HC Deb 21 June 2000 vol 352 cc329-38
Ql. [125506] Mr. David Chidgey (Eastleigh)

If he will list his official engagements for Wednesday 21 June.

The Prime Minister (Mr. Tony Blair)

This morning, I had meetings with ministerial colleagues and others. In addition to my duties in the House, I shall be having further such meetings later today.

Mr. Chidgey

The Prime Minister may not be aware that my constituents in Eastleigh have just lost their post office in Pitmore—to add to the hundreds of others that are closing across the country. He will be aware, however, that the Post Office has just lost £264 million because its new computerised system cannot even pay for itself. Does that not demolish the claim that a new, modernised Post Office can recoup the revenue it is losing because benefit payments are being transferred to bank accounts? When will the right hon. Gentleman produce a sound plan to provide our post office network with the strength it needs to ensure that it serves us in the future?

The Prime Minister

The short answer is that we shall be doing that in the next few days. Of course, we accept not only that it is important to introduce the new technology—that is important for post offices—but that it is right to give them a role and a function for the future. The Government have indicated that we are prepared to support that.

As the hon. Gentleman will be aware, the difficulty with the Horizon project that we inherited when we came into office is that hundreds of millions of pounds—literally—were wasted on it. As a Government, we have had to make provision to try to get ourselves out of that situation. When we publish our plan, I hope that it will give the rural post offices a sound and viable future, but one that is allied to modern reality.

Q2. Mr. Paul Goggins (Wythenshawe and Sale, East)

Will my right hon. Friend the Prime Minister join me in congratulating Age Concern and the citizens advice bureau in Trafford on the success of their recent pensioners benefit take-up campaign? During a period of 18 months, they helped 715 pensioners to claim an extra £827,000 in benefit. Will the Government enhance the work of those organisations by doing something that the Conservatives never did and ensure that, in providing help for all pensioners, they give priority to the poorest?

The Prime Minister

There may be 700 in my hon. Friend's constituency, but across the country more than 400,000 pensioners have been contacted so far to make them aware—if they are poorer pensioners—that the new minimum income guarantee support is available for them. About 1 million pensioners will be up to £20 a week better off. Of course, all pensioners get the £150 winter allowance, and the over-75s will get free television licences. The one thing we know for certain is that each and every one of those things will be taken off them by the Conservatives.

Mr. William Hague (Richmond, Yorks)

The Prime Minister will have seen the news report that the Government may soon receive advice to end the availability of beta interferon on the national health service. It is, of course, a preliminary report, but the right hon. Gentleman will understand that it will have caused immediate and deep concern to thousands of families. Will he now acknowledge that, after three years of a Labour Government, there is more rationing in the NHS than ever before?

The Prime Minister

First, as the right hon. Gentleman says, it is indeed a preliminary report. It is important to emphasise that no one who gets beta interferon at present will be affected by the report. However, it is important that we end postcode prescribing in the NHS. I remind him that it was his Government and he who introduced it.

Mr. Hague

It is no good the Prime Minister talking about postcode rationing. Now there is a threat of rationing where no one gets it, and the postcode is Downing street, SW1. Have not the Government tried to pass the buck by adding, after the passage of the original legislation, the criterion of affordability to the remit of the National Institute for Clinical Excellence—NICE—when its advice should be based on medical considerations? Ministers should decide on affordability in the NHS. As the drug is in use all over Europe, is it not vital that, whatever happens, there is continued freedom to prescribe in particular cases, backed up by an exceptional medicines fund within the NHS—as we have proposed?

The Prime Minister

Let me correct the right hon. Gentleman on two facts. First, nobody who gets the drug now will be denied it. Secondly, he said that it is available to all multiple sclerosis sufferers elsewhere in Europe. In fact, in France, Germany and Italy only 12 per cent. of MS sufferers receive it.

As for the right hon. Gentleman's claim that he is opposed to any form of cost-effectiveness being involved in the test, let me remind him of the document that was put out by the previous Government in 1995 when he was Secretary of State for Wales. He put out a Government document, "New drugs for multiple sclerosis", to the health service, saying that the key aims were to target the drug appropriately at patients most likely to benefit. The document then had a chapter on resource implications and funding and said that providers would need to consider the likely impact on resources of continued prescribing and, in particular, the impact on hospital drugs projects.

