HC Deb 01 March 2000 vol 345 cc415-24
Q1. Mr. Peter L. Pike (Burnley)

If he will list his official engagements for Wednesday 1 March.

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 meetings later today.

I should like to pass on the condolences of Labour Members to the Leader of the Opposition and other Conservative Members on the tragic deaths of the Member for Romsey, Michael Colvin, and his wife. Our thoughts and prayers are with his family at this difficult time.

Mr. Pike

I endorse the Prime Minister's comments on Mr. and Mrs. Colvin. I am sure that all hon. Members associate themselves with those comments.

In the week when the Labour party celebrates its centenary, and when we have a Government who are so keen on combating and eliminating poverty in the United Kingdom, is the Prime Minister not ashamed of banks' plans to charge customers for using cash machines? Does not the fact that the Nationwide is prepared to impose a lower charge demonstrate that mutuality is better and that we should have stayed with building societies? What are the Government going to do to address the issue?

The Prime Minister

First, I share my hon. Friend's concerns. However, it is important that we should try to establish the facts. There are indeed legitimate concerns: in particular, we need to know how such charges might impact on pensioners and lower-income customers, and what assessment has been made of the impact on small rural communities, where there may be only one cashpoint. We shall also be receiving shortly Don Cruickshank's report on banking efficiency and competition, which examines some of those issues.

I also remind the House that, today, the Competition Act 1998 comes into force. It will give Britain one of the toughest competition regimes in the world, with new powers to crack down on cartels and other anticompetitive practices that harm the consumer.

Mr. William Hague (Richmond, Yorks)

I thank the Prime Minister on behalf of the Opposition for his kind remarks on last week's tragedy and the death of Michael and Nichola Colvin. Michael Colvin was a fine Member of Parliament, and Nichola Colvin was a wonderful lady. The whole House is absolutely united on that.

Last night, the Prime Minister said: clinical need is supposed to determine whether people are treated or not. If that is not happening, that is wrong. Can the Prime Minister assure the House that doctors never have to distort clinical priorities to meet the Government's waiting list target?

The Prime Minister

The actual guidance that we issued—it is important that we repeat it—states: clinical priority must be the main determinant of when patients are seen as outpatients or admitted as inpatients.

Mr. Hague

What seems to happen in practice under the Government's waiting list initiative is quite different. The chairman of the British Medical Association said: The Government is obsessed with waiting list targets that distort clinical priorities to the detriment of patient care. Yesterday, Dr. Wilde, from Bristol, told the Prime Minister that the crisis in heart surgery was deepening, and that treating urgent cases first would save lives.

We also read stories such as that of the man who died after waiting 72 weeks for a heart bypass. If clinical need was paramount, how could those things happen? Will the Prime Minister accept that the waiting list initiative, as implemented by the Government, is distorting priorities, and that we need a policy on waiting lists in which the patients who most need treatment are treated first?

The Prime Minister

I believe that the principal problem with waiting and heart disease and heart operations is the shortage of heart and cardiac specialists and specialist nurses. That is why we now have 400 extra cardiac specialists in training, which will deliver by 2005—of course it takes time to train them—a 50 per cent. increase. That is a significant increase.

In relation to the Bristol Royal infirmary, which is where Dr. Wilde practises, additional funding will allow seven high-dependency beds to open in October 2000. That, too, will be of some assistance. The new cardiac centre in Plymouth also will help.

Mr. Hague

Is it not a fact that priorities are distorted? Is it not time that the Prime Minister gave all the facts? I have here the briefing that the Department of Health sent to No. 10 for Prime Minister's questions a few weeks ago. [Interruption.] Labour Members should listen, because the Prime Minister does not read it out. Under the heading "No. 10 Briefing for PM Questions" its fact number one is: At the end of September 1999 there were 264,000 more patients waiting over 13 weeks for an outpatient appointment than at the end of March 1997. We have asked the Prime Minister several times for that information, but he never reads it out. We now know that the civil servants give him the facts, but he does not read them out because he dare not do so in the House. Is he not in danger of being the polaroid Prime Minister who turns up for photocalls at hospitals, but does not listen to what is happening and blames doctors and managers and now the media? Is it not time that he took the blame and made sure that clinical priorities are dealt with first? Otherwise he really will be all mouth and no delivery.

