Sitting of 18 March 1985

Preamble
The House met at half-past Two o'clock
PRAYERS
[MR. SPEAKER in the Chair]
PRIVATE BUSINESS

  BIRMINGHAM CITY COUNCIL BILL (By Order)
  Order for Second Reading read.
  To be read a Second time upon Thursday 21 March.

  C-POULTRY COMPANY LIMITED BILL (By Order)
  Orders for Second Reading read.
  To be read a Second time tomorrow at Seven o'clock.

  GREATER LONDON COUNCIL (GENERAL POWERS) BILL (By Order)
  Orders for Second Reading read.
  To be read a Second time upon Thursday 21 March.

  HARROGATE STRAY BILL (By Order)
  Order for Second Reading read.
  To be read a Second time tomorrow at Seven o'clock.

  LINCOLN CITY COUNCIL BILL (By Order)
  Order for Second Reading read.
  To be read a Second time upon Thursday 21 March.

  STREATHAM PARK CEMETERY BILL (By Order)
  Orders for Second Reading read.
  To be read a Second time tomorrow at Seven o'clock.

  YORKSHIRE WATER AUTHORITY BILL (By Order)
  Order for Second Reading read.
  To be read a Second time upon Thursday 21 March.

Oral Answers to Questions
  TRANSPORT

    London Regional Transport (Fares Increase)
    Mr. Tony Banksasked the Secretary of State for Transport if, when he next meets the chairman of London Regional Transport, he will discuss the expected effect of the January 1985 fares increase on passenger-miles travelled on its bus and underground systems.
    The Minister of State, Department of Transport (Mrs. Lynda Chalker): Our discussions with the chairman of London Regional Transport cover a wide range of matters, including LRT's future business prospects.
    Mr. Banks: Will the Minister tell the House why the Secretary of State is allowing the chairman of London Regional Transport to cut a further 39 bus routes in April? Is the Minister aware that if that cut takes place one quarter of all London's bus routes will have been affected by cuts since London Transport became a Government quango? When the Minister or the Secretary of State next sees Doctor Bright, can he be told that Londoners do not want any more one-person-operated buses because they consider them to be slow, inefficient and dangerous?
    Mrs. Chalker: The hon. Gentleman must not believe everything that he reads in the newspapers. As be hon. Gentleman is chairman-elect of the Greater London council, I have to tell him that the net effect of LRT's plans for the buses is a reduction of 0·6 per cent.—about 2 million passenger miles out of a total of 170 million bus miles. Of the routes which have been changed, only three are not covered by other buses. There has been a loss of 2·25 miles of bus route because of a change in demand. In other areas where demand has been established, new bus routes have been introduced. One-person-operated buses are a major contributor to cost savings. They are used across the country without any real difficulty. The hon. Gentleman ought to be looking for improved services for passengers instead of, as he seems to be doing, staying in the past.
    Mr. Tracey: I tend to share my hon. Friend's view of the partial remarks of the chairman-elect of the Greater London council. However, does she agree that the ratepayers of London will be much more enamoured of the professional stewardship of LRT than of the blanket subsidies which were being thrown at London transport by the GLC, since those were simply a drain on ratepayers' pockets?
    Mrs. Chalker: My hon. Friend is right. Had the GLC gone ahead with its planned subsidy levels, the marginal external benefits at those levels would have been equivalent to only one seventh of the increased cost which would have fallen upon the ratepayers. That is exactly why business management was required in London Regional Transport.

    Channel Tunnel
    Mr. Adleyasked the Secretary of State for Transport what assessment his Department has made of the impact of a Channel tunnel on the traffic between London and Paris, Amsterdam and Brussels; and if he will make a statement.
    The Parliamentary Under-Secretary of State for Transport (Mr. David Mitchell): No assessment has been made of the impact of a fixed link on specific intercity routes. That would vary according to the nature of the fixed link, on which no decision has yet been made.
    Mr. Adley: Is my hon. Friend familiar with his Department's estimate that without the TGV or any new British Rail lines, up to 1·7 million air passengers from Heathrow would transfer to a rail tunnel if such a thing

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    were built? With the TGV, the London-Brussels journey time would be reduced to three hours. In the light of my hon. Friend's rather surprising answer, will he give the House an assurance that, as the Government are now reviewing airports policy, full account will be taken of the Channel tunnel so that we do not find ourselves in a position where it takes longer to get from London to Stansted than from London to Paris?
    Mr. Mitchell: We shall take my hon. Friend's point into account, but it is only fair to say that Paris is only one of the many hundreds of routes served from Heathrow.
    Mr. Simon Hughes: Will positive consideration be given to siting any terminus for the Channel tunnel rail line in London docklands where, as the hon. Gentleman is probably aware, there is considerable interest in that terminus? Is that already on his Department's agenda for positive consideration, and will he encourage that development?
    Mr. Mitchell: It is a little premature for us to know that when we do not know exactly what form, if any, the cross-Channel link will take, but I shall certainly keep the hon. Gentleman's point in mind.
    Mr. Hill: My hon. Friend will know that there have been many studies on the cost of linking the major cities of Europe once the Channel tunnel is built. May I draw his attention to the fact that I was the author of one called "Bridges and Tunnels of Europe, 1974", in which much valuable information is contained, although, naturally, it will need updating?
    Mr. Mitchell: I shall ask my hon. Friend for a copy of that excellent document.
    Mr. Snape: I assure the Minister that I have no books on this subject to peddle. Has the hon. Gentleman considered the impact that the Channel tunnel would have on railway freight carriage? Would it not give the railways a much better opportunity to compete on long-distance freight with other modes of transport? Will the Government consider the environmental aspects of the Channel tunnel before coming to a decision on any of the three schemes that they have before them?
    Mr. Mitchell: Yes, we shall take that into account. I can assure the hon. Gentleman that substantial environmental considerations will be taken into account in the assessment of the relative options.

    Concessionary Fares
    Mr. Pikeasked the Secretary of State for Transport if he plans any changes in his Department's arrangements for monitoring the nature and extent of concessionary fares schemes.
    Mr. David Mitchell: I see no need for the Department to collect information centrally. Under the Transport Bill, local authorities establishing concessionary fare schemes will have to publish details and supply copies on request.
    Mr. Pike: Will the Minister take the opportunity, during the passage of the Transport Bill, to ensure that no elderly or disabled person suffers any detriment as a result of the Bill? Would it not be a good starting point to ensure that all pensioners and disabled people have the same concession as that which is good enough for people in London?
    Mr. Mitchell: It is for each elected local authority to decide what it believes to be the right priorities for the people in its area. As the hon. Gentleman well knows, I cannot give the sort of undertaking for which he is asking. I can only give him the undertaking that, if the Bill does not go through, the chronic decline of the bus industry will continue, leaving more and more people isolated without bus services. With the Bill on the statute book, there will at least be a substantial opportunity for the revitalisation of the industry.
    Mr. Brandon-Bravo: Will my hon. Friend reiterate, perhaps for the umpteenth time, that Conservative Members are completely committed to the continuance of concessionary fares for the elderly? Will he take the opportunity to draw to the attention of his right hon. Friend the Secretary of State for the Environment the fact that local authorities of another persuasion are still spending ratepayers' money advertising the fact that the Bill will abolish concessionary fares?
    Mr. Mitchell: I join my hon. Friend in confirming that local authorities up and down the country will wish to continue concessionary fares.
    I also join my hon. Friend in condemning the scandalous way in which ratepayers' money is being used to finance party political propaganda against the Transport Bill. The hon. Member for Burnley (Mr. Pike), who represents an area which has spent over £130,000 of ratepayers' money campaigning against the measure and frightening old-age pensioners, should be ashamed of what is happening in his authority.
    Mr. Rogers: I shall not be drawn into the question of money which the Government are spending on a measure of an overtly political nature. Apart from any arrangements for concessionary fares, does the Minister accept that the removal of £48 million that was available as subsidy for the aged and elderly will mean a continuation of the Government's mean and spiteful policy towards that sector of the community?
    Mr. Mitchell: I trust that the hon. Gentleman is not intentionally confusing the House by comparing things which are not alike. He is comparing the outturn in one year with the provision in another year. As he will well know, the two rarely have much relationship to each other.
    Sir John Page: Is my hon. Friend aware that unscrupulous people in the London area are still trying to spread alarm and despondancy among pensioners and the disabled about the future of concessionary fares after the GLC is abolished? Will he make a further authoritative statement on the subject of concessionary fares in London, underlining the fall-back position enshrined in the Bill?
    Mr. Mitchell: I can confirm that there is no such threat in the London area. I am glad to take the opportunity of reassuring my hon. Friend, and, through him, the many thousands of people who have been scandalously and unreasonably frightened in the matter.
    Mrs. Dunwoody: If the Minister is really serious, what objection can he have to writing a guarantee of this kind into the Transport Bill? If we are to take him at his word, let him propose a Government clause to make sure that concessionary fares will be not only monitored but retained. If he does that, then and only then shall we believe that they are to be protected.
    Mr. Mitchell: I would not wish to launch into such an attack upon the rights of local authorities — [HON. MEMBERS "Oh".]—to make their own decisions in the light of their own circumstances and what they believe to be the right priorities for people in their areas.

    Traffic Offences (Penalties)
    Mr. Gregoryasked the Secretary of State for Transport whether he is satisfied with the effectiveness of the present system of penalties for traffic offences.
    Mrs. Chalker: On 31 Janauary my right hon. Friend announced the setting up of a review body to consider certain aspects of traffic law, including penalties. We are most concerned to have a system of road traffic law that is both fair and effective.
    Mr. Gregory: I thank my hon. Friend for that comment. Will she take account of the widely varying disparities throughout the county, particularly with regard to construction and use? If, unfortunately, the rear light of her vehicle is not functioning as she goes through one county, she may be advised to present a note to the police station when the fault has been rectified, but in another county there is an immediate prosecution. I hope that the review will deal with disparities of that sort.
    Mrs. Chalker: I am aware of the anxiety that my hon. Friend has mentioned. It is a matter for the review, under Mr. North. I am sure that the review body will look at that matter and at others where there seems to be inequality between one county and another. Some of the matters are for the Home Office, but it is a joint review between my Department and the Home Office.
    Mr. Higgins: Will my hon. Friend give me an assurance that the review will cover the activities of motor cyclists? They seem increasingly to be attempting to commit suicide by driving in and out between moving vehicles. Will she give particular attention to that matter? A considerable number of motor cyclists drive on the outside of moving traffic and go on the wrong side of islands in the middle of the road.
    Mrs. Chalker: Those activities are already outside the law. It is a matter of concern and of enforcement of the law. No motorist who ignores the "Highway Code" can be safe on the road. In the review we shall have to look at better ways of ensuring that the "Highway Code" is implemented.
    Mr. Roger King: Does my hon. Friend agree that, as with all aspects of the law, sensible traffic law should be readily obeyed by motorists? Does she further agree with the Select Committee report on road safety that a trial speed limit of 80 miles an hour on our motorways would be one step forward along that path?
    Mrs. Chalker: I wish that all sensible road laws were obeyed by motorists. Unfortunately, that is not so. I shall be coming to the House with our reaction to the Select Committee's suggestions on road safety. We are concerned to improve road safety, and that is why we are looking carefully at the range of suggestions made by the Select Committee.
    Mr. Tony Banks: It is a matter not only of the review of the system of traffic offences, but of policing. Will the hon. Lady be speaking to her right hon. and learned Friend
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    the Secretary of State for the Home Department and asking for an increase in the number of traffic wardens in London so that illegal parking and illegal use of bus lanes can be eliminated? Do we not need more policing of such matters?
    Mrs. Chalker: I think that the chairman-elect of the GLC knows already that the use of traffic wardens in the Greater London area is being discussed between his colleagues in the GLC, the London Boroughs Association, the Association of Labour Authorities and my Department, and we shall shortly be having a further meeting. Merely extending the traffic warden system will not necessarily improve the behaviour of motorists who park in a particular area.
    Mr. Peter Bruinvels: Will my hon. Friend look at speeding offences, which seem to be on the increase, particularly on motorways, with 80 miles an hour now being the traditional speed? Will she also look at the offence of drunken driving, particularly as a number of garages now have an off-licence facility? Could the penalties for drunken driving be increased?
    Mrs. Chalker: My right hon. and learned Friend the Home Secretary updates maximum penalties, and there is a regular review of different penalties for different offences. The fines for drunken driving are £2,000, obligatory disqualification and up to six months in gaol. They are harsh, and if they need to be made harsher, I am sure that the review body will recommend that.

    Railway Ancillary Services
    Mr. Robert B. Jonesasked the Secretary of State for Transport when he last discussed the options for contracting out ancillary activities on the railways with the chairman of British Rail.
    The Secretary of State for Transport (Mr. Nicholas Ridley): Last December BR published its new criteria for the supply of support services. At our regular meetings the chairman keeps me informed of progress in applying them.
    Mr. Jones: I am grateful to my right hon. Friend for that reply. The existence of these criteria will come as a great surprise to most businesses. Will he ensure that the chairman of British Rail spends more time promoting the existence of these criteria than making half-baked proposals for denying second-class passengers access to first-class dining cars?
    Mr. Ridley: I do not think that all that my hon. Friend has read in the press about dining cars is true. I strongly support what he said about the need for industry to get to know about these new criteria, because literally millions of pounds worth of business is let out by British Rail, and there are opportunities for firms, for more jobs, for improving the service and for saving money for British Rail, of which I hope the whole of industry will avail itself.
    Mr. Flannery: In view of the privisation of certain sections of the Health Service, where money is shamelessly being made out of the elderly and sick—and by some hon. Members — and when people are being put on the dole and work is not being done, can we be assured that any consideration of privatisation of the railway service will be abandoned?
    Mr. Ridley: The hon. Gentleman must not ask me about the Health Service. If private contractors can do work for or supply goods or services to British Rail that are cheaper and better, the hon. Gentleman, like every other hon. Member, should be pleased to hear about it.
    Mr. Snape: Does the Secretary of State accept that for those skilled tradesmen who formerly worked in British Rail Engineering Ltd. at Shildon, Horwich, and some at Swindon, privatisation has meant only a one-way ticket to the dole queue? When will he get British Rail to invest in the skills of its work force and give us a railway that is similar to railways in the rest of the developed world instead of seeking to destroy it?
    Mr. Ridley: The hon. Gentleman is not right. BREL will always be able to tender for British Rail orders that are put out to competition. The main reason for the decline in the work force at BREL has been the high level of investment in British Rail rolling stock, which is of a superior quality and requires less maintenance.

    Motor Insurance
    Mr. Chapmanasked the Secretary of State for Transport if he will report progress in preparing legislation to implement the second European Community directive on motor insurance requiring compulsory insurance for third party injury and property damage.
    The Parliamentary Under-Secretary of State for Transport (Mr. Michael Spicer): At the request of some organisations, we extended by six weeks the consultation deadline of 31 December. A number of points still have to be sorted out before we can bring considered proposals to the House for extending compulsory motor insurance to include third party property damage.
    Mr. Chapman: I am grateful for that encouraging reply. Will my hon. Friend assure the House that he will seek amending legislation well before the end of 1988? Since the directive explicitly gives uniform minimum protection to third parties in motor accidents, but implicitly encourages more than the minimum protection, will my hon. Friend look sympathetically at the need for our legislation to be much tighter than that laid down in the directive?
    Mr. Spicer: My hon. Friend has taken a close interest in this matter over a long time. He is right in implying that the legislation will not have to come into effect until 1988, according to the directive. Our intention is to bring the necessary secondary legislation before Parliament during the present Session.
    My hon. Friend asked about the possibility of raising our conditions above the minimum. We are consulting about that at the moment, and we shall take into account what my hon. Friend said.

    Lowlands Airport Policy (Report)
    Mr. Foulkesasked the Secretary of State for Transport if he has now considered the report of the Scottish Affairs Committee on lowlands airport policy; and if he will make a statement.
    Mr. Michael Spicer: I have read the Committee's report with interest. My right hon. Friend the Secretary of State expects to make a statement about Scottish lowland airports policy shortly.
    Mr. Foulkes: But the Minister said that months ago in exactly the same words. Will he confirm that, since the bulk of the evidence to and the report of the Select Committee and the report of his own working party favour retaining Prestwick as Scotland's transatlantic gateway, the only reason for delay is an internal battle between the political dogma of his Secretary of State and the interests of Scotland as represented by the Select Committee, Scottish Members of Parliament and the Secretary of State for Scotland? When shall we know whether sense triumphs over political dogma?
    Mr. Spicer: I understand the anxieties expressed by the hon. Gentleman and many of his colleagues. The hon. Gentleman has made it out to be a simple matter, but it is very complicated and perhaps more complicated than we anticipated originally. All I can say is that we hope to make our decisions known in the next few weeks.

    Coal Industry Dispute
    Mr. Marlowasked the Secretary of State for Transport what is the latest estimate of the cost of the coal dispute to British Rail; and how the money is to be recovered.
    Mr. David Mitchell: British Rail estimates lost freight receipts at £240 million. It is for British Rail to devise ways of recovering these losses and to achieve the financial target for the freight business.
    Mr. Marlow: If such losses were made by a private sector company, obviously they would not be made up by the taxpayer. Will my hon. Friend give a categorical assurance that the money lost by British Rail will not be forced as a burden on the taxpayer in any way?
    Mr. Mitchell: British Rail has not approached us for any financial recompense, and it is not expected to do so. But the losses may mean that it has to increase its borrowing. If it comes to us with that request, we shall consider it carefully.
    Mr. Maclean: Will my hon. Friend make it clear to the chairman of British Rail that part of that money could be recovered from the British Rail unions which took illegal secondary action during the coal strike? Will my hon. Friend also make it very plain to the chairman of British Rail that if he wants extra borrowing powers and Members of Parliament to vote for them, we expect some genuine productivity gains to be made on the British Rail network?
    Mr. Mitchell: It is regrettable that some £60 million of the losses during the coal strike were caused by railway men themselves. Action of this kind can do nothing but damage their own industry, the jobs which depend upon it and the future of freight carrying by rail.
    Mr. Gregory: As many economists consider that the figure of £60 million is a considerable underestimate, why did my hon. Friend the Minister not advise the chairman of British Rail—as he did the south Wales road hauliers — that he could take legal action against secondary picketing? My hon. Friend would not then have to announce such a staggering sum to the House after the coal industry dispute, which will presumably have to be picked up by the taxpayer.
    Mr. Mitchell: I must reassure my hon. Friend that the taxpayer will not pick up the bill. That is a problem for

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    British Rail. British Rail is running a commercial freight business, and the consequences will be felt by those who work in it. They damage themselves, and there is nothing that the taxpayer can or should do to bail them out of the results of their own actions. The question of taking legal action during the strike was entirely a matter for the management of BR to decide. It must make its own judgment as to what is best for its business.
    Mr. Rogers: Does the Minister accept that the alarming cost of the coal dispute, which is now becoming evident to everyone, is due to the Government's shortsightedness in not resolving the issue when they had an opportunity to do so?
    Mr. Mitchell: The sum lost by BR was £240 million in revenue, of which £60 million was lost as a result of railwaymen's actions and not as a result of anything that was outside their ability to control and influence.

    Buses
    Mr. Wallerasked the Secretary of State for Transport when he expects to publish a response to the report by the Transport Committee on the financing of public transport services, the buses White Paper.
    Mr. Ridley: The Select Committee report acknowledged the serious state of the bus industry and suggested as an alternative policy competitive tendering for all services. This is a much more restrictive system even than the present one; and will not secure the gains in productivity, and—more important—the concentration on the needs of the passenger, which deregulation will provide. We shall reply to the report as soon as possible.
    Mr. Waller: My right hon. Friend has already referred to the Select Committee's main recommendation, but, as it has gained some support since the report's publication, why is he opposed to it?
    Mr. Ridley: The system of competitive tendering for franchises on all routes would mean that once a franchise had been let, an unbreakable monopoly would exist on that route for the period of the contract. Consequently, passengers could be exploited, and the productivity gains and improvements in efficiency which we should be able to obtain could not be achieved. I am sure my hon. Friend will agree that if a major operator lost a franchise, it would be extremely difficult and wasteful if hundreds of buses and drivers were suddenly without occupation. The consequences for redundancy of a franchising system on that scale must be borne in mind.
    Mr. Madden: Is not the main thrust of the Select Committee's report highly critical of the Government's policy and of the main provisions of the Transport Bill? In view of that, why on earth are the Government and the Secretary of State pursuing such crazy policies?
    Mr. Ridley: The hon. Gentleman may not know that the Select Committee was split four-four on whether to approve the report. However, I do not think that the Select Committee will find that the system of franchising that it advocates is by any means popular with large sections of the bus industry.
    Mr. Nicholas Winterton: Bearing in mind what my right hon. Friend has said, will he give an assurance about the position in rural areas, given the substantial increase
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    in the price of fuel that has occurred in the past few months and the increase that may sadly result from tomorrow's announcement in the House? Is he aware that where bus services do not now exist the abolition of the current regulation will not result in any more public transport? In addition, people may not be able to afford to run their cars. Will he consider the problems that will face rural areas as a result of that policy, and perhaps give some assurances to the House?
    Mr. Ridley: My hon. Friend will know that buses receive a fuel duty rebate. In addition, it is proposed to give a rural bus grant of £20 million in the first year, which will be added to that rebate to make the costs of running buses in rural areas that much lower. That represents an improvement for rural services. When he adds to that the powers of county councils to call for tenders to subsidise uneconomic routes in such areas, he will see that our proposals are likely to lead to an improvement in the quality and quantity of rural bus services.
    Mr. Roy Hughes: Has the Secretary of State's attention been drawn to the article in The Observer on 10 March which shows that the Hereford experiment has been a complete failure? Since that experiment was the launching pad for the Secretary of State's proposals, what other evidence does he need to show that his policy is based upon a misconception?
    Mr. Ridley: One of the astonishing omissions of the article was that it neglected to ask any of the passengers. When passengers in the Hereford area are asked what they think about the experiment, they will be seen to be opposed to any change in the system there. Those who seek to knock the experiment in Hereford and Worcester have ulterior motives based upon vested interests. What we can learn from that experiment is useful in designing a bus policy, but it is by no means the only basis upon which that policy is founded.
    Mr. Foster: If the Secretary of State's proposals are so self-evidently supported, why are the Association of County Councils, the Association of District Councils and the National Association of Local Councils so much against them? Why is it that at a meeting in Teesdale on Friday night not one member of the right hon. Gentleman's party could be found to support them?
    Mr. Ridley: The hon. Gentleman is misinformed. The Association of County Councils supported the principle of the Bill, although it had some qualifications about some of the details. The Association of District Councils and many of the municipal and metropolitan counties are interested parties because they run bus companies themselves. That is why they are opposed to the policy.
    Mr. Chope: Will my right hon. Friend arrange for the widest possible distribution of his Department's excellent paper setting out the problems associated with franchising?
    Mr. Ridley: I recommend that paper to all hon. Members. If they believe that a system of competitive franchising might work, they should study the report to which my hon. Friend refers. They will find that there is severe objection to the course set out by the Select Committee.
    Mr. Stott: Is the Secretary of State aware that he should not try to mislead the House about the Select

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    Committee's report? Is he not aware that out of 44 Divisions the Chairman had to use his casting vote in only four and that when the report was presented to the House no vote was taken on it? Is the Secretary of State aware that the Committee found that there was no evidence that regulation had been an inhibiting factor to progress in the bus industry? However, the Secretary of State took no notice of that. May I ask the Secretary of State not to preempt the debate in Committee on competitive tendering? Will he keep an open mind so that we can fashion a better Bill in Committee?
    Mr. Ridley: The vote of which the hon. Gentleman must take account is that on Second Reading. The Bill was given a Second Reading by a substantial majority in the House. All hon. Members had the right to participate in that vote. Only eight members of the Select Committee voted on the issue. The vote that matters is that in the House of Commons.

    British Airways
    Sir William van Straubenzeeasked the Secretary of State for Transport whether he can now give a date for the privatisation of British Airways.
    Mr. Michael Spicer: It remains our firm intention to proceed with privatisation as soon as practicable within the next financial year. No date has yet been set.
    Mr. van Straubenzee: I understand the legal problems facing my hon. Friend with litigation, and I understand also the financial prudence involved in placing the shares. Does he appreciate that he has very warm support from behind him on the Government Benches and from a wide range of the electorate for the next further extension of wider share ownership?
    Mr. Spicer: I thank my hon. Friend for those remarks. As he rightly says, there has been some slippage due to the uncertainties arising from current anti-trust cases related to the Laker failure. I assure him that as soon as those are out of the way we intend to proceed with privatisation as quickly as possible.
    Mr. Campbell-Savours: Will the Government allow a privatised British Airways the right to operate twin-jet aircraft on long-haul routes across the Atlantic?
    Mr. Spicer: We shall have to consider that in the light of various arrangements which the Civil Aviation Authority is currently considering.

    Gatwick Airport (Noise)
    Mr. Soamesasked the Secretary of State for Transport if he will make a statement on aircraft noise at Gatwick airport.
    Mr. Michael Spicer: The noise climate around Gatwick has improved significantly over the last 10 years. Air transport movements have increased by 91 per cent. over this period, but the area in which people generally experience annoyance has decreased by 29 per cent.
    Mr. Soames: Does my hon. Friend accept that although aircraft noise has considerably decreased, it is still very disturbing for those who live around international airports? Will he assure the House that he will release the report on aircraft noise as soon as conveniently possible?
    Mr. Spicer: My Department has recently received the report and will be making it public by the end of the month. It will be sent to my hon. Friend as soon as it is available. The ill health of the CAA technical adviser has, I am afraid, caused a month's delay.

