but blithely seems to suggest that the problem is under control. If he thinks that, I hope to give him some evidence to suggest that, at least in the city of Leeds, all is not well.
  The Parliamentary Under-Secretary of State for the Home Department (Mr. Timothy Kirkhope): I came hotfoot to the Chamber. I apologise for not having been here earlier, but I have been watching the hon. Gentleman on my television screen and heard some of what he has been saying about the wonderful health service in Leeds, a city which I am as proud to represent as he is. He has not been very fair to the people who work in the health service in Leeds or to the Government, who as he knows, are responsible for the wonderful new Leeds general infirmary which, even as we speak, is being built. Perhaps he would like to join me in going to see the 14 operating theatres being developed. The very latest technology in the world is being installed for the benefit of the people whom he and I represent.
  Mr. Mudie: Before the hon. Gentleman came in, I was saying, as did the hon. Member for Lancaster (Dame E. Kellett-Bowman), that we had an excellent set of hospitals. Clearly, the hon. Gentleman had shifted channels. I had dealt with how the Leeds general infirmary was funded. If he wants to help me prevent what I described from happening, I hope that he will stay. The wonderful new LGI block is being funded by the sale of 46 acres of land in my constituency on which, at present, is a much-loved hospital.
  The people of Leeds are under the impression that they have a pledge from the Government that that site will remain a hospital. Unknown to them, the Government and their agents have applied for planning permission before the hospital has even closed. There is no large LGI block funded by a benevolent Government; it is paid for by the rape and asset stripping of a much-loved east Leeds hospital.
  If the Secretary of State, as the rational and intelligent man he is, thinks that the occupancy crisis is over, I hope that he will put in an order for the Yorkshire Evening Post, which carried the following headlines:
  "A disgrace: How many must more die, Mr. Dorrell?"

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  and
  "Tragic patient's eight hours on a trolley".
  In January, those who were not skiing abroad but working with their constituents will have noted the tragic death of a Bradford pensioner, a retired policeman who worked hard in his retirement for the British Heart Foundation. He was taken to, and turned away from, 12 Yorkshire hospitals. I can see some grins of amusement—I find the subject not amusing, but tragic. The man was flown 70 miles to a hospital in Scarborough where, sadly, he died shortly after arriving at the hospital. Incidents such as that prompt the Conservative newspaper in Leeds to run headlines such as the ones I have quoted for the second year running.
  A week later, while some people were still skiing—
  Dame Elaine Kellett-Bowman: Like the hon. Member for Rotherham (Mr. MacShane).
  Mr. Mudie: The hon. Lady does get over-excited—she should be careful, as there is a shortage of emergency beds.
  A week later, a pensioner—a 70-year-old stroke victim—spent six and a half hours on a trolley and died shortly after being found a bed in one of the Leeds hospitals. The trust is arguing that the pensioner waited on the trolley not for six and a half hours, but for five hours. The same week, another pensioner of 71 was one of 13 patients—one of whom was a lady of 96—who were left on trolleys for eight hours. That pensioner arrived at 1.30 pm and was found a bed at 10 pm.
  The newspaper ran a series of articles on those incidents. In December, a 16-year-old lad suffering from a bacterial infection was taken to St. James's hospital and turned away. He was taken to hospital after hospital and died a week after. The same month, a young lad from Stockport was driven 45 miles to Leeds. I could describe case after case involving such incidents. The Secretary of State would say that I am talking about December and January, and describing seasonal matters. Every year, the LGI turns away a minimum of 118 severely ill patients who are looking for acute beds—there is nothing seasonal about that.
  St. James's hospital, the biggest teaching hospital in Europe, turns away up to six people every day. Those people are severely ill and they are brought to the hospital to be given acute beds. When no intensive care beds can be found, those severely ill people who need urgent operations have to go from hospital to hospital.
  I am not making a joke of that, but I want to make the point in the context of my speech. I am not trying to make political points, but simply saying that if ours is a flourishing health service, it should flourish a bit better. To the individuals or families involved, it is no joke, but a matter of life and death. In several cases, those involved have, tragically, died.
  The LGI has five children's intensive care beds, and needs six. The extra bed is currently being run by doctors who work overtime simply to try to meet the demand. St. James's hospital has three such beds and needs six, which would cost £2 million. There is no likelihood of those severely ill children being found those beds.
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  When I said that I hoped that hon. Members would regard my speech as constructive criticism, there were groans and mutterings that it was a politician talking. Dr. Bodenham works at the LGI in Leeds. He says that the problems have occurred for years—they are not seasonal, as the Minister suggested. He states:
  "We have been complaining about the lack of resources for years, even before I started here four years ago.
  Basically, nothing happens. They set up working parties then nothing happens. What the public expects is going up and up but resources are not there."
  A spokesperson for the Leeds general infirmary trust said:
  "There is a national problem of rising admissions to hospitals, which has caused the problem here.
  There are more people coming into accident and emergency… It is simply that there are more patients than there are beds."
  The two doctors who run the intensive care units in both the hospitals undertook a report. It stated:
  "Intensive care facilities in Leeds and in Yorkshire as a whole are inadequate.
  There are insufficient high dependency facilities in Leeds."
  Dr. Harris of Bradford said:
  "But the big issue is not what we did at my surgery but the crisis with intensive care bed availability."
  I pay tribute to the local paper, the Yorkshire Evening Post, which has carried out a good campaign. If the Minister wants to smile, I hope that he will explain why he does so to the Yorkshire Evening Post. That newspaper has simply highlighted the fact that people are dying in our city because we do not have enough intensive care beds.
  The Yorkshire Evening Post received a promise from the present Secretary of State that he would do something about the problem. He set up a review. The Yorkshire Evening Post and the people of Leeds are unconvinced by his promise and, in order to be fair to the present Secretary of State, I shall explain why. A year ago, the previous Secretary of State was confronted by a similar campaign after the death of a two-year-old child and an elderly pensioner. The previous Secretary of State said that she would take action; we believe that she did so, but no one can find out what action she took. This month, when she was in the city in her new ministerial capacity, the evening paper asked her where her report was. She refused to comment.
  It was not a matter of someone making thoughtless or destructive criticisms; we have raised a genuine problem. The previous Secretary of State promised action, but that has not materialised and people have since died. We have now been given a similar promise by the present Secretary of State and I look for action and sympathy. Ministers must take off their rose-coloured spectacles and realise that, although they may have made achievements in the health service of which they are proud, there is still a long way to go.
  8.37 pm
  Mr. Richard Tracey: I am pleased to be able to contribute to the debate at last. You, Mr. Deputy Speaker, may have noticed an anomaly in our proceedings: according to the Order Paper, today is supposed to be an Opposition day initiated by the Labour party, but for most of the past few hours the Opposition

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  Benches have been almost empty and we have practically been debating with ourselves. I think that Opposition Members may have been drafted in from the Tea Room and the Labour Whips Office to address the House at some length in order to continue the debate from the Opposition Benches.
  The hon. Member for Peckham (Ms Harman) and one or two other Opposition Members did not seem to be speaking of the health service that I know, and nor does the Opposition motion. The sort of language used by the hon. Member for Peckham, which was criticised by my right hon. Friend the Member for Sutton Coldfield (Sir N. Fowler), is exactly the sort of language that puts fear in the hearts of those who hear it. That is particularly true of the elderly people in this country who, on hearing soundbites on the radio and reading accounts in newspapers, seriously fear that the health service is falling apart. In fact, it most definitely is not.
  We have a health service which, as various of my hon. Friends have said, is having £41 billion a year spent on it, is treating 3 million more people per year than it was in 1979—1 million more people per year than it was in 1991, when the reforms came in—and which accounts for 3,500 more people per day. That is not a health service which is in decline or falling apart limb from limb, as the hon. Member for Peckham claimed. It is a health service that is growing, and coping with the demands being placed on it. Those demands are considerably greater because there are more elderly people than there used to be. More intricate treatments are also being conducted, and people therefore expect far more to be done for them.
  The Labour party criticises what apparently the Conservative Government are doing. Labour Members obviously did not read what one of their colleagues, the hon. Member for York (Mr. Bayley), wrote in The Times last week. He said: "Labour's health policy will not look credible at the general election if we do not commit ourselves to matching the rate of growth delivered by the Conservatives in recent years".
  We need cite no more evidence to Labour Members than that. Those are the words of one of their colleagues, who recognises what the Government have been doing since 1979 and will continue to do, as may be appreciated by the pledges made by my right hon. Friend the Secretary of State for Health and by my right hon. and learned Friend the Chancellor of the Exchequer in the Budget.
  Rather than telling a grim tale, such as those that we heard from one or two Labour Members, I wish to pay a great tribute to my local hospital—Kingston hospital—which delivers fine service to my constituents and to the people of Kingston. It does so despite the fact that we have many elderly people and some neighbouring councils are not taking elderly people out of hospital quickly enough back into care in the community. We have now put in place a discharge liaison nurse to facilitate the smoother running of those procedures.
  Kingston hospital faced what was described by the chairman of the health trust and by the general manager as "an emergency situation"—a serious incident—during the new year period. Many hon. Members will recall that on 31 December 1995 there were extreme weather conditions, with icy rain falling on the pavements. As a result, there were many more emergency admissions to Kingston hospital than might remotely have been expected, and many more than had been catered for.
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  During the next three days, staff who in the normal way should have been having their bank holidays were drafted in. Operations took place, with double trauma operating lists in the operating theatres. The day surgery unit, which should have been off duty during the bank holiday, was called in and worked constantly. It was reported to me that staff worked solidly between 4 pm on Saturday 30 December 1995 and 5 pm on Monday 1 January 1996. Thirty-five full orthopaedic operations were completed in the main theatres, when usually only five such procedures would have been expected during that period.
  I therefore wish to place on the record, here in the House of Commons, a tribute to the staff of Kingston hospital. The chairman of the health trust, Mr. Rowan Cole, wrote to me three days ago:
  "The situation we faced over the New Year holiday was very unusual indeed. Our staff, in spite of great difficulties, coped with the situation magnificently, as indeed we would have to do in major incident conditions if there was a local disaster producing similar numbers of casualties."
  That is the type of health service that we have gradually begun to expect, and the type of health service to which our Government are committed.
  I believe that we are doing a good job. We are producing the resources. Labour Members have read out in the House details of individual cases. As my hon. Friend the Member for Harlow (Mr. Hayes) said, they should take up such cases with their national health trusts instead of describing the details in the House to produce soundbites. By contrast, Conservative Members come to the Chamber to praise the work of the national health service in our localities, and rightly so.
  8.45 pm
  Mr. Mike Gapes: I shall not recite a litany of individual cases. In the past year, I have spent many weeks and months writing letters on behalf of many of my constituents, who have been on trolleys for hours or who have been on waiting lists or whose appointments have been cancelled and so on. The Minister knows that.
  Last year, I also called for an inquiry into my local hospital following the press reports and the problems that we had but, in typical fashion, the then Secretary of State passed the buck to the North Thames region, which passed the buck to the health authority, which passed the buck back to the trust. That is typical of the way in which the health service is run today.
  I shall draw attention to the wider problems of the north-east London area. The Secretary of State, in his opening remarks, referred to "unexpected problems" in admissions to accident and emergency departments in the last two months.
  We are in January 1996. Since the end of September 1995, all local hospitals in north-east London have experienced extreme pressure and, to quote the words of a letter to me by the chief executive of the Redbridge Healthcare trust,
  "throughout October and November, trolley waits, overnight in A and E have been commonplace at King George Hospital".
  As I understand it, almost every night since October 1995, patients have been waiting overnight on trolleys at my local hospital.
  King George hospital is not alone. The local newspapers have referred to incidents there, but there have been others in all the other hospitals in our region. On 19 October 1995, the Ilford Recorder reported:

