§ Q4. Dr. Desmond Turner (Brighton, Kemptown)I hope that my right hon. Friend agrees that Railtrack's fate sends all private companies involved in the delivery of public services a clear signal that they can no longer expect to be feather-bedded. Can he assure the House that any future developments will be determined by the imperative to give quality and value in services to the public?
§ The Prime MinisterI can give my hon. Friend that assurance. It was important, particularly because we were being asked for billions of pounds of extra public subsidy for Railtrack, that we took the action necessary to put the company on a better footing for the future, so that the interests of the travelling public come first. We know what a disaster rail privatisation was; it is our job and our duty to make sure that it we put it right, and we are doing so.
§ Mr. Iain Duncan Smith (Chingford and Woodford Green)Why does the Prime Minister think that more than a quarter of all family doctors now want to leave the NHS?
§ The Prime MinisterThere are huge strains on family doctors at the moment because they are going through a period of enormous change. We are moving the whole of primary care to primary care trusts. However, I think that family doctors believe that primary care trusts are the right way forward. They also believe, as the right hon. Gentleman will see from the survey on which he based his question, that the services that they offer to their patients today are greatly improved compared with a few years ago.
§ Mr. Duncan SmithIf that is the case, why does the same British Medical Association survey show that nine 1167 out of 10 GPs believe that the Prime Minister's reforms are unachievable, and two thirds think that his plans will do nothing to improve care for patients?
It is not only the doctors. A constituent of mine—[Interruption.] They do not like it. A constituent of mine recently died in hospital after waiting nine hours on a trolley. His family were not aware that he had been admitted or, for a further three days, that he had died. When they came to pay their respects, they found that the body had been lost. Does not the Prime Minister think that all his promises of a better tomorrow will sound hollow to such people?
§ The Prime MinisterOf course what happened to the right hon. Gentleman's constituent is unacceptable. There are situations in the national health service today that are unacceptable. People wait too long for operations; we do not have enough doctors, nurses and consultants; we need to renovate many hospital buildings and introduce new technology. All those things require investment and money, and I am afraid that the difference between our two political parties is that we support the additional investment and his party opposes it.
§ Mr. Duncan SmithIt is the usual story. The Prime Minister talks about investment and then, as he did the other day, pleads for more time. What is the point when his own Ministers, some of whom are present, belie his words? His Health Secretary goes around telling everybody that the NHS will remain a state monopoly as long as Labour is in power. Labour Members are all nodding because they enjoy that. A senior Cabinet Minister is sent to tell the unions that their working practices will not change, no matter what. Is it not clear that when it comes to pleas for more time, with Labour it will be more wasted time? [Interruption.] They do not like it.
§ Mr. SpeakerOrder. The Leader of the Opposition must be heard.
§ Mr. Duncan SmithThey do not like it, Mr. Speaker. The truth that the Prime Minister has to be aware of is that Labour always puts favours to its friends ahead of fairness to patients.
§ The Prime MinisterFirst, on the trade unions, we want to ensure that when services are contracted out, it is not done on the basis of poorer terms and conditions of employment for the staff. One of the things that we have learned over the past few years, not only under this Government but under the previous Government, is that if the impact of contracting out is simply to undermine the terms and conditions of staff, it will not usually lead to a better service, and having discussions on that basis is perfectly sensible.
We are employing many thousands more nurses in the health service, and there are more doctors and consultants. The largest hospital-building programme since the war is under way, and GP premises are being renovated. Of course, it takes a very long time to do that, but it can be done only if we put in the necessary investment.
The position of the Labour party is that it is necessary to put investment into health care, education and other public services before short-term tax cuts. The right hon. 1168 Gentleman's position is to stand in the opposite corner. That is why, no matter how much the Conservatives talk about public services, they will never have credibility on that issue.
§ Joan Ruddock (Lewisham, Deptford)My right hon. Friend spoke earlier about the efforts to bring together the various interest groups that might form a post-Taliban Government. My concern is that they are probably all men. Does he agree that there are many courageous and able women in Afghanistan and in exile, and will he carefully examine the models of female participation that paved the way for women's political involvement in the transitions in South Africa and Northern Ireland?