  ATTORNEY-GENERAL

    "MI5's Official Secrets"
    Mr. Winnickasked the Attorney-General if any decision has been reached on whether any prosecutions are to take place arising from the film, "MI5's Official Secrets".
    The Attorney-General (Sir Michael Havers): I announced on 5 March that there would be no prosecutions under the Official Secrets Acts in connection with this film.
    Mr. Winnick: Is the right hon. and learned Gentleman aware that the makers of the film and the two former employees of MI5 will view that as an undoubtedly wise decision? Is he further aware that the serious allegations in the film about the malpractices and abuses carried out by the security service should be a matter of concern to his Department as well as to the Prime Minister and the Home Secretary?
    Does the right hon. and learned Gentleman not feel that if there is to be confidence in the security service it is essential that it should be able to carry out its duties without the political prejudice under which it clearly now operates?
    The Attorney-General: I am very much aware of the allegations contained in the film. I obtained a copy, watched it, and asked the Director of Public Prosecutions to request the Metropolitan police to carry out an investigation. That is now under way and the Metropolitan police will report to the Director of Public Prosecutions, who, in turn, will report to me.
    Sir Edward Gardner: Is my right hon. and learned Friend aware that during the debate on the Interception of Communications Bill last week a former Home Secretary gave it as his opinion and his knowledge that one of the allegations contained in the film was absolute rubbish?
    The Attorney-General: I am aware of that. It is fair to say that many of the other allegations were vague and unspecific. However, I am sure the House will agree that the allegations should be investigated, and that is taking place.
    Mr. John Morris: Is the right hon. and learned Gentleman aware that Lord Rawlinson, a former Attorney-General, expressed concern in another place on 28 February about The Times report that Ministers were saying that there was to be no prosecution in this case? Will he explain what ministerial consultations have taken place? Will he dissuade his colleagues, including the press officer at No. 10, from giving guidance in matters that are solely his responsibility?
    Since the Attorney-General has, in another instance, taken the initiative, will he consider doing the same about the sort of prosecutions that he will authorise under the Official Secrets Act, which might help to kill any parallel being drawn with the 19th century courts of equity, where it was said that the jurisdiction in equity varied with the length of the Lord Chancellor's foot?
    The Attorney-General: That criticism may have been apt then, but I do not think that it applies now.
    I consulted my right hon. and learned Friend the Home Secretary, my right hon. Friend the Lord President—as a former Home Secretary with great experience — and my right hon. Friend the Prime Minister. I consulted them on one issue only — the security implications of adducing evidence about interception and, in general, the implications of doing anything that might amount to confirmation or denial that particular interceptions had been made. I did not ask for their views on any other aspect of the case and they did not proffer any such views. I consulted no other Minister.
    As the right hon. and learned Member for Aberavon (Mr. Morris) will be the first to appreciate, if there were any prosecution, even in respect of just one interception, that would implicitly amount to confirmation of it.

    Coal Industry Dispute
    Mr. Peter Bruinvelsasked the Attorney-General how many cases have been heard by the courts and how many are outstanding in connection with the recent coal mining dispute to the latest available date.
    Mr. Adleyasked the Attorney-General if he will update the information given to the hon. Member for Christchurch on 25 February, Official Report, column 13, concerning cases outstanding in the courts about offences alleged to have been committed in relation to the miners' strike.
    The Attorney-General: During the period from 13 March 1984 to 5 March 1985, 7,917 persons were charged with a total of 10,372 offences alleged to have been committed during the course of the miners' dispute. Of these, 5,653 defendants had been dealt with by the end of that period and the cases of 2,262 remained to be heard.
    Mr. Bruinvels: Will my right hon. and learned Friend give an assurance that, although the miners' dispute is now over, the 2,262 cases waiting to be heard will be severely dealt with, that any amnesty for those people will not be considered until they have been convicted or acquitted and that the sentences will be properly and publicly detailed throughout the country?
    The Attorney-General: I should make it clear at the outset that I have no responsibility of any kind for the sentences imposed by the courts, and at no time would I seek to influence or interfere with the decisions of the justices. On the question of amnesty, whether to proceed with a case must be a matter entirely for the chief constable of the area concerned, and again I would not seek in any way to influence the decision.
    Mr. Hardy: Is the right hon. and learned Gentleman aware that in some coalfields men have been dismissed simply because they face a charge, not because they have been convicted? Does he agree that that is scarcely a helpful contribution from the NCB to the reconciliation that is needed in the industry?
    The Attorney-General: That cannot be my responsibility. It must be a matter for the National Coal Board.
    Mr. Adley: Is my right hon. and learned Friend aware that, with respect to him, not all of us share the view of my hon. Friend the Member for Leicester, East (Mr. Bruinvels) on this? Does my right hon. and learned Friend
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    agree, however, that with all the demands for amnesty it would be most helpful if the NUM and leading members of the Labour party took a lead in ensuring that those making vicious and violent attacks on people who merely exercised their right to go to work in the absence of a ballot do not continue to hound those workers in a manner that gives affront to many millions of people?
    The Attorney-General: I agree with my hon. Friend. I should have thought that the worst way of trying to persuade those considering whether to grant an amnesty would be to behave in the way that my hon. Friend has described.
    Mr. Ryman: Will the right hon. and learned Gentleman assist by providing the facts to the NUM and the NCB when individual applications for reinstatement are being considered? Is he aware that at present a conviction ipso facto constitutes dismissal in the eyes of the NCB and that when cases are reviewed under the appeal procedure the NUM and the NCB put forward different versions of the facts? Does he agree that it would be helpful if a short précis of the facts of the case were available, either through the Attorney-General or through the Home Secretary, when the appeals take place?
    The Attorney-General: Yes, I shall certainly arrange for that to be considered, but I would hope that the magistrates' clerk would have kept a sufficient note, which would be available to the appeal tribunal.
    Mr. Madel: Will my right hon. and learned Friend confirm that industrial tribunals are set up to deal with dismissal cases, and that the impartiality of those tribunals is guaranteed by existing employment law?
    The Attorney-General: That is right, but I think that what the hon. Member for Blyth Valley (Mr. Ryman) was suggesting was that there may be occasions when there is a conflict of evidence, when the tribunal's task will be assisted if there is an impartial note from, say, the magistrates' clerk.
    Mr. Nicholas Brown: As one fifth of those arrested have never been charged and two-thirds of the offences involve relatively trivial matters such as obstructing the highway, and as the acquittal rate in Nottingham is running at about 38 per cent. of the cases that eventually come to court, does the right hon. and learned Gentleman not feel that a conciliatory statement and intervention from himself would not only alleviate the present situation but would restore respect for law and order in mining communities which consider themselves to have been savagely treated by the forces of law and order over the past year?
    The Attorney-General: The acquittal rate varies enormously. In one or two areas, it is nought. The hon. Gentleman has picked the largest one — Nottinghamshire. It is very important that Law Officers —indeed, Ministers of all kinds—should not be seen to intervene in any way in questions of conviction or sentence. Those are matters for the courts and perhaps subsequently for the NCB.

  OVERSEAS DEVELOPMENT

    Ethiopia
    Mr. Tony Lloydasked the Secretary of State for Foreign and Commonwealth Affairs if Her Majesty's Government have any plans to restore development aid to Ethiopia.
    The Minister for Overseas Development (Mr. Timothy Raison): We provide development aid to Ethiopia mainly through our contributions to the European Community and the World Bank. We have also agreed to support postgraduate medical education and English language training in Ethiopia accompanied by appropriate training programmes in the United Kingdom.
    Mr. Lloyd: Does the Minister agree that his answer will not be acceptable to people throughout the country? There has been a massive goodwill exercise towards Ethiopia in terms of emergency aid from private sources and, of course, from the Government. Has not the time come when a massive effort must be directed towards development aid to make sure that Ethiopia does not face a crisis in the future? A blockage on that aid, caused by the ideological position of the Government, is in no one's interest.
    Mr. Raison: It is not just a question of ideological differences. It is difficult to give aid in a country where the whole approach to agriculture — a collectivist approach—is very different from ours, and where a civil war is raging. However, aid will be provided through the medium of the World Bank and the European Community, towards both of which we make substantial contributions.
    Mr. Bowen Wells: Is it not true that aid to the agricultural centres of Ethiopia needs to be directed towards the poor farmers in arid areas, who need support for small agricultural enterprises, and that the Government of Ethiopia are totally opposed to that obvious developmental need?
    Mr. Raison: I agree with my hon. Friend's definition of developmental need, but I must repeat that there are great difficulties connected with the attitude taken by the Ethiopian Government towards the nation's agriculture.
    Mr. Tom Clarke: Is the Minister not disappointed with the less than robust response from British industrialists towards development aid to Ethiopia? For instance, has he recieved any representations from the CBI?
    Mr. Raison: I cannot recall offhand having received any representations from the CBI. However, overall, British industry is capable of playing an important part in development across the world, and I have done what I can to encourage it to do so.

    British Volunteer Programme
    Mr. Soamesasked the Secretary of State for Foreign and Commonwealth Affairs whether he will increase the level of assistance to the British volunteer programme.
    Mr. Raison: I propose, subject to parliamentary approval, to allocate £6·95 million to the British volunteer programme in 1985–86. This represents a 15 per cent. increase on this year's grant.
    Mr. Soames: I thank my right hon. Friend for that reply and also for the extra money allocated to the programme. However, will he acknowledge that there are an immense number of young people in this country who would very much like to go abroad to do their bit to assist the disaster areas and other places in the developing world? Will he bear in mind that this is a most attractive and useful programme to which the Government could perhaps devote a little more money in future?
    Mr. Raison: I agree with my hon. Friend about the value of voluntary work overseas. However, from 1979–80 to 1984–85 we have increased our spending on the British volunteer programme by 94 per cent. in real terms.
    Mr. Simon Hughes: I, too, am grateful for this increased support for the British volunteer programme. May I suggest that, in this year of all years —International Youth Year—it would be a token of the Government's good will if they allowed the enormous numbers of young people who are unable to get work here but who have expressed a desire to help in areas such as Ethiopia and Sudan to do so through a special programme, with additional funding?
    Mr. Raison: The figures that I have announced show our commitment to the programme. The figure for the coming year will allow a small increase in overall numbers, although most of the extra money will help to meet increased costs overseas.

    International Fund for Agricultural Development
    Mr. Stuart Hollandasked the Secretary of State for Foreign and Commonwealth Affairs what action Her Majesty's Government are taking to ensure continued finance for the international fund for agricultural development.
    Mr. Raison: We have been taking a full part in the negotiations for the second IFAD replenishment and we hope that agreement will be reached early next month. We would expect to contribute to it on a basis to be decided following the usual burden-sharing discussions among donors.
    Mr. Holland: The Minister will be aware that IFAD needs between $500 million and $650 million—that is what it is asking for. It is the only United Nations agency which is concerned exclusively with agricultural development and, if we are to avoid storing up trouble or, indeed, starvation for sub-Saharan Africa, it must be supported on a sizeable scale. How much will the Minister be able to give?
    Mr. Raison: I expect that the figure that is likely to be agreed will be about $600 million, which is within the range of that the hon. Gentleman quoted.
    Mr. Mark Robinson: I welcome what my right hon. Friend has just said. Is he any closer to a decision on whether to untie assistance promised in connection with the World Bank's facility for Africa?
    Mr. Raison: There is a question about this matter later on the Order Paper, but I do not think that it will be reached so I can tell my hon. Friend that the answer is yes, it will be untied.

    Sudan (Grain Supplies)
    Mr. Tom Coxasked the Secretary of State for Foreign and Commonwealth Affairs what was the amount of grain sent by the European Economic Community to Sudan in 1984; and what was the price paid for it.
    Mr. Raison: The European Community delivered 13,000 tonnes of cereals, together with 3,117 tonnes of milk powder and 1,355 tonnes of butter oil to Sudan in 1984. The cost was about £6·8 million.
    Mr. Cox: Is the Minister aware that there are now enormous stocks of grain in the EEC? Does he agree that it is deplorable that the figures that he has just given were the same last year? Can he assure us that this year much more grain will be sent to Sudan from EEC countries and that the price will be advantageous to Sudan? Can he assure us—this has happened with other commodities—that grain will not be sold at the cheapest possible price to eastern Europe? Does the right hon. Gentleman agree that those who have given generously to help alleviate the famine in Africa look for such action from the Government? Will he ensure that it takes place?
    Mr. Raison: The quantity delivered last year was not very large, but the House must remember that it was only late in the year that the Sudan Government asked for assistance. The Community and its member states have now committed almost 170,000 tonnes of grain for this year. That is a substantial amount. I have stressed to the Community, and the Commissioner, whom I saw two weeks ago, that it is important that large quantities should go and that they should go as soon as possible.
    Mr. Robert Banks: I am aware that my right hon. Friend has a special knowledge of the Sudan. May I ask him, following his recent visit to that country, whether he hopes that larger quantities of grain from the EC can be got to that country? Is he satisfied with how it is distributed to the starving people there?
    Mr. Raison: It is important that large quantities go from the EC. The committed amount is substantial. It is
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    crucial to get on with delivery before the hoped for rains come in June. I believe that the grain will reach those who most need it, but one must always be careful about the business of distribution.
    Mr. Skinner: Does the Minister remember that in the early 1970s the Euro-fanatics were telling us that one reason why we should go into the Common Market was that if the 10 nations got together they could help the Third world and enable the starving millions to be fed? Has not that dream faded as rapidly as the SDP has faded from our Benches?
    Mr. Raison: The hon. Gentleman is exactly wrong. The European development fund—the Lomé convention —is one of the most valuable and positive aspects of the European Community. Whatever one may think about grain mountains and so on, they mean that substantial quantities of food are available to be sent to famine-struck areas, and that is now happening.
    Mr. Baldry: My right hon. Friend will be aware that many of the problems of Sudan are the result of the civil war in Ethiopia. Will he avail himself of any opportunity that he may have to talk to the Ethiopian Foreign Minister, who is in London this week, and to impress upon him the fact that the House would be delighted if the Ethiopian Government would initiate peace talks with the Eritrean and Tigrean rebels, with a view to establishing a ceasefire that would allow food aid to get to all parts of Ethiopia and stop the people of Ethiopia from simply killing themselves?
    Mr. Raison: The House will agree with the sentiments expressed by my hon. Friend. He knows that there would be great difficulties in persuading the Ethiopian Government to have formal talks with the representatives of the liberation movements. On the other hand, many people have made clear to the Ethiopian Government the great importance of making sure that food reaches all the people who are suffering so badly at the present time.

Cervical Screening
Mr. Frank Dobson(by private notice) asked the Secretary of State for Social Services if he will make a statement on the shortcomings in the cervical screening system revealed by the recent death of a woman in Oxfordshire and evidence of a survey carried out in Nottingham last year.
The Minister for Health (Mr. Kenneth Clarke): Last year we gave all health authorities updated, comprehensive guidelines on an effective cervical screening programme based on the advice of an independent expert advisory group. This followed the circular which we issued in December 1981 telling authorities to establish local recall arrangements for cervical screening by April 1983. All authorities should therefore now be offering a full screening service to all women with a recall service to those at highest risk.
Responsibility for operating the cervical screening programme rests with individual health authorities. It is obviously important for each authority to have effective arrangements for following up positive tests, which should always be notified to the clinician who initiated the test, who should then ensure that follow-up action is taken.
We are looking into the circumstances of the Oxfordshire cases to see whether there are any general lessons to be learnt. We were already preparing a questionnaire to all authorities to update our information on local screening services and we will be issuing that shortly.
Mr. Dobson: Does the Minister agree that although the Government received expert advice in 1981 from the Committee on Gynaecological Cytology that they should set up a computer-based, local call and recall scheme in every part of the country, on strict national guidelines, they implemented only one of those recommendations and, consequently, are directly responsible for the present shambles whereby only seven districts in this country have a decent system?
Secondly, why did Ministers ignore the findings of the Nottingham survey, published in the British Medical Journal and publicised by me in December 1984, which showed that some doctors were failing to follow up positive smears?
Finally, will the Minister accept that, as he has never asked health authorities what cervical cancer screening arrangements they have made, he can neither dismiss the Oxford tragedy as an isolated incident nor confirm that such failures are not widespread? Does he not recognise that people will notice the contrast between the efforts that the Government have constantly made to harass health authorities into introducing privatisation and the fact that the Minister, and his Department, officials and ministerial colleagues have not raised one finger to try to find out what was happening in the health districts or to urge them to do the proper job that people expect them to do?
Mr. Clarke: The hon. Gentleman's last question rather spoiled the remainder of his remarks. We are all concerned about the tragic cases in Oxfordshire and to protect women against the risk of cervical cancer, which is avoidable in many cases. We have been chasing up the authorities and it is wrong to make a political point in trying to draw a contrast between that and the tendering process.
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It is right to say that in 1981 there was a recommendation that there should be a call system as well as a recall system. However, because of doubts about its cost-effectiveness, only seven authorities opted for a call system. We are financing research into a particular system at Manchester. When we have the results of that, we shall consider whether it is justified and whether a national call system would save lives, as it is claimed. Meanwhile, recall systems, including computerised recall systems, are rapidly being spread. The Government have made money directly available through information technology money. Ten family planning clinics set up computerised systems, more than 20 have computerised systems, and others are operating effective manual systems.
As I said in my original reply, we have been stressing to authorities the importance of getting on with screening and protecting women in their localities. We have not ignored the article in the British Medical Journal in October 1984; indeed, because of my constituency interest, I was involved in its appearance. The fact that it appeared publicised to all health authorities the problems that had arisen in Nottingham and that they had been put right. Obviously it is necessary—it is so obvious that it does not need to be stressed constantly by the Government —that authorities should have screening programmes, that clinicians should be told the results of all tests, and that all clinicians should ensure that women at risk are notified.
I share the anxiety of the hon. Member for Holborn and St. Pancras (Mr. Dobson). I am sure that women would like all avoidable deaths in this area to be eliminated. I assure the hon. Gentleman that the matter is being given high priority. For most of the country the present arrangements are working well, and women should not be unnecessarily alarmed.
Mrs. Jill Knight: I urge my right hon. and learned Friend in no circumstances to stop his programme of privatisation, as the money saved by it is badly needed elsewhere. Is there any reason why general practitioners who have been notified of the positive result of a cervical smear should fail to inform the patient about it?
Mr. Clarke: I agree with the first sentiment. Regarding my hon. Friend's question, I agree that there can be no reason for that. I should have thought that all clinicians appreciate when they are notified that one of their patients has had a positive test that they should then notify the patient and take further steps as quickly as possible. One cannot prejudge individual cases because human error can be made and information mislaid. I certainly agree with my hon. Friend that the obvious step for a clinician is immediately to take a further test as soon as he or she is notified of a positive result.
Mr. Merlyn Rees: The Minister refers to the general lessons to be learnt from the inquiry, on which he will no doubt report to the House. What will happen if the inquiry finds either human error or administrative error in an individual case?
Mr. Clarke: There are procedures for dealing with individual cases of error and subsequent complaints, and they should be adequate to deal with what is sometimes a human tragedy which follows from a patient not being notified of a positive result of a screening test and that she

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is at risk. The Government's duty is to ensure that all authorities make themselves aware of this sort of survey, and that the standards of the screening service in all localities are brought up to the level of the best. As I said in my original reply, we were already preparing to update our information. It is not true that we had never got information before, as the hon. Member for Holborn and St. Pancras implied. We normally get it through direct contact with health authorities. We are now preparing a systematic questionnaire, which was already in preparation, and it will soon be issued so that we can compare the standards achieved by every health authority.
Mr. Tony Baldry: Does my right hon. and learned Friend agree that, in so far as any conclusions can be drawn from the Oxfordshire case, they are that within the considerable resources already given to the National Health Service it is always possible to be more efficient and to make more effective use of the resources? Does he further agree that when the Opposition seek to denigrate the NHS by such instances it is of no benefit or help to anyone?
Mr. Clarke: I hope, as my hon. Friend plainly hopes, that the controversy does not deter women from seeking screening. All sexually active women should be screened for cervical cancer once every five years. The guidance that we publish makes that clear. Where abnormality is detected, the second test often shows that it is a mistake and that there is none. If there are early signs of cancer, it can be treated with a high probability of success, and lives can he saved. There is no serious resource problem here, and it is not one of the most expensive services being developed in the NHS. We must improve administrative efficiency and ensure that no errors are made at any stage of the process so that people do not forget or omit to act when a positive test has been notified.
Mr. Michael Meadowcroft: Is it not worth emphasising the fact that, in the words of the British Medical Journal, 80 per cent. of those who develop cervical cancer have
"slipped through the screening process"?
Is it not also true that in some areas there is a far better response to those tests, because they have gone beyond the Government's guidelines? One example is Cornwall. If the Government are committed to preventive medicine, they should emphasise such matters and make the guidelines much more appropriate to the need rather than being over-concerned about administrative details, which will not necessarily cover all the cases that could occur.
Mr. Clarke: I agree that plenty of individual practices and health authorities have developed effective systems, which have the important result of saving the lives of women who might otherwise die from cervical cancer. The Government's efforts are designed to ensure that those standards are achieved everywhere. All health authorities and all members of the medical profession should back our efforts to do so. What should come from tragic cases such as the one in Oxfordshire is that health authorities will now check to ensure that such errors do not occur in their localities.
Mr. Roger Sims: Is it not clear from what my right hon. and learned Friend said that his Department, in issuing guidance, has discharged its duty in the matter and that the responsibility must lie with the general practitioner?
Mr. Clarke: We shall continue to discharge our responsibility by following up our guidance and ensuring that health authorities do what they have been clearly told to do. I agree with my hon. Friend. I am sure that most general practitioners will agree that a doctor does not need to be told that, if he is notified that a patient's test is positive, he should immediately contact that patient and submit her for another test. We know that errors can be made, but I do not believe that we are talking about a failure of policy or systems.
Mrs. Ann Clwyd: Does the Minister agree that it is equally important for women to be screened for breast cancer? He may be interested to hear about an example of a similar mistake, when a woman who had already lost one breast—
Mr. Speaker: Order. The question is not about breast cancer. The hon. Lady should confine her question to cervical cancer.
Mrs. Clwyd: I am sure that the Minister would agree that women should be screened regularly for other forms of cancer. Does he believe that such screening is satisfactory for the other parts of the body where cancer can occur?
Mr. Clarke: We are already financing much research into screening for breast cancer, but people are not as certain of the cost-effectiveness of screening for breast cancer as they are of the screening for cervical cancer. However, we all hope that effective screening methods will be developed for all sorts of feminine and other cancers, and that when adequate methods are devised health authorities will press on to implement them effectively in their areas.
Mr. Anthony Beaumont-Dark: Does my right hon. and learned Friend agree that the confidence of many women will, rightly or wrongly, have been somewhat damaged by what happened in Oxford? I received three telephone calls at the weekend from people asking whether the process was effective in the west midlands. Would it not be possible at least to provide self-addressed postcards so that even negative tests can be notified? I should have thought that the cost involved was so small, compared with the confidence that could be re-established in women, as to be well worthwhile.
Mr. Clarke: Any woman who is worried should straightforwardly approach her general practitioner, who will inform her of the result of her smear test. Any woman who is sexually active and who has not had a smear test during the past five years should in any event contact her doctor to have a smear test carried out. I agree with my hon. Friend that what the Government and the health authorities must do is to reassure women that they can be protected, and then devise adequate systems. His suggestion that each woman should be notified personally of the results of a test will be considered. We shall certainly ask our expert advisory committee whether it believes that to be necessary. But the systems that are being devised and that work well in some areas already notify the doctor adequately and are saving many lives.
Mr. Nigel Spearing: But is the Minister aware that in Newham, if a positive test has been notified and, within a given period, there is no voluntary recourse to the clinic, the district health authority sends a

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reminder of that notification directly to the individual? Is not that a sensible long-stop system? Why was it not incorporated in the original guidelines that were circulated by the Minister? Is not the failure to require the use of such a long-stop administrative procedure prime facie maladimistration on the part of his Department?
Mr. Clarke: The East Ham arrangement seems to be very sensible. It is my belief that that arrangement is to be put in hand in Nottingham as well so that when no response is received after somebody has been notified of a positive test the authority can follow it up and ask the doctor concerned why there has been no response. It would therefore act as a reminder.
We can of course reinforce all the guidance, but I believe that the hon. Gentleman will agree with me that it is a matter of common sense. The health authorities do not need all these obvious steps to be spelt out to them in circulars. They are responsible public bodies which should be capable of taking the necessary elementary steps for a screening procedure under which the doctor is given the results and then tells the patient. Fortunately, as my hon. Friend the Member for Birmingham, Selly Oak (Mr. Beaumont-Dark) said a moment ago, that happens in the vast majority of cases, but we have to guard against exceptional errors and make sure that no such errors occur again.
Mr. Jonathan Aitken: Is not one of the keys to avoiding the kind of tragedy that occurred in Oxfordshire the greater use of computerised call and recall systems? Although the greater use of such systems is primarily a question for the management of the National Health Service which my right hon. and learned Friend is doing so much to improve, does he agree that private and charitable fund raising could join the NHS in providing the necessary computer hardware.
Mr. Clarke: We are steadily advancing with the computerisation of the records of all the family planning committees. The software that has been developed, which is based upon a model developed by the Exeter FPC, enables an FPC, if it wishes, to have a fully computerised call and recall system. I believe that about one quarter of all FPCs already have such computerised systems. Some of them are financed directly by the Government. I agree that computerisation needs to be more widely spread. However, I stress that many authorities provide perfectly good manual call and recall systems. There is no reason why a proper system should have to wait for the computer.
Mr. Donald Coleman: May I remind the Minister that it is now over 20 years since this subject was ventilated in the House and pressed upon the then Labour Government? The Minister appears to get extremely cross
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when hon. Members refer to the system, but is he not aware that in previous years there was a recall system to deal with tuberculosis by means of mass radiography which worked perfectly satisfactorily without computers?
Mr. Clarke: I agree with the hon. Gentleman that good recall systems can operate without computers, but it is easier to operate such systems with computers. Computers are spreading throughout the NHS. We have ended the national recall system for the simple reason that it did not work. We took steps three years ago to instruct authorities to replace the national system with better local systems, and that is what they are doing. The number of deaths in this country from cervical cancer is dropping very slightly. I agree that it is not dropping enough. That is why we shall continue with our efforts to make sure that all authorities properly protect those women who are at risk in their areas.
Mr. Derek Foster: I well understand why the Minister is throwing up a smokescreen to disguise his Department's ineffectiveness in this area, but it comes ill from a Secretary of State who has continually interfered in the affairs of health authorities to ride roughshod over their decision making when he wants action to be taken. Will he now show the same energy in this direction as he has in the direction of privatisation?
Mr. Clarke: I referred in my original answer to a circular that was issued in 1981. I have also referred to the guidelines that were issued last year. We keep in contact with the authorities by telephoning to find out what progress has been made. We have part financed the computerisation of the system. We have been helping with the development of the software at Exeter which will lead to the development of call and recall systems. I believe that the system is steadily improving and saving lives.
I very much regret the tragic cases in Oxford where there appears to have been human error, as a result of which two women have died. However, I do not believe it is right to build upon the grandiose claim that we are not interfering enough or that there is a lack of policy. We simply have to make sure that no tragic and avoidable deaths of women occur elsewhere.
Several Hon. Members rose—
Mr. Speaker: Order. I have to protect the subsequent business on the Order Paper. We have had 19 minutes on this important matter.

WELSH AFFAIRS
Ordered,
That the matter of the consequences of the Budget and the Government's economic policies in Wales, being a matter relating exclusively to Wales, be referred to the Welsh Grand Committee for its consideration.—[Mr. Lennox-Boyd.]