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  "Hospital crisis sparks bed plea.
  Ambulances were asked to avoid taking patients to King George Hospital again on Sunday because there were not enough Accident and Emergency beds.
  The call went out from the hospital in Goodmayes to the London Ambulance Service just after 9am asking crews to avoid King George if possible. Blue light cases, ie emergencies, were still allowed.
  The situation continued for about six hours."
  In November 1995, the local medical committee had a discussion about what had happened at the other hospital in the Redbridge and Waltham Forest health authority—Whipps Cross hospital, which is a very large hospital under the Forest Healthcare trust. As the Redbridge Guardian and West Essex Gazette of 16 November 1995 reported:
  "We're full up, says hospital.
  Even some 999 patients are refused admission.
  Patients were turned away from Whipps Cross Hospital this week when management admitted hospital resources were stretched to their limits.
  The hospital was closed to admissions and victims of major accidents on Tuesday 'to ensure patient safety'"—
  [Interruption.] Conservative Members may think that that is funny, but I am sure that their constituents would not think so if they suffered the same problems.
  When we discussed the situation with the local medical committee the following week, it reported that two extra wards had been opened at the hospital to try to cope with the problem. However, there were not enough staff to maintain them and the decision was taken to close the hospital on the ground that nursing practices had become unsafe. No other local hospitals could assist. King George hospital still had 17 patients on trolleys from the previous night. Three ambulances had waited at the door of the hospital, but there were no trolleys available.
  The same situation was narrowly avoided in the week of 24 November. Discussions took place at that time between the chief executives of the trusts in Redbridge, Waltham Forest, Newham and Hackney in an attempt to adopt a co-ordinated approach to the problem. That was the situation in October and November last year.
  In December, the Newham Recorder carried a front-page story on 13 December under the headline, "Hospital Crisis". The article stated:
  "Resources at Newham General Hospital are being stretched to the limit according to the Director of Nursing, who admitted waiting times have tipped 14 hours".
  In a story entitled "Prescription for Disaster", the Ilford Recorder of 4 January stated:
  "Health bosses in Redbridge have admitted the overnight closure of Oldchurch Hospital's"—
  in Romford—
  "accident and emergency department to ambulance cases created chaos in casualty at King George".
  The newspaper also carries the story of a 65-year-old woman who waited 12 hours for a bed at the hospital after suffering a stroke and the case of a two-year-old toddler who had fallen and hit his head and did not receive treatment for 12 hours. They are examples of real suffering experienced by real people, many of whom are my constituents, but Ministers and Conservative Back Benchers do not care because they do not use the national health service.
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  We face a very serious problem in the North Thames region. I asked for an inquiry to be conducted last May, but the situation is now far worse. It is not the fault of the staff—the nurses, doctors and the hard-pressed administrators. It is the fault of the system that they have to try to administer and work with in order to treat patients.
  I visited King George hospital's accident and emergency department at 10.30 on a Friday evening at the end of October. I was at the hospital for about six hours, during which I saw unbelievable pressure placed on the patients. People with broken limbs, head wounds and other conditions waited four or five hours to see doctors. There was massive overcrowding and the hospital had no real facilities to cope with families, especially children. That occurs day after day and night after night in the hospitals of north-east London. Families and staff are suffering along with the patients and, regrettably, the situation is worsening.
  Conservative Members have wheeled out all kinds of platitudes and statistics, but let us consider what has happened so far in 1996. The hon. Member for Surbiton (Mr. Tracey) referred to the new year period. On Monday 1 January, which was a bank holiday, King George hospital was very busy and on 2 January I was told that it was swamped. More than 20 patients were waiting on trolleys at that hospital and 45 patients were waiting on trolleys at Whipps Cross hospital on 2 January. On the same day, the London ambulance service reported that every hospital in London was full. Nine hospitals were closed and all hospitals were turning away ambulances. Ambulances searched as far as North Middlesex hospital in one direction and Basildon in the other in a desperate attempt to find beds so that people could be admitted to hospital.
  Whipps Cross hospital deals with those problems regularly. As it is an old hospital, it has some flexibility in that it can put old, disused wards into service temporarily in an attempt to cope with patient numbers. King George hospital, however, is a new hospital: it has no space and no flexibility, and it is already bursting at the seams. We are told that the winter has been particularly severe this year, but that is not really true: there has been no epidemic.
  Sir Ivan Lawrence: Yes, there has.
  Mr. Gapes: There may have been an epidemic of Conservative Members quitting their party, but it has not been a particularly bad winter in terms of the medical services. What will happen if there is another disaster on the scale of the King's Cross tragedy? How could our system cope with a disaster the like of which occurred on the Tokyo underground?
  The Government, who know the price of everything and the value of nothing, have pared our health service and our accident and emergency departments to the bone. There is no flexibility in the system, which is crying out for space and the ability to deal with the unexpected. The Government's policy, which is based on accountancy rather than care, has led us to that situation. We cannot cope now, so how shall we be able to cope if there is a real crisis in the future?
  I understand that there is a national shortage of D-grade nurses. We are told that the number of practice nurses assisting general practitioners has increased. That has

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  taken the pressure off GPs, but it does nothing to solve the problem—in fact, it complicates it—of the nursing shortage in the hospital system.
  Why are patient numbers increasing? The population is aging and people are becoming more dependent on the health service, but there is a wider and deeper problem: the failure of the Government's community care policy. Local authorities do not have enough occupational therapists, and local government resources have been cut to such an extent that they are unable to cope. People remain in hospital for weeks or months because there is no social support in the community. But the Government cannot use that as an excuse for hospital bed shortages, because ultimately they are responsible for that problem, too.
  The problems in my area are reflected across the nation. However, the north-east Thames area faces some unique difficulties. The Redbridge trust is being asked to treat more patients while receiving 3 per cent. less funding. It currently operates on the target of the 12-month waiting list and it is trying to keep to that target, but the general crisis caused by accident and emergency department closures and hospital closures means that all hospitals in the area—they are in financial deficit from Tower Bridge to Basildon—are in danger of defaulting on that target and incurring financial penalties.
  In a public relations stunt, the Government have said that the 12-month waiting list will come into force on 31 March and that trolley waits will be reduced to a two-hour maximum. Conservative Members should try telling that to my constituents who have waited for 30, 24 and 16 hours on trolleys in hospital corridors. If the hospitals have to meet that target, how will they cope with the other targets set for them?
  The accident and emergency department at Oldchurch hospital is to be closed. The community health council in Redbridge estimates that the result will be 20,000 extra admissions per year for King George hospital. But that hospital does not have the space to take those patients. It is situated just two miles further along the A12, but it does not have the capacity to deal with extra admissions. So who will suffer as a result? It will be the patients—my constituents—who cannot receive treatment in their local constituency hospital. Financial penalties and the local trust's other difficulties will only compound the problem.
  The National Association of Health Authorities and Trusts states that
  "hospitals are faced with conflicting national priorities. On the one hand, they are expected to meet the Patient's Charter guarantee… At the same time, the Patient's Charter stipulates that nobody should wait for a bed in accident and emergency departments longer than four hours".
  That is to go down to two hours, but the association adds:
  "A study of 20 hospitals in the Thames region found that only 18 per cent. of patients received a bed within two hours."
  The figure for the rest of the UK was 80 per cent., but how can north-east London possibly cope?
  The situation is so serious that I fear for the future of many of my sick and elderly constituents. I am not shroud-waving—it is the responsibility of any elected representative to bring to public notice the serious problems that doctors, nurses, administrators, and constituents and their families, draw to our attention. If something is not done in terms of extra resourcing and
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  more accident and emergency beds, and if priority is not given to analysing the problem, the situation will grow even worse for my constituents and people throughout north London. I fear for the future.
  9 pm
  Mr. David Tredinnick: The description of doom and gloom by the hon. Member for Peckham (Ms Harman) to which I listened bore no resemblance to the health service in Leicestershire—the county that I represent. The hon. Member for Leeds, East (Mr. Mudie) pointed out a north-south divide in health services. Leicestershire has none of the problems that they mentioned, and I wonder whether we were listening to a severe distortion of the reality of today's health service.
  The hon. Member for Ilford, South (Mr. Gapes) alluded to problems in his constituency, but the changes in Leicestershire and the midlands since the last Labour Government departed office have been substantial, and represent great improvements.
  I want to talk a little about Leicestershire, but I also wear the hat of the long-standing treasurer of the parliamentary group for alternative and complementary medicine. In that capacity, I will refer to trends in Europe and the United States that my right hon. Friend the Secretary of State should be addressing as demand for alternative and complementary medicine in the UK increases at an exponential rate.
  In 1979, the discharge rate at which patients left Leicestershire hospitals was running at 6,500 a year. By 1987, the figure was 12,500—nearly a 90 per cent. improvement during that Conservative period of office. In 1994, the latest year for which figures are available, 15,500 patients were discharged. That shows a threefold improvement in the number of patients being treated in the county.
  The hon. Member for Peckham said that the health service was being torn limb from limb. She could not have noted the substantial capital investment in Leicestershire. Major developments at the Leicester royal infirmary include two new phases, the new children's hospital being just one of them. Currently, development work on an oncology unit is being undertaken. At the Glenfield general hospital, £50 million has been spent on development. That hospital specialises in cardiac and general acute services, and it has one of the most modern scanners in the world.
  There have been improvements also in the Leicestershire mental health service trust. Approximately £25 million has been invested in new accommodation to replace the old institution, Carlton Hayes hospital. At Leicester general hospital, another £35 million has been spent.
  At Hinckley, at the heart of my constituency, Fosse health trust has revealed plans for effectively a new £9 million hospital. Five years ago, the fate of that hospital hung in the balance. I remember meeting the chairman of Leicestershire health authority to discuss whether or not it should be closed and arguing that it was essential for the town, and that it was at an important location on the A5.
  Since the reforms that my right hon. Friend and his predecessors have put in place, there has been a rapid development and expansion of improved facilities. It will be for Hinckley and Bosworth borough council to

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  consider the planning application that is before that authority, but in principle that is an excellent proposal for the town.
  The range of services offered at the district hospital in Hinckley has increased exponentially. It is now undertaking outpatient work and minor operations that could never be performed at the hospital before—principally because of referrals by GP fundholders, the number of whom is increasing all the time as doctors see the benefits of controlling their budgets and having the right to send patients to whichever hospital they choose. If GPs want to send patients to George Eliot hospital in Warwickshire or to hospitals in Leicestershire, they can do so. It will considerably encourage my constituents to know that a larger number of operations will be available at the enlarged Hinckley hospital.
  Wearing now my alternative and complementary medicine hat, it may interest hon. Members to be reminded of the range of treatments available. They include osteopathy and chiropractic for back problems; herbal medicine and homeopathy; acupuncture, which originated in China; aromatherapy, which is the use of essential oils to help repair the body; allergy assessments; dietary improvements; and healing, which has been on the edge of alternative and complementary medicine but is now coming in from the cold to be considered as a serious treatment. The public have voted with their feet in respect of alternative medicine, and there is a huge demand for such services.
  The growth has been phenomenal. It is not surprising that, on 10 January in another place, there was a three-hour debate on the subject, which was attended by no fewer than 80 peers. That well-attended debate is a reflection of people's interest in alternative medicine. However, out of a total annual health budget of approximately £37 billion, only £1 million is spent on supporting projects and research into alternative and complementary medicine.
  I must tell my hon. Friend the Minister and my right hon. Friend the Secretary of State for Health that something is out of line, because demand for services has become very great. It is time that the Department of Health considered increasing the amount of money available for research.
  In the United States since 1993, there has been an Office of Alternative Medicine, and well funded it is too. In Germany, the Government have been tasked by Parliament to help with scientific evaluations of alternative medicine. In Switzerland, since 1990, there has been a national research programme on alternative medicine.
  In Europe, the report produced by Paul Lannoye for the European Parliament's Environment Committee proposed that 10 million ecu should be spent on research over a five-year period. My hon. Friend the Minister should accept the point that other countries are introducing proposals to increase funding, or they have already done so. I respectfully suggest that he should do the same.
  According to my European colleague, Giles Chichester, a Member of the European Parliament who spoke to the all-party group recently, the United Kingdom is in many respects ahead on alternative treatments, because we are
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  regulating them in a step-by-step approach. We have had the Chiropractors Act 1994 and the Osteopaths Act 1993, and other Acts will follow.
  On behalf of the members of the all-party group, I wish to thank all the disparate practitioners who visit us to give us their views. I also wish to thank my right hon. Friend the Secretary of State and his colleagues for the sympathetic hearing that they have given to alternative and complementary medicine. My right hon. Friend the Secretary of State, when he was the Under-Secretary, agreed that alternative and complementary medicine could be made available on the NHS, providing that a doctor took clinical responsibility. That has had a significant impact on increasing the level of service available and the amount of money that has been spent by the health service on alternative medicine.
  Earl Baldwin of Bewdley, in a recent speech in the other place, mentioned an organisation called Foresight, which has had great success targeting the health of couples to improve the probability of conception. It had spectacular results, but it was instructed to carry out a double-blind trial. Given the evidence of an 89 per cent. success rate, that seems unduly harsh.
  Chinese medicine is growing in popularity, and has been successful in treating eczema. Tough restrictions and conditions have been imposed on practitioners who seek funding, despite the fact that there are 500,000 professionals practising in 1,500 hospitals throughout China. Surely that is evidence enough of the success of the treatment.
  My message for the Secretary of State and the Minister is that demand for alternative and complementary medicine in all its many different hues has never before been so great, and it will increase. I suggest that it is not in the interests of the Department of Health to spend so little—£1 million out of £37 billion—on those important medical treatments.
  9.13 pm
  Mr. Edward O'Hara: With all due respect to the hon. Member for Bosworth (Mr. Tredinnick), I must express my frustration after listening to such a lengthy excursion into alternative medicine. It has left me with very little time to discuss the ills of the national health service. They are what concern my constituents, for whom alternative medicine is not exactly an everyday option. In the few minutes I have at my disposal, I want to refer to the real experience of real people on Merseyside and in Knowsley, South, and to the accountability, or lack of it, of the NHS to my constituents.
  Despite all the fine words about the magnificent resources being globally allocated to the NHS, inadequate resources have been allocated to Merseyside, given its demographic and medical needs. I shall base my remarks on one battle in the health service in our area—over the closure of the accident and emergency department of Broadgreen hospital.
  By a quirk of a line on a map, the hospital is not in my constituency, but it could have been: it is on the other side of the road. It serves my constituency and is located on the junction of Liverpool's inner ring road and the M62, which leads to east Lancashire and joins the M57 and the M6, the main north-west route. One would have thought that an ideal location for an accident and emergency