§ The Prime MinisterFemale participation would certainly be an innovation in Afghanistan after the Taliban regime. I assure my hon. Friend that we are considering how to have a post-Taliban Government in Afghanistan that is as broad-based as possible, and how we can help Afghanistan get over some of the extremism that has so disfigured the country. Under the Taliban, not only are women not allowed to occupy any position of power in public life, they were first driven out of Kabul university, and then girls were forbidden to go to school. There are many changes in which female participation would be most welcome.
§ Q5. Mr. Simon Thomas (Ceredigion)I remind the Prime Minister of the words of the Foreign Secretary in the House yesterday:
There is no problem finding the money to pay for aid to Afghanistan".—[Official Report, 16 October 2001: Vol. 372, c. 1060.]The Prime Minister has just told the House that the humanitarian aspect is as important as the military aspect. How does he explain the fact that to date the World Food Programme has received only one third of the money promised to it by the west to feed the starving in Afghanistan? How can we stop the Muslim world feeling that we find it easier to find money for bombs than for bread? Will he now lead a humanitarian coalition, as he has led the military coalition, to squeeze out of the rich west the money to feed 6 million people?
§ The Prime MinisterThe hon. Gentleman's question is predicated on a misunderstanding of the true position: $700 million have been pledged and the World Food Programme needs about $130 million of that immediately. It has got it. When it needs more, it will have more. The issue is not the sum that has been pledged: it has been made absolutely clear that that money will be available. The issue is how we get the food into Afghanistan. On the question of the humanitarian coalition, we are doing everything that we can, but, as I said earlier, we face obstruction by the Taliban regime.
As for the military action, I ask the hon. Gentleman to reflect on the fact that there is no alternative to taking action against those who perpetrated the terrorist attacks on 11 September other than to say that we will sit back and let them carry on doing it, which would be interpreted as another sign of weakness. I find it extraordinary that anyone can look at the situation and not realise the absolute necessity of acting and of carrying that action through.
1169 Of course it is difficult. Anyone with any sense of humanity who sees the humanitarian problems and realises the appalling difficulties of any form of military conflict would prefer not to take the action, but what have we learned since 11 September? It is that the Taliban will not yield up the terrorist networks and, what is more, those people will do anything they can to repeat the atrocities that they committed on 11 September. In such circumstances, we have no alternative but to act. Our primary aim should be to make the action effective and to get it done as swiftly as we can.
§ Mr. Piara S. Khabra (Ealing, Southall)Is the Prime Minister aware of the existence of madrasas in Pakistan in which the indoctrination of young people in fundamentalist education takes place, preparing them for future terrorist activities? Is he also aware that there are in Pakistan centres where training in the use of weapons is carried out? Will he take the opportunity to speak to the President of Pakistan and say that those institutions should be closed to ensure that the culture of terrorism is rooted out of society?
§ The Prime MinisterI do not think that it is for us to start dictating to countries what they do, but I agree with my hon. Friend that it is important that we address the issue. I found, both when I was in Pakistan and out in the Gulf, that there was considerable understanding of the need for the moderate parts of Islam to regain full and proper ownership of their own religious beliefs from the 1170 extremists. I hope very much that that is what happens; I know that it is essential for the future stability of the world.
§ Mr. Roy Beggs (East Antrim)Does the Prime Minister share the opinion expressed by Northern Ireland Assembly Minister Brid Rodgers that only the IRA can save the Belfast agreement? Does he agree that the issue of decommissioning all illegally held weapons and explosives cannot be fudged? All terrorist organisations in Northern Ireland, whether so-called loyalists or republicans, must commit exclusively to democratic processes and sever immediately all links with other terrorist groups, such as those based in Turkey, Slovakia, Spain and, indeed, Colombia.
§ The Prime MinisterI do agree that it is important for all people to express themselves and indeed to be committed to exclusively peaceful and democratic means. Of course, that is the very reason why we are insistent that weapons are put beyond use, not merely by republicans, but by loyalists and all those groups who have acted and used terrorism in the past 30 years to do so much damage in Northern Ireland. I very much hope that, if we can get that process under way, the hon. Gentleman and his colleagues will work with us to make sure that the institutions can be given the stability that they need, derived from people's confidence that exclusively peaceful and democratic means are going to be used.