Common Agricultural Policy Prices
3.49 pm
The Minister of Agriculture, Fisheries and Food (Mr. Jopling): I beg to move,
That this House takes note of European Community Documents Nos. 4582/85, including Addenda I, II and corrigendum and III, No. 4637/85 on the situation of the agricultural markets in 1984, No. 6248/84 on the designation of milk and milk products, No. 11172/84 on the production refunds for starch, and the Ministry of Agriculture, Fisheries and Food's unnumbered explanatory memorandum of 16th July 1984 on the payment of an additional national aid to German farmers; and supports the Government's intention to seek an agreement on 1985–86 farm support prices and related measures which builds on the success achieved in 1984 in introducing greater realism into the operation of the Common Agricultural Policy, is consistent with the financial guideline for agriculture, maintains a policy of price restraint in the Common Agricultural Policy, avoids discrimination against United Kingdom interests, and takes account of the interests of United Kingdom producers, consumers, traders and food processors.
Last year we made important steps towards a more realistic and cost-effective common agricultural policy. I remind the House that at the 1984 price fixing, common prices were reduced on average and, even after allowing for green currency changes, real prices were reduced in every member state. It was agreed that guarantee thresholds would be set for all products in or likely to be in surplus or for which expenditure was rising rapidly. Those were major achievements.
Additionally, the Council of Ministers agreed on a quota scheme for milk at a level of production about 6 million tonnes below that currently prevailing. Let there be no doubt that the quota scheme represents a major advance in bringing reality to the CAP. At the time it was introduced, every extra tonne produced could, on the Commission's own analysis, be disposed of only by applying subsidies at the level of the full target price for milk. In other words, every extra million tonnes of production — production was increasing by 2 million tonnes a year or more—resulted in an extra cost to the Community budget of 275 million ecu or about £165 million. Although we still have a substantial surplus in the milk sector things would have been very much worse without the quota scheme.
Other major advances made in 1984 included the conclusions on budgetary discipline, including a financial guideline for agriculture specifying broadly that from 1986 expenditure on the CAP should grow less fast than the Community's own resources base.
At the same time, it was agreed that our net contribution to the Community budget, much of which results from our disproportionate contribution to the CAP, which itself stems from our relatively small agricultural sector, would be offset to a considerable extent by a reduction in our VAT contribution to own resources.
There can be no doubt that in 1984 we made more progress than ever before in improving the CAP and in mitigating its adverse effects on the United Kingdom.
So far this year progress has been maintained by agreement—
Mr. Tony Marlow: Is it correct to say that we have reached an agreement whereby the proportion of Community expenditure on agriculture will become less only if the absolute amount of expenditure on agriculture in the Community becomes more? If so, what is the advantage in that?
Mr. Jopling: I am afraid that my hon. Friend is not right. The agreement is that the growth of spending on agriculture will not be faster than the growth in own resources. That is slightly different from the way in which my hon. Friend put it.
Mr. Nicholas Budgen: When the financial mechanism was agreed it became clear that it depended upon the political will of the main nation states. I recollect that my right hon. Friend, particularly in 1984, pointed to the determination of the West Germans to hold down agricultural prices. We now hear that the West Germans have entirely changed their position and are once again in favour of high prices. What elements of political pressure are now available which will ally with my right hon. Friend in order to protect the consumer and the taxpayer?
Mr. Jopling: If my hon. Friend would allow me to develop my speech, I shall be talking about some of the issues where there may be a divergence between member states, including West Germany.
Mr. Gavin Strang: The right hon. Gentleman has just completed an important passage in his speech and I should like to refer to it. With regard to the statement about the CAP, will the right hon. Gentleman confirm that the British Government opposed the milk quotas that he now describes as a major advance? Secondly, will he confirm that, within any framework of quotas, it is desirable that United Kingdom agriculture should at least retain its total share of Community production?
Mr. Jopling: Yes. The House knows very well that I thought that a better way to bring the milk surplus and the overspending on milk under control would be through the discipline of price rather than quotas. The hon. Gentleman will remember that I told the House that on 1 December 1983, and I have always said that. Even though we should have preferred to do it through price, we have had to do it through quota because we were isolated. As I told the House, I believe that the quota system has done a good deal to bring the surplus under control.
So far this year, progress has been maintained by agreement on regulations to implement the European Council's decisions on a reform of the wine regime, and also on a structures package which entails a significant cutback from the level of expenditure proposed by the Commission and has other advantages for the United Kingdom. I have already explained those two matters to the House in the past few weeks.
However, major problems remain. Sensible decisions over a period of years will be needed if all the problems of the CAP are to be solved. It is very important that at this year's price fixing we should consolidate the gains made last year and take further steps in the right direction. I believe that this is necessary not only for budgetary reasons but because only a well balanced and efficient policy can provide our producers with the long-term security that they need.
My attitude to this year's price fixing will be determined by a number of key elements. First, a realistic view must be taken of the market possibilities in each and every sector. This ought to go without saying, but too often in the past over-sanguine assumptions have been

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made. In accordance with the agreement on guarantee thresholds, action must be taken to restore market balance if circumstances so warrant.
Secondly, proper account must be taken of the financial situation, and in particular decisions should be consistent with the constraints imposed by the financial guidelines for agriculture that I have just mentioned.
Thirdly, all producers and all products must be treated on a comparable basis. In recent years some products, notably the Mediterranean products, have secured consistently greater price increases than others, and it is therefore no surprise that Community expenditure on them has risen by very much more than the average for the CAP as a whole.
Fourthly, proper attention should be paid to the need for policies to be administered effectively. I am very conscious that our producers are concerned that policies should be fairly and equitably administerd throughout the whole Community.
Judged against those criteria, I can give a qualified welcome to the Commission's proposals this year. In general, I think that they recognise the overriding need to put the CAP on to a sounder and more realistic footing, although there are specific points on which I am disappointed.
With regard to the financial aspects, the Commission has produced figures showing that, so far as can be judged, at present its proposals are consistent with the Financial Guidelines for Agriculture, and this is therefore satisfactory.
On commodity aspects, dealing first with milk, the dairy produce quota tribunal has now virtually completed its work and it will shortly be possible to finalise production quotas. In the Council of Ministers earlier this month we agreed on a method of introducing greater flexibility for producers with direct sales and wholesale quota. We also secured some temporary relaxation in the rules relating to liability for and collection of the levy in recognition of the particular problems that producers have faced in the first year of quotas. As a result, producers in Northern Ireland are unlikely to be required to pay any levy in respect of production in 1984–85. Those amendments will be of great benefit to the United Kingdom industry.
In its price proposals, the Commission reaffirms its commitment to the proper enforcement of the quota system, including the cut in quotas of about 1 million tonnes, agreed last year, for 1985–86 and the consequent cut of 1 per cent. in the co-responsibility levy. It has made it clear that the implementation of the proposed price increases is dependent on member states abiding by the rules of the scheme. There is no longer any excuse for failure to apply the system properly, and I shall continue to press that the rules be properly respected in all member states.
At the same time, the detailed regulations still present problems in some respects, and I am especially conscious of the need for more flexibility in the rules governing the transfer of quotas. I shall seek a solution on this point as part of the price fixing package if this seems tactically advantageous, or, otherwise, shortly thereafter.
Mr. Robert Maclennan: I am grateful to the Minister for giving way to me,
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particularly as he answered a written question about this and we have not had an opportunity to question him about it. Why is he not prepared to press for a fully tradable system of milk quotas, which is preferred to leasing by the industry?
Mr. Jopling: For one particular reason. At this moment I do not believe that we are likely to get early agreement by the Council of Ministers and the Commission to sell and purchase a quota. I have taken the view that, while I am not philosophically opposed to that system, if we want more flexibility more quickly, the most practical way to get it is to go for the first stage of leasing. That was in the answer that I gave, if the hon. Gentleman cares to go back to it.
The Commission has proposed an increase of 1·5 per cent. in the target price for milk this year. Given the continuing surpluses in the milk sector — even with quotas fully operative, the surplus amounts to some 13·5 million tonnes—I do not believe that any price increase this year is justified. I shall press for a freeze, although it is already clear that some member states will press for an increase greater than that proposed by the Commission.
The Commission has proposed a further rebalancing of the butter and skimmed milk powder ratio which would result in a cut of 3·99 per cent. in the intervention price for butter. In this context, it would be acceptable to end the butter subsidy, as the Commission has proposed, as the two measures taken together should have no effect on the retail price of butter. I shall press for the freeze in the target price to be implemented by means of a smaller increase in the skimmed milk powder price than that proposed by the Commission.
Sir John Farr rose—
Mr. Eric Deakins rose—
Mr. Jopling: I have given way many times, but I shall give way once more to my hon. Friend the Member for Harborough (Sir J. Farr).
Sir John Farr: Were representations made by Her Majesty's Government, and, if so, what response was there, on the abolition of the co-responsibility levy, which is desperately unfair to British producers?
Mr. Jopling: I have consistently argued against the continuation of the co-responsibility levy, even at the level of 2 per cent., after we have made, as I hope, the reduction this year. On many occasions, I have said that I believe that the best way to help dairy farmers is to reduce the co-responsibility levy rather than to increase prices.
Production of cereal expanded enormously in 1984, and it was only the increase in the value of the dollar which prevented a very great increase in the costs of this sector. The Community must take full account of the very great potential financial liability represented by the current levels of cereal production. Calculations made in my Department show that productivity increases in Community cereals production in recent years have been such that real returns per unit area have increased significantly despite a reduction in the real price. Firm action on prices is therefore needed.
In my view, the full 5 per cent. reduction required by the application of the guarantee threshold should be applied without any norm price increase—that is, the common price level should be cut by 5 per cent. rather than the 3·6 per cent. proposed by the Commission.

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Further, the Council of Ministers should give a clear signal to producers of its intentions to keep close control on this sector in future years by agreeing that for three years there should be no increase in the norm price, or by adapting the guarantee threshold by abolishing the ceiling on the price reduction to which it can give rise.
In general, we must allow for a greater operation of market forces in the cereals sector. There is clearly scope for increased consumption on the domestic animal feed market and also for increased exports if the price is right. I hope that the Council will endorse radical measures, such as those that I have outlined, although already some of my ministerial colleagues have shown their reluctance to consider any reduction in prices.
Mr. Peter Hordern rose—
Mr. Jopling: I have already said that I had given way for the last time, but, as I know my hon. Friend, I shall make this the last time.
Mr. Hordern: Does my right hon. Friend agree that the Commission's calculations show that there should have been a decrease of 8 per cent. in cereal prices but that it felt bound to recommend a reduction of only 5 per cent.? Will my right hon. Friend assure the House that, in view of the gross oversupply of cereals, which looks likely to continue, especially if the dollar should fall, he will press for an even greater reduction in the price beyond the 5 per cent?
Mr. Jopling: I hope that tomorrow morning my hon. Friend will carefully read what I have said, because 5 per cent. is the maximum allowed under the rules. I repeat that I did not rule out the option of adapting the guarantee threshold by abolishing the ceiling on the price reduction to which it can give rise. I hope that I have covered my hon. Friend's point.
I am concerned that there is an imbalance between the support we give to arable and to livestock products. Much the best way of improving this balance is to cut cereals prices, which would not only reduce support for the arable sector but reduce the costs of livestock production.
The Commission's price proposal for beef takes proper account of the difficult budgetary and market situation for that product. In 1984, FEOGA expenditure on beef rose by 18 per cent. to almost £1·3 billion and Community intervention stocks increased by more than 60 per cent. In these circumstances, the proposed price freeze is fully justified.
Intervention buying-in prices are now based on the carcase classification grid, and I hope to ensure that there is no delay in proceeding to the second stage of harmonisation, which is due to take effect at the beginning of the 1985–86 marketing year.
I support the Commission's proposal to maintain the basic suckler cow premium and to abolish the costly and discriminatory calf premium. However, I see no justification for the proposal not to renew the beef variable premium scheme, which has served United Kingdom producers and consumers well. The premium scheme has wide support in the House, and I shall be fighting hard to ensure its retention.
Mr. Robin Maxwell-Hyslop rose—
Mr. Jopling: I was not going to give way again, but I see that that is a lost cause.
Mr. Maxwell-Hyslop: Does my right hon. Friend recall that he told the House last year that he agreed to the extra milk quota for southern Ireland only on the condition that we were allowed to retain the beef variable premium? Will he make certain that the Irish lose their extra quota if we lose the beef variable premium?
Mr. Jopling: With some fear and trembling, I take issue with my hon. Friend, who is so nearly always right. If he looks it up, he will see that at no stage did I agree to the extra milk quota for the Republic of Ireland. I have made it clear that if there had ever been a vote on that issue, I should have been against an extra quantity of milk being given to the Republic of Ireland.
I shall not give way to any more interventions.
In the sheepmeat sector, the Commission has proposed a price freeze for the rest of 1985 with a 2 per cent. increase in January 1986 after a change in the starting date of the marketing year. It also proposes placing a limit on the variable premium payable each week so that if, as at present calculated, it would amount to over 25 per cent. of the guide price, in future the amount actually paid would be abated by up to 5 per cent. of the guide price. Further, it has proposed a "recovery bar" to prevent the annual premium from increasing to compensate our producers for loss of income due to abatement. It does not propose any changes to the seasonal scale of guide prices.
We have the largest interest in the sheepmeat regime as both producers and consumers, and it is therefore particularly reasonable in this case to insist that the regime should take full account of our interests. Overall, the regime introduced in 1980 has been reasonably successful, though clawback has hindered our exports.
I am naturally willing to consider any non-discriminatory method of reducing Community expenditure, and in that context I could agree to a price freeze for 1985. Nor do I see the case for a price increase in 1986. However, adjustments must operate in a non-discriminatory way. The recovery bar would discriminate unfairly against British producers, and I am therefore determined to resist it.
I also consider that the existing seasonal scale of guide prices causes instability in our market and that savings in expenditure could be made by adopting a better scale designed to promote more orderly marketing. Last autumn, the Commission appeared to accept that argument, and it is disappointing that it has not proposed amendments to meet that point.
I shall just briefly summarise the Government's policy on other products.
We support the Commission's proposals on sugar, including the price freeze on sugar beet.
On oilseeds, the rapeseed price should be reduced to the same extent as that for cereals, and a greater cut should be made in the sunflower price than the 1·5 per cent. proposed by the Commission.
There is no case for any increase in olive oil prices.
A price freeze for wine is clearly needed, given the problems in this sector, which I explained to the House a short time ago.
Taking account of the mounting cost of the market regime and the level of withdrawals, support for some fruit and vegetables should be reduced by more than the Commission has proposed. The Commission has proposed useful changes to the regime for processed fruit and vegetables.

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I support the price cuts proposed for tobacco and also the price freeze proposed for pigmeat.
The motion refers to other proposals on designations of milk and milk products and on starch. Both those proposals would have significant implications for our industry and consumers and therefore require further detailed consideration. I shall, therefore, do my best to resist any pressure from other member states to include those proposals in the price settlement, unless they have first been thoroughly considered.
Finally, given the current volatility of sterling, in my view, it is still too early to take a view on the proper level for the green pound. Any Commission proposal to adjust our green rate will be considered on its merits at the time.
These are very important proposals for United Kingdom taxpayers, consumers and food retailers and processors. I believe that the Government's policies are best designed to protect our national interests, and I commend the motion to the House.
4.14 pm
Mr. Brynmor John: Taken together, the documents before the House are about as long as "Gone with the Wind". However, they are not half as readable, and they lack any central theme. It is appropriate to consider them today for two reasons. First, today's debate is on the eve of our Budget. The £12 billion cost of this programme, taking up 75 per cent. of the total EEC budget, makes it especially important. Secondly, it is important to discuss them in advance of the meeting of Ministers. Although it is clear that there is no difference in sentiment between the two sides of the House in that all right hon. and hon. Members are determined to rein back the EEC Commission on this issue, it is a way of enabling the Minister of Agriculture to let his colleagues know the feelings of the House.
The one document that I have been able to read is the explanatory memorandum. It is a mere 110 pages long —a Booker prize entry compared with "Gone with the Wind". In that document the Commission itself makes noises of concern about the size of the surpluses now being produced. That being so, we shall be looking at achievement rather than at general sentiment.
The negotiations into which the right hon. Gentleman will be entering have changed radically in their nature. Perhaps one of the problems is that for a lot of EEC Ministers the negotiations are too often looked upon as a price-fixing operation for the coming year—in other words, an income operation—whereas it is now a matter of balancing what is an imbalance and of adjusting agriculture to the realities of the market.
I am disappointed that today's debate is somewhat limited in scope. I know the reason for that. But this occasion used to be the central debate of the agricultural year in parliamentary terms. Last year, it came on after 10 o'clock. This year, it is given a mere half day.
Notwithstanding the right hon. Gentleman's preference for price measures to control agricultural surpluses, there is now beginning a fairly wide debate on methods of controlling agricultural surplus. Even the National Farmers Union is considering the unconsidered—quotas in cereal prices. Therefore, whether it be in the Commission or at home, there will be a continuation of that debate.
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I believe that Parliament should have a day devoted to a debate on this issue, possibly guided by a White Paper from the Minister. I know that White Papers of themselves do very little. However, they help to focus the debate and to set out the possibilities. I hope that the Ministry will agree both to publish a White Paper and to arrange for a debate on it so that right hon. and hon. Members can look in an open way at the future of agriculture.
I do not think that we could be more cruel to our farmers than to pretend that there will be no change in the next decade or no adjustments to which we need to turn our minds. That is instanced by the fact that, had we been debating the 1973 position today, the Commission area would not have been self-sufficient in cereals, sugar, wine, beef, veal, sheepmeat, goatmeat, eggs and tobacco. Now only sheepmeat, goatmeat and tobacco remain. Although we have passed the point of self-sufficiency in most of these products, the agricultural machine which has been set up carries on remorselessly.
I accept that it is unwise to aim for exact self-sufficiency in agriculture. We must retain some margin of surplus to buffer us against crop failure or a poor harvest and to enable us to play our full part in the fight against world poverty. But even overproduction would be tolerable if we could sell our surpluses on world markets. The tragedy of the common agricultural policy at the moment is that, although the strong American dollar has narrowed the gap between CAP prices and world prices, we still have dearer agricultural products than the United States of America.
The Minister rightly warns us that if the American dollar weakens, our prices will become uncompetitive and the cost of subsidising our exports will increase. I think that Mr. Pooley estimated that a 10 per cent. devaluation of the American dollar would cost us 700 million ecus. Consequently, as the recent very high levels of the dollar probably will not last, the present position, unsatisfactory as it is, is unlikely to be maintained.
We must also consider what will happen if the American farm Bill goes through without any change in farm support prices in the United States. It will force down the price of American products on world markets and will make EEC agricultural produce that much more uncompetitive. Although some surplus is justified, the present surpluses are intolerable and should not be supported. But if we cannot afford to sell our products, or cannot be sufficiently competitive in selling them on the world market, food mountains may well engulf us, and, I suppose, the wine lakes may drown us.
An idea of how inexorable overproduction has become in the EEC can be gained by looking at the intervention stocks in the United Kingdom since 31 January last year. We find that butter has risen by 15 per cent., wheat by 60 per cent., barley by 168 per cent., rye by 196 per cent., durum by 35 per cent. and beef by 49 per cent. That is an immense increase for one year and severe strain is being put on storage facilities. The EEC may say that the only answer is to extend storage facilities, but that is like saying that the answer to a crime wave is to build more prisons. Such a solution would be limitless, and we must tackle the problem at source instead of trying to treat the symptoms.
The Commission seeks to balance farm incomes with control of production. The disappointing aspect about the document and the Commission's proposals is that they do not do that, at least in their present form. Next year, there will be an increase of 138 million ecus. Although the

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figure falls in the following year by 34 million ecus, it is subject to so many assumptions as to be easily proved wrong by the time that we reach that date. The Minister knows that price discipline does not come into force until 1986, so his colleagues may be tempted, in negotiating with him, to bump up the prices in the following two years so as to anticipate the price discipline regime that will come into force in 1986.
The Minister rightly devoted much of his attention to cereals. The 1984 harvest was a record 144·2 million tonnes. But since 1978, cereal production has risen on average by 3 per cent. per year. To an extent that shows that, although we fear climatic change, some of the old fears about bad harvests and poor climates have been guarded against by the tremendous increase in crop yields. World production is at its greatest ever, and as a result farmgate prices have, as the Minister said, declined by 24 per cent. At least, that is the view of Mr. Capstick at the Ministry. Yet it is said that real revenue per hectare has risen by no less than 10 per cent. The reason for that is to be seen in the rising yields, where, in the case of wheat alone, we have a 43 per cent. rise in crop yield.
If there has already been a 24 per cent. fall in farmgate prices, yet the income from cereals has increased, what would a 3·6 per cent. reduction in cereal prices do that has not already been done? Despite the record nature of this year's crop, it is obviously not anticipated that it will be a freak crop. By 1990, the Commission expects cereal production to rise to 148 million tonnes, and many would say that it is being unduly conservative. At this rate, cereal production is more likely to be about 160 million tonnes.
However, consumption will not be rising very rapidly, and is likely to amount to about 115 million tonnes. Therefore, even on the Commission's figures, there will be a gap of some 33 million tonnes in 1990. That is why the Commission's proposal is so incredible. I agree with the Minister, and cannot understand how it can move from there to suggesting a 1·5 per cent. rise, to be set off against a 5 per cent. decrease. Obviously, there will be a 3·6 per cent. overall decrease. However, given the extra yield and the history of Britain in the past few years, that will not mean any real decrease in cereal incomes. Therefore, the idea that a 3·6 per cent. reduction will force people out of cereal production or will make such production unattractive does not bear examination. History has shown that better crop yields have more than offset price reductions.
If that price reduction is being brought about with a view to bringing surpluses under control some calculation must have been made of what a net reduction in the cereal price of 3·6 per cent. will do with regard to limiting cereal production. I hope that a calculation has been made of the decrease that will result. If so, perhaps the Minister will tell us, or ask for the figure to be produced. If the question of what reduction will flow from the 3·6 per cent. proposal has not even been considered, the Commission has failed at the first hurdle. Unfortunately, I believe that that calculation has not been made.
Nor is the logic of the attitude held on dairy products immediately apparent. The milk quota system was introduced with hardly any notice, and has caused the maximum dislocation and uncertainty within the industry. I refer the Minister to paragraph 34 of the explanatory memorandum, where it says:
"The introduction of quotas has proved difficult, and is not yet fully assured in all Member States".
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That is a fairly ominous and guarded statement about milk quotas, which the Minister did his best to rebut. But I wonder whether his robustness on this issue is shared by all his ministerial colleagues. Clearly, many countries are reluctant fully to implement the milk quota scheme. But having done that, as if to make a futile gesture of conciliation, a 1·5 per cent. rise is then offered. The quota system has brought no benefit to the producers, or—with the pressure for higher prices—to the consumers. Thus, there is bound to be lower consumption of the very commodities now so heavily in surplus.
The Minister mentioned the butter subsidy. In Britain, surplus butter now stands at 25,000 tonnes more than last year. If that is the present situation, what of the future? The EEC forecasts that even in 1991 we shall be producing 13 per cent. more of those commodities than we need, and will be oversufficient. The Commission's proposal will do nothing to bring about a long-term solution to the problem.
The beef and sheep variable premiums deal nationally with two different systems generally in a satisfactory way. The Commission's explanatory memorandum succeeds in being neither explanatory nor logical when dealing with the recommendation to scrap the beef variable premium. Anyone who has studied the matter will agree that the variable premium has stimulated consumption at a time of increasing difficulty.
The long term future set out in the explanatory memorandum states that
"consumption … is at best likely to stabilise."
Since the variable premium's abolition would, according to Agra Europe, add 10 per cent. to the price of beef or, according to the NFU and the Consumers in the European Community group, add 7p per pound to the cost of beef, it would cut consumption. All the pointers are for the retention of the scheme. However, the Commission leaps in logic from arguing the case to asserting it and it suddenly recommends abolition.
The reason is set out in a brief paragraph. The reason is that the scheme is not tidy. It is a national scheme which happens to be working well, but it offends the Commission's bureaucratic sensitivities. The House will support the Minister if he defends the system because it is good for the consumer and for the producer. Far too few of the Commission's proposals can be said to be that.
The sheep premium involves different problems. We are only 75 per cent. self-sufficient in the production of sheepmeat. The Minister admirably outlined the results and details of the change. As he said, the farming press estimates that the change will result in a 5 per cent. cut in income for sheep rearers in Britain. That must be borne in mind when the EEC considers raising by 2 per cent. the price of sheepmeat from next January. The Commission propose a 2 per cent. increase, not a freezing of prices.
The problems of wine and fruit must also be tackled. I commend hon. Members with a fascination for the horrid to look at the explanatory memorandum, which deals with fresh fruit and vegetables. It discloses the most Alice-in-Wonderland situation ever. For example, page 66 refers to the withdrawal of fruit and vegetables from the market. The memorandum says that that is
"a major market outlet for growers."
That is an analysis of nonsense and devalues much of the good work that is being done. That way of looking at things causes worry to consumers and taxpayers about the control to which the system is subjected and about how it will be conducted in the future.