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  department, so I was deeply concerned about the loss of such a well-placed facility and the consequent impact on my constituents.
  I was assured that magnificent new resources would be provided at the Royal Liverpool hospital, the trust that eventually merged with Broadgreen, and at Whiston hospital at the other end of my constituency. I did not want the closure to be effected until the new resources were available and on stream. I was assured that they would be, but as it happens, we lost the battle.
  In the course of the battle to retain the Broadgreen A and E department, the public of Merseyside and my constituents lost all confidence in the people who were running the trusts. Even as a public representative, I found it difficult to get information and to make my voice heard. The closure was agreed by unaccountable NHS trust appointees. We suspected that the rationalisation would be accelerated—I had no illusions about that.
  From my local government experience, at the delivery end and on the receiving end of rationalisations, I have learnt all the tricks; and when there were suggestions that the closure might have to be accelerated because staff could not be appointed to fill essential posts, I certainly had my suspicions. I asked why the staff were not appointed earlier and advertised for in good time.
  Next, the closure took place, and I was assured of all the magnificent facilities that would be available at the Royal and Whiston hospitals. Instead, I found that patients were waiting as long as 12 hours for beds. There were no spaces for emergency cases. Ill and even terminally ill people were having to wait for hours in casualty. The surgical assessment unit had to be kept open all night so that people could lie there on beds. Emergency admissions had to be put in beds in the reopened but doomed Broadgreen hospital.
  This information was given me in early November by a mole in the hospital trust, whose identity must be protected—a sad reflection on the system. The mole told me:
  "The weather so far this autumn has been kind. I shudder to think what will happen if the weather turns cruel in the winter."
  So it turned out. Before Christmas, all the things that people were worried about in Merseyside happened.
  Ten days before Christmas, there was an accident just around the corner from my house. A lady suffered multiple injuries and had to be transferred from Whiston hospital while connected up to drips and all sorts of life support systems. She was taken to Oldham, 40 miles away. Her condition was stable when she left, but deteriorated during the 40-mph journey through snow along the motorway. Ten days later, she died. I shall protect her identity, out of respect for her grieving family.
  On Christmas eve, a heart attack patient presented herself at Whiston hospital and had to be transferred to Wythenshawe—another journey out of the area. I remind hon. Members that, if critically ill patients are transferred out of the area, the whole family is in crisis. My constituents in Knowsley, South should not have to travel 40 miles during their own crisis to visit sick friends and family.
  The crisis in the NHS came to a head before Christmas, and I saw a system that had finally broken down. Emergency services on Merseyside could not cope. Beds were needed on Merseyside, but they could be provided
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  only out of the area. Ambulances that were needed for emergencies on Merseyside had to travel large distances out of the area and were not available for emergencies on Merseyside.
  I am describing the failure of a system and the lack of accountability to my constituents of the people who run it. The hon. Member for Harlow (Mr. Hayes) referred to returning the NHS to ordinary people. Is that what he means? Not ordinary people like Margaret Pritchard, my constituent, who provides me with information and keeps an eye on what is happening. She has been told that her requests for simple information about what is going on and what difficulties are being experienced in the hospitals on Merseyside will no longer be answered by the chairman's office. Delivery of the national health service to the people of Knowsley, South? Not on your life.
  9.21 pm
  Sir Ivan Lawrence: I am delighted to see that the hon. Member for Peckham (Ms Harman) has returned from the school run. Perhaps she will hear something from me in the remaining two or three minutes about just how the national health service is "falling apart limb from limb" in Burton-upon-Trent.
  The Queen has just opened the brand spanking new Burton district NHS hospital, costing £34 million. It is one of the best equipped in the country. It has 463 beds, which is 294 more than the old hospital had. It is modern, spacious and cheerful, and has integrated acute services. This is not a system that is falling apart limb from limb.
  The hospital won the charter mark for excellence—the only acute hospital to do so in 1994—from the Prime Minister. It led the country in day surgery cases and has now increased the number of such cases by 10 per cent. We have slashed waiting lists, and nobody now has to wait for as long as nine months. The hospital leads the country in information technology. It has the first fully operational computerised information system, which is being spread to general practitioners, who can get their information from the same computer.
  Ten per cent. more treatments take place there. Some 8,000 more of my constituents and those in neighbouring constituencies are able to access the new Burton hospital. This is not a system that is falling apart limb from limb.
  There has been a magnificent reduction in waiting lists—down from 4,686 in December 1992 to 2,800 last December, which is a 40 per cent. reduction. I can go on, but, alas, I do not have the time. We have had two new nurse specialists from the Cancer Relief Macmillan Fund, who are doing magnificent work in helping cancer patients, in the finest traditions of those nurses. Last year, the Burton Hospitals NHS trust screened a higher proportion of women than anywhere else in the west midlands region.
  The Burton trust has not been the only great NHS achievement in my part of the world. There is also the Premier Health NHS trust, which opened a £700,000 psychiatric unit only last year on the district hospital premises. There are 13 fundholder practices in nine funds, representing 85,000 patients and costing about £14.5 million.
  Before all that was set up, I heard plenty of dread prophecies about what would happen, but I hear no complaints now about the concept of fundholding, either

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  from GPs or from patients. They now receive better direct patient care, more quickly, efficiently and effectively and to a higher standard. My doctors and patients will be most interested to learn that Labour, if it ever got into power, would abolish fundholding practices and all the successes that went with them.
  In my part of the world, the Staffordshire ambulance service is now better equipped, better organised and better performing—the fifth best in Britain. What on earth is the Labour party talking about when it speaks of the wreckage of Conservative policies, with the national health service falling apart limb from limb? It is preposterous that, in a debate such as this, so much time should be spent attacking what is clearly succeeding throughout Britain.
  I know that, from place to place and from time to time, one can find things going wrong, but I am fed up with having to try to explain to people that what the Labour party says about the overall picture simply does not apply to my region. There are magnificent achievements there, and it is offensive to those who dedicate so much of their time—doctors, nurses and staff workers in the hospital—continually to have their achievements run down and rubbished by the Labour party.
  I am pleased that I have managed—I thank everyone concerned—to say a few words which will perhaps correct the false impression. I hope that the hon. Member for Peckham, when she has finished delivering her children to their schools, will take a little drive around the country so that she can see what is really happening.
  9.26 pm
  Mr. Henry McLeish: There have been some excellent contributions in the debate. I want to single out two and, to show my impartiality, there will be one from each side of the House. My hon. Friend the Member for Strathkelvin and Bearsden (Mr. Galbraith) demolished the Government's excuses for the crisis over Christmas in terms of bed numbers. It is useful to have an authoritative view on health care in the House and I congratulate my hon. Friend.
  I also congratulate the hon. Member for Broxbourne (Mrs. Roe) on her contribution. She is Chairman of the Select Committee on Health, which has produced an excellent report on continuing care, and we await with interest its evaluation of the Government's response.
  That said, the Government have a real problem. I recall the famous John Maples memorandum. [Interruption.] I hear the Secretary of State going on from a sedentary position, but I think that he will enjoy the next two or three comments. That memorandum suggested that the Tories should bury the NHS in any debate in any part of the country. Having listened to Conservative Members today, in particular the Secretary of State, I believe that that was probably the soundest piece of advice that they have been given in many years.
  The Tories have a threefold crisis when it comes to their concept of a one-nation health service. We are now seeing the cumulative effect of the so-called reforms during the past three or four years and the Government's barely concealed incompetence. That rich mixture is fuelled by the obsession with privatisation.
  The problem for the Government is that when the public perception of what is going on matches up with the reality facing patients, they have a crisis of credibility. As the
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  Secretary of State undertakes his so-called charm offensive around the country, he would do well to face up to the fact that his problem is one of credibility, not charm.
  The other part of the problem facing the Government is the inescapable conclusion about the future of the NHS. My hon. Friend the Member for Peckham (Ms Harman), in an excellent contribution to the debate, highlighted the fact that the Government were moving slowly but surely towards a privatised health service and, at best, a residual NHS. There has been fragmentation, contractualisation and commercialisation. If, for any reason, the Government won the next election, which is unlikely, the British public should be aware that those would be the building blocks for a privatised health service.
  The other point that concerns us is the apparent tale of two health services. According to Conservative Members who have spoken up, there are no problems, and Opposition contributions have merely been encompassed by shroud-waving criticism. But if the Government think that everything in the garden is lovely, the public, patients, specialists within the health services, doctors, consultants, nurses and Labour are all marching together.
  Mr. Whitney: If the hon. Gentleman had really listened to what was said by Conservative Members, he would know that no one suggested that everything in the garden was lovely. Everyone recognises the existence of a huge challenge, not only in Britain, but in every civilised and industrialised country in the world. Several of us enumerated the reasons for that. The hon. Gentleman and the Labour party ignore the challenge, because they have no solutions to offer; they try to pretend that there is no problem. There is a problem, however, and the Conservative party is contributing to the achievement of a magnificent solution following the mess that Labour left in 1979.
  Mr. McLeish: I am pleased to find that we discussing semantics. Conservative Members call it a challenge; we call it a crisis.
  In fact, I listened to all the speeches with great interest, noting the praise for the Chairman of the Health Select Committee. The fact remains, however, that Labour Members were accused of shroud waving and ambulance chasing. Conservative Members have been impertinent enough to suggest that we should not raise the cases that we have raised in the Chamber. That brings us back to the Maples memorandum: "If there is a problem, just bury it." We will not bury important NHS issues; we will raise them at every possible opportunity.
  The Government tell us that they care for the national health service, but that is not the case if linage and word counts are anything to go by. At last year's Tory party conference, the party chairman, the right hon. Member for Peterborough (Dr. Mawhinney), devoted three lines of a 22-page speech to the national health service. The Deputy Prime Minister did not mention it once in a 19-page speech. Five lines of the Prime Minister's 31-page speech dealt with the subject. In those 72 pages of speeches, eight lines were devoted to the NHS.
  Conservatives' attitude to the NHS is akin to Lady Thatcher's attitude to the Prime Minister: grudging, insincere and deeply damaging, with the suggestion that the object of criticism is not sufficiently right wing.
  Mr. Hayes: Will the hon. Gentleman tell us how many lines of his speech the leader of his party devoted to the health service?
  Mr. McLeish: What defines the difference between ourselves and the Conservative party is the fact that the leader of the Labour party is committed to a one-nation health service. The Conservatives are not committed to a one-nation anything.
  We have been accused of shroud waving. We have heard of grim tales, and of people being scared by soundbites. The health service, however, touches everyone in the country; it is a precious asset. Meanwhile, we see headlines such as:s "Children are dying and we can't offer a bed"
  in the Evening Standard,
  "Hole in the heart of the NHS"
  in the Sunday Express—referring to children in intensive care—and
  "Crisis for Britain's sick children"
  in The Independent.
  Are we making those stories up? It seems to us that the Government simply will not pay attention to the crisis that has engulfed the national health service. We could present a litany tonight, including ward closures, bed closures, staff morale, lack of trainees, accident and emergency problems, failure to meet "The Health of the Nation" indicators and poverty as a cause of malnutrition. There is also the way in which the Government have driven dentistry out of the NHS. Those are the issues that dominate the agenda of most ordinary people, and the Government ignore them at their peril. This is the NHS in 1996, Tory-style.
  We should examine the case that we are making against the Government. The first issue, which arose recently, is poverty triggering malnutrition. It is happening not in 1896 but in 1996. An article in The Observer was headlined:
  "Poverty triggers UK diet crisis".
  True to form, the Government commissioned a report, but saw the results and decided to shelve it. I challenge the Minister to comment on that damning report. More important, will he place a copy of it in the House of Commons Library?
  The second issue is preventive health care. We thought that there was a consensus about the future of such care. Why is it then that the NHS is being pushed out of dentistry, which is vital as a preventive health measure, especially for children? A recent survey conducted by the British Dental Association shows that even 44 per cent. of Conservative Members believe that, in 10 years' time, the NHS will be outwith dentistry. That is a condemnation and a sad indictment of a so-called one-nation health service.
  Mr. Tony Marlow: Will the hon. Gentleman give way?
  Mr. McLeish: I am not giving way because I need to make some progress.
  A one-nation health service can accommodate the cash to provide for dentistry.
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  The third issue is resources. We hear the Government say that funding always increases by more than inflation, but the Government must face real questions about waste. They are always lecturing people on their fiscal prudence, but they are happy to see £100 million in England tied up in GP fundholding balances held by health authorities. As some of my hon. Friends have said, that money should be spent immediately on the vital things that are missing from the NHS.
  True to form, the Government have ensured that, in the most recent year for which figures are available, nearly £500 million has been spent on non-NHS providers. That is a leakage from the NHS. At the same time as children are touring the Pennines looking for a bed in a hospital, £500 million is being spent on non-NHS provision. That is a challenge to the Government. [Interruption.] Conservative Members are harping on from sedentary positions, but the harsh reality is that our NHS needs national investment, not the approach that is being taken by the Government.
  I know that the Secretary of State for Health will not like this, but his so-called purge of bureaucrats comes too late. The Government have closed the door after the horse has bolted, which is typical. How laughable that, at the Conservative party conference, he should suggest that we tackle bureaucracy. The key issue for us on waste is that a large part of the finance is being spent on efficiency measures. We want an efficient NHS, but we cannot be bothered with more and more people policing an internal market where hospitals are competing with hospitals for patients' beds. That is ridiculous.
  Over the next two or three months, we shall develop the issue of wasting taxpayers' money, but I want to return to the role of the Secretary of State for Health. Over Christmas, he decided to relax the drinks limit. That is nothing special in itself, but even the Conservative Medical Society, whose patron is the Prime Minister, said in its submission on the review:
  "At a recent meeting of the Conservative Medical Society Executive there was unanimous opposition to any raising of the so called sensible limits for alcohol consumption.
  Any increase in recommended 'safe' limits is likely to encourage some or many individuals to consume nearer the levels to cause problems."
  It said that about 1 million people in Britain have alcohol-related problems. The question for the Secretary of State is this: if medical opinion was not moving him, and if the Conservative Medical Society was so opposed to the relaxation of the limits, why did he change the limits over Christmas and whose pockets were being lined by that development?
  I also want the Secretary of State to respond to questions on bureaucracy. There is no point in shedding crocodile tears now, when during the past five years we have seen an increase of nearly 20,000 managers, while 50,000 front-line nurses have simply left the wards. It is important for the Secretary of State to come clean and explain that the Government have made historic mistakes. There has been burgeoning bureaucracy while, at the same time, they have sacrificed what patients and the public want—front-line care at the sharp end.
  It is also crucial that we examine an experiment that is taking place in Scotland, in which the Secretary of State for Health does not seem to be interested. The experiment, in Stonehaven, is about clinical services and every other