Let us have no more of this opportunistic pretence that somehow, when the right hon. Gentleman was in government, people had all the drugs they wanted. In fact for the first time, rightly, there is now an independent institute that can advise the Government. This Government has increased the drugs bill by 9 per cent. in real terms.

Mr. Hague

Whatever the right hon. Gentleman is responding to is an entirely different question from the one that I actually put to him. The chief executive of the MS Society said today that thousands of people are waking up this morning with the icy fingers of dread closing round their hearts. [Interruption.] Those are the words of the chief executive of the MS Society.

Do not the Government have a responsibility to find a way through this issue for the future? Instead of trying to attack other parties on the issue, why does the Prime Minister not respond to a constructive proposal? Will he tell us, when he answers the question, whether he will look seriously at our proposal for an exceptional medicines fund that will reimburse GPs directly for expensive drugs in particular cases, and will avoid arbitrary rationing by health authorities?

The Prime Minister

If the right hon. Gentleman does not like to be reminded of what he did in office, let me just quote—[Horn. MEMBERS: "More, more."] The right hon. Gentleman asked me to continent on his proposal, so let me read what his health service spokesman said three weeks ago about it. He said: In any limited budget, priorities have to be set … There will therefore be a system of more clear … and transparent priority setting. Anything else would simply mean putting our heads in the sand and pretending the problem doesn't exist. As a result of the national institute coming into being, we will now, for example, make taxanes for the treatment of cancer available to everyone. The logic is that we have an independent institute that advises us. Of course it is important to examine how much money the health service can spend, but we are the people who are giving it the biggest increase that it has ever had.

I remind the right hon. Gentleman that although it is all very well to put his proposal to me, there is one flaw with it, and perhaps he will respond to it when he next rises to speak. Under his proposals for private medical insurance, he will take £1 billion out of the health service—money that will no longer be there to be used for beds, nurses, doctors or drugs. That is why our proposals are rather better.

Mr. Hague

The Prime Minister cannot escape his responsibilities—[Interruption.]

Madam Speaker

Order. The House must come to order.

Mr. Hague

The Prime Minister cannot escape his responsibilities with trivialised fiction about Opposition policies when we are asking him to respond to a specific proposal. There is now a serious problem of arbitrary rationing in different health authorities. There is a solution on the table—an exceptional medicines fund, which would reimburse GPs directly. We are asking him only whether he will look at that proposal instead of trying to blame everybody else for every problem that ever comes his way. Will he look at that proposal?

The Prime Minister

First, the right hon. Gentleman is right to say that an arbitrary system is in place. It is called postcode prescribing and it was introduced by his Government. Secondly, I have told him that finance is the flaw in his proposal. Unless we can fund everything that we want to fund, we cannot fund the drugs that people need. Perhaps the right hon. Gentleman will give us an explanation. How will he fund his proposal when £1 billion would be taken out for private medical insurance?

Mr. Hague

The Prime Minister knows—[Interruption.] Once again, this Government blame everybody else for every problem. They blame problems that they created on the Opposition. They blame the media for the way in which the Government get publicity—[Interruption.]

Madam Speaker


Mr. Hague

No one is proposing to reduce the national health service's budget. The proposal is to use NHS money to set up an exceptional medicines fund and use it in a particular way, otherwise the problem that is now arising with beta interferon will arise on many other issues in future. If the Prime Minister thinks that he is not responsible for finding a way through that, when thousands of people are desperately worried about these things, he is not fit to hold the office of Prime Minister or sit on that Bench.

The Prime Minister

I appreciate that people are worried. However, the right hon. Gentleman is proposing to take out £1 billion for private al—[Interruption.] Is it his proposal to have private medical insurance tax relief? A nod of the head would do. The problem with the right hon. Gentleman's exceptional drugs fund is finance. The question is, therefore, who can the nation trust with finance and the health service? We are putting in the largest ever settlement for the NHS. The right hon. Gentleman is committed—or has been until today—to private medical insurance that would take £1 billion out of the NHS. Under this Government, there are 5,500 more nurses and 2,000 more doctors, and the new hospital building programme is under way. All of that would be cut.

How can the right hon. Gentleman say that he would fund absolutely everything that he wants in the health service when he has a tax guarantee in place that would mean tax cuts for a few at the very top and savage cuts in public spending? Just for once, let the right hon. Gentleman get up and explain his policy.