The Prime Minister

First, on cardiac services, the national service framework is being published on Monday. I have pointed out the number of extra cardiac surgeons in training. Nobody disputes that there are problems that need to be sorted out, but we are taking action to sort them out: the £21 billion extra investment, all the accident and emergency departments being renovated, 37 new hospitals—the largest capital programme ever—4,000 more nurses, 2,000 more doctors, a 60 per cent. increase in cancer specialists, NHS Direct, the new primary care groups, which handle three times the budget of the old two-tier fundholders, and half a million more operations. That is not to say that there are not still many other problems to be sorted out, but we are trying to sort them out. The difference is that we see those problems as a reason for action. The right hon. Gentleman sees them as an excuse for undermining the health service in principle.

Q2. Ms Rosie Winterton (Doncaster, Central)

I welcome the steps taken this week to boost volunteering, but will my right hon. Friend accept that, particularly in less prosperous areas such as South Yorkshire, the networks set up to support volunteering can be successful only if they are properly funded? Will he also assure me that employers will be encouraged to allow staff to do voluntary work without it affecting their pay or prospects?

The Prime Minister

We are already funding the millennium volunteers scheme. I want to see how we can do more to give opportunities to people who want to volunteer. I also entirely accept my hon. Friend's comment that employers can do more. A number of major companies intend to embrace the scheme to allow their staff to take a paid day off once a year to work in the voluntary sector. I intend to do that myself, both as an individual and as an employer, with people in Downing street and the Cabinet Office able to take a minimum of one day's paid leave a year to do voluntary work. I hope that many will take up that opportunity throughout the country.

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

I associate my colleagues and myself with the proper expressions of condolences to the Colvin family for the truly terrible experience that they have endured. I also take this opportunity to welcome back warmly my hon. Friend the Member for Cheltenham (Mr. Jones). We are all very pleased to see him restored to his parliamentary duties. He has told me of the case of his constituent, Mr. Bob Howes, who has suffered two heart attacks, yet he is still waiting an inordinate length of time for the cardiac treatment that he needs. Dr. Wilde's remarks have been well reported. Is it not a deplorable state of affairs, three years into a Labour Government, with all the expectations that were generated at the general election, that he is citing the fact that 10 of his patients have died who could have been saved had the medical procedures been available?

The Prime Minister

I welcome the hon. Member for Cheltenham (Mr. Jones) back to the House of Commons, as we all do. I am delighted to see him back here.

In relation to waiting for heart surgery, there is no doubt that this is a serious problem, although it is always as well, in the interests of balance, to point out that some 46,000 operations are carried out. It is precisely for that reason that we need to deal with the root of the problem. The root of the problem is the absence of sufficient specialist nurses and specialist surgeons. That can only be cured, I am afraid, over time. That is precisely what we are doing.

Mr. Kennedy

Does it remain the Prime Minister's intention over five years to get health spending in this country up to European levels? If so, does he believe that the tax cut in April will assist that process? Does he not acknowledge that the pledge that he and his party were elected on was to save the NHS before cutting tax? Is it not the case that we are getting tax bribes from the Government instead of saving lives from the Government?

The Prime Minister

The £21 billion is extra money for the national health service. It is also infinitely more than the Liberal Democrats have ever promised. Indeed, we have already put more money into the health service than the Liberal Democrats promised. The plain fact of the matter is that yes, we can get additional money into the health service if we manage the economy properly. It is important that we do that, which is why we have pursued policies that have given us 800,000 extra jobs in the economy, that have given us the best record on inflation of any European country and that have managed to cure the appalling debt that we inherited from the Conservatives. If we followed the recipe set out by the Liberal Democrats, and spent and spent and spent without any idea of where the money came from, we would not be able to maintain the funding in the consistent way that the country needs.

Q3. Ms Oona King (Bethnal Green and Bow)

Is the Prime Minister aware that I have never started a question by congratulating him? Is he further aware that I have to break the habit of a parliamentary lifetime due to the astonishing work being done by himself, the Chancellor and the Secretary of State for International Development in combating world poverty? Given that Britain is spearheading the relief effort in Mozambique, and given the scale of that catastrophe, which I saw for myself a few days ago, will the Prime Minister or Members of his Government undertake to contact Heads of State in the European Union and, indeed, President Clinton, so that our allies take the lead that we have taken in saving lives around the world?