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When the right hon. Gentleman goes to Brussels he will represent the whole country. The remit for agriculture will no longer be—as it has been almost without break since the war—to produce at any cost, whether that cost is financial, to the taxpayer, or environmental.
The right hon. Gentleman has two serious problems. The first concerns the performance of the Council of Ministers. History is against him. I have expressed serious doubts about the Commission's proposals, but we must recognise that, although the Commission is fairly wobbly on prices, Ministers have not in the last five years even been willing to go as far as the Commission wants them to go.
On average, Ministers have allowed price rises which are 3·5 per cent. more generous to farmers than the Commission has proposed. If that happened on this occasion Ministers would wipe out at one stroke the cut in cereal prices and all the benefits that flow from that. It would be a total abdication of the Minister's responsibilities to the population of the EEC. In some cases— for example, in connection with cereals — the Commission does not go far enough. Sometimes its proposals do not do what it says that they will do. However, there is no case at present for being more generous than the Commission suggests, notwithstanding the remarkable German somersault on dairy products and wheat.
The right hon. Gentleman's second difficulty is his price restraint strategy, which is his preferred way of making the CAP more rational. I can see that there are many great attractions about that, but a year ago he adopted the same strategy for milk. He would be unwise to ignore the moves already under consideration for alternative methods of bringing surpluses under control.
In paragraph 50 of the memorandum the Commission states:
"A solution to these problems cannot be found solely in the policy on prices and markets."
Paragraph 1.10 states:
"There is no doubt that … price policy, except where it is extremely restrictive, cannot be the only instrument used in future."
If the price measures fail and do not reduce production and surpluses, other means might be sought to control the surpluses. The steady accretion of surpluses which are neither wanted nor capable of being dealt with constructively is becoming intolerable to all EEC inhabitants. We must bring surpluses under control. If the right hon. Gentleman intends to change tack, for heaven's sake let him negotiate a system which allows more time for preparation than was allowed for milk quotas. We must have a better scheme for those who will be forced to leave farming as a consequence.
My verdict on the EEC proposals is that they are radical in analysis and timorous in their practicality. The Council cannot possibly repeat its mistake. Heaven forbid if it should worsen it.
4.38 pm
Mr. Jim Spicer: I thank the Minister and his team warmly for their work over the past 12 months to reach this final stage in negotiations. The Minister made it clear that the 1984 price fixing marked a historic change in the attitude of all member states. For the first time, they accepted the need for a realistic price
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policy for the Community. That meant that we could hope to see an end to open-ended stock piling and the start of a policy to bring production more into line with consumption.
As I represent part of Dorset, I must tell the Minister that I thought that the milk quotas were too quickly introduced and not fully thought out. I do not blame the Minister. He has made it clear that the introduction of quotas was a Community decision made as a result of sudden agreement. However, it involved savage cuts for those least able to withstand them.
I know that in all discussions since quotas were introduced my right hon. Friend has made it clear that he understands the effects of the cuts upon the small family producers who represent the backbone of our farming industry, not only in their dairying capability on the family farms, but within the social structure of the countryside. I hope that my right hon. Friend accepts that it is the Government's duty to do all that they can to aid that particular group in the years ahead. Therefore, everyone in the House must welcome his statement and approach, especially on the need for quota mobility.
Once we dig beneath the harmonious layer on top of the European Community, we find that every nation plays its cards as hard as it can and will use every trick in the book at all times. I hope that my right hon. Friend—indeed, I know that he will as a practical farmer—will be up to all these tricks and that he will press his Cabinet colleagues to give even more support to every national scheme that we can use to help to alleviate the effects of quotas on smaller producers.
I fail to understand why we must still have the co-responsibility levy. We welcome the cut of 1 per cent., but what on earth does the co-responsibility levy actually do? Why do we have to have the 2 per cent? The architect of the co-responsibility levy was the late Finn Gunderlach, but within a short time of its institution he made it clear that he thought it to be a ridiculous instrument that was serving no purpose. It is not a co-responsibility levy in the sense in which it originally applied. It is a tax of 2 per cent., which could be used to give our farming community a much needed fillip in income in this and subsequent years without raising prices to the consumer.
The whole object of quotas has been to screw down the lid on production. Once that is done, every possible way should be found to help the small producer. Hon. Members will remember that when my right hon. and learned Friend returned from the final negotiations last year one great success was the retention of the beef variable premium for the United Kingdom. All hon. Members welcomed that. At the end of the negotiations this year, he must again return to the House and announce a similar success.
The movement of beef into intervention now stands at record levels. I wish to cite figures that show the absolutely astronomical rise of stocks going into intervention. In the Community as a whole in 1980, 302,000 tonnes went into intervention. By 1984, the figure had risen to 604,000 tonnes—a 100 per cent. increase. If the beef had not been boned, the figure would have been 660,000 tonnes. In the United Kingdom alone, the figure rose from 23,800 tonnes in 1980 to 47,000 tonnes in 1984. Where can we find the storage capacity for that quantity of beef going into intervention? It must be purpose built; it cannot be a converted aircraft hangar which might be suitable for dumping corn. We cannot support such increases in the years ahead.

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It is in that context that I wish to make my final point. The United Kingdom has a beef variable premium without which prices would rise by 7p in the pound. Evidence given to the Select Committee on Agriculture last week by the Ministry team and the Meat and Livestock Commission showed that consumption would fall by 8 per cent. if the premium disappeared. What on earth is the Community thinking about when, at a time when all our efforts should be directed towards increasing consumption, it is trying, purely for the sake of dogma, to impose upon the United Kingdom the end of a system that has worked well and has helped to increase consumption? Instead, the Community should adopt a similar scheme, coupled with a positive policy of lowering prices to the consumer.
What can we do with 660,000 tonnes of beef in intervention? How long can it stay there and what is the cost of keeping it there? That is one area—although not the only one — that makes the Community look very stupid. Unless the other Council members are prepared to be flexible on this point, my right hon. Friend should go into the negotiations with that issue as a sticking point. He should try not only to obtain a year's extension of the premium, but to get it written in on a longer-term basis.
As we stand in the negotiations now, year after year our Ministers, both Labour and Conservative, have defended the beef variable premium and, in doing so, have had to trade off unnecessarily in other areas. That is an insupportable position. I hope that my right hon. Friend and his team will go into the negotiations determined to retain the premium and that they will hold firm for the sake of the United Kingdom farmer and consumer. My right hon. Friend has many long nights ahead of him, and I wish him and his team well in these negotiations.
4.47 pm
Mr. James Nicholson: I rise to speak mainly with the aim of bringing hon. Members face to face with the problems of agriculture in Northern Ireland. I do not want in the limited time available to go into the more heavy aspects of the CAP. I wish to emphasise that agriculture in Northern Ireland has been through a traumatic time during the past 12 months. The imposition of dairy quotas caused great difficulty because in Northern Ireland, when the dairy industry sneezes, everyone else catches a cold. That is what happened with the dairy quotas.
Northern Ireland has also had difficulties in finding storage for intervention beef. We have witnessed the continuing decline of our intensive sector. Although Northern Ireland is an integral part of the United Kingdom, because of its peripheral position both in the United Kingdom and in Europe, it has suffered. Our raw materials cost more, and when we have produced the finished products we have the added costs of shipping them to the markets.
The Commission's proposals will damage agriculture, and because of our greater dependence on agriculture than any other part of the United Kingdom the proposals will hit our farmers hardest. I am opposed to them because they do not offer any opportunity for our farmers even to cover inflation. Greater realism about the needs of agriculture is required.
In Northern Ireland the pig and poultry sectors, which have limited coverage in the proposals, are half the size they were when the United Kingdom entered the Common
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Market. That speaks volumes about what the EEC has done to the intensive sector in Northern Ireland. I shall not labour the point today, but a system must be developed to give us greater access to intervention grain at prices which will allow our farmers to compete on an equal basis not just with the rest of the United Kingdom but with the rest of Europe, especially as Northern Ireland is a net importer of grain. I am asking not for any special advantage but for parity—for a position closer to parity in the prices for the grain that our intensive sector requires to sustain. Nor am I asking for a great increase in production. I am asking for the stabilisation of the half that remains of the industry that we had 11 or 12 years ago. We have the expertise and the health standards to produce bacon and other intensive products as well as, if not better than, other parts of the United Kingdom. We merely ask for equal treatment.
The beef industry requires a period of stabilisation which has not yet been possible. Annual discussions about the variable premium have not helped the industry, as the hon. Member for Dorset, West (Mr. Spicer) has said. I appreciate that the Minister has constantly expressed his determination to retain the variable premium for the United Kingdom, but he should now strive to have it taken out of the price negotiations and agreed by our partners as an acceptable form of support. That would be a major stabilising factor and would give confidence to the industry. Other EEC countries can no longer object to that form of support to the United Kingdom beef industry since the introduction of clawback last year.
The premium not only assists the producer but keeps down prices for the consumer. I believe that its disappearance would mean an increase of 10p in the pound in the price of beef to the housewife. This form of support is most suited to the United Kingdom because a far greater percentage of our heifers are slaughtered, mainly for home consumption, than is the practice in other European countries. Dependence only on intervention support, which at present applies only to steers, would have to be modified to take that into account. Moreover, intervention as a support system gives cause for concern because it is costly and creates surpluses rather than helping the consumer.
The Minister should give greater encouragement to the suckler cow herd and consider increasing the suckler cow premium which has remained static since 1982. With the cuts in the dairy herd, the number of calves coming into the beef herds can only decrease, so we should be acting to avert the shortage that will occur in the future. We should also encourage a gradual expansion of sheep farming as this is the only commodity that is not at present in surplus and the United Kingdom has the stock and the capacity for expansion.
The milk industry has been an experiment in how not to implement quotas. It is important that the United Kingdom as a whole retains its share of the quota in Europe. It would be outrageous and deplorable if we lost any of the share that we now have. In Northern Ireland, the implementation of quotas has caused many people to consider production costs and has brought a new awareness and realism to the industry. It is no longer sensible to feed expensive concentrates merely to increase the milk surplus. Northern Ireland opted for an on-farm quota rather than a dairy quota, which was the right decision at the time because it placed the responsibility on the individual farmer. Northern Ireland has responded positively to the implementation of quotas, with a cut of

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6·5 per cent. up to the end of January, compared with the rest of the United Kingdom which had greater drought problems last summer. That shows the responsible attitude of the vast majority of Northern Ireland dairy farmers.
For the coming year, Northern Ireland will join the rest of the United Kingdom with a quota on the dairies, but that will not of itself solve all our difficulties. Last year Northern Ireland was supposed to have received an allowance of 65,000 tonnes which would have placed us in an intermediate position between the United Kingdom and the Republic of Ireland, recognising our dependence on grass-based sectors, but many of us would still argue that that allowance was never received. Of one thing I am certain, and I hope that the Minister is also certain of it: we need the same 65,000 tonnes from the Community reserve next year. Indeed, I suggest that the Minister should aim to increase the amount not just for Northern Ireland but for the whole of the United Kingdom.
A further difficulty, of which the Minister is well aware, is the lack of uptake in the buy-out scheme. All these matters are intricately related to the imposition of dairy quotas in Northern Ireland. The buy-out scheme was reintroduced some weeks ago. We now have 12·5 million litres available instead of the 66 million litres that the Minister proposed to purchase. Dairy farmers in Northern Ireland are entitled to expect the Minister to strive to give them the same conditions as the rest of the United Kingdom. I refer to his proposal that diary farmers in England, Wales and Scotland with less than 200,000 litres annual production should be brought up to 1983 production levels. Northern Ireland farmers were told that they had to accept a 10·35 per cent. reduction on the 1983 level because of their extra expansion since 1981 while farmers in other parts of the United Kingdom faced reductions of only 6·25 per cent. to 6·39 per cent. Producers in Northern Ireland, especially the smaller producers, are entitled to the benefits that producers elsewhere in the United Kingdom are to receive.
I add my voice to the call for the abolition of the co-responsibility levy. That is the one way in which dairy farmers could achieve an increase in income without any harmful effect on the consumer. The levy should never have been introduced. It never achieved its aim and there is no chance of its doing so in the future. It is no longer necessary and the industry should not have to bear that burden any longer.
Northern Ireland farmers not only suffer from the imposition of quotas but have to take lower prices for what they produce. When the Secretary of State goes to Brussels to complete the final negotiations, I hope that he will remember that he has the livelihoods and responsibilities of many thousands of people at his disposal. I wish him well during the long nights of negotiation and urge him to bring back a package that will assist farmers not only in Northern Ireland but in the United Kingdom as a whole.
5 pm
Sir Hector Monro: I am not sure whether the hon. Member for Newry and Armagh (Mr. Nicholson) will be supporting the Government in the Lobby tonight, and I am not clear why the Opposition are voting against us. I believe that the hon. Gentleman should thank my
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right hon. Friend for what he has achieved in the switch in levy, saving a great deal of expenditure by Northern Ireland.
Farming has been a great success story and farmers and farm workers have done so much in terms of productivity that they deserve our congratulations. It is ironic that that success is now marred by overproduction — whether caused through our domestic policies or through the CAP and price-fixing—which has caused uncertainty and lack of confidence.
We hear those views at conferences and in the press and, more importantly, in the market place and in talking to farmers themselves. High interest rates, overdrafts and loss of investment allowances, too, have all led to low and declining profits. The problem now is how to maintain income while curtailing uneconomic production and ensuring fairness throughout the EC on the issue of price fixing.
I know that our Ministers wish to help farming through this transitional period, which is really not of farming's making. We are at a watershed, and it is vital that we should use the mechanism of the CAP prices to our best advantage. That will be a difficult task, but not as difficult as it would be under a Labour or an alliance Government, when we would have to cope with rates on farms, planning controls and other thoroughly disagreeable policies.
We can lose ourselves in a mountain of statistics, but, whatever the statistics may say, our contacts with farmers and experience of farming tell us more about the facts of life. We know that livestock farmers have done far less well than those who grow cereals.' It is unfair that generalisations about all farmers enable the statistician to show that 1984 was a thoroughly good year for profits. No livestock farmers whom I know would agree with that. Profit is a most misleading concept. If one spoke to the members of any branch of the Scottish National Farmers Union or of the National Farmers Union, it would be brought home to one that there is great anxiety in the world of livestock and that it must be—as I believe that it is—the Government's highest priority to redress the balance and to help the dairy, beef, pig, sheep and poultry sectors.
As part of that process, we must begin to develop a truly rural policy. There are some glimmers of light that encourage me to hope that we shall do so in future. We must develop all aspects of the countryside—the village school, the village hall, the bus services, the shops and post offices — in order to maintain a viable rural community of which, of course, profitable agriculture must be the keystone. My right hon. Friend has done exceptionally well in assisting the less-favoured areas. I am glad that he has been able to extend them. It is now the duty of the Commission to consider these areas specifically.
I warmly congratulate my right hon. Friend on what he has achieved in terms of conservation. He has achieved a great triumph. There has been a major swing in policy among all the major European agriculture departments. When he negotiates with the Department of the Environment and his own Department I hope that he will be able to ensure that the assistance that may be available to agriculture will be simple in form and will include support for habitats and other aspects of conservation and especially for afforestation.
I hope that my right hon. Friend will reconsider, in that context, the issue of capital grants for draining and fencing. The conservation lobby may wish to persuade us

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that all drainage is a bad thing. I accept that we do not wish to see the marshes and the wetlands drained unnecessarily, but the regular tile drainage of arable fields and grassland must go on in a rotation system. The tile drains must be replaced regularly. That grant should be maintained at as high level as possible, for obvious reasons.
I welcome what my right hon. Friend has done for the less-favoured areas in respect of livestock in general. There is the hill compensatory allowance, which is vital, the beef premium, the suckler cow subsidy and the sheepmeat regime. He should look carefully at clawback and the seasonal weighting, and at the impact of those factors on the export market, which we should be developing.
I quite agree with my hon. Friend the Member for Dorset, West (Mr. Spicer) that it is most important in the interests of the housewife and the farmer to keep beef out of intervention. Let us eat beef and avoid putting it into store. That is the right policy.
The crucial issue is the dairy sector. This has been a dramatic year. I pay tribute to the Scottish NFU and to the Scottish Milk Marketing Board for their constructive approach throughout the year to helping the dairy farmers in Scotland to come to terms with a very nasty surprise. The panels and tribunals have all done good work. However, we must not underestimate the effect on farms and creameries.
I agree with my hon. Friend the Member for Dorset, West about the co-responsibility levy. Once we are locked into a quota system, we must look at the levy again. The figure is 3 per cent., of which 1 per cent. has been rescinded this year to help the transition to the quota era. Let us now try to rid ourselves of the other 2 per cent. It is a tax on dairy farmers. It will not affect the price to the consumer but it will have a tremendous impact on the price to the producer. Let us try to remove the rest of the coresponsibility levy. The dairy farmer has really been hit twice, with the dairy quota and the co-responsibility levy. That double impact is less than fair on an industry that works long and hard to produce a worthwhile product.
I am pleased about what my right hon. Friend has been able to do for the producer-retailer and for the cause of flexibility in quotas within the United Kingdom. In the circumstances, the outgoers scheme has been a great success. I hope that when we have additional quota from that scheme my right hon. Friend will be able to move it to the most hard-pressed areas and to some of the producers who have suffered most but who have not received much response from tribunals.
It is not easy to diversify without large resources. Investment is stagnant and bank borrowing is increasing. Interest rates are high and, in Scotland alone, will lead to an increase of some £20 million in 1985—half of last years' supposed income. In 1984, incomes were 7 per cent. lower than in 1982 and only half, in real terms, of those in 1975. That is why we need renewed confidence through the CAP prices system.
Our aims must be to keep grain at a standstill price, to avoid putting it into any form of quota system and to switch any resources from that standstill to livestock, especially with a view to retaining some profitability in the milk sector. As to beef, my right hon. Friend should remember that the suckler herd is now 29 per cent. smaller than it was in 1975, so it is essential to keep up all possible help to less-favoured areas and the uplands. As for sheep,
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I know that my right hon. Friend is doing his best with the variable premium and the ewe premium. All hill farmers look forward to another increase in wool prices.
My right hon. Friend has done exceptionally well through a most difficult period and has never deserved the criticism that he has received from many directions. He has stuck up for farmers in the CAP negotiations and gained the enormous advantage of environmental assistance. He should keep up the good work. If so, he will get all support from his colleagues who are determined to ensure that agriculture remains profitable and provides employment for the best workers in the world.
5.12 pm
Mr. Gavin Strang: I am happy to follow the hon. Member for Dumfries (Sir H. Monro). Although I shall not comment on much of what he said, his reference to the possibility of quotas on cereals is important.
I get tired of Conservative Members reminding us of our experiences under a Labour Government, but today I cannot resist, having listened to the Minister, recalling the things he used to say to Labour Ministers. I welcome the change in the Minister's stance on the cost of intervention buying. I remember when beef stocks were belittled and intervention buying was presented as a great system for farming. Far from the costs of the CAP and intervention buying declining, they have increased in the past few years. The CAP is a grotesque misuse of resources, just as it was under Labour. It involves massive spending on supporting agriculture, and most inefficiently. A more effective system of support would enable us to sustain our farmers and the small producers in, for example, France and Italy.
Mrs. Elaine Kellett-Bowman: Does the hon. Gentleman acknowledge that, under Labour, British farmers were occasionally paid 45 per cent. less than their counterparts in Germany because of the green pound, and that my right hon. Friend and his predecessor, now the Secretary of State for Energy, have got the CAP into far better shape than did the right hon. Member for Lewisham, Deptford (Mr. Silkin)?
Mr. Strang: If the hon. Lady knows anything about agriculture, the level of production, the level of investment, what happened from 1974 to 1980 and compares that with what has happened since, bearing in mind the fact that investment is the key test of the industry's future, she should be a little restrained. She and the National Farmers Union know that such statements have no basis in fact.
I do not wish to make party political points, but the fact remains that CAP expenditure is continuing to rise sharply. In 1983, it increased by 28 per cent., in 1984 by 14 per cent., and in 1985, on the basis of the Commission's current proposals, it is estimated to rise by 16·5 per cent. Moreover, CAP spending has risen as a proportion of total EEC spending.
I do not blame the Minister for that increase. He knows that it is the consequence of strategic decisions taken by the Government. The Prime Minister and the Government made a great mistake when they put all of their effort into getting a clawback of our contribution to the EEC budget rather than into a more long-term view and trying to change the CAP to help us to get a bigger share of CAP spending.

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I hope that we shall not have the Prime Minister telling us that Spain and Portugal should not enter the EEC because that would increase CAP expenditure. It is equally valid to argue that their accession will help us to get to grips with the problems of the CAP. The Government's policy has been to support the entry of Spain and Portugal. I hope that that continues to be the Prime Minister's policy when she goes to the EEC summit. The Select Committee on Agriculture, of which the hon. Members for Dorset, West (Mr. Spicer) and for Newry and Armagh (Mr. Nicholson) and I are members, has examined this matter closely and is anxious that British interests, not least fishing interests, are protected, but in my view the case for Spanish and Portuguese entry is overwhelming on political grounds.
I hope that the Government will obtain a quid pro quo in the lamb sector if we have to have a change in the system of payments for premium. The Minister of State knows that there is a strong case for moving away from the sharp fall in price guarantees in June. I put that argument on behalf of Scottish industry. With lamb production the way it is in hill areas, especially in the north of Scotland, lambs will not be finished in June. There is a good case for altering the sharp fall in price, although many of the lambs are bought by lowland farmers and sold in winter. The problem with the lamb regime, as the House was told in the debate on the sheepmeat regime, is that it has been designed to keep our lamb out of the French market. It would be much better to tackle the problem of clawback.
The Labour Government negotiated the beef variable premium scheme in 1975 as part of our renegotiation of the CAP. No doubt Ministers will correct me if I am wrong, but I recall that when the Labour Government left office the regime provided for other member states to implement a variable premium on beef. That regime was changed under the present Government. I do not suggest that there is collusion between the Commission and the British Government, but I do not believe that the removal of the variable premium is a serious possibility. That indefensible proposition is put forward every year, but, even in terms of managing the EEC market, let alone in British terms, there is no case for it.
I hope that we can at least make progress towards a change in the regime that will enable us to make it more permanent, which will probably mean the inclusion of a provision to enable other member states to operate a premium.
Mr. Maxwell-Hyslop: The hon. Gentleman is reminding us of what the Labour Government did, but did not that Government sign the agreement whereby, when we send beef into Europe, we have to repay the subsidy, but when Eire sends beef into Great Britain it does not have to repay the subsidy? That gives southern Irish farmers an unfair advantage over own own farmers.
Mr. Strang: I believe that was the deal that was negotiated by Lord Wilson of Rievaulx when he was Prime Minister. It at least secured some offsetting benefits for manufactured goods.
The Minister of Agriculture is right to take a stand over cereals. We must have no moves towards quotas in cereal production. The right hon. Gentleman rightly said that there has been an imbalance between cereal and livestock
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production. That is one reason why it is important that we should not introduce cereal quotas. There is an overwhelming case for a free market in cereals and for tackling the problem of cereal surpluses by a policy of price restraint. Quotas mean higher prices in the long term.
Some arguments that apply to cereals do not apply to milk. For example, cereals are a major input in other sectors of agriculture. I should like to make a number of other points about cereals, but I shall confine myself to saying that we are stuck with intervention, though I hope that the emphasis will be on holding to the Commission's proposal for a price cut. The motion makes no reference to that.
I reminded the Minister of Agriculture that his Government were opposed to the introduction of milk quotas. I was not trying to make a party political point, because I have reluctantly accepted milk quotas. I noted at the weekend that the Farmers Union of Wales has come round to accepting milk quotas as a means of achieving a balance between production and demand—though there is still a long way to go.
The cut in United Kingdom production required as a consequence of the quota negotiated by the Minister of Agriculture is greater than the Community average. I acknowledge that it is not as bad as the cut accepted by some member states, but it compares unfavourably with the position of Ireland and France — neighbouring countries which could easily supply the British market.
It is crucial that there should be no further erosion of the British quota as a proportion of the Community quota. The Minister of Agriculture met a deputation from the Transport and General Workers Union on Thursday. I was a member of that deputation. I assume from what he told us that there is no likelihood that we shall be able to increase our share of the quota. Therefore, I urge him to get a settlement in the price fixing round that maintains the 1 per cent. Community cut for the next milk marketing year. We do not want anything worse than that to cope with.
If we have to go to great pains to establish a quota system, we want it to work. I stress to the Minister that that may require a few more civil servants. We also want to maintain the maximum share of production within the Community and to help the parts of this country that have been hard hit by quotas. I refer particularly to west Wales, the south-west, the north-west and west Scotland. As I said at Question Time last week, many of those farmers do not have an alternative to milk. They can only grow grass. Beef and lamb are not viable options because of the size of holdings. Therefore, we have to build into the quota system a means of minimising the damage done in those areas. I visited west Wales with members of the TGWU a few weeks ago and we saw the determination of local people to fight for their communities and their production — just as the miners fought. It was a sign of the importance of this matter to that local economy.
I hope that the Government will not adopt the policy of a free market in quotas proposed by the SDP in the person of the hon. Member for Caithness and Sutherland (Mr. Maclennan). Such a policy would not be in the interests of milk producers and the areas that have been hardest hit by quotas.
The Minister of Agriculture says that he is committed to leasing, but I urge him to recognise that that must be within the framework of a central agency and controls. It has been suggested that the milk marketing boards could

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take on that role, but I am not so sure about that. The Government might be well advised to do the job themselves or to set up an agency for that purpose.
It would he unacceptable if wealthy farmers, who may have made a fortune out of cereal production, were able to bid for quotas in an open market against smaller producers in Wales and elsewhere. Even with the system of panels and tribunals, some producers have been hit unfairly by the quotas.
The system of buying quotas, establishing an outgoers scheme and redistributing quotas was a good idea, and there may be a case for pushing it even further. I agree with the Select Committee on Agriculture that we need a parallel scheme to the outgoers scheme offering compensation to workers in agriculture and to those in the dairies, the feed compounders and the milk dependent industries, who lose jobs as a consequence of the implementation of quotas.
Eventually, there will be a horse trading session when the Government will have to make some concessions. The price-fixing exercise should be judged, above all, on what is achieved on cereals and milk. We want changes in lamb and the retention of the beef variable premium, with a commitment to change in the beef regime, but, above all, we need a cut in cereal prices — which is of great importance to the future of the CAP and of our industry —the removal of the co-responsibility levy in milk and the maintenance of Britain's share of the Community quota. I hope that the right hon. Gentleman will accept that we are confident that he will be able to retain the variable beef premium. We wish him well in his efforts in that direction, but he will be judged by the House on the other issues.
5.30 pm
Mr. Robin Maxwell-Hyslop: When my right hon. Friend the Minister of Agriculture, Fisheries and Food was generously giving way during his speech, I intervened to ask him whether he would not have agreed to the extra quota for Eire, had it not been for the quid pro quo of the variable beef levy. He replied that my memory had let me down, and that he had not agreed to the extra quota for Ireland. I therefore remind the House of what he said on the occasion that I had in mind. He made a statement to the House on the final meeting of the Agriculture Council to settle details of the quota. The record reads:
"Mr. Robin Maxwell-Hyslop: Is my right hon. Friend aware that a settlement that allows Southern Ireland, which greatly contributed to creating the problem, an increase as compared with others members of the EC is disgraceful and not a basis on which many right hon. and hon. Members would regard it possible to grant any more resources to the EEC?
Mr. Jopling: I opposed the proposals for Southern Ireland throughout the discussions, but was forced in the end to accept the package because there would otherwise have been no way in which to have got all the other things that are of benefit to us, especially the continuation of the beef variable premium." —[Official Report, 2 April 1984; Vol. 57, c. 667.]
It was therefore wholly right to ask my right hon. Friend whether, if we lost the beef variable premium, he would insist that Eire should lose the corresponding advantage which it got when we agreed to that increase on condition that we had the continuation of the beef variable premium. If the one does not continue, nor must the other. That was the point that I sought to press on my right hon. Friend. As I have refreshed his memory that his memory, not
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mine, is at fault, I again ask him to assure us either by intervention now or through his hon. Friend the Minister of State who will reply.
I shall draw attention to only two matters because of the short span of the debate and because many of my hon. Friends wish to speak. First, there are cases in which tribunals have misdirected themselves, because either they have read the regulations wrongly or they have arrived at conclusions that no reasonable person could reach. Under the present system there is no redress for that, as my hon. Friend the Minister told me in a letter. Therefore, a farmer who is ruined by a wrong decision from a tribunal can only go to the High Court and ask for a judicial review. However, that is impossible for most of them, unless they do so in person without a lawyer— because in many cases they cannot get legal aid—or unless my right hon. Friend gives an undertaking that the dairy produce quota tribunals will not ask for costs. That is a wicked way of depriving farmers who have been done down by clear errors of tribunals from getting the only source of justice left to them.
Secondly, the quota system is proving to be the only system which could bring excess milk production under control, as some of us said as long ago as 1977. I am still of the opinion, as I was then, that to have relied on massive cuts in prices to producers would only have resulted in a reduction in milk production at the point of multiple bankruptcy. That system would then have been far worse. The tragedy is that the milk quota system was not introduced when some of us foresaw that happening, in 1977, before the massive French and Irish expansions and, to a lesser extent, expansions in other countries. If it had been introduced then, the quota that could have been allocated would not have resulted in personal disasters, many of which resulted from expansion schemes financed by taxpayers until the day before quotas were introduced with the full encouragement of the national agricultural advisory service, for which my right hon. Friend is responsible. Those facts will not go away.
5.36 pm
Mr. Robert Maclennan: The hon. Member for Tiverton (Mr. Maxwell-Hyslop) is entirely right in saying that if the Government had considered the introduction of milk quotas earlier, done their homework and made contingency plans, the hardships that have been felt this year by the dairy sector, especially in his part of the country and in west Wales, would not have been felt. I am frightened that the Ministry is equally unprepared to deal with the problem of a continuing imbalance between supply and demand in the cereal sector. It was notable how little the Minister had to say about what the Commission had said about that. The Commission drew attention in its explanatory memorandum to the probability that price restraint alone would not in the long term deal with the problem of surplus. Apparently the Minister is not prepared, even now, to take that problem on board. As we suffered hardship in the dairy sector, we can expect also to suffer hardship in a few years' time in the cereal sector.
I do not know why the hon. Member for Edinburgh, East (Mr. Strang) is so rootedly opposed to the introduction of cereal quotas. He did not explain why today. Although I recognise the considerable administrative problems involved in introducing cereal quotas, it is right that both the National Farmers Union and