Mr. Hague

The Prime Minister should not worry, as it will not be too long before I am answering the questions and he is asking them. We will get some answers then. If the Government are not prepared to consider a single constructive proposal because they did not think of it themselves, they will continue to betray the NHS.

The Prime Minister

I have already said that the entire basis of the right hon. Gentleman's proposal is that there should be a £1 billion fund. That is the cost, is it not? I have been asked to consider the proposal, so I will. How can the right hon. Gentleman spend £1 billion more when he is dedicated to taking £1 billion out? I would have thought that even he could work out that numeracy and literacy.

The plain fact is that, of course, there are problems, as there always have been in relation to drugs in the NHS. However, the question is whether we carry on with the old postcode prescribing or have an independent body to advise us. We have established an independent body—which was the right thing to do—and are funding it. What the right hon. Gentleman would do would mean that people would lose their ability to get those drugs, as his finance plans have a £1 billion deficit which he cannot fill.

Mr. Joe Ashton (Bassetlaw)

Is my right hon. Friend aware that, in two and a half weeks, a decision will be taken on whether England will host the world cup in 2006? Is he aware that the Football Association and the Government have mounted a magnificent campaign over the past two years, pointing out to the world that we have the best stadiums and organise football better than any other country? They have also pointed out that our police have no problems with crowds in Britain. The hooligans go abroad, but in this country we have a magnificent record of crowd control—[Interruption.] We do. The statistics show that the figure for arrests is 10 per cent. of what it was 20 years ago.

Will my right hon. Friend ask television and the tabloids, and some Tories, to start backing England and telling people how good we are, instead of constantly retelling the events of a Saturday night abroad with a bunch of hooligans? Tory Members are dwelling on that as much as some of the tabloids are, and it is time that we started shouting our support for England.

The Prime Minister

Nothing could excuse the appalling behaviour of those hooligans, who are not connected with football but are simply mindless thugs. It is worth pointing out that the last tournament that we hosted here, Euro 96, was very well policed, very peaceful and very friendly. I have no doubt that the same would happen again.

Mr. Charles Kennedy (Ross, Skye and Inverness, West)

Why does the Prime Minister think that today's World Health Organisation report rates our health service ninth in Europe and 18th in the world?

The Prime Minister

I am pleased that the right hon. Gentleman has asked me that question as it enables me to say two things to him. First, one would think, to read the reports, that we were rated 18th out of about 20; we are 18th out of more than 190 countries in the world. Of course, that is not to say that we do not need to do a lot better, and it is true that we fall behind France in the table. However—this point will interest Conservative Members who want the American health care system in this country—we are in front of the United States and in front of Germany, Sweden, Canada and Australia. There is a lot more that we need to do, but in many ways, particularly on the fairness of funding, the report was complimentary to the UK.

Mr. Kennedy

Such was the commendable detail of that reply that one might almost think that the Prime Minister had received advance warning of the question. Funnily enough, however, after this morning's press reports, this was one of the quieter mornings outside my office, and there was nothing to be heard at all.

Is it not a fact that the number of people waiting for consultant appointments has doubled, that the waiting times are as persistently long as ever, and that on the eve of the last election the Prime Minister said that the country had only 24 hours left to save the health service? Which 24 hours was he talking about, and is not it time that, in government, Labour started sticking to the pledges that it made in opposition?

The Prime Minister

If the right hon. Gentleman wants to discuss election pledges, I point out that the Liberal Democrat pledge on the health service was to spend £500 million more. We are spending billions more on the national health service. As for the in-patient waiting list pledge, that has been met. It is correct that the out-patient lists went up, as they did for many years, but they are now coming back down. There are more nurses and doctors in the health service.

However, nobody should be in any doubt that there is an awful lot more to do, which is why we are publishing the national health service plan in the next few weeks. We need more nurses in the health service, we need better equipment, and we need better systems to reduce waiting times and lists. All those things have to be done, but they will be achieved only by the combination of investment and reform to which we are committed.

As for the WHO report, as I said, 18th out of 190 is not good enough, but it should debunk any absurd notion that Britain has a third-world national health service; it does not. We should be proud of our health service but recognise how much more it should be improved.