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  service being simply passed over to the private sector. In an interesting article in The Sunday Times about the Secretary of State for Health, unfortunately headed:
  "Misfit with a mission against meddling",
  the Secretary of State said:
  "What I'm not in favour of is privatising clinical care".
  We need to find out tonight—[Interruption.] I should be happy to send a copy of The Sunday Times interview to the Secretary of State. We did not bother with the other sources because one is damning enough.
  The Secretary of State is quite happy for a poll tax-type experiment to take place again in northern Scotland, but is he willing to tell the House that he will not allow clinical services to go into the private sector in England? Double standards are being operated by the Secretary of State for Scotland and the Secretary of State for Health. The right hon. Gentleman should clear up that confusion as quickly as possible.
  Labour Members want our Secretary of State for Health to be active on some of the issues that concern us. There has been much discussion recently about pregnant women being manacled by the Prison Service, but I did not hear the Secretary of State make much of an outburst about it. I should also like to reveal to the House that a Daily Mirror article of 12 January reveals that women prisoners who are being treated for cancer and pneumonia are also shackled. I expect the Secretary of State to give a lead and tell the Home Secretary that such barbaric behaviour is unacceptable. The Secretary of State for Health has been conspicuous by his absence on that issue.
  We have raised with the Secretary of State the issue of intensive care beds for children. The tragedy about a hand-wringing, couldn't-care-less Government is that they say, "We don't know the answers to the questions you asked." On 16 January, my hon. Friend the Member for Sheffield, Hillsborough (Mrs. Jackson) asked the Secretary of State
  "what is the present occupancy rate of intensive care paediatric beds?"—[Official Report, 16 January 1996; Vol. 269, c. 549]
  The Minister said that, because the information on bed occupancy was not available, the Department had asked the Sheffield Children's hospital to find out the bed occupancy rate from the 17 units. Is not that a damning indictment? People are concerned about serious issues, and this Secretary of State is not aware of the figures. The Department of Health instead asked the hospital to find the information that the health service executive should have had immediately available. Again, that speaks volumes for what is going on.
  If there is one single issue on which morale reels in the health service, it is staffing. If one reads submissions from the Royal College of Nursing, the British Medical Association or GPs' committees, on every occasion, one finds a situation in which—[Interruption.] The Minister for Health can sit there and rant, saying "More, more," but I can tell him what the nation would like to see: more nurses, more trainee nurses and far fewer bureaucrats.
  When are the Government going to stop pretending that the real world does not exist? When will Government Front-Bench Members acknowledge that, during the past five years—I shall repeat the figures for the Secretary of State; he got very excited when they were read to him
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  earlier—50,000 front-line staff have disappeared from the wards? We have 19,000 fewer nurses in training, which is a scandal for investment in the new millennium. At the same time, the Government keep feeding through more and more money for an extra 20,000 managers.
  How can the Secretary of State wonder why morale is low, when nurses give more than the hours they work suggest in terms of commitment, dedication and skill? How do they feel when they see a Government who deliberately ignore their needs and patients' needs and push the growth of a burgeoning bureaucracy on every possible occasion?
  If the Government were serious about the national health service, they would stop acting on the basis of hearing no evil, seeing no evil and speaking no evil, and start to get to grips with the problems that surround them. [Interruption.] The Government Whips are suggesting that I sit down. They do not like hearing the truth about what is happening to the NHS throughout the country. It is crucial to tell the Government that, if they believe in a one-nation health service—in view of their recent behaviour, that is a laughable concept—they must stop shuffling structures and start to think about patients and the professionals who do an excellent job on our behalf.
  Unfortunately, some time will elapse before we take over the national health service. Until then, the Government should try to make an effort. We want some urgency and understanding, and we want them to realise that, ultimately, the national health service is our most precious public resource. In 1952, Aneurin Bevan said:
  "What emerges in the final count is the massive contribution that the national health service makes to the equipment of a civilised society. It has now become part of the texture of our national life. No political party would survive that tried to destroy it."
  We do not want the Tory party to survive, but the health service will certainly be safe in our hands.
  9.45 pm
  The Minister for Health (Mr. Gerald Malone): The only interesting discovery to emerge from the contribution of the hon. Member for Fife, Central (Mr. McLeish) is that he reads party conference speeches after they have been delivered and analyses them. The only problem was that he had not read the Leader of the Opposition's party conference speech and could not even say how much he had addressed the subject of health, so it was not a compelling contribution.
  I am grateful to my right hon. and hon. Friends who have spoken in and remained throughout the debate. Opposition Members pushed off following the solidarity photo opportunity, which was probably orchestrated by the hon. Member for Hartlepool (Mr. Mandelson), who pulls the puppets' strings from time to time. According to the Order Paper, this was an Opposition day, but on the Floor of the House it was an Opposition away day. If anyone in the House showed an interest in the health service, it was my right hon. and hon. Friends, who made excellent contributions to the debate.
  As usual, the Labour party has alleged crisis. My right hon. Friend the Secretary of State referred to the pressures on the system, which I acknowledge. The hon. Member for Fife, Central suggested that Conservative Members had tried to say that there were no problems in the health service. We do not say that. We acknowledge the fact that pressures exist and that steps have been put in hand to

  445
  deal with them. I take this opportunity to pay tribute to all those health service staff who do so well in difficult times to deliver service to the public. It can do them no good to hear Labour Members denigrate time and again the service that they deliver, basing their arguments on partial facts rather than the full story of what is happening. If anyone should be upset about the tale delivered by the Labour party, it is not the Conservative party but those who serve within the health service.
  There is no doubt about the challenge that faces us, and a number of hon. Members dealt with it. I shall respond to the detail of the debate briefly because of the lack of time available to me.
  The hon. Member for Strathkelvin and Bearsden (Mr. Galbraith) always makes an important contribution. He was on all fours with us about the difficulties of meeting the challenges of modern medicine and he referred to a number of matters on which we could agree. He mentioned emergency admissions and scoffed when I suggested that there was some doubt about why they were rising. Our research on whether premature discharges have caused the increase in emergency admissions comes from Scotland and shows that they are not necessarily a pressure.
  My right hon. Friend the Member for Sutton Coldfield (Sir N. Fowler) made yet another powerful Back-Bench contribution on behalf of his constituency, and he illustrated clearly the two sides of the coin. Opposition Members tried to say that the service was in crisis, but my right hon. Friend pointed quite properly to what was happening in Good Hope hospital in his constituency. He reminded the House about proper management arrangements, the need for which was rooted in the failure of the service in 1980s. The matter was addressed by my right hon. Friend, and the health service needs proper management.
  Mr. McLeish: What about nursing?
  Mr. Malone: I shall be pleased to refer to nursing in a minute. Proper management is right for the health service, and cutting away bureaucracy and cutting management—the policy of my right hon. Friend the Secretary of State—are also right. The two are quite compatible. The hon. Member for Southwark and Bermondsey (Mr. Hughes) talked about the structure of the health service, and about defining the boundaries of clinical effectiveness. I agreed with him on that, but he went on to say we that we should have local government participation.
  I read with some interest a famous Liberal Democrat document, "Towards 1996", which said:
  "Obviously this document will have a very limited circulation."
  I am not sure whether every one of my hon. Friends now has a copy of this document, but probably most do. The document referred to the work done by somebody called the Liberal Democrat party's political warfare officer—whoever that might be. The document dealt with health in some detail, and listed the Liberal Democrats' strengths and weaknesses on the issue. It managed to find one strength and four weaknesses, one of which was the policy enunciated by the hon. Gentleman, who talked of having councillors in control of health authorities. The document said:
  "Lib-Dem policy of putting councillors in control of LHAs is a barmy idea."
  446
  The hon. Gentleman would do well to listen to his advisers on that point.
  My hon. Friend the Member for Broxbourne (Mrs. Roe), the Chairman of the Health Select Committee, made a powerful and thoughtful speech in which she set out an important future agenda for the Committee, with which we will work with great interest. The Government are keen to respond to the work of the Select Committee—as my hon. Friend pointed out—and we have just submitted an important memorandum on the subject of long-term care. I know that the Committee will consider that with great interest.
  The hon. Member for Bootle (Mr. Benton) came out with the real tactic of the Opposition, which was to have a saga of cases to which Ministers might have been able to respond had they been given some notice. I say that because I made an offer to another hon. Member—he is not in his place—at our previous debate on the matter to investigate every single case that he raised. I must say that he was deficient in the facts when we looked at the cases. I make the same offer to the hon. Member for Bootle—I shall look at each of the cases that he raised and respond to him in detail.
  The Government suggest that people go to the point of first resort, which is the trust. But if there is dissatisfaction, Ministers are happy to look at the case and take up matters on behalf of hon. Members. The hon. Member for Bootle mentioned specifically a reduction in beds, and the loss of a 59-bed unit at Walton hospital. There is to be a new bed block in an associated hospital, but the hon. Gentleman may be disappointed to hear—as it rather destroys his point—that it will contain not 59 but 72 beds.
  The imbalance in the debate was that, although we heard tales such as that told by the hon. Member for Bootle, Opposition Members positively refused to talk about what was happening. The hon. Gentleman referred to Fazakerley hospital, but I was surprised that the hon. Gentleman—as an hon. Member who represents his constituents' interests—failed to mention the investment of £1 million in accident and emergency services in 1994–95. Although he illustrated his point with three cases, he failed to point out that 95 per cent. of patients are now admitted within one hour of the decision to admit. It would be helpful if he looked at the facts.
  My hon. Friend the Member for Birmingham, Edgbaston (Dame J. Knight) paid tribute to what the NHS is achieving, but she raised concerns about mixed wards. We share those concerns, and we need to make progress towards eliminating such wards. She also suggested that NHS staff ought to have care when referring to patients by their Christian name, as that might be insulting. All I can say is that any staff member who referred to my hon. Friend as "Jill" should she ever be in hospital will probably get a thick ear. It is certainly not something that I would try.
  I was pleased that the hon. Member for Blyth Valley (Mr. Campbell) acknowledged that there had been improvements in the service. He dealt specifically with nursing, to which I promised the hon. Member for Fife, Central I would return. I find fault with the Labour party because it always refuses to tell the full case. If one looks at the figures and notes that learners and Project 2000 students are now treated in a different way, and includes general medical services practice nurses, whom the