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farmers' representatives should consider how best to tackle them, and the Government Departments that will be responsible when the Community tackles the problem.
Mr. Strang rose—
Mr. Maclennan: This is a short debate and the hon. Gentleman has made a speech. I must press on. He misrepresented me when he spoke about the attitude of the Social Democratic party to milk quotas. I remind him that before the Government were prepared to talk about that, we advocated the introduction of milk quotas, subject to three important conditions being met: first, that the position of the small dairy men in particular should be safeguarded; secondly, that there should be a regional framework for the introduction of quotas; and thirdly, that the position of new entrants should be considered. None of those matters was properly considered by the Government before they followed this path. That is partly why we have seen so much suffering, so many bankruptcies and an impossible position created for tribunals, to which the hon. Member for Tiverton properly addressed himself.
I fully support what the hon. Gentleman said about legal costs. It would be outrageous if those who sought judicial reviews were forced to bear the legal costs of the public agency that is responsible for the administration of the scheme. I hope that the Minister has listened to that.
The Minister showed today that, as ever, he is far from having a firm hand on the tiller. Once again, he showed the limitation of his capacity to steer the industry. He has no clear sense of the direction in which he wishes to go. It was noticeable that when he discussed the tests that he would apply to the ultimate settlement in the Community he did not for one moment consider the incomes of British farmers. He talked about what he called a realistic view of market possibilities, and said that the settlement must follow the financial guidelines. He said that all producers and products should be treated on a comparable basis, and talked about the need for effective administration of the schemes throughout the Community.
No doubt each of those factors is worthy of debate, but he failed to mention the predicament of the farmers upon whom we depend, not only for the prosperity of our food production but for the prosperity of rural economies. He has not faced the fact that, under his administration and that of the Chancellor of the Exchequer, the indebtedness of the industry has become a crippling burden. According to his White Paper, last year borrowing increased by no less than 14 per cent. Thanks largely to the favourable weather, incomes — in the cereal sector especially —recovered substantially, in global terms, from last year's figures. However, tables 26 and 27 of the White Paper show the reality of what has happened to farm incomes: in the livestock sector, the position remains bleak, and for the milk industry as a whole incomes decreased by 50 per cent. during the past two years. It is extraordinary that the Minister should come to the House for the most important agriculture debate of the year and fail to draw attention to the need to tackle those matters, and to have them in mind when negotiating for our national interests in Brussels.
I share the Minister's objective — I hope he is successful—in eliminating the co-responsibility levy. As has been said, it is a tax on food which is naturally treated by farmers as though it were an additional input cost to be
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recouped by a quota addition to the support price. With the reduction in milk profits such as I have described, perhaps an increase in quota price is justified, notwithstanding the remaining surplus production. It is wrong to try to switch milk production on and off as though it were a light bulb. It is impossible for farmers to adjust to such sudden lurches in direction without tremendous hardship and bankruptcies.
The Government must give some help to milk producers. Beef production has been especially hard hit by the increased cow culling following the introduction of quotas, and there is a considerable case for an increase in the suckler cow premium to encourage quality beef production.
No doubt the Government will attach their usual high priority to the proposal to end the variable premium scheme. Hon. Members on both sides of the House recognise the necessity to resist that proposal, but it must be regretted that, once again, it will not feature as a central objective of the British Government. No doubt when the Minister succeeds in retaining it he will trumpet it as a great success. Every British interest that has been surrendered to save the beef premium, because the Minister failed to put it on a proper lasting basis, will be overlooked. It is an entirely unsatisfactory way to proceed. It is time that the beef premium was put on a longer-term basis, because it is a wholly sensible measure introduced by the previous Administration.
We must change last year's arrangements for lamb, especially the seasonal scale. The hon. Member for Edinburgh, East was right to say that it is outrageous that there should be a drop in support in June at the level that was agreed by the Government. The litmus test of the Government's commitment, especially to the hills and uplands, will be whether they succeed in effecting an appropriate change in the seasonal scale.
On cereals, which from a budgetary point of view and the point of view of the expenditure involved are the greatest problem, the Minister will be assisted by the bad spring in continental Europe. The harvest this year is likely to be much below what was thought likely. Although it is true that, to some extent, weather is no longer the conditioning factor that it was, the Minister need only travel through the cereal-growing prairies of France to see what a bad spring it has been. Therefore, I hope that it will not be necessary to attack cereal production too savagely in one year. I recognise the need to edge down prices, and farmers are satisfied that that can be done without undue hardship to the cereals sector and with great benefit to the cereals-using sector. A reduction along the lines proposed will be acceptable.
I commend to the Minister the need seriously to start thinking about the introduction of cereal quotas. It is imperative that we are not caught late again, with the Minister trailing behind the rest of the Community saying, "I was the odd man out and there was nothing I could do. I was outvoted. The package is not mine, but I will do my best to make it work." That will not wash next year.
Mr. Jim Spicer: Throughout his speech, the hon. Gentleman has referred to the British Government beating the table hard. He is the only representative of his party in the Chamber, and he has no support from the Liberal party. What would happen if we had a representative of his party at the negotiations? The alliance has sold the pass

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in advance and said that there will be no veto and no standing firm, because it is communautaire. What would happen if the alliance were conducting the negotiations?
Mr. Maclennan: The hon. Gentleman must come to terms with the fact that it is being communautaire to try to tackle the problems of surplus in a way that has a chance of succeeding. That is what the Government have plainly not grasped. Not only is it not communautaire to proceed down the road which the Minister has taken this year and last year; it is profoundly against the interests of the British farming community, about which I have talked during my speech—
Mr. Jim Spicer: No veto.
Mr. Maclennan: The hon. Gentleman keeps saying, "No veto", from a sedentary position. I do not know what he is talking about. The two alliance parties have always been in favour of maintaining the Luxembourg agreement. Where the national interest is at stake, properly defined, we would use the veto, but only then. In any event, the Minister is always the odd man out and does not attempt to wield the veto.
I conclude with a matter that the Minister mentioned but with which he did not deal at great length—the green pound.
Mr. Jopling: The hon. Gentleman has made a very clever speech. He has avoided coming to grips with the central question, with which, to do him justice, the official spokesman for the Opposition did deal. Will he tell us what is the view of his party and also of the Liberal party, if he can speak for its members, too—
Mr. Albert McQuarrie: They are not here.
Mr. Jopling: I know that the Liberals are not here, but presumably the hon. Gentleman is speaking for both parties. Can he tell us about the attitude of his party or the Liberal party to the general price proposals that the Commission has put forward? The hon. Gentleman has alluded rather obliquely to cereals, but could he tell us whether the Commission's proposals are too stringent or whether he believes that we ought to be a little more stringent in certain ways? The hon. Gentleman ought in justice to give the full picture to the House.
Mr. Maclennan: I am very gratified at last to have received some praise from the Minister. He has described my speech as a very clever speech. I shall find it useful to refer on other occasions to that bouquet from the Minister. May I say to the Minister, as he said to so many hon. Members who intervened during his speech, that if he reads carefully in Hansard what I have said he will find precisely my reaction to the specific proposals and also my reaction to what he has had to say about them. The Minister will have to do rather better than that.
I want to deal with two points before I sit down. The first relates to milk quotas and their tradability. It is a great disappointment not only to me but to many in the farming industry that the Minister does not appear to understand the need to move towards tradability. It is another example of the Minister running behind opinion instead of leading it, as he ought to do.
As for the green pound, in recent months a small, negative monetary compensatory amount has come into effect in this country. Although I acknowledge the force of what the Minister had to say about the uncertain level
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of the pound, I believe that during the price fixing negotiations we ought to lay on the table, as undoubtedly will be done by Germany and France, the case for a green pound devaluation. Although there is some instability in the rate of the pound, it is more noticeable in relation to the dollar than in relation to the other European Community currencies. I hope that the Minister will be no less trenchant in his defence of British farming interests than his colleagues in the countries of continental Europe will be in defending theirs.
5.52 pm
Sir Paul Hawkins: May I first refer to the remarks of my hon. Friend the Member for Tiverton (Mr. Maxwell-Hyslop) about the unfairness of tribunals. In Norfolk there is a fairly large number of dairy farmers. One dairy farmer, not a constituent of mine, sold his herd but retained all his in-calf heifers and young stock from a pedigree breeding herd because he had been prosecuted by the Anglian water authority and made to spend a very large sum of money upon putting right the means of disposing of his effluent. Having retained all his young stock, including the in-calf heifers, he wanted to return to milk production. In fact he is producing milk again but he has not been awarded one single gallon of quota. This kind of treatment is grossly unfair and it is one of the injustices that needs to be looked at again, as my hon. Friend the Member for Tiverton pointed out.
I apologise for having arrived halfway through the speech of my right hon. Friend. However, I congratulate him upon his forthright and clear explanation. He has received a hell of a lot of stick from those who ought to know better, in particular from the National Farmers Union. Although it cannot be compared to a carthorse, like the TUC, the NFU seems to be rather like an ancient and perhaps valuable motor car that is running on only a couple of cylinders. It does not appear to be looking after the interests of the smaller farmers. The Tenant Farmers Association and the Small Farmers Association would not have developed as they have if the NFU were looking after their interests.
The speech of the hon. Member for Pontypridd (Mr. John) was excellent. I am grateful to him —as, I am sure, are other hon. Members—for the support that he has given to the Minister in his battle in Brussels. As has already been mentioned by my hon. Friend the Member for Dumfries (Sir H. Monro), farming has been a tremendous success story in recent years. We are now able to go to the supermarkets and obtain anything that we want. In Poland they have to queue for the smallest rations of meat, butter and other commodities. Who would prefer to live in Poland rather than in this country? British agriculture has been a great success.
Farmworkers are often thought of as walking about with a piece of straw in their mouths. In my part of the country they are highly skilled men. They are very well equipped to look after the very expensive machinery that is used in farming today. When farming falls upon difficult times it seems as though a pack of wolves or hyenas gather round the farming community and try to pull it even further down. Although I am in favour of caring for the environment, I believe that some of the environmentalists have gone much too far. The best way of ensuring the preservation of a lovely countryside and the retention of

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a beautiful England is to have a profitable farming industry. Farmers look after their farms well, 99 per cent. of them.
Mr. John Home Robertson: There are no profitable farms in Scotland.
Sir Paul Hawkins: I do not know about Scotland. I have been there only once, although I should love to go there again. However, the opportunity has not arisen.
May I continue by referring to Norfolk, not Scotland, although we had an invasion of Scotsmen in the 1920s and 1930s. The farmers of East Anglia are modern, scientifically minded, and highly efficient, and are quite prepared to accept cuts by increasing yields by using modern strains of seeds and by the use of up-to-date equipment, sprays and artificial manures. If the cutbacks in the amounts of sprays and artificial manures were to mean an increase in livestock on land previously cultivated for grain, this would be a very welcome move. The beef premium is absolutely essential.
Mr. John: I hope that the hon. Gentleman will not encourage unduly diversification on cereal farms. It is comparatively easy for farmers in Norfolk to diversify but the reverse process cannot happen on the western side of the country. The hon. Gentleman's suggestion regarding diversification would spell ruin for many farmers in the west who are dependent upon livestock.
Sir Paul Hawkins: East Anglia has always had a high head of livestock. Pig fattening is one of the largest industries in East Anglia. In my youth there were always fattening cattle in the yards in winter. That produced fat cattle when supplies were short from the west country, the Welsh hills or anywhere else. There is room for livestock production on the grain farms, which can use some of their own grain, thus creating more employment in East Anglia, which has been cut back so much recently.
The beef premium is essential. Beef consumption must be increased. The price is far too high at present. Sadly, the best beef is being put into intervention. That is ridiculous.
I hope that my right hon. Friend will agree to the request of the hon. Member for Pontypridd for at least a day's debate. If there were not so much nonsensical legislation we would have time for three days' debate on agriculture. I hope that my hon. Friend will press his colleagues for at least one day. Half a day on this most important subject at what is a turning point for so much in agriculture is essential. We should discuss not just EC prices, but the structure of farming and the rural communities. We have lost far too many family farmers, particularly in my area. They are the backbone of the countryside. We must help and encourage them in the same way that many smaller farmers are encouraged in Germany and France.
I wish my right hon. Friend the best of luck and good fortune in the further meetings that he will have in Brussels.
6.1 pm
Mr. Eric Deakins: I agree with much of what the hon. Member for Norfolk, South-West (Sir P. Hawkins) said, particularly his remarks about the contribution which farm workers make in agriculture,
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especially in his part of the country. He should have added that they are not well paid. One of the aims of agricultural policy should be to try to do more for them without at the same time necessarily giving all farmers higher wages.
I apologise to the Minister and to my hon. Friend the Member for Pontypridd (Mr. John) because I cannot be here for the wind-up speeches. I have a previously arranged outside engagement and must leave at about 6.30 pm. I hope that they will forgive me.
The motion assures us that the Government will ensure that we shall obtain an agreement consistent with the financial guideline. That is a matter of great importance, although it has not been considered in this afternoon's debate.
It would be difficult for us to know whether any agreement which emerges in Brussels will be within the financial guideline. Will the Minister give us some guidance on that? An anomaly goes on from year to year. We are dealing with farm prices in the agricultural marketing year 1985–86 but the financial guideline relates to decisions taken in 1985 which affect expenditure in 1986, the calendar year of the Community. On that ground alone it will be difficult to tell whether any final agreement in Brussels will be within the financial guideline, although we have the Government's assurance that the Commission's proposals come within that.
The new own resource legislation will come into effect on 1 January 1986. No doubt that will come before the House later this year. The own resources available to the Community next year will increase by 15 to 20 per cent. Out of that extra amount must come the cost of accession, and, in particular, the integrated Mediterranean programme which has not yet been agreed within the Community. That will still leave a certain increase for what is called ordinary agricultural expenditure on the present members of the Community whose prices we are debating this afternoon.
I do not understand—I hope that the Minister will give us some guidance — by how much, if the Commission's present proposals come within the present financial guidelines, those proposals could be increased and still remain within the financial guideline. There must be some limit. Are we talking about an extra 1 or 2 per cent. or 5 or 10 per cent? Can the Minister give us an idea? We must bear in mind that we are debating price proposals within the guideline, but the outturn in terms of agricultural expenditure could be well in excess of that. We shall have to watch that this year and in future years.
We have debated the problem of surpluses time and again in the House since the mid 1970s. It was a theme of the Minister's speech and that of my hon. Friend the Member for Pontypridd. Milk has created major problems of surplus production, intervention stocks and sales on world markets at knock-down prices at a fantastic cost to the CAP, the taxpayer and the consumer. Over several years price restraints on milk and milk products did not achieve their objective and suddenly quotas were introduced. As the hon. Member for Caithness and Sutherland (Mr. Maclennan) said, quotas were introduced suddenly and we should have prepared for them, but it is the principle that worries me.
In the circumstances of the CAP I tend to agree that quotas are a good idea, but why is the Minister so optimistic that we can get away with reducing cereal production without considering the need for quotas? He is optimistic. Cereal productivity has increased apace in the

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past decade or more under the impetus of higher prices in the Community and the investments that cereal producers, large and small, are putting into production—good luck to them—and will go on doing so.
One of the dilemmas of the CAP has always been that we cannot always control the volume of production by price incentives or disincentives. Farming is not like a factory where production can be turned off. It is not always based on economic incentives. There is such a thing as the farming way of life. There are many instances in the postwar history of British agriculture where producers whose whole production was relatively uneconomic have nevertheless gone on producing because of their addiction to the way of life. Who can blame them for that?
We should consider carefully whether a price cut in cereals in particular, which is what we are being offered and what the Minister is supporting and thinks should go further, will be a disincentive. My forecast, for what it is worth, is that it will not and that cereal production in 1985–86 — subject to the weather because obviously there may be a bad harvest—will continue to grow in the long term despite the price disincentive. Therefore, we should be prepared to consider other means.
Cereals are important and will form the crux of the arguments which the Minister will have in Brussels. Government policy on that is unclear. In parliamentary answers in the past week the Government have admitted that neither the Commission nor the Government are proposing that the Council should take any direct action on the volume of cereal production in the CAP. The Government's objective is a better balance, not merely between cereals and livestock, which has always been an objective of British agricultural policy, but a better balance in cereals, whatever that may mean. When I asked the Minister during Question Time last week whether the Government were in favour of an increase or decrease in cereal production in the Community he avoided giving a direct answer. I hope that we are in favour of a decrease in total cereal production because surpluses are getting larger and larger.
Even if all the Commission's price proposals are agreed by other members of the Council, they will be subject to green currency devaluations and revaluations which can make a tremendous difference. Moreover, we have heard from the Minister that there will be difficulties and that it is unlikely that they will be agreed in their present form. The notional prices in the Community as a whole for cereal production for next year are all well and good—perhaps there is a cut—but when we learn what the Commission is proposing on green currency devaluation for France, and appreciate, as Agra Europe has pointed out, that the effect of that green currency devaluation will be to increase the prices to French cereal producers by 1·9 per cent., no wonder the French are sitting back and saying, "Yes, we will accept the Commission price package". It is coupled with a green currency devaluation which will make life for French cereal producers, if not rosy, a lot better than for other countries in the European Community — and France is the largest cereal producer in the Community. That is another reason for our being concerned even about the present Commission price proposal.
As my hon. Friend the Member for Pontypridd said from the Opposition Front Bench, we have to consider the position of the United States. It will not necessarily affect cereal marketing in the coming year, although, if the dollar were to begin to slide, that could have an effect. My hon.
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Friend mentioned the United States farm Bill, which will make more surplus grain available from the United States for export to world markets at lower prices, with the cutting back of the Federal budget and the efforts to reduce the United States deficit, and so on. That is with a very strong dollar, which makes United States farm exports relatively uncompetitive in world markets. As hon. Members know, when a country has a very strong currency it is much more difficult for it to export, because the country's goods are so much more expensive for the rest of the world.
If in addition to the United States farm Bill— if it goes through—there is a weaker dollar, that will add even more to the pressures on the Community in regard to costs of disposal of surpluses, because it will be competing with much cheaper world prices which are in large part determined by American export prices. We have to consider that for this year and for the future.
Agra Europe has estimated that the extra cost of the common agricultural policy by 1988–89 could be as high as 1·5 billion ecu as a result of what the United States proposes to do this year.
My last point on cereals—it has not been mentioned in the debate so far—is that the Government and the Commission are looking favourably on the use of surplus cereals for other purposes. I refer to a recent answer by the Minister of State:
"The Government are always prepared to consider the merits of new uses for grain but we would have to be convinced that a project involving the conversion of grain into plastic or other non-food materials was viable."—[Official Report, 14 March 1985; Vol. 75, c.266.]
In support, the Commission has proposed that there should be some investigation into the possibility of using cereals —the French have taken it up, as naturally they would —for conversion into starch, ethanol and chemicals Is not that disgraceful when there are millions of hungry and starving people in the world, particularly in sub-Saharan Africa? Yet here we are considering not making food available more cheaply to the rest of the world—there would be some argument for that—but continuing to produce surpluses, not to feed human beings but to turn them into industrial products.
Mr. Nigel Spearing: Shame.
Mr. Deakins: We shall be paying for that, and at the same time other people in the world will be going hungry.
The Minister of State's answer could not have been off the cuff because it was a written answer, but I hope that he and his Department will at least reconsider the policy. I believe that there would be tremendous public objection throughout Britain if we were to subscribe to a policy which enabled cereals grown for human consumption to be turned into plastic, ethanol or some other non-food material.
I apologise again to the Minister for the fact that I shall not be present to hear his reply, but I shall read it with great interest. I hope that the debate will enable the Minister to approach his colleagues much more firmly next time so that we may have a full day's debate on a very important subject. We are dealing with between £1 billion and £2 billion of public expenditure from Britain in support for the CAP, the EC and all its works. It is wrong that we should be given only just over three hours in which to debate the matter.
6.15 pm
Mr. David Maclean: I add my congratulations to those already given to my right hon. Friend the Minister of Agriculture, Fisheries and Food not only on his remarks to this House but on the stance that he has taken in negotiations in Brussels.
My hon. Friend the Member for Norfolk, South-West (Sir P. Hawkins) congratulated the Opposition spokesman, the hon. Member for Pontypridd (Mr. John), on his remarks. I also found myself in agreement with the hon. Gentleman from time to time.
Like my right hon. Friend the Minister, I found the speech of the hon. Member for Caithness and Sutherland (Mr. Maclennan) clever. Indeed, it was a cunning speech. It reminded me of those exciting, interesting, but rather esoteric discussions that one used to have in the students' union at 2 am over innumerable cups of coffee on the subject of existence or "Am I really here?". I say to my right hon. Friend the Minister that by the time I sit down he will be in no doubt whatever about what to do concerning the price of milk or cereals. The hon. Member for Pontypridd touched on a wide range of subjects, with many exhortations to the Minister. It may have been my fault, but at times I was at a loss to know what specific point the hon. Gentleman was urging on my right hon. Friend.
I agreed with much of what was said by my hon. Friend the Member for Dumfries (Sir H. Monro). I think he said that it was the efficiency of farming that had brought us to our present problems. That is certainly the case. When I was a lad on the family farm, we were urged to expand and to produce more. Our whole mentality in the industry was that it was our moral duty to produce more from our land, and eventually to hand over good farms to our children and successors, so that they in turn would be able to produce more.
Mr. Maxwell-Hyslop: "Food From Our Own Resources."
Mr. Maclean: Yes, that may have been the slogan, but the attitude of mind to which I referred arose from the fact that during the war we were dependent on the convoys. There was a feeling in agriculture that never again should the British Isles have to depend on food from abroad, and that we should grow as much as we could. That attitude has continued through two generations in farming, and it is still present.
Now, suddenly, in 1985, we find ourselves in surplus in nearly every commodity. If we had not joined the European Community or if we had put the brakes on earlier, it might have been another two or three years before Britain was self-sufficient in dairy products — New Zealand produce is another factor — but in any event we were heading for self-sufficiency. We are self-sufficient in beef and we shall become self-sufficient in sheepmeat, especially if we continue our present expansion, as many farmers are doing. We must seize more export opportunities for sheepmeat. Marvellous things are being done, but we must maintain the pressure. Great quantities of sheepmeat are going into the middle east from Australia and New Zealand. We may soon have a surplus in sheepmeat.
We are now at a watershed in agricultural production, and I feel lost. I wish I could give guidance to farmers. Indeed, I wish I could give guidance to my brother on the
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family farm. I wish I were able to say, "This is what I think you should do over the next few years," but I cannot see the way ahead. I know that some things cannot continue. I know that we must have a subsidy system to support the small family farm. But if one has a small mixed arable and beef unit, with 70 acres of grain, the subsidy system which gives a cereal grower a reasonable, just and fair living gives to the man with 1,000 acres of grain a grossly inflated income. That is what has caused most of the cereal side of agriculture to get a very bad name in recent years.
My hon. Friend the Member for Dumfries complained that farmers are purported to have had a 14 per cent. increase in profits last year when the increase in the capital value of their land is added. That is like saying that hon. Members had a 15 per cent. increase last year because they had a 5 per cent. pay increase and house prices rose by 10 per cent. When we analyse farming income sector by sector, we find that the increase was caused by the grain farmers, who have had an exceptionally good time in the past few years, but it cannot and should not continue.
The Commission's proposals on surpluses are gutless. There should have been an 8 per cent. cut because of the market last year, but it did not ask for that. It could have cut the maximum allowed under the rules by 5 per cent., but it settled for 3·6 per cent. The NFU says that producers need time to adapt to lower prices, but farmers did not need time to adapt to higher prices on the way up. What is good enough on the way up should be good enough on the way down.
We all know that cereal prices are causing distortion in the market. Some of my hon. Friends might not like what I am saying, but they will be left in no doubt of my feelings. Many of my constituents wish that they had 1,000-acre grain farms. In my constituency I have five times the national average of dairy farmers and livestock producers. They, the few poultry producers in my constituency and the few pig producers that are left, together with the beef producers, want lower cereal prices.
A few weeks ago I saw one of the Sunday farming programmes. It may have been the Border Television station Tyne Tees, or it may have been the BBC. Mr. Rowan Cherrington was interviewed on lower input farming. He was asked how big a cut would be needed in cereal prices before it would drastically reduce the surpluses, or before farmers would say, "This is all too much. I am getting out of cereals or cutting down." He replied that it would take a cut of about 30 per cent. before there was any serious difference.
Sir Paul Hawkins: Cherrington always makes funny remarks.
Mr. Maclean: I was naive enough to believe his reply.
If we have evidence to the contrary—that a 10 per cent. cut in cereal prices would solve the problem—let us hear it. However, does any hon. Member believe that a 3·6 per cent. decrease in cereal prices will cure the surpluses? There is no way that it will. That is why we hear demands for quotas. I am gravely suspicious about talk of quotas in cereal production. I am afraid that we would end up with a quota system that might take 10 or 15 per cent. of land out of production, but farmers would then pile on the concentrate, and, with the new grain strains, produce every bit as much as before. The product would be pegged at a price that would be too high, and with the remaining land they would go into beef production and we would end