The Prime Minister

We are certainly in touch with our allies. I am sure that the whole House will be appalled by the terrible scenes in Mozambique. We have now found and chartered five more helicopters locally, making, I think, a total of nine. We are sending two large transport aircraft with 69 inflatable boats and motors, 39 self-inflating rafts and Land-Rovers, and there is a team of 30 expert volunteers going with this equipment. We are also sending more shelter material and sheeting. The United Kingdom has, in fact, already committed £4.2 million to help people in Mozambique. That is more than any other country, but it is what is necessary, and we hope that other countries will join in with the effort.

Mr. John Butterfill (Bournemouth, West)

Could the Prime Minister confirm the rumour that is circulating in the House that the right hon. Member for Holborn and St. Pancras (Mr. Dobson) is resigning as Labour's candidate for London mayor?

The Prime Minister

No, I cannot.

Q4. Mr. David Stewart (Inverness, East, Nairn and Lochaber)

The Prime Minister will be aware that more than 1.5 million people in this country suffer from diabetes. It is the main cause of blindness in the under-65s, and half of lower limb amputations are because of diabetes. Does the Prime Minister share my view that the decision today to make pen needles free on prescription will benefit the 400,000 diabetics who inject insulin and will continue our battle against a condition that kills, maims and blinds?

The Prime Minister

I pay tribute to the work that my hon. Friend has done as secretary of the all-party group on diabetes. This is an issue, as he says, that affects more than 1 million people. We take the burden of diabetes very seriously. I am therefore delighted that from today, people who treat their diabetes with insulin will be able to get pen needles and reusable pens on prescription from their GP.

Q5. Mrs. Eleanor Laing (Epping Forest)

What would the Prime Minister say to my constituent, Mr. Thomas of Loughton, who faced the choice of either a long and dangerous—[Interruption.] I do not know what was funny about my constituent. It is a tragic case. What would the Prime Minister say to Mr. Thomas, who faced the choice of either a long and dangerous wait for a heart bypass operation or spending his life savings so that he could have the operation more quickly? At the same time, the health authority was carrying out many minor operations. Today, the Prime Minister has been glib with his statistics. Does not he realise that, in the real world, people like Mr. Thomas know that clinical priorities are being distorted just to make the Prime Minister's waiting list statistics look better?

The Prime Minister

Obviously, I do not know the individual case of the hon. Lady's constituent. As I have said, the only way to deal with these matters is to deal with the root of the problem—insufficient specialists and insufficient specialist nurses to carry out those operations. I hope that she will agree that what is necessary in the health service is additional investment. I hope, therefore, that she will also agree that any political party that had the policy of cutting taxes before anything else would have the wrong priority for the country. The one group of people who cannot say that they would do more for people in the health service are the Conservative party.

Q6. Mr. Eric Martlew (Carlisle)

I am sure that my right hon. Friend is aware of the massive hospital building programme that has gone on since he came to office. In fact, he has given the go-ahead for 37 new hospitals at a cost of £3 billion. Is he aware that the first hospital to be completed will be the new Cumberland infirmary in my constituency? We waited 20 years for that hospital under the previous, Conservative Government. Will he join me in congratulating all the staff involved in the construction and design of the building? I understand that it will be delivered 13 weeks early and on budget; that is probably a first for the NHS. Does he agree that that is another example of the Government delivering for the NHS?

The Prime Minister

I know that my hon. Friend campaigned for many years for that hospital. It is worth pointing out that, although about £30 million was spent on consultancy fees under the previous Government, not a single hospital was built under the private finance initiative. This is the first acute private finance hospital to be completed; it is on time and on budget. It will provide a state-of-the-art hospital with more than 400 beds for the people of Carlisle and the surrounding area. However, we know that in many other parts of the country the same thing is wanted. We shall get there and deliver them their hospitals too.

Mr. William Hague (Richmond, Yorks)

Which of the Labour candidates for mayor of London supports the Government's policy on the tube?

The Prime Minister

The right hon. Gentleman should allow me to run the Labour party and he can run the Conservative party.

Mr. Hague

This is a question about the Government's policy. Which of the Labour candidates for mayor of London supports the Government's policy on the tube?

The Prime Minister

The policy on the tube has been well set out and is, in fact, supported; it is the policy that will be carried through. I repeat that I will take care of running the Labour party and the right hon. Gentleman can run the Conservative party.