  447
  Labour party always seems on purpose to exclude, one sees that there has been a 1.6 per cent. increase in qualified and unqualified nursing and midwifery staff between 1989 and 1994. The full picture shows a different story.
  Mr. McLeish: There are not enough.
  Mr. Malone: The hon. Gentleman says from a sedentary position that that is not enough, but that is not the point. His hon. Friends have said that nursing numbers have decreased, but that is simply not true.
  Mr. McLeish: Will the Minister confirm that if one takes Project 2000 nurses and adds them to the learners who are still within the NHS, there are, based on the Minister's figures, 19,000 fewer nurses in training now than in the past?
  Mr. Malone: The numbers of nurses in training at any given time, as of doctors and any other medical staff, are those sufficient to man the service. The hon. Gentleman forgets that when his party handed the health service to the Government, people were leaving it in droves. The NHS was not retaining its staff. More nurses are now being retained than in the past, and that explains why the figure is different.
  My hon. Friend the Member for Wycombe (Mr. Whitney) challenged the Labour party to say what management levels are right. We did not hear anything about that from the Labour party. Judging from what the Opposition have said, however, one would expect them to say that no management was appropriate. That, of course, is absolute nonsense.
  The hon. Member for Rossendale and Darwen (Ms Anderson) spoke about the plans for her hospital. The plans to which she referred were based on the recommendations of a working party composed of health care professionals and consultants. They have been discussed with the community health council and the staff. I am sad to say that the chief executive of the hospital has been trying, I understand unsuccessfully, to discuss the plans with the hon. Lady. Perhaps I will write to him tomorrow to tell him of the concerns that the hon. Lady has expressed in the House, and perhaps a meeting can now take place to illustrate what is going on.
  Various other speakers contributed to the debate, and I would like to refer specifically to the hon. Member for Ilford, South (Mr. Gapes), who said that he was fed up with statistics. Too many statistics mask a story. What tell a false story are partial statistics, which the Labour party cites. It is all very well for the Opposition to say that they do not like statistics, but the truth of the matter is that the facts do not suit them. That is the problem with the health service—more people are being treated more effectively and there are more satisfied customers than ever before. The hon. Gentleman asked for more resources. I ask him to put that question to his hon. Friends on the Front Bench. The Government have been committed to putting more resources into the health service year on year, but it is his party that is silent on that.
  My hon. and learned Friend the Member for Burton (Sir I. Lawrence) paid tribute to what has happened to the health service in his constituency. He is quite right to
  448
  point out that it is a great achievement that day surgery is at record levels at his local trust hospital. That improvement is one reason why we have been able to make such progress.
  I apologise to other hon. Members to whom I have not been able to respond directly, but my time is limited.
  This has been an interesting debate in which the Labour party has not dealt with the current issues in the health service. We heard nothing from the Opposition about the primary care-led NHS and where it is going. They said nothing about how that service will shape the health service for the 21st century. Not a word did we hear.
  We heard a mealy-mouthed answer to the question of fundholding. The hon. Member for Peckham (Ms Harman) will have to answer to a number of fundholding practices in her constituency, including Dr. Virji and partners, who offer clinical psychology, minor surgery and other services; Dr. Brownsdon and partners, one mile north of Herne Hill, who offer excellent services; and Doctor Hossain and partners, who provide outreach teaching clinics for dermatology and in-surgery clinics for antenatal treatment, asthma and hypertension. Those are the benefits that her party is, at bottom, committed to sweeping away. She is fudging the issue and refuses to tell the story.
  Yesterday, we heard from the Leader of the Opposition that he was not buckling under pressure. The whole country could see that he was twisting. His party has been twisting on the health service today. Policy by staccato soundbite will not do. From what we have heard today, the hon. Member for Peckham is more credible when she acts on education than when she speaks on health.
  Question put, That the original words stand part of the Question:—
  The House divided: Ayes 262, Noes 285.

  Division No. 35]

  [9.59 pm

  AYES

  Abbott, Ms Diane

  Byers, Stephen

  Adams, Mrs Irene

  Caborn, Richard

  Ainsworth, Robert (Cov'try NE)

  Callaghan, Jim

  Allen, Graham

  Campbell, Mrs Anne (C'bridge)

  Alton, David

  Campbell, Menzies (Fife NE)

  Anderson, Donald (Swansea E)

  Campbell, Ronnie (Blyth V)

  Anderson, Ms Janet (Ros'dale)

  Campbell-Savours, D N

  Armstrong, Hilary

  Canavan, Dennis

  Ashdown, Rt Hon Paddy

  Cann, Jamie

  Ashton, Joe

  Carlile, Alexander (Montgomery)

  Austin-Walker, John

  Chidgey, David

  Barnes, Harry

  Chisholm, Malcolm

  Battle, John

  Church, Judith

  Beckett, Rt Hon Margaret

  Clapham, Michael

  Beggs, Roy

  Clark, Dr David (South Shields)

  Beith, Rt Hon A J

  Clarke, Eric (Midlothian)

  Bell, Stuart

  Clwyd, Mrs Ann

  Benn, Rt Hon Tony

  Coffey, Ann

  Bennett, Andrew F

  Cohen, Harry

  Benton, Joe

  Connarty, Michael

  Bermingham, Gerald

  Cook, Frank (Stockton N)

  Berry, Roger

  Cook, Robin (Livingston)

  Betts, Clive

  Corbett, Robin

  Boateng, Paul

  Corbyn, Jeremy

  Bradley, Keith

  Corston, Jean

  Bray, Dr Jeremy

  Cousins, Jim

  Brown, Gordon (Dunfermline E)

  Cunningham, Jim (Covy SE)

  Brown, N (N'c'tle upon Tyne E)

  Cunningham, Rt Hon Dr John

  Bruce, Malcolm (Gordon)

  Cunningham, Roseanna

  Burden, Richard

  Dafis, Cynog

  449

  Dalyell, Tam

  Keen, Alan

  Darling, Alistair

  Khabra, Piara S

  Davidson, Ian

  Kilfoyle, Peter

  Davies, Bryan (Oldham C'tral)

  Kirkwood, Archy

  Davies, Chris (L'Boro & S'worth)

  Lestor, Joan (Eccles)

  Davies, Rt Hon Denzil (Llanelli)

  Liddell, Mrs Helen

  Davies, Ron (Caerphilly)

  Litherland, Robert

  Denham, John

  Livingstone, Ken

  Dewar, Donald

  Llwyd, Elfyn

  Dixon, Don

  Loyden, Eddie

  Dobson, Frank

  Lynne, Ms Liz

  Dowd, Jim

  McAllion, John

  Eagle, Ms Angela

  McAvoy, Thomas

  Eastham, Ken

  McCartney, Ian

  Etherington, Bill

  McCartney, Robert

  Evans, John (St Helens N)

  McCrea, The Reverend William

  Ewing, Mrs Margaret

  Macdonald, Calum

  Fatchett, Derek

  McFall, John

  Faulds, Andrew

  McGrady, Eddie

  Field, Frank (Birkenhead)

  McKelvey, William

  Fisher, Mark

  McLeish, Henry

  Flynn, Paul

  Maclennan, Robert

  Forsythe, Clifford (S Antrim)

  MacShane, Denis

  Foster, Rt Hon Derek

  McWilliam, John

  Foster, Don (Bath)

  Madden, Max

  Fyfe, Maria

  Maddock, Diana

  Galbraith, Sam

  Maginnis, Ken

  Galloway, George

  Mahon, Alice

  Gapes, Mike

  Mandelson, Peter

  Garrett, John

  Marek, Dr John

  George, Bruce

  Marshall, David (Shettleston)

  Gerrard, Neil

  Martin, Michael J (Springburn)

  Gilbert, Rt Hon Dr John

  Martlew, Eric

  Godman, Dr Norman A

  Maxton, John

  Godsiff, Roger

  Meacher, Michael

  Golding, Mrs Llin

  Meale, Alan

  Gordon, Mildred

  Michael, Alun

  Grant, Bernie (Tottenham)

  Michie, Bill (Sheffield Heeley)

  Griffiths, Nigel (Edinburgh S)

  Milburn, Alan

  Griffiths, Win (Bridgend)

  Miller, Andrew

  Grocott, Bruce

  Mitchell, Austin (Gt Grimsby)

  Gunnell, John

  Molyneaux, Rt Hon Sir James

  Hain, Peter

  Moonie, Dr Lewis

  Hall, Mike

  Morgan, Rhodri

  Hanson, David

  Morris, Rt Hon Alfred (Wy'nshawe)

  Harman, Ms Harriet

  Morris, Estelle (B'ham Yardley)

  Harvey, Nick

  Morris, Rt Hon John (Aberavon)

  Hattersley, Rt Hon Roy

  Mowlam, Marjorie

  Hendron, Dr Joe

  Mudie, George

  Heppell, John

  Mullin, Chris

  Hinchliffe, David

  Murphy, Paul

  Hodge, Margaret

  Nicholson, Emma (Devon West)

  Hoey, Kate

  Oakes, Rt Hon Gordon

  Hogg, Norman (Cumbernauld)

  O'Brien, Mike (N W'kshire)

  Home Robertson, John

  O'Brien, William (Normanton)

  Hood, Jimmy

  O'Hara, Edward

  Hoon, Geoffrey

  Olner, Bill

  Howarth, Alan (Strat'rd-on-A)

  O'Neill, Martin

  Howarth, George (Knowsley North)

  Orme, Rt Hon Stanley

  Howells, Dr Kim (Pontypridd)

  Parry, Robert

  Hoyle, Doug

  Pearson, Ian

  Hughes, Kevin (Doncaster N)

  Pendry, Tom

  Hughes, Robert (Aberdeen N)

  Pickthall, Colin

  Hughes, Simon (Southwark)