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up with beef in Norfolk once again. I do not mind that, provided that it does not destroy the living of my beef farmers in Cumbria. That is what it is all about.
Sir Paul Hawkins: There is much better beef in Norfolk.
Mr Maclean: I regret that my hon. Friend the Member for Norfolk, South-West has been to Scotland only once. All good Border men and Scotsmen came south for their cattle and their women, in that order. As a good Border man, I assure my hon. Friend that if he comes to Cumbria he will find not only food cooks and women, but, more importantly, the best stockmanship in the country.
My right hon. Friend is right to argue for a price freeze in milk. It gets me no votes in my constituency to say this, but there is no doubt about it. Even quotas have not solved the problem of surpluses. Much as I should like to say to my dairy farmers, "Here is a bit more, because it has been tough over the past few years," I could not put my hand on my heart and justify a price increase in milk. We are now seeing reports in the press that there has been an increase of 17 per cent. in gross margins over concentrates. We are beginning to see what my right hon. Friend said would happen. Although quotas were rushed in, things have settled down. Farmers are beginning to plan, to adjust and to change their inputs to live with the quota system.
I know that many farmers have shown incredible hostility to the quotas, but they were necessary and had to come. I was critical of my right hon. Friend because of the speed with which he introduced quotas. However, it is interesting to note that I now find many farmers who are saying that it is not as bad as they thought it might be, and they feel that they can live within the system. Now we must have the flexibility in all of it that my right hon. Friend has brought to some parts of it.
My right hon. Friend has been good in getting the transferability quotas and in working hard on leasing, but I agree with my hon. Friend the Member for Tiverton (Mr. Maxwell-Hyslop) that some hard cases are not covered by the quota legislation, or, if they are, they are being misinterpreted. Farmers will not be able to afford to go to the High Court, so the only solution will be to find a quota from some other source. We shall have to examine the matter again and keep the tribunals open for another year. We shall have to look at it again and find a little more quota from another source to deal with such people.
In my constituency some farmers, who have been on a development scheme, intended to go into milk production later this year. They went to their tribunal and were asked how many cows they would be milking on 1 April. When they said, "None", they were allocated no quota. Other farmers took the advice and played cautious. They were on a development scheme to go up to 60 cows, which is about the minimum viability level—one is not a big farmer at that level—but they played cautious and had about 40 cows. They did not want to expand because they were not sure about the effect of quotas. When their neighbour, who bought all the cows that were going at a cheap price a few months ago when there was uncertainty in the market, was asked the magic question, "How many cows will you be milking on 1 April?", he was allowed a quota of all that he wanted, minus 9 per cent. But the person with 40 cows had to cut production even on that level. We must redress that injustice.
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Let us get rid of the co-responsibility levy. There is no longer any case for it. As for the super-levy, I should like my right hon. Friend to say that it will be assessed and collected, if it is to be collected next year, on an annual, not a quarterly, basis. Many dairy farmers are way over in the first two quarters, frantically have to adjust, and may have to pay the super-levy. However, in the third and fourth quarters they may be under, and, at the end of the year as a whole, they may be in balance or even under the level. It would be unfair if they were clobbered because they are making adjustments. Let us average out the whole thing.
The Commission's proposals for lamb would reduce the benefits available to Great Britain under the lamb regime. There is no doubt that they would discriminate severely against British producers. The proposed limitation of the variable premium is acceptable only if there is also a change in the seasonal price scale. That has to be changed to reflect British marketing patterns, if the revenue lost through the cut-off in the weekly variable premium is to be taken into account in determining the annual new premium.
There is no doubt that every hon. Member, and even the hon. Member for Caithness and Sutherland, feels that the beef premium scheme must remain. We all acknowledge that the United Kingdom is out on a limb on this one. The United Kingdom seems to be the only country arguing for the system, because the Europeans do not like it, but we all know that it is eminently sensible. It puts the best bits of beef down the throats and into the stomachs of the housewife and her family, and that is where it should be. The prime cuts of beef should not be stuck into intervention.
My hon. Friend the Member for Norfolk, South-West spoke about the success of British agriculture. I saw a slogan on the rear window of a young farmer's car in Cumbria, a slogan that all hon. Members should remember. It said, "Don't criticise British farmers with your mouth full." Other countries have to queue for grisly scraps of meat, but we have some of the best beef. Let us keep the variable beef premium scheme and make sure that beef is eaten.
What can my right hon. Friend do in Brussels? How can he keep the scheme? He should not make any concessions on milk, except possibly to permit a small price increase. I should like to see a freeze in prices, but as a fall-back position, to keep the beef variable premium, I should concede a small price increase in milk. We cannot make any concessions on lamb or sheep. We must demand a larger cut in cereal prices. I should concede only the 3·6 per cent. reduction, if we must do that, to keep the beef variable premium scheme. If we go in threatening that we want a bigger cut in cereal prices, that may be the quid pro quo for keeping the beef variable premium. I hope that my hon. Friend the Minister of State will say that that may form part of his negotiating stance.
6.30 pm
Mr. Nigel Spearing: I rise just in time to speed my hon. Friend the Member for Walthamstow (Mr. Deakins) on his way out of the Chamber with the bad news that for some years millions of pounds of British taxpayers' money have gone into converting British grain into starch for chemical feedstock. My hon. Friend's fears are not only well founded; unfortunately, they are already to be seen in fact.

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I am glad that we have heard from hon. Members who represent Norfolk constituencies. I want particularly to take up one remark by the hon. Member for Norfolk, South-West (Sir P. Hawkins) about family farms. It appears that the EEC is incapable of providing the policies for which it is ostensibly in being. I thought that it was the very objective of keeping people on the land that was one of the reasons for having a common policy.
The hon. Gentleman also dealt with another important topic, bearing in mind that Halvergate marshes are in that county. It concerns conservation. The hon. Gentleman was a little hard on some people because today we have a system of high inputs and high outputs and, if maximum profits are based upon such a system, land values are related to that system of farming.
We need a system of farming of reasonable or medium inputs and reasonable and medium outputs which both provides the farmer with a reasonable margin on which to live and at the same time is good husbandry so that our farms can be passed on in good heart to those who come afterwards.
I put it to the House and especially to hon. Members representing Norfolk constituencies that that is not happening. The common agricultural policy neither encourages it nor permits it.
Mr. Teddy Taylor: Will the hon. Gentleman give way?
Mr. Spearing: I regret very much that I cannot give way. The Government have chosen to devote only half a day to this debate, and I have only four or five minutes left to me.
It is neither right nor proper to debate the price mechanism for British agriculture in three hours. It is disgraceful. The Leader of the House and the Government have been criticised heavily about their parliamentary timetable and their attitude to Parliament. This debate is a prime example of the way in which they treat hon. Members and of their apparent contempt for agriculture. I appreciate that we have had only three hours or so in the past three years, but I do not feel that this is an adequate way to treat the House.
The Parliamentary Under-Secretary of State was good enough to appear before the Select Committee on European Legislation, of which I happen to be the Chairman. The hon. Gentleman gave us an hour of his time last week. As a result, we have produced not a "Gone with the Wind" volume and not a 100 page memorandum, but we have tried to present a 22-page summary, which is in the Vote Office and will be published as House of Commons Paper 5/XIV in due course, of the whole of these difficult negotiations.
Let us be under no illusion. Unlike tomorrow, when the House will be invited to decide on a system of taxation, and unlike the Estimates on a system of expenditure, the House has lost control of British agriculture. We do not know what the prices will be. There will be no real estimate of the expenditure, although it is in a notional budget. Even the Commission's best efforts are only estimates. We do not know the price level. All that we know from what the Under-Secretary told us last week is that the likelihood is that the Council will decide on price scales which are higher than those that the Commission has
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proposed. That is bad news for the British taxpayer, even though it may be preferred by some other members of the Community.
Contrary to the Government's wishes, and contrary to the terms of the motion, the Under-Secretary will not be able to get what he wants. He may not even be able to salvage what the hon. Member for Tiverton (Mr. Maxwell-Hyslop) wanted him in logic to salvage—the beef premium.
Life in the EEC does not work like that. It is package bargaining all the time. A lot of people foresaw it, hence the speech and the interventions by the hon. Member for Dorset, West (Mr. Spicer) which, welcome though they may be, echo some of our remarks 10 years ago. I welcome the hon. Gentleman to the club.
I take up a point made by my hon. Friend the Member for Walthamstow, which was also touched upon during the Select Committee's proceedings, about the prospects for the control of agricultural expenditure. I am sure that the Under-Secretary will agree that the so-called mechanism will not be assessable until this debate two years hence, in March 1987, for the reasons that my hon. Friend the Member for Walthamstow and I gave the other day during Question Time.
Secondly, this agricultural disciplinary mechanism, of which there was talk at Fontainebleau, is applicable only in respect of the guarantee scheme. It does not include guidance money which may be given out in some form of compensation.
Thirdly, we do not know whether the mechanism will work at all because it is not obligatory and it is not written into the legislation. It is only a conclusion and a desire of members of the Council.
Fourthly, the base from which the mechanism is to be started is the average of prices in 1984 and 1985. Therefore, there is every incentive for other members of the Community which do not agree with the Government's point of view to up prices in 1985 so that the threshold from which we start is higher than it would be otherwise.
I fear from the examination of the Under-Secretary by the Select Committee and from the contents of its report that there is naught for our comfort and naught for our desire in the prospects for this agricultural price round, which is outside the control of the House. The Minister of Agriculture may be a tiller of the soil, but his hand is not on the tiller because the House has no rudder on its agricultural ship.
Mr. Deputy Speaker (Sir Paul Dean): Mr. John Home Robertson.
Mr. McQuarrie: On a point of order, Mr. Deputy Speaker. You will recall that earlier today we had a private notice question after Question Time which took up half an hour of the time of the House. This debate was supposed to continue until seven o'clock. It has been reduced by that half hour. I seek your guidance—
Mr. Deputy Speaker: Order. I understand the hon. Gentleman's point. We are governed by a decision made by the House some time ago that this debate should end at seven o'clock. I am afraid that there is no question of injury time.
6.38 pm
Mr. John Home Robertson: I am sorry that my hon. Friend the Member for Newham, South (Mr.

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Spearing) has had to cut short his speech. We all know what a deep interest he takes in these affairs, and I have no doubt that he could have enlightened our proceedings considerably more than the limited time available to him enabled him to do.
We have had an interesting debate on the farm price proposals. As my hon. Friend the Member for Pontypridd (Mr. John) said, the documents are physically weighty — to be precise, 1·6 kilos. They cover everything from sunflower seeds to silk worms. This mass of detail cannot conceal the failure of the Council of Ministers to address itself to the scale of the problem which the CAP has generated. I rather doubt whether mere amendments to the policy will ever succeed in achieving the policy's stated objective of protecting both consumers and producers.
The hapless Commissioner, Mr. Frans Andriessen, looks rather like the Dutch equivalent of the sorcerer's apprentice about to be overwhelmed by the surpluses being generated by the common agricultural policy, which are massive. The Parliamentary Under-Secretary of State should know that even in British terms we are set to have a carry-over of about 3 million tonnes of wheat in intervention stores into the next crop year—wheat which was harvested in 1984 and which will still be in intervention stores after the harvest of 1985. That is a sign of the scale of the problem.
The difficulty with the CAP is that it is paying too much cash to the wrong farmers for producing too much of the wrong food. The original intention was to support the incomes of smaller farmers. I suppose that it is predictable that an indiscriminate high-price intervention system has created a disproportionate incentive for bigger producers and perverse penalties for consumers. The result is a grotesquely distorted agriculture industry. We have farmers growing for intervention rather than for a market. We also have excessive food prices for consumers, and there is still a continuing struggle to survive in the so-called less-favoured areas. The CAP appears to be failing on practically all counts.
The debate has demonstrated growing despair on all sides about the basic concept of the CAP. It is time that we thought of more constructive and positive ways of supporting rural areas and agricultural enterprises which need to be sustained in order to protect Britain's rural economy. It is worth remembering that some farming areas already face a crisis. It has been drawn to my attention that even now in Scotland the net farm income for the current year is likely to be about £141 million, while bank borrowings for farmers in Scotland stand at £870 million. Thus, it is not surprising that, despite all the money supposedly thrown at the industry, some people face bankruptcy in certain sectors.
I wish to mention some specific commodities, starting with cereals. As has been repeatedly said, we have 30 per cent. too much grain in the EC. On the one hand, the Commission proposes a 3·6 per cent. net cut in prices for cereal producers, and, on the other, the Minister suggests that there should be a 5 per cent. cut. However, both of those proposals would have only a minimal impact on the level of cereal production in the EC. Tinkering with prices will not solve the major problems. The minor adjustments which the Minister or the Commission suggests would not be sufficient to encourage a significant rise in consumption or to deter effectively the increase in production.
It is too late anyway to do anything about surpluses in 1985–86, because the crops have already been planted. But
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even for the future, minor price cuts will probably stimulate extra production as farmers try to maintain income by boosting production. In that sense, I disagreed with my hon. Friend the Member for Edinburgh, East (Mr. Strang), who referred to the possibility of quotas.
It would take absolutely savage price cuts to have a significant impact on cereal production. Indeed, I think that that was the point made by the hon. Member for Penrith and The Border (Mr. Maclean). Such cuts would lead to bankruptcies among many small farmers, and that sort of measure would be politically intolerable for any party.
When I hear the Minister going on about price restraint I cannot help thinking that I have heard some of the arguments before. Only a year ago, the same Minister said the same things about milk. Perhaps we are going full circle, because the NFU and the farming press now publicly canvass the idea of quotas for cereal production. Quotas could be a fairer mechanism for controlling cereal production, because they can protect the interests of the smaller growers. The concept of quotas has, however, been given a bad name, probably because of the shambles that the milk sector has been suffering from for the past 12 months, largely due to the Minister's hasty introduction of quotas.
But with that in mind, I sincerely hope that the Minister will at least consult the industry about contingency plans for cereal quotas. Incidentally, before we all go overboard about cereal surpluses, we should pay heed to the fact that some areas would dearly love to have the volume of surpluses that Europe has. I hope that the Commission will do more about exporting some of them to areas that desperately need them, such as sub-Saharan Africa.
I shall deal briefly with beef and sheep. The variable premiums must be retained. They are good for consumers and producers, and scrapping them would simply put 7p a pound on the price of meat for consumers. There is nothing to be gained from doing that. I agree with all those who have referred to this issue. The Minister must ensure that the premiums are retained.
The Minister already knows what we think about the way in which he has handled the dairy sector in recent years. He has been stampeded into a quota system that has discriminated unfairly against British farmers, and which falls miles short of the objective of bringing dairy production into line with demand — about 12 million tonnes of milk short per year. National quotas will presumably have to be revised downwards sooner or later in order to get surpluses down to a strategically sensible level. But the House must make it clear that British dairy farmers have already borne more than their fair share of last year's cuts. We must demand that other nations bear an appropriate share of the next round of cuts, whenever they come.
The quota system and the super-levy give us ample power to control production, and I agree with all those who have said that the co-responsibility levy should be scrapped. There is no need for it, in addition to the other measures that are available to the Minister. The Minister should be familiar with our views about how the quota system should be made to operate more flexibly and fairly. At this stage, my only observation is that British dairymen have taken a hammering over the past year, and our objective should be to ensure that dairy farmers can make

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a reasonable return from producing milk within their quota restrictions, in so far as that is compatible with the interests of consumers.
Farming organisations are deeply concerned about the Government's lack of leadership. We know that the Government's main objective in life is to cut public expenditure, and they are doing that in relation to national support for agriculture and things such as agricultural research. We also know that the Government have no positive strategy to sustain the British rural economy. They must stand condemned for that. I wholeheartedly support the call of my hon. Friend the Member for Pontypridd for a White Paper on British agricultural policy. It has been too long since my right hon. Friend the Member for Lewisham, Deptford (Mr. Silkin) published the last White Paper on that subject.
This package will not achieve any radical change. Inasmuch as the Minister says that he is prepared to fight for effective controls on production while defending the special British interests, we support him. However, his performance in opening the debate did not inspire great confidence—[Interruption]. I listened carefully to what he said and on no fewer than four occasions he said that he would give way just one more time. On the fifth occasion, when the hon. Member for Tiverton (Mr. Maxwell-Hyslop) stood up, he threw up his hands in despair and said that it was a lost cause.
Sir Richard Butler has said that the Minister is ineffective and inept. I sincerely hope that the Minister will prove that judgment wrong in the coming negotiations. The British housewife, British farmers and the British taxpayer depend on his ability to get a fair settlement.
6.47 pm
The Minister of State, Ministry of Agriculture, Fisheries and Food (Mr. John MacGregor): The debate may have been relatively short, but it has been very constructive and thoughtful, and much has flowed from it. The tone was set by the speech of the hon. Member for Pontypridd (Mr. John), which was positive and reflective in its analysis. However, the tone of the debate was slightly let down towards the end of the speech of the hon. Member for East Lothian (Mr. Home Robertson). The example that he chose to show a lack of determination on the part of my right hon. Friend the Minister was both trivial and far from the point.
The debate has also been marked by a recognition in all parts of the House, perhaps for the first time in such debates, that we face a new situation because of the arrival of persistent surpluses in a considerable number of products. They are the result of what my hon. Friend the Member for Dumfries (Sir H. Monro) rightly called a great success story. In that sense, it has been a realistic debate, with the exception of the contribution of the hon. Member for Caithness and Sutherland (Mr. Maclennan). As so often happens with the alliance, he tried to make his speech appeal to all outside interest groups without facing up to the critical policy decisions. It was a cunning speech, but I think that the House saw through it and I hope that others will. He failed to say precisely what the alliance would propose on prices, yet that is what we were looking for. He knew that it would mean difficult decisions, but he was not prepared to face up to that.
Mr. Maclennan: Read the record.
Mr. MacGregor: I shall read the record, but I heard what the hon. Gentleman said.
I was anxious to let hon. Members speak in the debate, so I have had to cut short my speech. Consequently, I shall have to concentrate on only a few of the main points raised, which involved the cereal, milk and beef sectors. I have taken note of what has been said about all the other matters to which I do not have time to refer.
The cereal sector is at the heart of this year's negotiations. The projected expenditure in the cereals sector is running at a high level, although nothing like as high as in the milk and dairy produce sector. The latest Commission estimate for the 1985 calendar year is about £1,420 million, with the possibility, depending on what happens to the dollar, of a further increase. The estimates suggest that that could mean a further 700 mecu to 1,000 mecu, depending on what is included, for every 10 per cent. weakening of the dollar. We do not know if and when that will happen, but it is a possibility about which we must be fearful. It is right to concentrate on that sector, not only because of that, but because of the importance of achieving an even better balance between the livestock and cereal sectors.
Hon. Members have commented on our approach this year and urged further restraint on prices than that proposed by the Commission. There are a number of reasons why it is right for the Government to take their present line on prices rather than the alternatives. First, the proposal is on the table and it is likely to be negotiated this year. Secondly, price restraint linked to the guarantee threshold, if properly applied, can be effective. The House should not underestimate its effects.
We are not talking about the price support level alone. A 1 per cent. cut was made at last year's price fixing. We are urging a 5 per cent. cut this year and the Commission is proposing a cut of 3·6 per cent. In addition, if harvests follow their present trend for a number of years, the guarantee threshold will bring about further reductions.
The delay in intervention payments introduced at the beginning of 1984 cut prices by about £5 per tonne. The reductions in the premium for the intervention buying of bread-making wheat and the 3 million tonnes quota for that type of intervention in 1984, followed by this year's proposal almost to eliminate intervention for bread-making wheat, will also have their significant effect.
We are talking about significant reductions in support prices in real terms after taking account of inflation. The National Farmers Union, in the memorandum that it sent to hon. Members in advance of today's debate, said that the Commission's proposals would
"reduce cereal prices by over 4 per cent. in nominal terms. Such a cut, following last year's price reduction and changes in intervention payment arrangements, will substantially reduce producers' returns and discourage production."
The scheme must be rigorously applied over a period of years. If it is not, we shall have to face more disruptive and less attractive alternatives. We have done our homework on all the alternatives so that we are prepared for any future debate. That work points out the real disadvantages of such alternatives as quotas in the cereal sector. The current favourite among those who are looking for alternatives is the co-responsibility levy, to which so many hon. Members have objected today in relation to milk. That is the alternative that is most likely to be put

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forward. I believe that we are right in this year's price negotiations to take the line that we are taking on the reduction in support prices.
The hon. Member for Pontypridd asked whether the Commission had made any estimate of the likely production under the 3·6 per cent. proposal. Such calculations involve many imponderables, not least the forthcoming harvest. I am not aware of any precise estimates by the Commission. We shall certainly discuss that in relation to our position.
The milk price review for this year attracted attention to concentration on the co-responsibility levy. My hon. Friend the Member for Dorset, West (Mr. Spicer) referred to this and many other hon. Members urged that the co-responsibility levy be abolished. My hon. Friend the Member for Dorset, West asked what effect it was having. The levy still produces funds of about £380 million, or 530 mecu. The key programmes, in order of expenditure, are milk powder stock-feed, the use of butter in ice cream and pastries, the school milk scheme and publicity and promotion within the Community. If the co-responsibility levy disappeared this year, those programmes would disappear, or alternative means of financing them would have to be found—or a combination of both.
We certainly want the co-responsibility levy to be phased out, although other member states do not. Some other way would then have to be found of financing such measures or of achieving savings. I am aware of the feelings in the House and the agriculture industry about the co-responsibility levy. We share those feelings because it is clear that the levy has not reduced production.
My hon. Friend the Member for Tiverton (Mr. Maxwell-Hyslop) referred to what my right hon. Friend the Minister said on 2 April. I wish that I had more time to go into the details and the background. My right hon. Friend never suggested that there was a direct trade-off between increased Irish milk production and the beef premium scheme. What happened was much more complicated than that. Many other things were of benefit to us as well as the beef variable premium scheme.
At the ultimate stage of negotiations, if we had voted against the increase in milk quotas to southern Ireland—which we opposed throughout, but which other member states supported — we should not have defeated the proposal. However, we should have lost the beef variable premium scheme because no one else would have supported that.
My hon. Friend the Member for Tiverton also asked about the costs of judicial reviews. I have taken note of what he said, and I shall reflect on it.
My hon. Friend the Member for Dumfries urged that we should consider other hard-pressed areas, in relation to the quota system, which are not at present taken care of by the
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tribunals. We hope to make an announcement soon about secondary quotas this year as the tribunals reach the end of their work, and about money for the outgoers scheme. Our declared aim is to help the small producers next year and the exceptional hardship cases through the outgoers scheme. We shall then have to consier what scope we have to help others, and how to allocate that help. We have been keeping a list of the cases that current regulations exclude. I cannot make any promises, but we shall be examining that aspect.
From all sides a call has been made for the retention of the beef variable premium scheme. We have made it clear, and we shall do so in the negotiations, that retention is the United Kingdom's wish. Several speeches have emphasised the argument that we have constantly used about the scheme.
Regret has been expressed that the scheme has to be renewed annually. We have been urged to make the scheme more permanent. The hon. Member for Caithness and Sutherland mentioned this. His Government and that of the hon. Member for Edinburgh, East (Mr. Strang) negotiated that annual renewal originally. I do not know whether there were difficulties, but it is more difficult to negotiate a permanent retention once the original decision has been taken.
I regret that it has not been possible to answer all hon. Members. We have heard interesting comments on what the Government should be doing in the current negotiations. I warn the House that they will not be easy. There are already signs that some member states are losing sight of market and financial realities. It is extremely helpful to know that in taking the line outlined by my right hon. Friend we are carrying with us a surprisingly wide spectrum of views in the House, coming from quarters that do not usually agree. However, on this occasion they have agreed with us, and have given us support in what we are seeking to achieve.
Question put and agreed to.
Resolved,
That this House takes note of European Community Documents Nos. 4582/85, including Addenda I, II and corrigendum and III, No. 4637/85 on the situation of the agricultural markets in 1984, No. 6248/84 on the designation of milk and milk products, No. 11172/84 on the production refunds for starch, and the Ministry of Agriculture, Fisheries and Food's unnumbered explanatory memorandum of 16th July 1984 on the payment of an additional national aid to German farmers; and supports the Government's intention to seek an agreement on 1985–86 farm support prices and related measures which builds on the success achieved in 1984 in introducing greater realism into the operation of the Common Agricultural Policy, is consistent with the financial guideline for agriculture, maintains a policy of price restraint in the Common Agricultural Policy, avoids discrimination against United Kingdom interests, and takes account of the interests of United Kingdom producers, consumers, traders and food processors.