Mr. Gwyn Prosser (Dover)

Last night in Dover, local people gathered at the docks near the area where 58 people were found dead in the back of a container lorry on Monday night to hold a vigil to remember the dead and express the compassion of the town. As we come to terms with that terrible tragedy and as the Prime Minister considers what areas he should look at, such as international co-operation, to ensure that similar tragedies do not occur in future, will he investigate the following reports? First, it is alleged that some four weeks ago the 60 victims were deported from Belgium without an escort. Secondly, it is reported that the tell-tale characteristics that drew the attention of the customs officers in Dover were detected by those in Zeebrugge some time before the vessel left, and when timely intervention could have saved lives.

The Prime Minister

The short answer to the last two points is that I do not know whether those allegations have any substance. Of course they should be looked at, although it is important that, until we know the full facts of what happened, we reserve judgment. No one could fail to be appalled at the tragic loss of human life or at the wickedness and evil of that trade. It can only be tackled by having the right measures here, which is why it is important that we now have measures that allow us to detain people who come here and to search the vehicles, to ensure that we penalise and punish properly those who are engaged in the trade.

That emphasises yet again the need to take action at international and, in particular, European level. It seems almost certain that those people travelled through several European countries before they came here. That underlines, once again, the need for some of these issues, particularly that of organised crime—and it is organised crime—to be tackled on a Europe-wide level.

Q3. Dr. Vincent Cable (Twickenham)

Can the Prime Minister clarify Government thinking on civil liberties? The Government have recently restricted the freedom of movement of people from outside Europe into this country; they are proposing to restrict, through surveillance, internet business operations—but at the same time they have upheld the civil liberties of football hooligans who wish to travel freely between this country and the continent, and upheld the freedom of an American rapist to operate his trade in this country. What is the consistent thread running through those Home Office decisions?

The Prime Minister

First, let me correct the hon. Gentleman on a point: there is no question of intercepting everyone's e-mail. There are intercepts now in telephone communications, and intercepts in e-mail will be done on the same basis for very necessary reasons. There are circumstances, especially with organised crime and the drugs trade, in which we need such powers. All Governments have recognised that in the past. As for football hooligans going abroad, this Government have introduced measures to restrict their movement and to impose not just domestic but international banning orders. Following the announcement by my right hon. Friend the Home Secretary on Monday, we shall consider what further measures we will take.

Ms Margaret Moran (Luton, South)

Is my right hon. Friend aware that a report was launched yesterday on an online consultation with the survivors of domestic violence and with parliamentarians? Is he further aware that 90 per cent. of those who referred to their children in that consultation spoke of their fear of further violence or abuse, because the courts almost automatically grant child contact orders to violent parents? Will he undertake to review the legislation and the Government's domestic violence policy, "Living without fear", to ensure that we protect those most vulnerable women and children?

The Prime Minister

As my hon. Friend knows, we have in fact taken several measures to strengthen the law on domestic violence and to ensure that acts of domestic violence are properly reported. I am aware of the report to which she refers, and we will of course look into it and study its findings very carefully.

Q4. Mr. David Amess (Southend, West)

How does the right hon. Gentleman justify the fact that the Chancellor of the Exchequer used two different rates of inflation so that the increase in tax on petrol—[Interruption.]

Madam Speaker

Order. I shall issue some Members with editions of "Erskine May"—they can read the appropriate chapter—because of the farmyard noises they are making, which are not allowed in the House.

Mr. Amess

I have brought some food for them, Madam Speaker.

How does the right hon. Gentleman justify the fact that the Chancellor of Exchequer used two different rates of inflation so that the increase in tax on petrol was three times the increase in the basic retirement pension?

The Prime Minister

Very simply, my right hon. Friend the Chancellor used precisely the method for calculating pensions that has been used since 1987. I have no doubt that the hon. Gentleman will remember that from his days as Member of Parliament for Basildon.

Q5. Mrs. Eileen Gordon (Romford)

Is the Prime Minister aware that many of my constituents in Romford work for Ford at Dagenham, either directly or for contractors that work within Ford, or for companies that rely on Ford for work? Obviously, they are deeply worried about their futures because of the proposed closure of the assembly plant. I know that he has taken a personal interest in this issue, and I thank him for that, but can he tell me and my constituents what support is being given to the work force, what assurances he has had from Ford about its long-term future and commitment to Dagenham and the United Kingdom, and whether he believes them?

The Prime Minister

I will certainly continue to take a personal interest in this matter. We will make sure that Ford sticks to the commitments it has given, which are important. It is worth emphasising that Ford still employs more than 36,000 people in the United Kingdom. This is a very important country for Ford as a market in Europe.