  Pike, Peter L

  Hutton, John

  Pope, Greg

  Illsley, Eric

  Powell, Ray (Ogmore)

  Jackson, Glenda (H'stead)

  Prescott, Rt Hon John

  Jackson, Helen (Shef'ld, H)

  Primarolo, Dawn

  Jamieson, David

  Purchase, Ken

  Jones, Barry (Alyn and D'side)

  Quin, Ms Joyce

  Jones, Ieuan Wyn (Ynys Môn)

  Randall, Stuart

  Jones, Jon Owen (Cardiff C)

  Reid, Dr John

  Jones, Lynne (B'ham S O)

  Rendel, David

  Jones, Martyn (Clwyd, SW)

  Roche, Mrs Barbara

  Jones, Nigel (Cheltenham)

  Rooker, Jeff

  Kaufman, Rt Hon Gerald

  Ross, Ernie (Dundee W)

  450

  Ross, William (E Londonderry)

  Taylor, Rt Hon John D (Strgfd)

  Rowlands, Ted

  Taylor, Matthew (Truro)

  Ruddock, Joan

  Timms, Stephen

  Salmond, Alex

  Tipping, Paddy

  Sedgemore, Brian

  Touhig, Don

  Sheerman, Barry

  Turner, Dennis

  Sheldon, Rt Hon Robert

  Tyler, Paul

  Shore, Rt Hon Peter

  Vaz, Keith

  Short, Clare

  Walker, Rt Hon Sir Harold

  Simpson, Alan

  Wallace, James

  Skinner, Dennis

  Walley, Joan

  Smith, Andrew (Oxford E)

  Wardell, Gareth (Gower)

  Smith, Chris (Isl'ton S & F'sbury)

  Wareing, Robert N

  Smith, Llew (Blaenau Gwent)

  Watson, Mike

  Smyth, The Reverend Martin

  Welsh, Andrew

  Snape, Peter

  Wicks, Malcolm

  Soley, Clive

  Wigley, Dafydd

  Spearing, Nigel

  Williams, Rt Hon Alan (Sw'n W)

  Spellar, John

  Williams, Alan W (Carmarthen)

  Squire, Rachel (Dunfermline W)

  Wilson, Brian

  Steinberg, Gerry

  Wise, Audrey

  Stevenson, George

  Worthington, Tony

  Stott, Roger

  Wright, Dr Tony

  Strang, Dr. Gavin

  Young, David (Bolton SE)

  Straw, Jack

  Sutcliffe, Gerry

  Tellers for the Ayes:

  Taylor, Mrs Ann (Dewsbury)

  Mr. David Clelland and

  Mrs. Jane Kennedy.

  NOES

  Ainsworth, Peter (East Surrey)

  Cash, William

  Aitken, Rt Hon Jonathan

  Chapman, Sir Sydney

  Alison, Rt Hon Michael (Selby)

  Churchill, Mr

  Allason, Rupert (Torbay)

  Clappison, James

  Ancram, Michael

  Clarke, Rt Hon Kenneth (Ru'clif)

  Arbuthnot, James

  Clifton-Brown, Geoffrey

  Arnold, Jacques (Gravesham)

  Coe, Sebastian

  Arnold, Sir Thomas (Hazel Grv)

  Colvin, Michael

  Ashby, David

  Congdon, David

  Atkins, Rt Hon Robert

  Conway, Derek

  Atkinson, Peter (Hexham)

  Coombs, Anthony (Wyre Forest)

  Baker, Rt Hon Kenneth (Mole V)

  Coombs, Simon (Swindon)

  Baker, Nicholas (North Dorset)

  Cormack, Sir Patrick

  Baldry, Tony

  Couchman, James

  Banks, Robert (Harrogate)

  Cran, James

  Bates, Michael

  Currie, Mrs Edwina (S D'by'ire)

  Batiste, Spencer

  Curry, David (Skipton & Ripon)

  Bellingham, Henry

  Davies, Quentin (Stamford)

  Bendall, Vivian

  Davies, David (Boothferry)

  Beresford, Sir Paul

  Day, Stephen

  Biffen, Rt Hon John

  Deva, Nirj Joseph

  Body, Sir Richard

  Devlin, Tim

  Bonsor, Sir Nicholas

  Dorrell, Rt Hon Stephen

  Booth, Hartley

  Douglas-Hamilton, Lord James

  Boswell, Tim

  Dover, Den

  Bottomley, Peter (Eltham)

  Duncan, Alan

  Bottomley, Rt Hon Virginia

  Duncan-Smith, Iain

  Bowis, John

  Dunn, Bob

  Boyson, Rt Hon Sir Rhodes

  Durant, Sir Anthony

  Brandreth, Gyles

  Dykes, Hugh

  Brazier, Julian

  Elletson, Harold

  Bright, Sir Graham

  Emery, Rt Hon Sir Peter

  Brooke, Rt Hon Peter

  Evans, David (Welwyn Hatfield)

  Brown, M (Brigg & Cl'thorpes)

  Evans, Jonathan (Brecon)

  Browning, Mrs Angela

  Evans, Nigel (Ribble Valley)

  Bruce, Ian (Dorset)

  Evans, Roger (Monmouth)

  Budgen, Nicholas

  Evennett, David

  Burns, Simon

  Faber, David

  Burt, Alistair

  Fabricant, Michael

  Butcher, John

  Field, Barry (Isle of Wight)

  Butler, Peter

  Fishburn, Dudley

  Butterfill, John

  Forman, Nigel

  Carlisle, John (Luton North)

  Forsyth, Rt Hon Michael (Stirling)

  Carlisle, Sir Kenneth (Lincoln)

  Forth, Eric

  Carrington, Matthew

  Fowler, Rt Hon Sir Norman

  Carttiss, Michael

  Fox, Dr Liam (Woodspring)

  451

  Fox, Sir Marcus (Shipley)

  MacGregor, Rt Hon John

  Freeman, Rt Hon Roger

  MacKay, Andrew

  French, Douglas

  Maclean, Rt Hon David

  Gale, Roger

  McLoughlin, Patrick

  Gardiner, Sir George

  McNair-Wilson, Sir Patrick

  Garnier, Edward

  Madel, Sir David

  Gill, Christopher

  Maitland, Lady Olga

  Gillan, Cheryl

  Malone, Gerald

  Goodlad, Rt Hon Alastair

  Mans, Keith

  Goodson-Wickes, Dr Charles

  Marlow, Tony

  Gorman, Mrs Teresa

  Marshall, John (Hendon S)

  Gorst, Sir John

  Marshall, Sir Michael (Arundel)

  Grant, Sir A (SW Cambs)

  Martin, David (Portsmouth S)

  Greenway, Harry (Ealing N)

  Mates, Michael

  Greenway, John (Ryedale)

  Mawhinney, Rt Hon Dr Brian

  Griffiths, Peter (Portsmouth, N)

  Mayhew, Rt Hon Sir Patrick

  Grylls, Sir Michael

  Mellor, Rt Hon David

  Gummer, Rt Hon John Selwyn

  Merchant, Piers

  Hague, Rt Hon William

  Mills, Iain

  Hamilton, Rt Hon Sir Archibald

  Mitchell, Andrew (Gedling)

  Hamilton, Neil (Tatton)

  Mitchell, Sir David (NW Hants)

  Hampson, Dr Keith

  Moate, Sir Roger

  Hanley, Rt Hon Jeremy

  Monro, Rt Hon Sir Hector

  Hannam, Sir John

  Montgomery, Sir Fergus

  Hargreaves, Andrew

  Needham, Rt Hon Richard

  Harris, David

  Neubert, Sir Michael

  Hawkins, Nick

  Nicholls, Patrick

  Hawksley, Warren

  Nicholson, David (Taunton)

  Hayes, Jerry

  Norris, Steve

  Heald, Oliver

  Onslow, Rt Hon Sir Cranley

  Heath, Rt Hon Sir Edward

  Oppenheim, Phillip

  Heathcoat-Amory, David

  Page, Richard

  Hendry, Charles

  Paice, James

  Hicks, Robert

  Patten, Rt Hon John

  Higgins, Rt Hon Sir Terence

  Pattie, Rt Hon Sir Geoffrey

  Hill, James (Southampton Test)

  Pawsey, James

  Hogg, Rt Hon Douglas (G'tham)

  Peacock, Mrs Elizabeth

  Horam, John

  Porter, David (Waveney)

  Hordern, Rt Hon Sir Peter

  Portillo, Rt Hon Michael

  Howard, Rt Hon Michael

  Powell, William (Corby)

  Hughes, Robert G (Harrow W)

  Redwood, Rt Hon John

  Hunt, Rt Hon David (Wirral W)

  Richards, Rod

  Hunter, Andrew

  Riddick, Graham

  Hurd, Rt Hon Douglas

  Rifkind, Rt Hon Malcolm

  Jack, Michael

  Robathan, Andrew

  Jackson, Robert (Wantage)

  Roberts, Rt Hon Sir Wyn

  Jenkin, Bernard

  Robertson, Raymond (Ab'd'n S)

  Jessel, Toby

  Robinson, Mark (Somerton)

  Johnson Smith, Sir Geoffrey

  Roe, Mrs Marion (Broxbourne)

  Jones, Gwilym (Cardiff N)

  Rowe, Andrew (Mid Kent)

  Jones, Robert B (W Hertfdshr)

  Rumbold, Rt Hon Dame Angela

  Jopling, Rt Hon Michael

  Sackville, Tom

  Kellett-Bowman, Dame Elaine

  Sainsbury, Rt Hon Sir Timothy

  Key, Robert

  Scott, Rt Hon Sir Nicholas

  King, Rt Hon Tom

  Shaw, David (Dover)

  Kirkhope, Timothy

  Shaw, Sir Giles (Pudsey)

  Knapman, Roger

  Shephard, Rt Hon Gillian

  Knight, Mrs Angela (Erewash)

  Shepherd, Richard (Aldridge)

  Knight, Rt Hon Greg (Derby N)

  Shersby, Sir Michael

  Knight, Dame Jill (Bir'm E'st'n)

  Sims, Roger

  Knox, Sir David

  Skeet, Sir Trevor

  Kynoch, George (Kincardine)

  Smith, Tim (Beaconsfield)

  Lait, Mrs Jacqui

  Soames, Nicholas

  Lamont, Rt Hon Norman

  Spencer, Sir Derek

  Lang, Rt Hon Ian

  Spicer, Sir James (W Dorset)

  Lawrence, Sir Ivan

  Spicer, Sir Michael (S Worcs)

  Legg, Barry

  Spink, Dr Robert

  Leigh, Edward

  Spring, Richard

  Lennox-Boyd, Sir Mark

  Sproat, Iain

  Lester, Sir James (Broxtowe)

  Squire, Robin (Hornchurch)

  Lidington, David

  Stanley, Rt Hon Sir John

  Lilley, Rt Hon Peter

  Steen, Anthony

  Lloyd, Rt Hon Sir Peter (Fareham)

  Stephen, Michael

  Lord, Michael

  Stern, Michael

  Luff, Peter

  Stewart, Allan

  Lyell, Rt Hon Sir Nicholas

  Streeter, Gary

  452

  Sumberg, David

  Walker, Bill (N Tayside)

  Sweeney, Walter

  Waller, Gary

  Sykes, John

  Ward, John

  Tapsell, Sir Peter

  Wardle, Charles (Bexhill)

  Taylor, Ian (Esher)

  Waterson, Nigel

  Taylor, John M (Solihull)

  Watts, John

  Taylor, Sir Teddy (Southend, E)

  Wells, Bowen

  Temple-Morris, Peter

  Whitney, Ray

  Thomason, Roy

  Whittingdale, John

  Thompson, Sir Donald (C'er V)

  Widdecombe, Ann

  Thompson, Patrick (Norwich N)

  Wiggin, Sir Jerry

  Thornton, Sir Malcolm

  Wilkinson, John

  Thurnham, Peter

  Willetts, David

  Townsend, Cyril D (Bexl'yh'th)

  Wilshire, David

  Tracey, Richard

  Winterton, Mrs Ann (Congleton)

  Tredinnick, David

  Winterton, Nicholas (Macc'fld)

  Trend, Michael

  Yeo, Tim

  Trotter, Neville

  Young, Rt Hon Sir George

  Twinn, Dr Ian

  Vaughan, Sir Gerard

  Tellers for the Noes:

  Viggers, Peter

  Mr. Richard Ottaway and

  Waldegrave, Rt Hon William

  Mr. Timothy Wood.