National Health Service
7 pm
Mr. Donald Dewar: On a point of order, Mr. Deputy Speaker. Can you help me on a matter of some difficulty? I wonder whether you have seen the 15th report of the Joint Committee on Statutory Instruments for the Session 1984–85, which deals with the regulations that we shall be discussing tonight. Paragraph 3 states:
"In oral evidence, the Departments pointed out that while the England and Wales Regulations carry one alphabetically arranged list, the Scotland Regulations carried three separate alphabetical lists. There were still, however, differences between the two Regulations which were not intended and which had arisen through printing and compilation errors."
It went on to say that the lists were not accurate and would have to be amended by subsequent instruments.
I recognise the difficulties of the Committee as regards what was or was not in the list. It was a morass of different lists which were difficult to cross-reference. It was thought that there were substantial differences between the English and Scottish appendices. It has now become clear that, thanks to a great deal of effort at the last minute, most of the discrepancies have been ironed out. However, some still remain, and I think that that is common ground between the Government and the Opposition.
I understand that the Scottish list leaves out Vicks coldcare capsules, and that a cough syrup called Guaiphenesin will still be available for prescription in Scotland under the NHS. On the English list, Vicks inhalor has been missed out, but I presume that it can be prescribed under the NHS in Scotland.
It is clear that those are errors and that the Government's intention was that the appendices to the two sets of regulations should be identical. However, they are not identical. That is a mark of the chaos and confusion, the muddle and haste, with which the whole scheme has been thrown together by the Scottish Office and, I suspect, its colleagues south of the border. I ask you, Mr. Deputy Speaker, where that leaves the House. We are being invited tonight to accept regulations which, by the Government's public declaration, do not have the effect that was intended. That is bound to lead to a great deal of confusion and difficulty in Scotland and in England.
I also wish to ask you about the Scottish schedule, Mr. Deputy Speaker. It is a remarkable document to lay before Parliament. Pages 31 and 32, for example, are spattered with pen emendations. It looks as though a Victorian clerk with an inefficient quill pen has been trying to improve the draftsmanship before the fair copy was ultimately made. I wonder about the standing of the pen additions interpolated between the lines and added at the bottom of the page. Do they carry full authority and are we to take them seriously?
The main point is: what is the standing of the regulations and how can we amend them? We are in the ludicrous position that, because of the incompetence and inefficiency of the Scottish Office and the DHSS, Ministers are asking us to accept regulations that, quite clearly, are not the ones that they intended to lay before Parliament. That is a thoroughly unsatisfactory position. I ask your guidance, Mr. Deputy Speaker, on how we can protect ourselves from the results of such maladministration.
Dr. M. S. Miller: Further to that point of order, Mr. Deputy Speaker. In view of the serious anomalies that have been disclosed by my hon. Friend the Member for Glasgow, Garscadden (Mr. Dewar), can you guide us on whether there should be a separate debate for Scotland so that we are not forced to debate something that applies to England and Wales and into which, by cross-reference and the sort of notations made in the statutory instrument alluded to by my hon. Friend, Scotland will be brought without a debate of its own?
Mr. Charles Kennedy: Further to that point of order, Mr. Deputy Speaker. When I raised this matter last week during business questions, I thought that the Leader of the House was extremely helpful and constructive when he said that the anomalies and discrepancies that the DHSS and the Scottish Office had admitted in evidence to the Joint Committee would be dealt with by relevant Ministers. Obviously, that would clear up many of the difficulties faced by hon. Members on both sides of the House.
I appreciate that the choice of Ministers in any debate is not a matter for you, Mr. Deputy Speaker, but Scottish Members face the difficulty that departmental Ministers, the Minister of State and the Secretary of State for Social Services, will be delivering the opening and concluding speeches. While I do not doubt that they will refer to the difficulties facing Scotland, it is predominantly a matter for the Scottish Office. Therefore, it is incomprehensible that Scottish Members should be asked to accept the regulations.
An official, in reply to a question relating to the difficulties, said:
"I think, Sir, that there may be difficulties, but we cannot, at the moment, gauge the extent of that. This has only just been drawn to our attention and we have not had an opportunity to collate the lists in any detail."
If the Departments have not had an opportunity to collate the two lists, surely it is utterly unreasonable, without a speech from the Scottish Office Minister responsible for the Health Service in Scotland, for the House to make a decision on the lists.
Mr. Christopher Murphy: Further to that point of order, Mr. Deputy Speaker. As the acting Chairman of the Joint Committee, it may be for the assistance of the House to know that the report is available in the Vote Office as is the evidence that was taken and the written memorandum. If hon. Members avail themselves of the opportunity to consult the report, they will be in a better position to assess the merits or otherwise of the regulations.
Mr. Deputy Speaker (Mr. Harold Walker): The House is grateful to the hon. Member for Welwyn Hatfield (Mr. Murphy). The hon. Member for Ross, Cromarty and Skye (Mr. Kennedy) referred to the Ministers who would speak in the debate. That is not a matter for me, but I do not doubt that what he said will have been heard by Ministers.
I must tell the hon. Member for East Kilbride (Dr. Miller) that the decision to debate the two prayers together was agreed by the House on 12 March.
I am grateful to the hon. Member for Glasgow, Garscadden (Mr. Dewar) for giving me advance notice of his point of order. I have looked at the 15th report, and I must tell him that there is nothing that invalidates the regulations before the House. I do not doubt that what he

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has said will be taken into account in the debate and in any subsequent Divisions when the Questions are put to the House. There is nothing that I can do this evening. The Ministers will have heard the hon. Gentleman's remarks and will, no doubt, take them into account.
Mr. Dewar: I do not wish to delay the House, Mr. Deputy Speaker. However, is it not unsatisfactory that the House should be presented with regulations which, on the Government's admission, are not the ones that they intended to lay? The result is that a minor number of drugs — although significant in themselves — will be available in either England or Scotland but not in both? Is there no way in which a manuscript amendment could be tabled, given the fact that the Scottish regulations are already spattered with manuscript amendments?
I hope that you will not think that I am in any way seeking to take advantage of you, Mr. Deputy Speaker, but, as an ordinary Member, I have the greatest difficulty in deciphering the last item added in ink at the bottom of page 31. Perhaps you could help by telling me which drug is referred to there. If so, you are certainly a better man than I am.
The Secretary of State for Social Services (Mr. Norman Fowler): Perhaps I can help the House. The hon. Member for Glasgow, Garscadden (Mr. Dewar) is correct in saying that there are one or two differences. I think he will concede that they are very minor differences. There are three drugs at issue out of a list of about 1,760. The main complaint was of spelling mistakes. For instance, "Scott's husky biscuits" came out as "Scott's husky buscits". I think, however, that the hon. Gentleman's acumen is such that his comprehension of the regulations will not be affected. In direct reply to him, I should state that we shall be putting amending regulations before the House to amend the mistakes.
Mr. Deputy Speaker: No doubt the House will take into account what has been said by Members on both Front Benches.
7.10 pm
Mr. Michael Meacher: I beg to move,
That an humble Address be presented to Her Majesty, praying that the National Health Service (General Medical and Pharmaceutical Services) Amendment Regulations 1985 (S.I., 1985, No. 290), dated 1st March 1985, a copy of which was laid before this House on 1st March, be annulled.
In explaining why the Labour party strongly opposes the regulations I shall begin with three quotations. The first is:
"It is almost impossible to establish whether the introduction of a limited list of drugs will in itself produce any financial saving for the NHS. What does seem apparent is that any attempt so to do is likely to arouse hostility, result in higher administrative costs, affect the pricing of drugs and the industry, generate unwelcome pressures for GPs and pharmacists, and possibly cast some doubt on the Government's intentions towards the standard of provision of general medical services in the NHS."
That quotation comes not from the British Medical Association, the Royal College of General Practitioners, the Association of the British Pharmaceutical Industry or the Labour party but from the DHSS itself in evidence to the Greenfield committee in 1981. Perhaps the Secretary of State should read that.
The DHSS document summarising the consequences of introducing a limited list states:
"Export sales of pharmaceutical products would be likely to suffer (countries with central control of the supply of medicines
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would tender to purchase only those products on the list); research would suffer (the uncertainties of whether a product might eventually gain acceptance on the list might inhibit research); competition would suffer (although competition in pharmaceuticals is imperfect, it does arise because companies seek to produce alternatives to existing successful medicines and a limited list would discourage this); investment would suffer (one of the attractions of the UK as a base for research and production of active ingredients is the existence of a local market open to all licensed products)".
Perhaps the Secretary of State should read that, too.
The third quotation reads:
"we have resisted any system of limiting the freedom of a doctor to prescribe whatever he thinks his patient needs. Not for us are such devices as limited lists, black lists, the compulsory substitution of generics, or the financial pressures involved in reimbursement regimes or the like. We talk about the doctor's freedom to prescribe. But what we should really talk about is the patient's freedom to be treated as his doctor recommends."
Those are not the words of the last Labour Minister for Health. They are the words of the Tory Secretary of State for Social Services on 2 April 1981 and they reveal beyond any doubt the complete somersault on thinking that the Government are trying to palm off as a common-sense development.
That is a devastating indictment. The present Secretary of State has answered none of the objections of his Department or of his predecessor. In previous exchanges on this we have been treated to one of the most unconvincing exercises in justification of an over-hasty, half-baked scheme that I have ever heard in the House. I can think of no starker example in recent years of a Secretary of State being so entirely contradicted by the evidence of his own officials. By any standards, this is a rushed, ill-thought-through and damaging measure. It has been condemned by almost every organisation associated with the National Health Service and it is being forced through precipitately before essential parts of the scheme are in place.
From the Department which gave us the housing benefit scheme which the Tories described — that was a Freudian slip—which The Times described as
"the biggest administrative fiasco in modern times"
we now have the limited list, which has all the same hallmarks in terms of sensitivity and sophistication.
Mr. Anthony Beaumont-Dark: This may sound strange coming from the Conservative side, but many of us think that the Opposition are playing the drug companies' game. Is the hon. Gentleman aware that many of those companies are trying to force through changes in their favour to safeguard their profits? This is the only country to allow an entirely unlimited list. Why is what is good for other countries—including Scandinavia, where there are some Socialist Governments — so bad for this country? Will the hon. Gentleman address himself to those points?
Mr. Meacher: I assure the hon. Gentleman that we are not playing the ABPI game. We are playing the patient's game, as the previous Secretary of State did until the Treasury proved too strong for him. In fact, important countries such as Sweden do not have a limited list.
Mr. Thomas Torney: Is my hon. Friend aware that the proposals will cause considerable unemployment in the drugs and chemical industry? Evidence to that effect has been submitted to me by my trade union, the Union of Shop, Distributive and Allied Workers, which organises people in that industry.
Mr. Meacher: I repeat that none of us is playing the drug companies' game and I shall certainly not be using the arguments and techniques of the ABPI, of which I disapprove as much as anyone else.
The measure will certainly lead to significant unemployment. The Secretary of State has yet to answer that point or to give his estimate of the likely job losses.
Mr. David Heathcoat-Amory: Will the hon. Gentleman give way?
Mr. Meacher: No, I should like to make some progress. Many hon. Members wish to speak. The hon. Gentleman may have a chance to contribute later.
This measure was introduced without a shred of consultation with the medical profession. At 3.15 pm on 8 November, during a routine negotiating meeting, DHSS officials pushed towards the chairman of the general medical services committee of the British Medical Association a brown envelope containing a letter from Dr. Acheson, chief medical officer at the DHSS, setting out the proposals which the BMA then saw for the first time at the same time as the Secretary of State was making his announcement to the House.
Because there was no consultation, the earlier proposed list was so ill concocted and so abbreviated that it looked like the thin end of a very thick wedge. It resembled an ill-disguised attempt to begin the shift to the privatisation of clinical medicine. Even with the longer final list, that suspicion has by no means been fully removed. There is a report in The Guardian today that the Government are considering requiring patients to pay for treatment by their doctors through a voucher system. The Secretary of State should immediately disown that report if it is not true. I will gladly give way to him if he will do so. If he does not do so, our suspicions will be substantially increased.
Perhaps the clearest sign that these proposals are being rammed through in far too precipitate and ill-digested a form is that there is still, with only two weeks to go, no appeals machinery in place, no agreement with the BMA to allow general practitioners to prescribe black-listed drugs in special circumstances, and no settlement of the appalling shambles of the arrangements in Scotland.
A week ago, officials of the DHSS and the Scottish Office admitted to the Joint Committee on Statutory Instruments that Parliament was being asked to approve a Scottish black list that was inaccurate in several items. When asked why the English and Scottish lists did not tally as they were supposed to do, the DHSS official said:
"It was because they were laid in something of a hurry that there were some errors of compilation".
It is monstrous that Parliament should be asked to pass regulations that are known to be significantly inaccurate. The Government should withdraw them until correct regulations can be put before the House.
There have been so many zigzags and voltes-face in the Government's handling of the matter that it is beginning to resemble the terminal voyage of the Belgrano, with exactly the same smokescreen of innuendoes and misinformation.
In 1980, the then Minister for Health said that he was not yet persuaded that a limited list would of itself produce lasting economies in the cost of the NHS or necessarily be in the best interests of patients.
That is not all. As late as 22 November 1983, the present Minister for Health said — [Interruption.] It is
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not funny. To people outside this place this is an extremely serious matter. What the Government are doing offends millions of people. The Minister for Health said:
"We are not convinced that such a list confining the judgment of doctors"—
hon. Member should note that phrase—
"would be in the best interests of patients."—[Official Report, 22 November 1983; Vol. 49, c. 112.]
Now we are told, in a complete reversal of policy, that the interests of patients will not be jeopardised. I wonder who is persuaded of that.
On the comprehensiveness of the limited list, the original DHSS letter of 8 November of last year stated, referring to the original list of 31 items:
"An adequate range of cheap and effective generic drugs will remain available for those cases where doctors feel that the clinical needs of individual patients genuinely require such medication."
If the Government originally claimed that 31 items were adequate, why has the Secretary of State now increased the list three and a half times to about 113 items, and why should his assertion that it is now comprehensive be any more credible?
On the question of flexibility, the DHSS was at first totally uncompromising. In a letter of 4 February this year to the BMA, Mr. Pilling, a DHSS official, said:
"From 1st April GPs will not be able to issue NHS scripts for any listed drug under any circumstances. To do so will be a breach of their terms of service."
A month later, the Government are having second thoughts yet again on that point. BMA leaders met the Minister for Health at 6·15 pm last Thursday to discuss a Government concession on that issue, and I understand that there is to be another meeting later this week.
On the question of generic drugs, the Minister for Health stated on 28 January this year in a parliamentary answer:
"There is no, and never was any, element of generic substitution in the limited list proposals".— [Official Report, 28 January 1985; Vol. 72, c. 59.]
A month later, in his statement of 21 February, the Secretary of State told us that generic substitution is to be enforced by the Government wherever possible.
The whole story is a sorry one of constant backtracking and indecision. However, wriggle though they have in U-turn after U-turn, the fundamental fact remains that—
Dr. M. S. Miller: Will my hon. Friend make it clear that generic prescribing and generic substitution are two very different matters? It is one thing to persuade doctors to prescribe generically—which is not necessarily a bad thing — and another to leave it to the whim of the chemist to substitute generic equivalents for the substance prescribed by the doctor.
Mr. Meacher: That is another question that the Secretary of State must address. In the past two months the DHSS has given contradictory answers. We need to know exactly what the Secretary of State's policy is well before the scheme comes into operation.
The objections to a limited list raised by the DHSS's own evidence to the Greenfield committee in 1981 are as valid today as they were then, and the Secretary of State must know it. Those objections have in no way been answered. In its evidence, the DHSS referred to
"the concern of individual doctors at having to take account of a patient's financial circumstances when deciding whether to continue treatment with drugs not on the limited list".
That still remains true. It referred to

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"the confusion and worry—and possibly hostility—of patients who found themselves with a changed regime of treatment as a consequence of the limited list".
That still remains true. It referred to the fears of
"those who saw in the very act of delineating which drugs the NHS could afford to provide the introduction of an explicit system of second-class medicine."
That still remains true. Lastly, it stated that
"in the new dispensation there would be little distinction between a private patient of a family doctor (who would, as now, pay the full economic rate for any drugs prescribed) and the NHS patient of that doctor who was prescribed drugs not on the limited list (and would also have to pay the full economic rate for the drugs prescribed)".
That was the view of the DHSS in 1981, and the Secretary of State has failed to answer any of those central points. How could he do so when not even his own officials believe him?
In trying to defend the indefensible, Ministers have given three main reasons for standing on their heads, each of which is specious. First, they say that a fuller study of the health system in other countries has convinced them that financial savings of the order indicated by the Secretary of State can be made. [HON. MEMBERS: "Hear, hear."] That comforting illusion is clearly shared by some Government Back Benchers. It must also please the Treasury, but it will not convince me. The DHSS's own document of 1981 once again reveals what a two-faced confidence trick the Ministers are trying to pull off. I quote again from that invaluable document:
"Examination of the schemes"—
abroad—
"suggests that no simple comparison of them is possible and that evaluation of them to determine their suitability for adoption by the NHS is extremely difficult … representatives in the UK of the countries concerned have suggested their schemes do not serve to effect the economies expected of them."
Secondly, the Government have tried to justify their somersault over the limited list by complaining that the number of prescriptions dispensed each year by doctors has been rising too quickly, thus implying some profligacy. The opposite is the case. Britain is at the bottom of the spending league of prescriptions per head of population in developed countries. In the United States, 16·6 prescriptions are issued per head of population each year. The equivalent figures are 11·2 for Germany, 10 for France and only 6·9 for the United Kingdom. There is therefore no justification for introducing this scheme from that quarter.
Thirdly, Ministers fall back on the £75 million savings to explain the exercise. I must tell them that analysts in the industry think that it could turn out — [HON. MEMBERS: "Ah."] I am not saying that they are right, but they are worth quoting. If the Secretary of State thinks that they are wrong, he can tell us why. Analysts in the industry say that savings are much more likely to be about £20 million to £35 million—so low that presumably even the Secretary of State would not claim that it warranted blacklisting 1,800 drugs.
I hope that the Secretary of State will read the DHSS document. I shall be glad to make a copy of his own document available to him. It suggests that the industry is probably right. This is my last quotation. [HON. MEMBERS: "Hear, hear."] I shall be glad to send every Conservative Member who votes in support of the regulations a copy. It says:
"The Department would be forced to ensure that only a fair share of costs and a fair profit were accepted, and this would lead to the control of the price of each item separately — a difficult and costly administrative exercise."
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It does not suggest much of a saving.
Mr. John Butterfill: Does the hon. Gentleman agree that some savings might be made in the £140 million a year that drug manufacturers spend on promoting their products to general practitioners?
Mr. Meacher: That is an excellent proposal. I entirely agree with it. I hope that the Secretary of State will stop these regulations and listen to his hon. Friend, who is making a much more sensible suggestion. I shall be glad to give way to more hon. Members such as the hon. Gentleman.
Ministers have tried to save face by suggesting that limited lists have long been used by hospitals locally and that this is merely an extension. Presumably they know that hospital formularies are a completely different mechanism. They are arranged and agreed by the doctors who do the prescribing—that will not be the case here. They are adaptable and subject to change in the light of the effectiveness of new drugs — that will not be the case here. In hospitals, drugs are given under close supervision — that will not be the case here as patients will be at home. There will be confusion, especially among elderly people, with changing colours and shapes of drugs as different generics are prescribed. It is clear, therefore, that what we are debating is quite different from hospital formularies.
Mr. Henry Bellingham: Has the hon. Gentleman read his speech of 8 December 1983 in which he asked:
"Is the Minister aware that … £25 million could he saved by substituting unbranded versions of the branded drugs that cost the NHS £60 million a year? Does he agree that an enormous saving could be made in this area? Does not his rejection of generic substitution owe much more to the arm-twisting of the drug companies"?—[Official Report, 8 December 1983; Vol. 50, c. 476.]
What does the hon. Gentleman have to say about that?
Mr. Meacher: I am delighted to hear my words repeated — they are extremely sensible. I hope that they will be taken on board. However, that is not what we are discussing today. This is a completely different matter. What I said was sensible and I should like to repeat what the Minister for Health said on 28 January:
"There is no, and never was any, element of generic substitution in the limited list proposals we announced on 8 November 1984."— [Official Report, 28 January 1985; Vol. 72, c. 59.]
Perhaps the hon. Member for Norfolk, North-West (Mr. Bellingham) would have a word behind the Chair with his right hon. and learned Friend the Minister for Health. I think that he could learn a lot from him.
For the reasons that I have given, none of the Government's arguments about the regulations wash. The motives for its introduction are wrong and we oppose the entire framework of the scheme. It is not, as the Secretary of State claims, comprehensive. I have been briefed by doctors that, for example, the white list includes Sudafed, a decongestant, while three alternatives are blacklisted. Sudafed leads to hyperactivity and cannot be given to children late at night because it would prevent them from sleeping. Orovite is omitted from the white list, but it is needed to control alcohol withdrawal symptoms. Cologel, which is designed to counter chronic soiling problems, is on the black list, but Celevac, which contains the same substance, is on the white list. Celevac is in the form of

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granules and I understand that its consistency is frogspawn-like. It is clearly unacceptable to children and is therefore not suitable. I am simply quoting information that I have been given by doctors.
Another example concerns a drug which controls temporal lobe epilepsy. A GP who has contacted me finds that Tranxene controls it well, but Tranxene and its generic equivalent are on the banned list. The alternative, called Clobazam, is on the white list. The GP believes that changing the drug to Clobazam could well result in the patient having a fit. That also clearly is unacceptable.
I quote those merely as examples. I have no doubt that doctors could — and will — provide many others. Once the Secretary of State's claim that the list meets all of the clinical needs of patients is significantly breached, the rationale of the list falls to the ground. And so it has.
Mr. Patrick Nicholls: If, by any chance, there are still any omissions from the list, does the hon. Gentleman agree that they could have been avoided if the BMA had co-operated with the Government in the interests of patients and tried to get the list right? Does not the hon. Gentleman feel slightly embarrassed to use information supplied by BMA-inspired doctors when it is saying now what is would never say in the consultation process?
Mr. Meacher: It is typical of the Conservative party, in its defensive mood, to lay the blame elsewhere. The BMA was never consulted. The Secretary of State made his statement in the House on 8 November without a shred of consultation with the BMA.
Mr. Butterfill rose—
Mr. Meacher: No, I shall not give way.
There have been further meetings with the BMA, including that of 10 January. At none of them has the Secretary of State taken the BMA into his confidence or shown any desire to take account of its opposition to the scheme, or the reasons for it.
Mr. Roy Galley: Will the hon. Gentleman give way?
Mr. Meacher: I shall not give way. I understand that many Conservative Members wish to speak and I do not wish to prevent them from making valid arguments.
There is serious doubt about whether the list is legal under EEC law. I understand that the Duphar case in the Netherlands, which was decided on 7 February — I am sure that Ministers know what I am talking about — showed that if a limited list was not to infringe EEC law it must not be discriminatory concerning the origin of products, be carried out on the basis of objective and verifiable criteria and be capable of amendment whenever compliance with the specified criteria so required. It is arguable that none of those conditions applies here, and that is yet another reason why we believe this over-hasty, pig's ear of a scheme should not be rushed through.
There is also the question of job losses resulting from the package. Despite the small savings that we believe will result from the likely switch in prescribing patterns, there may be a disproportionate loss of jobs because of the huge length of the black list. For those reasons, too, we reject the regulations.
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The central point for us is that, because the list is not comprehensive in meeting the clinical needs of all patients, it runs directly contrary to the fundamental principle of the National Health Service — that the individual's ability to pay determines his tax, but not his medical treatment. Once that principle is breached, a two-tier system of care within NHS general practice is established. The regulations could turn out to be the thin end of a very thick wedge.
Our policy is that prescribing should be exclusively on the basis of clinical need. The regulations would inevitably mean that the treatment that patients require may be influenced by their ability to pay. That is why we reject them.
There was a word that gained currency on the Western Front, SNAFU — situation normal, all fouled up. Perhaps we are seeing a variant of it—situation normal, all Fowlered up.
We all know that the scheme is being introduced as a simple, straightforward, squalid little cost-cutting measure. It is being introduced because the Secretary of State caved in to the Chancellor of the Exchequer in Cabinet, and we all know that the present Chancellor is the most heartless, arrogant, and dogmatic holder of that office in modern times. A little less kow-towing to the Chancellor and a little more standing up for patients would not come amiss from the Secretary of State. If he will not do that, we will. We shall not only vote against the regulations, but we shall be taking the issue into the country, along with the Secretary of State's obnoxious £2 prescription charge.
7.42 pm
The Secretary of State for Social Services (Mr. Norman Fowler): In the long debate on the selected list, nothing has been more remarkable than the policy that has finally emerged from the official Opposition.
Given the terms that the hon. Member for Oldham, West (Mr. Meacher) has been using today — "half-baked", "two-faced", "confidence trick", "squalid" and so on—one would think that when I announced the policy it met with his instant and outraged opposition. No one would ever accuse the hon. Gentleman of understating his case. "The destruction of the Health Service" is a phrase that falls as easily from his lips as does "Have a nice day" from an American waitress, but the extraordinary fact is that at the time of the announcement in November the hon. Gentleman said absolutely nothing — not a thing. It was not until four weeks later that the Opposition came out against the policy.
The House may take the view that the indignation welling up in the hon. Member for Oldham, West was of such a quality that it took a four-week gestation period to find expression. Alternatively, it might take the view that he was labouring long and late to find a way to reconcile his opposition to the Government's proposals with his previous calls for a reduction in the drugs bill.
Only last July, the hon. Member for Oldham, West said:
"while the drug companies are permitted to rip off the NHS, with excessive profits this year probably in excess of £250 million, Government talk of 'Can't afford any more for the NHS' is simply stinking hypocrisy."— [Official Report, 5 July 1984; Vol. 63, c. 481.]
After years of campaigning for cuts in the drugs bill, the hon. Gentleman is now inviting his hon. Friends to oppose