We will play our part in helping the people who have been or will be affected by the announcement of job losses. We have announced a comprehensive plan for the regeneration of Dagenham, including retraining, assistance for small businesses and the development of a science park. Ford has committed funding for that, but I well understand people's anxieties. It is true that the time when the job losses will take effect is some way off, but we will want to work closely with the company to make sure that all the undertakings it has given are indeed honoured.

Mr. Michael Mates (East Hampshire)

In the context of the Prime Minister's much-vaunted health initiative, is he aware that a fine hospital in my constituency with a long-standing reputation for excellence in orthopaedic surgery, the Lord Mayor Treloar, is standing idle with two state-of-the-art theatres, two further theatres and upwards of 50 beds available, because the health authorities want to knock it down and sell the land for development? If he really means what he says, will he look at that scandalous waste of resources in an area with orthopaedic waiting lists of between a year and 18 months, and show us that his initiative is more than just fine words?

The Prime Minister

I am not aware of the particular situation to which the hon. Gentleman draws my attention, but of course I will look into it for him. He says that we offer only fine words on the national health service. However, this year alone we have put in an additional £2 billion. The facts are, of course, that waiting lists are still too high and waiting times are still too long. Precisely for that reason, we need the extra investment in nurses, doctors and hospitals. We are committed to that.

Q6. Mrs. Sylvia Heal (Halesowen and Rowley Regis)

Does my right hon. Friend recall that at every stage of its parliamentary process, the minimum wage was opposed by the Conservative Opposition? Although I welcome their policy U-turn on the minimum wage, has he heard rumours that they would exempt many of this country's small firms, which would mean that more than 2,000 workers in my constituency and millions across the country who benefit from the minimum wage would be betrayed? Does he agree that that would indeed be a betrayal and that the Opposition's new-found commitment to the minimum wage is no more convincing than their new-found commitment to the national health service?

The Prime Minister

Following the earlier exchanges on the policy of the right hon. Member for Richmond, Yorks (Mr. Hague), it is interesting that when my hon. Friend mentioned the Opposition's policy, or non-policy, of exempting small firms, one half of them nodded their heads and the other half shook theirs. That is the state of the Conservative party.

I am proud that the Labour party introduced the minimum wage and I believe that it provides good protection for low-paid workers. However, it is also important that it is combined with other measures such as the working families tax credit. For that reason, there is a concerted attack involving the issues of skills and poverty, and encouraging people back to the workplace. We now have almost a million extra jobs in the British economy.

Mr. Humfrey Malins (Woking)

Given the Government's expressed desire to help Gulf war veterans, will the Prime Minister personally consider the case of my very brave constituent, Paul Connolly, who was a civilian attached to and working with the military in the Gulf conflict? Paul Connolly is now a very sick man with a bad kidney disease. His life expectancy is not great. The disease may well have been caused by exposure to depleted uranium. He was a civilian as opposed to a member of the military, and it seems that no Army or other pension is available to him. He lives on £70 a week incapacity benefit. Will the Prime Minister consider very carefully those civilians who did so much in the conflict and who are now suffering?

The Prime Minister

I will, of course, look carefully at the case of the hon. Gentleman's constituent, and I understand that both he and Mr. Connolly have been in contact with Ministers at the Ministry of Defence. Detailed research, which will take some time, is under way, but I know of the concern of many of those people who are Gulf war veterans, either military or civilian. We are trying to ensure that the research is a priority, and I will look into the case of the hon. Gentleman's constituent.

Q7. Mr. Dennis Turner (Wolverhampton, South-East)

I have very good news for the Prime Minister. Is he aware that my right hon. Friend the Secretary of State for Health—bless him—last Friday announced a £12 million, state-of-the-art cardiac centre for Wolverhampton? That investment will improve the health and life chances of thousands of our citizens in Wolverhampton and the black country. Is not that an example of good old-fashioned public spending in modernising our health service?

Hon. Members

Give us an answer!

The Prime Minister

It is a hard question, but the answer is yes. It is not just that cardiac surgery centre which is a good example, but the new hospital that I opened in Carlisle last week. There are another 30 new hospitals being opened and every accident and emergency department in England is being modernised, with more nurses and doctors. Yes, there is a long way to go, but under this Government we will get there.