Mr. Hague

So the answer is that there is no Labour candidate who supports the Government's policy on the tube. Was not it all summed up by the Labour spokesman? He said: Basically, Frank can say what he likes about the tube, but the policy is the policy. Then he added: Of course, Frank's going to be his own man. Did not the Deputy Prime Minister say that unless a candidate agrees to support the party manifesto, he cannot stand as a Labour candidate? Now that the official Labour candidate is not going to support the Prime Minister's policy, is he going to change the policy or is he going to impose a new candidate?

The Prime Minister

What the right hon. Gentleman says about the policy is nonsense. The real difference is between the Labour party, which supports a public-private partnership, and the Conservative party, which will privatise the whole tube system. People know, if they vote for the Conservative candidate, that the same privatisation that happened with the railways will happen with the tube. That is not the case with us.

I repeat what I said to the right hon. Gentleman. I suggest that he look after the problems of running the Conservative party. I notice that, as there has been a lot of talk about independent candidates, he has decided to appoint an independent as his shadow Chancellor.

Miss Anne Begg (Aberdeen, South)

I have just returned from being a patient who received excellent care and attention in two NHS hospitals, so I have to pay tribute to the hard-working staff—both medical and non-medical—of ward 9B of Aberdeen royal infirmary and of ward 10 of Woodend hospital. Will my right hon. Friend promise me that he will do everything in his power to ensure that all NHS patients get the excellent care that I received? Will he also continue the Government's policy of making sure that there are above inflation increases in the wages of all NHS staff?

The Prime Minister

We will certainly do that. First, in relation to NHS staff, we have now got the large starting pay increase for new nurses and that has resulted in a 25 per cent. increase in the numbers taking nursing degrees. Of course, the number of nurses in training was cut before we came to office under the previous Government. Secondly, the almost 8 per cent. increase for grade E nurses will mean that more than 60,000 of them will get a decent pay increase. I can tell my hon. Friend that 4,500 extra nurses have come back to the health service since we began our recruitment campaign.

My hon. Friend is right. There are many problems in the health service that we need to deal with. However, as I said yesterday and repeat today, we need a sense of balance. The vast majority of people get treated very well in the health service; we have fine staff in the health service who treat them well. For example, 99 per cent. of operations are carried out on time. That is no excuse for the 1 per cent. that are not, but it is simply a plea to get balance in the debate. If we carry on with both the reform and the money, we will improve the health service and make it once again what it should be, but failed to be under the previous Government: the pride of Britain and the envy of the world.

Q7. Mr. Richard Ottaway (Croydon, South)

Will the Prime Minister say why council tax payers should have to pay more to house the nation's asylum seekers?

The Prime Minister

In fact, we provide help to local authorities that face the pressures of asylum seekers and we are trying to make sure that, in circumstances where they face additional costs, we do what we can.

Of course, the problem is the asylum system. That system requires fundamental reform. That is why we are introducing a new system from April this year in which cash payments are limited simply to £10 a week and people do not get the old benefits payments that they used to get under the system that the hon. Gentleman's Government introduced. We are now imposing a penalty of £2,000 on hauliers carrying illegal entrants. Those measures will help us separate bogus asylum seekers from genuine asylum seekers. The measures have one other thing in common: both were opposed by the Conservative party.

Mr. Bob Blizzard (Waveney)

Is my right hon. Friend aware of Beach Radio, a local radio station that serves the far eastern part of East Anglia, including my constituency? If he had been able to listen to Beach Radio yesterday, he would have heard our local hospital, the James Paget hospital, announce that it had just taken on 20 new nurses. In the millennium period the hospital said that it was managing extremely well, it is on course to meet its waiting list reduction targets at the end of this month and it is having a £700,000 refit of its accident and emergency service. Is that not proof on the ground that the NHS is being rebuilt, unlike under the Conservative party, which would just privatise it?

The Prime Minister

Of course that is precisely what the Conservatives intend to do. They want to force all people who have conditions that are not serious or life threatening to go for treatment outside the national health service. That is absolutely wrong and we will not go down that path at all.

On new nurses, it is important that we recruit extra nurses and that we retain them. It is important that we invest in accident and emergency departments, but it is important also that we reform the system. By the end of this year, at least 2 million people will be able to get a booked appointment without any system of waiting at all. In time, we will have to extend that throughout the health service. If we recruit the right staff, make use of the best technology and have proper co-operative partnerships between the various players in the NHS, we can radically improve the whole concept of waiting lists and waiting times.