  Walden George

  Question accordingly negatived.
  Question, That the proposed words be there added, put forthwith pursuant to Standing Order No. 30 (Questions on amendments), and agreed to.
  MADAM DEPUTY SPEAKER forthwith declared the main Question, as amended, to be agreed to.
  Resolved,
  That this House believes that the NHS is a great British success story which delivers health care of international quality, which is and will remain available free at the point of use on the basis of medical need and provides excellent value for money for taxpayers; congratulates all NHS staff for their hard work and dedication, particularly during the exceptional period of increased demand for NHS services over recent weeks; welcomes the increasing number of qualified nurses and midwives over the last seventeen years and looks forward to the NHS continuing to flourish under the policies of a Government which has backed its commitment to the service with year-on-year increases in real resources.

  DELEGATED LEGISLATION
  Madam Deputy Speaker (Dame Janet Fookes): With permission, I shall put together the motions relating to delegated legislation.
  Motion made, and Question put forthwith, pursuant to Standing Order No. 101(6) (Standing Committees on Delegated Legislation),

  DELEGATED LEGISLATION
    MARINE POLLUTION
    That the draft Merchant Shipping (Prevention of Pollution) (Law of the Sea Convention) Order 1995, which was laid before this House on 15th November, be approved.

    INTERNATIONAL IMMUNITIES AND PRIVILEGES
    That the draft International Sea-Bed Authority (Immunities and Privileges) Order 1995, which was laid before this House on 15th November, be approved.
    That the draft International Tribunal for the Law of the Sea (Immunities and Privileges) Order 1995, which was laid before this House on 15th November, be approved.—[Mr. Streeter.]
    Question agreed to.

  Saudi Arabia
  Motion made, and Question proposed, That this House do now adjourn.—[Mr. Streeter.]
  10.15 pm
  Mr. George Galloway: I hope that the Minister of State, the right hon. Member for Richmond and Barnes (Mr. Hanley), will accept that I mean him no disrespect when I say that he should not be here this evening. Given the great interest among the British people and internationally about the subject of Britain's relations with Saudi Arabia, and given the intense controversy surrounding the Government's plan to deport the leader of the Saudi opposition, the Foreign Secretary himself should have come to the Chamber tonight to defend the Government's position. His absence is an act of cowardice, which is all the more shameful in view of the important role that he played—as we shall see in a moment—in the plot that was hatched many months ago to rid the Saudi tyrants of this turbulent Muslim priest.
  As the organiser of the "Masari must stay" campaign, I want to deal with the professor's deportation, but only inasmuch as his case crystallises the corrupt and infectious nature of our relationship with that medieval, absolutist royal dictatorship. It is my contention that our unhealthy obsession with, and increasing dependence upon, the single-family rulers of Saudi Arabia is demeaning to us as a country, is diminishing to us as a democracy and is potentially disastrous for us as a trading and manufacturing economy.
  We have reached a nadir in the Government's brazen and almost certainly unlawful decision to deport a peaceful law-abiding refugee and probably send him to his death in Dominica. However, the illness of which I speak is of far longer standing. It reaches to the commanding heights of the military industrial complex, into the inner sanctum of the Cabinet and even into the family home of a former Prime Minister of this country, Baroness Thatcher.
  The infamous Vickers memorandum, which was revealed by The Guardian on 6 January, establishes the nexus as clearly as the most fantastic conspiracy theorist could have dreamt. In the memorandum, two captains of industry—Dick Evans, chief executive of British Aerospace, and Sir Colin Chandler, chief executive of Vickers, who was knighted by Her Majesty the Queen—reveal the complex web that has been woven.
  That web encompasses the British arms industry, the Government and Foreign Office grandees such as Andrew Green—who was revealed by The Independent newspaper to have been at one and the same time the head of the middle east desk at the Foreign Office, ambassador designate to Saudi Arabia and a director of Vickers, a private arms company. It involves the British security services and a brutal foreign autocracy. It is the last absolute monarchy in the world, surviving 350 years after the death of the last such monarch in this country, who was executed not a quarter of a mile from here under the authority of the House.
  The purpose of the web was to conspire to sell more and more guns to that dictatorship not for jobs, but for private profit, and to conspire with its customer to silence or to "stifle personally"—in the chilling words of the
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  memorandum—any opposition to the conspiracy, however peaceful, representative or democratic. No other construction is possible than that the memorandum was referring to, at best, the kidnapping or more likely the assassination of the Saudi opposition leader.
  Last August, in an interview given at his request to the Saudi-controlled newspaper Al-Hayat, the Foreign Secretary carefully laid the ground for the conspiracy. Breaking all protocol in his desperation to appease the Saudi potentates, the Foreign Secretary singled out Professor al-Masari—then an applicant for political asylum—for savage personal attack. He said that the professor represented nothing, but by what process the Foreign Secretary discovered that is unclear, as there are no elections of any kind in Saudi Arabia and no such thing as opinion polls. In any case, the Foreign Secretary has never been known for his special insight into, or interest in, the Arab world.
  The Foreign Secretary contradicted his point by raising and repeatedly returning to the al-Masari case, showing an unhealthy obsession with it. In that interview, the British position began to change. Previously, the stated position was:
  "We can only take action against deeds, not words."
  Thereafter, the position was, "Never mind the law. Never mind our international obligations. This man's faxes and e-mail are dangerous to the continued survival of the rich milch cow that is Saudi Arabia under the dictatorship. He must, one way or another, be stifled personally."
  The wave of revulsion that followed the al-Masari deportation order signed on 3 January was considerable. It can be charted in newspaper editorials across the political spectrum, correspondence columns and the torrent of parliamentary questions and motions, and in the huge number of people of all political colours who are united in the campaign against Professor al-Masari's deportation.
  I visited Saudi Arabia in 1989 as part of a group of parliamentarians—all specialists in the middle east—under the able leadership of Lord Pym. That visit took place in the wake of a squall in British-Saudi relations, after the publication of a private memorandum by Sir James Craig—the recently retired British ambassador to the kingdom. Although years had passed, the regime was still smarting from the British television documentary, "Death of a Princess".
  At every meeting at the highest levels, our delegation was regaled with complaints by the Saudis about the licence, as they saw it, of the British press. With great skill and incomparable charm, Lord Pym painstakingly described the nature of press freedom in Britain, humorously explaining that politicians were frequently on the receiving end of that freedom but that there was nothing we could do about it.
  Late one night, I spoke to Lord Pym about the pressure to which the Saudis were subjecting him. Taking a long sip of water, as was his wont, Lord Pym said something that I have never forgotten: "You see, my boy, we are here to soft-soap really—but we can never, never apologise." What a distance we have travelled since then, under the corrosive influence of the Saudi embrace.
  Mr. Charles Hendry: On a point of order, Madam Deputy Speaker. In the Register of Members' Interests, the hon. Member for Glasgow, Hillhead (Mr. Galloway) declares a remunerated directorship of Hawk Communications International Ltd.—

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  "a communications company…to assist democratic development in the Middle East".
  I am seeking to establish whether the hon. Gentleman has an interest to declare in relation to Saudi Arabia.
  Madam Deputy Speaker (Dame Janet Fookes): It is not for the Chair to find out such things. If the hon. Member concerned feels that he has an interest to declare, he should declare it.
  Mr. Galloway: If I had an interest to declare, Madam Deputy Speaker, I would have declared it. All the interests in Saudi Arabia sit on Conservative Benches—as is clear from the catcalling even from the Treasury Bench. I have no interest to declare except in democratic reform in Arabia and in the overthrow of the absolutist monarchy in that country. I resent the implication of the hon. Gentleman's remarks.
  In Lord Pym's words, "We are here to soft-soap really—but we can never, never apologise." What a distance we have travelled since then, under the corrosive influence of the Saudi embrace. Let us walk down the road that we have travelled and see what landmarks paved the way to that sorry pass. The most corrupting turn was when we opened the door to the Aladdin's cave of the Al Yamamah arms deal and gorged ourselves in a trough of larceny and backhanders. We have to face the fact as a country that that contract was landed by British Aerospace as a result of corruption on an unprecedented scale.
  Enormous bribes—[Interruption.] Interestingly, someone on the Treasury Bench has just said "Hear, hear."
  Mr. Peter Atkinson: I said, "Hear, hear."
  Mr. Galloway: Enormous bribes and commissions of up to 30 per cent. of the multi-billion pound deal were paid. They were shared between the Defence Minister, Prince Sultan and his family, and the sons of King Fand, notably Prince Mohammed, about whom I will say more later. If we are talking about declarations of interest, a whole gang of middlemen was involved in London in that affair and made millions of pounds in pay-offs.
  Those middlemen included Wafic Said, who became a business partner of the right hon. Member for South Thanet (Mr. Aitken) and a close friend of, and generous benefactor to, the Conservative party. They included Mark Thatcher, the son of the then Prime Minister, who gave 10 Downing street as his address at the time, but who was later given his own house and other lavish benefits by Wafic Said and who has become mysteriously and inordinately rich.
  Among those who shared the millions of pounds sucked from those commissions was the former Cabinet Minister and former Chief Secretary to the Treasury, the right hon. Member for South Thanet. Some of those secret commissions on the Al Yamamah deal have been handled by British Aerospace through a British business man, Douglas Leese, who has close connections with an offshore bank, the Bank of NT Butterfield in Bermuda.
  As you know, Madam Deputy Speaker, a report by Sir John Bourn of the National Audit Office, which reveals some of those commissions, has been suppressed by the Select Committee on Public Accounts for more than three years. Public opinion is increasingly asking why.
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  Another part of the deal was concluded in 1988, when the regime agreed to buy minesweepers from Vosper Thorneycroft. Vosper used as its agent a Saudi named Fahd al-Athel, who, like the right hon. Member for South Thanet, worked for Prince Mohammed. Vosper made huge payments to al-Athel's company, which were laundered with the knowledge of Vosper through a front company in Saudi Arabia and were divided 20 per cent. to al-Athel, 40 per cent. to Prince Mohammed and 40 per cent. to unnamed others, some of them known to be prominent figures in British life.
  In a third part of the Al Yamamah deal, Colonel Thomas Dooley, an executive of Sikorsky, testified in a United States court that, while trying to sell Black Hawk helicopters to the Saudi regime, there took place what he described in his testimony as a "competition for bribes". He said that Prince Bandar told him what bribes must be paid for the deal, through which middleman they must be paid, and how he would distribute the money to other members of the royal family.
  In a fourth part of the Al Yamamah deal, the right hon. Member for South Thanet was hired personally by a British arms company—Astra—which hoped to land a contract to fit guns to those helicopters. The right hon. Member has acknowledged that he was paid to introduce his business partner, the aforementioned Fahd al-Athel, to Astra, which was also paying him, as a commission agent.
  The bribes and commissions linked to those deals extended to every subcontract. Last year, Thorn EMI admitted that it had paid bribes totalling 26 per cent., which were illegal even by Saudi law by a factor of five, on the sale of smart fuses for the bombs carried by the Saudi Tornados. Half of those bribes paid off the Saudi princes and the other half went—via a small-scale arms dealer, Michael Gay, who, interestingly enough, is based near the British Aerospace headquarters outside Preston—to those mysterious bank accounts in the Bank of NT Butterfield in Bermuda. There, like other things that venture into the Bermuda triangle, they promptly disappeared.
  The British Government insist that they are expelling al-Masari because of their new-found concern for British industrial jobs. In fact, it is British Conservative politicians, their relatives and business associates, and the revolving-door arms barons-cum Whitehall mandarins who are milking the Saudi cash cow. As the newly elected president of the engineering union, Davey Hall, a man who has represented Vickers workers in the north-east for so many years, has pointed out, a future based on pandering to unstable and unrepresentative middle eastern dictators can never guarantee a secure future for British defence exporters.
  In fact, Vickers is a case in point. An order for the very same Challenger tanks for which Sir Colin Chandler is prepared to sacrifice human rights, to sell them to bloated Saudi princes, was one of the first contracts to be cancelled after the overthrow of the Shah of Iran—a decision that came about precisely because of the craven support, until the last hours, of successive British Governments for the despot in Iran. It is by investment in high-tech performance that British manufacturing will sell around the world, not by giving baksheesh to Saudi princes whose days are, in any case, numbered.
  The contagion of corruption is not confined to business or to Government. The television film "Death of a Princess" is now under lock and key, and all requests for