Q8. Sir Sydney Chapman (Chipping Barnet)

In the spirit of good will, will the right hon. Gentleman join me in congratulating my right hon. Friend the Member for Old Bexley and Sidcup (Sir E. Heath) on being elected to the House for the first time 50 years ago and serving his constituency since then? I know that my right hon. Friend will be as concerned as I am that in the past two and a half years the number of operational officers in the Metropolitan police has been reduced by 793. What hope is there that in the next two and a half years the trend will be reversed, let alone the number increased? Before the right hon. Gentleman answers, I remind him that under the previous Government, Metropolitan police numbers went up from just under 22,000 to more than 28,000.

The Prime Minister

I understand that from March 1992 the figure fell by 2,000. As a result of the additional money that is now being put into the crime fighting fund, we can start to recruit extra officers. I am delighted to join the hon. Gentleman in congratulating the right hon. Member for Old Bexley and Sidcup (Sir E. Heath). He has been not only an outstanding politician and leader in this country, but an outstanding parliamentarian. The whole House is delighted to welcome him here today and to pay tribute to him.

Q9. Mr. Vernon Coaker (Gedling)

Is the Prime Minister aware that the viewing figures for the ITN news at 11 pm are much lower than they were when the news was at 10 pm? Will he join me in calling on ITN to review its decision and to put the news back to 10 pm, to restore the national institution that we all loved?

The Prime Minister

I share my hon. Friend's views on that issue, and I know that the Culture, Media and Sport Committee will take evidence on it later this week. Although this is obviously a matter for the Independent Television Commission, I liked "News at Ten" and I had concerns about the likely consequences of moving it, as did many Members, and I am afraid that those concerns have been largely borne out by what has happened since. "News at Ten" had developed an important place in our national life, and I fear that the decision to move it eroded that position, so I very much hope that ITN will think again.

Q10. Mr. Andrew Stunell (Hazel Grove)

I thank the Prime Minister for his kind words about Stockport council's crime and disorder fight. Will he instruct the Home Secretary to make available the £335,000 required to implement the strategy to which he gave great praise?

The Prime Minister

I am taking urgent instructions from the Home Secretary, but I think that a bid has gone in to the relevant fund that finances those projects. Far be it from me to admit that I did not know the answer, but I shall certainly look into the matter and write to the hon. Gentleman about it.

Mr. Bob Russell (Colchester)

With a cheque.

The Prime Minister

I shall not say that the cheque is in the post. I shall say simply that the decision is with the Home Secretary.

Q11. Dr. Desmond Turner (Brighton, Kemptown)

Is the Prime Minister aware that it is now a year since the royal commission on long-term care policy, which was chaired by Sir Stewart Sutherland, reported its conclusions and recommendations? Since the problems addressed by that report are still very much with us and are a matter of urgency, will my right hon. Friend give an indication of the Government's response to the report's recommendations?

The Prime Minister

The Government's deliberations on the report have taken some time, because of its importance. Also, there are obvious cost implications that must be examined and worked through. My hon. Friend will be able to see the results fairly shortly. We are well aware that it is a major issue that must be considered in the context of the health service as a whole.

One of the other problems of management in the health service is to ensure that we have the proper system of long-term care in place so that the acute beds that are needed for acute care in the health service are occupied by people who must have them. We are trying to make sure that any proposals that we produce on long-term care tie in with what we are doing with community hospitals and social services, to make sure that we have adequate levels of care for everyone. That is why I say, once again, yes, there is a problem of finance, but we also need to change the system under which that money is used.

Q12. Mrs. Virginia Bottomley (South-West Surrey)

When the Prime Minister last answered questions, he informed the House that there had been a fall in the number of midwives under the previous Government. The Health Minister subsequently confirmed that actually the figures increased by 7,760. In the past, there would have been four occasions when Back Benchers could have challenged the Prime Minister on that inaccuracy. Will he clarify the situation now?

The Prime Minister

I understand that during the previous Parliament, the number of midwives did fall. If that is wrong, I am happy to correct it. There has undoubtedly been a 79 per cent. increase in the numbers registering for midwifery as a result of the changes introduced by the Government. That is in addition to the additional numbers of nurses now registering for nursing degrees and the extra nurses in the health service. There can be no dispute about the overall direction. When we came to office, we inherited a situation where the number of nurses in training was cut, and we are now putting extra resources into the health service.