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  footage from it are routinely denied. Its producer has taken an inexplicable vow of silence, and will make no comment about the film to anyone.
  Nothing, however, could be more humiliating for the world's pre-eminent broadcasting organisation, the BBC, than to have had its editorial integrity prostituted by its reckless commercial involvement with the Saudi royal family. In the wake of the deportation order against al-Masari, all reports of the case on the BBC's Arabic World Service Television were censored by the corporation's partner, the Saudi-owned Orbit Communications, based in Rome. The BBC has still been unable to restore its once incomparable reputation throughout the middle east, despite intensive negotiations with Orbit, and the Secretary of State for National Heritage has still not explained the circumstances of this censorship to the House.
  Who could have predicted that the country which made "Death of a Princess" would itself fall victim to the Saudi virus which has strangled the fragile flower of press freedom throughout the middle east by corruption and larceny?
  It is the Government's case that Britain's strategic and economic interests are bound up with the propping up of what, by anyone's standards, is a rotten and crumbling dictatorship. It is our contention that only by befriending the people of Arabia and extending help to those working for freedom, human rights and democracy in Arabia can we guarantee our long-term future. At the moment, we are guaranteeing the enduring enmity of those people by propping up the people who oppress them. That is why the British people have risen against this decision—and why the British courts will overturn it.
  10.32 pm
  The Minister of State, Foreign and Commonwealth Office (Mr. Jeremy Hanley): The hon. Member for Glasgow, Hillhead (Mr. Galloway) has given us the opportunity to debate Britain's relations with Saudi Arabia, and I welcome that—although it will come as no surprise to him to learn that I do not agree with most, if any, of his remarks. The hon. Gentleman says that it is a disgrace that my right hon. and learned Friend the Secretary of State is not here. That is absolute rubbish. Can he give me a precedent of a Cabinet Minister taking an Adjournment debate, particularly since I am the Minister responsible for our relations with Saudi Arabia?
  Mr. Galloway rose—
  Mr. Hanley: The hon. Gentleman did not allow any interventions—
  Mr. Galloway: Madam Deputy Speaker, the Minister asked me a question.
  Mr. Hanley: No, the hon. Member may not answer.
  Mr. Galloway: Douglas Hurd answered my hon. Friend the Member for Linlithgow (Mr. Dalyell) on the subject of Lockerbie just a few months ago.
  Madam Deputy Speaker: Order. I deprecate this kind of behaviour. It is very important that the courtesies be observed. Mr. Hanley.
  Mr. Hanley: If there is a—
  Mr. Tam Dalyell: On a point of order, Madam Deputy Speaker. The Foreign Secretary did answer me on Lockerbie, as a matter of fact.
  Mr. Hanley: I find very few precedents for the fact that not one Labour Front Bencher is present for the debate on a matter as important as this. Indeed, the hon. Member for Linlithgow (Mr. Dalyell) did not come in until some 15 minutes after the hon. Member for Hillhead had started his speech. I believe that the presence of so many Ministers on the Government Bench shows how importantly we take our relations with Saudi Arabia.
  The United Kingdom has a long-standing and close relationship with Saudi Arabia, based on mutual respect and shared interests. Not only is Saudi Arabia a country of great strategic, economic and commercial importance to us, but there are many ties of history and friendship between Britain and that kingdom, including well-developed cultural, educational and sporting exchanges.
  Britain's links with that country date back to the founding of the modern state of Saudi Arabia in the 1920s and 1930s. Britain never acted as protector of the kingdom, as it did with some of the smaller Gulf states. Instead, the relationship has always been one between two independent sovereign states. Britain recognised the important strategic role that Saudi Arabia was likely to play in the post-war world when Winston Churchill met King Abdul Aziz, the founder of modern Saudi Arabia, on the Suez canal in February 1945. Since then, successive British Governments, with our allies in America and Europe, have sought to ensure that Saudi Arabia remains a force for stability in the region.
  Our bilateral trading relations are extensive. In 1994, visible exports to the kingdom amounted to more than £1.5 billion—a trading surplus of around £800 million. The figures for 1995 are likely to he even better. There is a major invisible account with numerous British financial institutions and companies investing in Saudi Arabia to the tune of £1 billion or more annually, and Saudi Arabians are investing in the City of London. With the exceptions of Hong Kong and Singapore, Saudi Arabia is our largest export market outside the Organisation for Economic Co-operation and Development. There are more than 100 Saudi-British joint ventures currently under negotiation, ranging from construction to pharmaceuticals.
  Saudi. Arabia is also our biggest defence sales market in the world. I welcome the presence of my hon. Friend the Minister of State for the Armed Forces in the Chamber. The sale of military equipment, and the provision of military advice and support is, without doubt, a vital strand in our relationship. Nowhere is that better illustrated than in the Al Yamamah project, which accounts for tens of thousands of jobs in the defence and defence-related sector and contributes to the overall health of our aerospace industry. That may not be important to the hon. Member for Hillhead, but it is important to many thousands of industrial workers throughout the United Kingdom.
  Saudi Arabia is not just a trading partner, but a country whose foreign policy has shared similar objectives to our own. Whether in the Organisation of Petroleum Exporting Countries, the Organisation of Islamic States or other organisations or groupings of which it is a member, Saudi Arabia has played a crucial role in the promotion of

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  moderate and sensible policies. During the cold war, Saudi Arabia, while at all times remaining staunchly independent, was a vehement opponent of communism and the spread of Soviet influence throughout the region.
  Saudi Arabia has been in the forefront of efforts to establish credible regional security blocs. In 1981, it helped to create the Gulf Co-operation Council which, although not perfect, has none the less proved to be a workable model for developing regional co-operation. There is a growing relationship between the GCC and the European Union and the next in a series of ministerial level meetings will take place in April.
  We share with Saudi Arabia a particular concern for the continued stability of the Gulf, to which we make a substantial contribution on the ground and at the United Nations. We stood shoulder to shoulder with Saudi Arabia in the Gulf war in 1991, with the largest deployment of British armed forces since the second world war, and we are ready to do the same again if necessary. As the leading member of the GCC and our major Gulf ally, Saudi Arabia played a vital role in the coalition against Iraq, helping to defeat the expansionist ambitions of Saddam Hussein—I think that we know the hon. Gentleman's views on that subject—and has since been steadfast in support of all UN resolutions designed to force Iraq to adhere to internationally acceptable standards of behaviour.
  Mr. Tim Devlin: Will my right hon. Friend give way?
  Mr. Hanley: I hope that my hon. Friend will understand if I do not give way as I have a lot to say and very little time.
  Saudi Arabia remains an important bulwark against any further Iraqi attempts to threaten or invade its neighbours. The Saudis share our suspicions of Iranian policies in the region and they share our support for the middle east peace process. Saudi Arabia has been a bastion of stability and moderation in a region not always known for those qualities.
  Our warm friendship with Saudi Arabia is reflected in a number of ways, which perhaps I can illustrate. There are close relations between the two royal families. Hundreds of thousands of Saudi Arabians visit Britain every year on holiday. Many have homes here and look upon Britain as their second home. They are important contributors to the British economy. So, too, are the nearly 30,000 Britons who work in Saudi Arabia. Many official visits have taken place between the two countries.
  Saudi Arabia has enjoyed an impressive rate of economic growth and stability. It is important for the economic well-being not only of Britain, but of the whole industrialised world, to ensure ready access to middle eastern oil at an economic price. Saudi Arabia, the leading member of OPEC, has by far the largest proven crude oil reserves in the world. Saudi Arabia is therefore a key element in that equation. Her policy of sustaining a moderate and stable oil price has benefited Britain enormously.
  As our Prime Minister recently emphasised, the continued stability and security of Saudi Arabia are vital to the health of the global economy, to the prosperity of British industry and to the preservation of so many jobs in this country.
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  The hon. Gentleman, as he has made clear on many occasions inside and outside the House, is a fervent supporter of the beliefs of Dr. al-Masari. Dr. al-Masari has launched a vituperative campaign from London aimed at the overthrow of the Saudi Arabian regime. He has at times appeared to condone violence. He has abused our hospitality.
  The hon. Gentleman sees Dr. al-Masari as a western-style liberal. That is clearly not the case, and the hon. Gentleman knows it. Dr. al-Masari's organisation—the Committee for the Defence of Sharia Law—indicates that he would insist on an even stricter application of Islamic law than that followed by the Saudi Government, who themselves adhere to a strict interpretation of Islam. In recent newspaper interviews, Dr. al-Masari has clearly stated his support for an Islamic republic in which only Islamic political parties committed to ruling the country strictly by Koranic law would be able to stand for election.
  Mr. Galloway: How many parties, Islamic or otherwise, are allowed to exist in Saudi Arabia now? And how many elections, of any kind, for anything, are allowed now?
  Mr. Hanley: I am not in any way trying to say that Dr. al-Masari's views are different from many in Saudi Arabia. What I am trying to say is that Dr. al-Masari is not the liberal saint that the hon. Gentleman likes to suggest.
  Not only would Dr. al-Masari ban any party other than those which are strictly bound by Koranic law, but his prescription is for a Saudi Government on the Iranian model. He has also been quoted as following strict anti-blasphemy laws, as wanting women to stay at home and claiming that women sin if they do not submit to sex with their husbands at any time and in any manner, and as favouring stricter applications of the punishments of execution by beheading for criminals and amputations for theft. That does not make him a western-style liberal in my book.
  Mr. Galloway: Rubbish.
  Mr. Hanley: I refer the hon. Gentleman to articles in the press setting out Dr. al-Masari's views.
  The United Kingdom takes seriously its obligation to protect those who seek asylum, but asylum seekers cannot pick and choose which countries suit them best. Against that background, my right hon. and learned Friend the Home Secretary has directed that Dr al-Masari be removed to a country which is willing to receive. him and which is a party to the 1951 refugee convention and the 1967 protocol. We believe that that decision, against which Dr. al-Masari has appealed, was made in accordance with our law and our international rights and obligations.
  The immigration rules provide that an asylum application may be refused without substantive consideration if there is clear evidence of admissibility to a safe third country. My right hon. and learned Friend the Home Secretary was satisfied, following receipt of a letter from the Prime Minister of Dominica, that not only would Dr. al-Masari be admitted there but he would be granted refugee status should he wish to apply.

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  My right hon. and learned Friend the Home Secretary believes that Dominica is a safe third country for the purposes of the refugee convention. Had he thought otherwise, the decision to remove Dr. al-Masari there would not have been taken. Dominica has an excellent human rights record, with freedom of speech and worship enshrined in the constitution.
  Dr. al-Masari's wish for protection under the convention does not entitle him to choose Britain. It is relevant in this context that he also had no ties with this country before entering illegally, and we have all seen how he has taken advantage of our communications network in order to campaign against the Saudi Government—a campaign which the hon. Member for Hillhead, by his own mouth this evening, supports.
  We have made no secret of the fact that the action taken in Dr. al-Masari's case took account of the United Kingdom's strategic and economic interest in the stability of Saudi Arabia. On being satisfied that Dr. al-Masari was not at risk of persecution in Dominica, or of removal from there to a country in which he might fear persecution, it
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  was entirely consistent with the 1951 refugee convention to give wide consideration to the United Kingdom's overall interests.
  We believe that a regular dialogue on human rights is the most appropriate and effective way to address this issue. As for human rights, we and our European partners regularly discuss human rights with the Saudis. In September, for instance, the European Union made a demarche to the Ministry of Foreign Affairs in Riyadh expressing concern at the increasing number of executions taking place in Saudi Arabia. In early December, at the United Nations General Assembly in New York, the European Union pointed out, in a reference to Saudi Arabia, the existence of serious obstacles to the enjoyment of human rights and freedom of religion and expression—
  The motion having been made after Ten o'clock and the debate having continued for half an hour, MADAM DEPUTY SPEAKER adjourned the House without Question put, pursuant to the Standing Order.
  Adjourned at fifteen minutes to Eleven o'clock.