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a reduction and to oppose the resources thereby released being made available for health care. The House can judge whether that is "stinking hypocrisy" or just a typical taste of Meacher humbug.
On the subject of humbug, the hon. Member for Oldham, West mentioned an article in The Guardian. I say frankly that that article is a load of nonsense. The Government have no plans to introduce a voucher system and never have had. Indeed, the article did not suggest that was the case.
The essential issue of the debate is that in the next financial year the Government will be spending over £17 billion on the National Health Service. That is the biggest budget that the Health Service has ever had, in both cash and real terms. However, to say that is not remotely the end of the responsibility of the Government.
The Government must ensure that the money is being spent to the best effect. That is why we have followed a series of measures to achieve value for money in the Health Service. It would be indefensible if the drugs bill were to be exempt from that examination.
Clearly, there are a number of factors to be balanced. The drugs bill is now £1,500 million a year. That is 10 times as much as it was 15 years ago and represents an increase of about 5 per cent. a year more than price rises over the past 10 years. The aim has been to find a way in which that bill could be reduced, while, at the same time, giving the medical profession a choice of drugs to meet all clinical needs and not harming the essential interests of our research-based pharmaceutical industry.
Mr. Allen McKay: Can the right hon. Gentleman tell us the cost of drugs as a percentage of total NHS spending? Has that percentage altered over the past few years?
Mr. Fowler: The proportion has kept more or less the same, but it is £1,500 million out of a total budget of £17 billion. The hon. Gentleman seems to be arguing that we should not seek any economies in the drugs bill. Even the hon. Member for Oldham, West is not proposing that view.
A number of options have been put forward to contain the drugs bill. The BMA apparently now favours what I can best describe as a modified Greenfield approach—an entirely voluntary form of generic substitution. That approach might make it easier for doctors who wanted to prescribe generically to do so, but the trouble is that no one thinks that it would much reduce the drugs bill.
Others would favour compulsory generic substitution across the whole range of drugs, including what are undoubtedly life-saving drugs. That would be totally opposed by the pharmaceutical industry. It would mean that a company could lose the market for any drug the day after its patent expired. There is no doubt that the industry's research efforts would be seriously undermined by that sort of action.
The Labour party would go one step further. It would add to all this by taking major pharmaceutical companies into public ownership. That would cost money, not save it; it would destroy the British pharmaceutical industry; and, if the record of eastern Europe is anything to go by, it would put an end to innovation and research.
The Government adopted a different approach. We began by asking whether all the drugs being prescribed needed to be prescribed. Having examined the evidence
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carefully and having looked at what happened in other countries, we concluded that there was room for improvement and that the Health Service was not getting the best value from the money that it spent, particularly in the groups of drugs we identified and which are covered by the selected list. These are basically tonics, antacids, laxatives, cough and cold remedies, vitamins, analgesics and tranquillisers.
It was clear to us that in those groups the Health Service could achieve a more economical pattern of prescribing without harming the interests of patients, without infringing the clinical freedom of doctors and without discouraging research into medicines for the more serious conditions.
Mr. Bowen Wells: Before my right hon. Friend proceeds further, can he tell us, regarding the clinical freedom of doctors, whether he has been able to work out some method by which there could be an appeal, if a doctor considered it essential for a drug not on the list to be prescribed in a particular case?
Mr. Fowler: I shall come to that point shortly. I realise that many of my right hon. and hon. Friends and, perhaps, some Opposition Members are worried about it. I promise to deal with it in my own time.
Mr. Colin Shepherd: Is my right hon. Friend aware that many general practitioners are worried that this may be the thin end of the wedge and that it could be taken on a broader basis later? I should not like to think that this is the thin edge of the wedge. Will my right hon. Friend assure the House that the list will be restricted to those categories only?
Mr. Fowler: I can and shall come to precisely that point shortly.
The mechanism that we chose was the selected list. That is a list of drugs selected from all those available in the seven categories which will cover patients' clinical needs as effectively as the full range.
Schedule 3A to the regulations lists all the drugs which we have not selected for NHS use. Copies of the much shorter selected list have been sent to every doctor and pharmacist to help them to operate the new system when it is introduced.
The selected list has been the result of a thorough process of consultation and consideration. Not only did we seek views from all the interested organisations but the chief medical officer also wrote to every doctor m the country asking for comments. We received comments from about 2,000 doctors. Those comments have been taken fully into account. What is more, the chief medical officer brought together a group of eminent doctors to help him in a detailed examination of all the medicines covered by the list. That group contained experts practising in all the relevant specialties. It included a clinical pharmacologist, a physician, a geriatrician, a paediatrician and a psychiatrist. It also included three practising general practitioners and a practising community pharmacist. It is ludicrous to suggest that the group was anything other than highly qualified for its task. It is absurd to seek to belittle its experience and expertise or to deny the authority of its recommendations. That group prepared the selected list which we are now introducing. It recommended it unanimously as providing a sufficient range of drugs to

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meet all clinical needs. I accepted the group's recommendations in their entirety, and I hope and believe that most doctors will do so.
Mrs. Anna McCurley: Does my right hon. Friend agree, despite the fact that he has attempted to get a broad spectrum of opinion, that one swallow does not make a summer, one doctor does not represent the whole specialism in his profession and that there are many conflicting views in the specialisms that were represented on the panel?
Mr. Fowler: I entirely accept what my hon. Friend said. We tried to produce and provide as wide a range of specialities to deal with the problem as we conceivably could. From the beginning, I made that clear to the House and indeed, I announced the proposals to the House first. I make no apology for that because it is vital to announce proposals to the House before announcing them elsewhere. At the same time, I invited the British Medical Association to consult me. It is a matter of deep regret that it did not accept that invitation.
Mr. Meacher: Before the right hon. Gentleman reads Department of Health and Social Security briefs, he should ensure that he reads from the correct one. What he said had nothing to do with the question asked by his hon. Friend the Member for Hereford (Mr. Shepherd). Will he now answer the question? Does he or does he not propose to extend the principle of the limited list to other clinical areas?
Mr. Fowler: My hon. Friend asked whether this was the thin end of the wedge, and I said unequivocally that it was not. I shall come precisely to that point in a moment.
Mr. Meacher: The Secretary of State must answer what is perhaps the single most significant question in the debate: does he propose to extend the principle of the limited list to other clinical areas? Will he answer yes or no?
Mr. Fowler: I made it absolutely clear that I did not intend to extend the list. I gave my hon. Friend the Member for Hereford (Mr. Shepherd) that assurance. The hon. Gentleman had better calm down and listen to what is being said. Then he might get a glimmer of understanding about the debate. He made a most pathetic speech, even by his standards. Now he must relax, sit back and educate himself.
The final selected list contains about 100 drugs, compared with the 30 on the provisional list, demonstrates that we meant what we said about consultation, and that we have listened to the comments made to us. Indeed, the final list contains almost all the drugs on which substantial representations were made by doctors. Many of the changes were made for convenience—to enable patients to take more than one drug in a single medicine—or for greater palatability. But the result is that the list contains not only what is essential, but sufficient choice to ensure that it can meet the clinical needs of all patients.
The House will be aware that the selected list contains not only generic drugs, but some branded ones. That is because the chief medical officer's group advised that in some cases there was no suitable generic drug available and that we should retain a branded drug, or a number of similar branded drugs, for the time being. Wherever
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possible, it is the generic name which will be used on prescriptions, not the brand name. That is to allow other manufacturers to bring their own generic versions of the branded drugs on to the market. That will introduce an element of price competition into the supply of medicines, for which the promotion of brand names has, until now, been the main determinant.
The regulations provide that from 1 April general medical practitioners may not prescribe at NHS expense the products listed in schedule 3A. Nor may community pharmacists and dispensing doctors dispense them. General practioners will, however, be able to issue a non-NHS prescription for schedule 3A drugs, if their patients wish it. They will not be able to charge a fee for such a prescription. Doctors will not be able to sell or dispense schedule 3A drugs, except that dispensing doctors will be able to supply and charge for those drugs to patients on their dispensing lists when they are prescribed as part of the patients' NHS treatment. For dispensing doctors the regulations will, therefore, effectively maintain the status quo and their dispensing patients will look to them for the supply of all prescribed medicines.
Mr. James Wallace: I acknowledge that that maintains the status quo and that patients in remote rural areas will be able to get drugs which are on the so-called black list from dispensing doctors, but what message would the Minister give to dispensing doctors who find it repulsive to be brought into such a commercial relationship with their patients?
Mr. Fowler: With respect, I should say that we are trying to take the point that has been put to us by dispensing doctors. The Liberal party had better make up its mind before the end of the debate what it wishes to achieve for dispensing doctors in rural areas.
When I announced the final selected list last month, I explained that there were several issues about the operation of the list on which I would be ready to hold discussions with the professional interests concerned. There were two major points. First, there should be a committee of professional and independent advisers to review the contents of the list on a continuing basis. The committee will be asked to consider whether new drugs coming on to the market fall within the scope of the selected list and, if so, whether they should be added to it. It will also be asked to review the existing list on a regular basis to help to ensure that it still gives the best possible value for money. I wish to consult on the arrangements for the new committee as soon as possible, so that there is no delay in the important task of maintaining the list.
Secondly — I come to the point that was raised a moment ago—as I have already made clear, I am also ready to consider with the profession whether in exceptional circumstances doctors should be allowed to prescribe drugs not on the list when they believe their patients need them. My expert advice is that the list is comprehensive as it stands, and obviously I have accepted that advice. None the less, I have said persistently that if the profession believes that there are real problems here, I shall be ready to consider with it any proposals that it might make to overcome such difficulties. Clearly, I could not agree to exceptional arrangements that would enable a doctor simply to ignore the selected list. There must be adequate safeguards. But, given that, it should be possible to reach an agreement.

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Perhaps I can tell the House about the latest developments here. In my statement on 21 February, and again at Question Time last Tuesday, I made it clear that I was ready to discuss this matter with the representative medical organisations. The result was that on Thursday I received a request from the general medical services committee of the British Medical Association to discuss with me an appeals mechanism. A meeting was immediately arranged, and it took place the same evening. We were agreed on several points. We agreed that any mechanism should be non-bureaucratic and should be applied locally. The crucial issue is the exact nature of the mechanism: whether it should operate on the basis of prior approval or monitoring; in what circumstances appeals should be allowed; and whether the proposed committee should be based on the local medical committees, on family practitioner committees, or on the sort of system that is common in hospitals. Clearly, we shall need some time to work out the details, but I have asked my right hon. and learned Friend the Minister for Health to convene a meeting on Wednesday this week with the general medical services committee and representatives of the Royal College of General Practitioners. That means that the matter will now be pursued with urgency. As the discussions have started at such a late stage, it will be impossible to bring any mechanism into effect from 1 April. But it will be my aim, provided that a satisfactory agreement can be reached, to introduce a system as soon as possible after 1 April.
Mr. Michael Meadowcroft: Since the Secretary of State has accepted the principle that, in certain circumstances, appeals might be necessary and that an override mechanism would be valuable, would it not be better to delay the implementation of the regulations until after 1 April? If it is right in principle to have an override mechanism, is it not right to delay the implementation of the regulations?
Mr. Fowler: I cannot accept that, and I made that entirely clear to the general medical services committee when it came to see me. I shall tell the hon. Gentleman why. I made it clear at the beginning of November, when I announced the proposals, that I was willing to talk to the general medical services committee of the BMA. I repeated that invitation frequently. The fact is that the GMSC came to see me last Thursday. I cannot take the responsibility for the delay, which was entirely the fault of the GMSC, not of the Government.
Mr. Beaumont-Dark: Will my right hon. Friend deal with the unscrupulous campaign carried out by some pharmaceutical companies? Will he accept from me that, of 47 letters from people who were scared that their sick relatives would be unable to receive specific drugs, having checked with the DHSS, only two proved to be justified? Is that not a case of sick advertisements being made at the expense of sick people?
Mr. Fowler: I shall come to that point.
I recognise the anxiety of some pharmaceutical companies about the implications of the list for their activities. As sponsor of the industry, I appreciate the enormous benefits for patients and for the country as a whole that have resulted from the existence of a strong and independent research-based pharmaceutical industry. But
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it is unreasonable for the companies to expect the NHS to accept responsibility for providing a continuing market for all the products of all manufacturers.
We have a responsibility to be selective in order to achieve the best value for the money spent by the NHS, where that can be done without harm to patients. I should make it clear that we were selective in the groups to which we decided to apply the selected list. This is not, as some have described it, the thin end of the wedge. It is a sensible, limited measure that has enabled more Health Service resources to be applied to the development of new services.
It is important to retain a sense of proportion about the impact of the selected list on the industry as a whole. For example, the groups of drugs covered by the selected list account for little more than 10 per cent. of the United Kingdom drugs market. In any case, more than 95 per cent. of the drugs affected can be bought over the counter from a pharmacist without a prescription.
That sense of proportion—this deals with the point raised by my hon. Friend the Member for Birmingham, Selly Oak (Mr. Beaumont-Dark)—has been absent from some of the campaigning against this measure. Some of the tactics used to frighten patients have been disgraceful, and I much regret that any general practitioner should have had any part in suggesting to patients that a drug would not be available before the consultation was completed. It is easy now to see that the vast majority of those scare stories were simply untrue. To use the phrase of the hon. Member for Oldham, West, they were humbug. It is less easy to allay the unnecessary fears and anxieties that have been caused to patients during the campaigns.
One campaign especially that helped to cause those fears and anxieties was run by the Association of British Pharmaceutical Industries. The ABPI has spent about £1 million on a highly misleading series of advertisements. Its latest tactic has been to pose publicly as the defender of old people, while behind the scenes suggesting that to save money reductions could be made in the range of exemptions from prescription charges—exemptions that benefit old people more than any others. The time has come to ask the ABPI where it believes that it is leading the industry—and I speak as a supporter of the industry. It now appears to be lining up with the Labour party, whose policy it is to nationalise the drug companies. I leave it to the ABPI's members to decide whether they should have allowed themselves to be dragged into such an alliance.
The question over the campaigns goes further. We have seen a crude exercise of political pressure, advertising, poster campaigns and the rest. One company sent to all general practitioners a completely distorted standard letter on to which general practitioners were asked to put their surgery stamps before sending it to their Members of Parliament. The same stock letter warned Members of Parliament in these terms:
"Your reply will undoubtedly be of interest to my patients and I shall consider the best way of informing them. It may be appropriate to post a copy on my surgery notice board."
That was a deeply insulting campaign, and I say to the company and to those involved that it would be a sad day for this House if such crude threats were ever to work here.
The selected list has achieved one thing—far wider recognition than ever before of the need for action on the scale and quality of prescribing. The debate that has taken

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place over the past few months has probably been the most extensive on prescribing in the history of the National Health Service.
I should like now to build on that base — not in extending the list but in promoting other wider action on prescribing. All the professionals involved in the debate have acknowledged that there is room for more effective and economical prescribing. Therefore, I propose to convene a conference involving the relevant professional interests which will set the agenda for detailed discussions of further ways in which we can voluntarily raise prescribing standards and reduce costs. I hope to announce details of this new proposal shortly.
One of the benefits of such a conference would be to set in its proper perspective the selected list proposal. The selected list is about putting resources to better use in the Health Service while protecting the clinical needs of patients, preserving the freedom of doctors to prescribe and recognising the legitimate needs of the pharmaceutical industry.
On those grounds, I commend the regulations to the House.
Mr. Willie W. Hamilton: On a point of order, Mr. Deputy Speaker. You will know that there are a considerable number of Conservative Members of Parliament in the pay of the drug companies. In view of the very disparaging remarks made by the Secretary of State for Social Services about the despicable behaviour of these private enterprise companies, will you make sure that every single one of those Conservative hacks is called in this debate?
Mr. Deputy Speaker (Sir Paul Dean): Because of the large number of hon. Members who wish to speak, the hon. Gentleman knows that that is bound to be beyond my power.
8.12 pm
Mr. Gordon Oakes: I agree with the Minister's remarks about the drug companies. They have waged not only a disgraceful campaign but a most inept and counter-productive campaign. We were bombarded not with a letter a day but with several letters a day from the association as well as from individual drug companies. As the Minister stated, we received letters from doctors who did not even sign those letters but merely put upon them their practice stamp. Neither I nor my hon. Friends will be influenced in any way in the view that we take tonight by that inept and counter-productive campaign.
I was more impressed by the letters I received from doctors who are genuinely concerned about their right to prescribe being undermined and about the effect that this will have upon their patients. Care and thought had obviously been put into the typed and handwritten letters that were sent to me by those doctors. However, what impressed me most were the scores of handwritten letters that I received from ordinary people in my constituency, many of them old and most of them chronically sick. Nearly all of them said that they had never before written to a Member of Parliament. They are seriously worried about their own medication being affected.
It is all very well for the hon. Member for Birmingham, Selly Oak (Mr. Beaumont-Dark) to quote figures to the House and say that many of the drugs to which he referred
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are not blacklisted. They were originally blacklisted. Only about 30 drugs were at one time able to be prescribed. The Minister has trebled the number of drugs which can be prescribed. Therefore, one cannot blame the patients for being afraid. The patient does not read Hansard or see the list. All he knows is that the drug which his doctor correctly prescribed for him at the time will have to be paid for in future, although he cannot afford to pay for it because he is old and chronically sick. That is the kind of thing that has influenced the Opposition, not the counterproductive efforts of the drug companies.
I am a little surprised that no hon. Member has mentioned the Pharmaceutical Society of Great Britain. That society has got nothing whatever to do with the industry. It sets the examinations for pharmacists, registers pharmacists and disciplines both retail and hospital pharmacists in a way similar to that by which the Law Society disciplines the legal profession in England and Wales. Neither my hon. Friend the Member for Oldham, West (Mr. Meacher) nor the Minister saw fit to mention its views. The society is opposed in principle to the Government's proposals. In its letter to me it says:
"It is our view that appropriate treatment should be available without restrictions, at the time of need. It is the prescriber's responsibility to make the clinical judgment. These proposals are a further attack on the very basis of the health service."
That is the view of this statutory body, the Pharmaceutical Society of Great Britain. The society is also completely opposed to the disgraceful increase in prescription charges to £2. Almost every week the National Health Service is under attack in one way or another from the Government.
The Pharmaceutical Society of Great Britain discussed with the Minister ways in which to reduce the drugs bill. The society believes that much could be achieved by the elimination of excessive prescribing. It wants prescriptions to be made available to long-term patients. However, it wonders whether the 28-day period, even as a maximum, is sensible, provided that we look after the chronically sick. Even in the case of the chronically sick the society has proposed a triple prescription scheme. This was agreed with the doctors and the medical profession generally but the Minister steadfastly sets his face against it.
The society also suggests that money could be saved if doctors used the box on the prescription form to indicate the number of days for which treatment is needed. Although the inclusion of this box on prescription forms was agreed by the professions and the Department, doctors seldom use it. Money could be saved in that way rather than by means of the bull-in-a-china-shop scheme that the Minister has put before the House today.
Generic substitution is a subject upon which people hold many different views. The society has written to me and said that it is not opposed to generic substitution. However, before giving its blessing to it, it says that pharmacists would need to be reassured by an independent sourse of the quality of the generic substitutes that would be made available. That is a perfectly fair point of view for a responsible profession to hold.
May I put one question to the Minister, which is causing great concern to the Pharmaceutical Society of Great Britain. If a doctor writes out a prescription for a blacklisted medicine it is the pharmacist who, under the regulations, will bear the financial responsibility. That is the complete opposite of the present method. The society believes that the best way to ensure that doctors write

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correct prescriptions is to place the financial responsibility not on the pharmacist but on the doctor. That is a technical point affecting the regulations, but my main point is that the statutory body which is responsible for the registration, examination and policing of the pharmaceutical profession in this country is opposed to the Government's proposals.
Several Hon. Members rose—
Mr. Deputy Speaker: Order. I hope that hon. Members will follow the good example set by the right hon. Member for Halton (Mr. Oakes) because many hon. Members wish to speak.
8.19 pm
Mrs. Sally Oppenheim: I shall detain the House only briefly. I declare an interest in that I am on the main board of Boots plc which is affected both as a drug company and as a retailer of drugs. I shall not, however, be playing what has been referred to as the drug company game. I shall not be speaking with a forked tongue and I make it clear from the beginning that I support the regulations.
Many points have been raised by the Opposition which cloud the issues and important principles which have arisen. The principle which concerns the pharmaceutical industry is, first and foremost, whether this is the thin end of the wedge. If the Labour party came to power and nationalised the pharmaceutical industry, would widespread and wholesale generic alternatives be imposed which would not be in the patient's interests?
Mrs. Renée Short: Why not?
Mrs. Oppenheim: Many generic substitutes are imported. They are not made under the same quality control as drugs with proprietary names made by British companies. That is why one has to approach generic substitution with the greatest caution. That is why I urge my right hon. Friend the Secretary of State, when listening to the review committee, to pay attention to the quality control of the generic substitute drugs that are being prescribed. That is a valid and important point.
A point of principle has been raised by the doctors and, in particular, the BMA. They have got on their high horse about their clinical judgment in prescribing. Yes, fair enough, they are entitled to that because if they make a mistake they must carry the blame for it. But we must ask those same general practitioners and doctors about their clinical judgment in prescribing such things as are on the black list at the moment—raspberry tablets, buttercup syrup, rhubarb mixture, male gland double strength supplement, skin-glow capsules and rock salmon cough mixture, to name but a few.
That brings me to the main point of my right hon. Friend's objective, which to is to make available resources in the Health Service where they will be most useful. Those placebos may have some sort of psychological value —I am not saying that they have not—but it is not for the medical profession to conduct a scare campaign among patients on the basis of drugs which are being prescribed for which there are alternatives or which their patients can go into any chemist and buy without a prescription at a reasonable price.
However, it must be said that many people, not just the elderly, will be confused during the transition period by different names, different coloured tablets, and, in some
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cases, different drugs. It is up to the medical profession not to frighten them but to reassure them that in most cases there will be no difference in the treatment. I can tell those who say that my right hon. Friend is trying to fob people off with cheap drugs that there is still an antacid on the white list which costs £96 for about 50 tablets and that is still prescribable because it is considered the best remedy. Anybody who thinks that my right hon. Friend has been partial in the way that he is trying to save money and thinks that he is trying to fob NHS patients off with cheap drugs is wrong.
I hope that my right hon. Friend will tread carefully during the transition period. I hope that he will listen quickly to any complaints from the review committee about standards and quality control and make available to the public, if possible, a list such as I believe exists in America, published by the Food and Drugs Administration, of drugs of no proven efficacy, a number of which I believe appear on the black list. That would be a constructive step which would complement the measure, which I support.
8.24 pm
Mr. Donald Stewart: If the Government had followed more closely the recommendations of the Greenfield report instead of going down the wrong road, we might already have arrived at a more sensible conclusion. A number of alternatives were proposed, particularly the introduction and encouragement of generic prescribing. It suggested that a box should be provided on the prescription form to enable general practitioners to show whether a branded or generic drug was desired.
It should be noted that the report also categorically rejected the idea of a limited list. But the Government, with their usual obstinacy, decided to ignore that good advice. The Greenfield committee rejected a limited list on the ground that
"We have not seen any convincing evidence that suggested financial benefits would outweigh the administrative problems in drawing up and maintaining the list."
That committee is not the only body to oppose a limited list. The BMA has stated its concern that the proposal will undermine a fundamental principle of the parent NHS Act that a patient's ability to pay should not dictate the treatment that he or she receives. It has also pointed out that on 22 November 1983, after consideration of the Greenfield report, the then Minister for Health told the House:
"We are not convinced that such a list confining the judgment of doctors would be in the best interests of patients." —[Official Report, 22 November 1983; Vol. 49, c. 112.]
In the course of a year that sound judgment has been overturned.
The Royal College of General Practitioners has also stressed its opposition to a list. Although the Minister for Health assured the House in a written answer of 21 December 1984 that the drugs still available after the first limited list had been published would "meet all clinical needs", the college rightly described the provisional list as "clinically inept".
Scottish Members have been informed by the hon. Member for Argyll and Bute (Mr. McKay), the Minister with responsibility for health matters in Scotland, in a letter of 22 February 1985, that the new revised list will

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"meet every clinical need". I accept that the revised list is far less damaging than the original one, but I can only say that we have heard that promise somewhere before.
I share the doubts of bodies such as the BMA and the Royal College of General Practitioners that the introduction of a list will save much money. Doctors, who will obviously still regard as their first and greatest priority the effect of the drug that they will have to prescribe for their patients, will always try to prescribe the best and most effective treatment available. It may not necessarily be the cheapest alternative to a drug on the banned list.
It may be that we shall not save much money, but I am sure that it is the patients who will suffer because of the introduction of a list and those who will suffer most will be the poor and the disadvantaged.
Mr. Richard Tracey: The right hon. Gentleman has quoted rather selectively the BMA and the Royal College of General Practitioners. Will he deal with the fact that the Royal College of Physicians, the Royal College of Surgeons and many general practitioners and pharmacists have written to hon. Members and the Government supporting the measure?
Mr. Stewart: Like every other hon. Member, I have received submissions and representations. It is rather odd to describe the views of the BMA and the Royal College of General Practitioners as being rather selective in a debate of this kind.
Most doctors and the bodies who represent them have nothing against the idea of generic prescribing where generic drugs of a reasonable and consistent quality are available. But the BMA in Scotland said:
"It should not be necessary for doctors to be required to enquire into their patient's financial status as part of the consultation before deciding what to prescribe".
That brings me to a particular problem that will be faced by doctors in rural areas such as my constituency where doctors are also the dispensers of drugs. Some patients in my constituency live 60 miles from a chemist's shop. They may now have to be advised by the doctor to have a particular drug. That will put the doctor in an unfair position. It represents a fundamental and potentially damaging change in the doctor-patient relationship.
When the limited list becomes law, some of the dispensing doctors in the rural areas will be left with large stocks of expensive drugs that cannot be disposed of by sale. Small practices cannot bear the financial cost. There is no way of getting rid of the drugs, and some of the doctors will be in severe financial difficulties as a result.
What arrangements will the Government make to compensate dispensing doctors for stocks of drugs that they are unable to sell but which they have been required to stock heretofore under their obligations in the terms of service of the NHS?
I underline the total opposition of my colleague and myself in the Scottish National party to any attempt to introduce a two-tier National Health Service. The introduction of any kind of limited list is bound to lead towards that. I realise that the banned category of drugs has been curtailed since the original list was published last November. Nevertheless, I believe that, as has already been said in the debate, it is the thin end of the wedge. It
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will mean second-class treatment for the less-well-off people. It is shameful and unacceptable, and should be strongly opposed.
8.31 pm
Mrs. Jill Knight: I was brought up in a fairly hard and thrifty school in which waste was regarded as wicked. I believe that waste is not only wicked but very wrong, and it is never so wrong as when what is being wasted is desperately needed elsewhere.
It makes me feel sick when I hear members of the Labour party screaming for more and more money to be spent on the National Health Service, for when we seek to make savings they fight us all the way along the line.
The waste of expenditure on drugs in the NHS is a national disgrace. There are hundreds of thousands of medicine cupboards in ordinary homes throughout the country that are jammed with NHS medicines that have not been used. [Interruption.] I am sorry that Labour Members are so incredibly ignorant, because many details have been published about it.
Anyone who claims that general practitioners prescribe only what is necessary should ponder on the fact that some general practitioners give repeat prescriptions for years without ever seeing the patient. The regulations being discussed this evening may not alleviate that practice, but over the years many efforts have been made to get doctors to do something about waste in drug prescribing. Unfortunately, they have repeatedly failed to listen or to take note of the fact that the money they are wasting could be used to great benefit in another part of the NHS.
Many doctors prescribe merely to get the patient out of the consulting room. Some doctors will admit that they do that. My right hon. Friend referred to the placebo syndrome.
Some elderly patients are already receiving seven, eight or nine different drugs. Some of them have pink pills, blue pills, purple pills, heart-shaped pills, square pills and all sorts of other pills, and no one monitors them.
Mr. Robert Hughes rose—
Mrs. Knight: I know that many hon. Members wish to speak and I am anxious to finish my speech, so I shall not give way.
No one monitors whether elderly people take their pills. It is very confusing for many of them to be told that they must take four pills after breakfast, seven at 11 am, seven more at lunch time, and so on. I am told by pharmacists that many elderly people, having run out of one of the seven or eight types of pill that they have to take, always return to the pharmacist and ask for the whole lot to be prescribed, whether they need them all or not. That is something that will always happen. It is largely due to the confusion that people feel when they are taking so many different drugs.
My mother had to take about seven different kinds of pills, and then she developed a duodenal ulcer. [Interruption.] I am sorry that hon. Members will not allow me to recount a personal experience that is relevant in the context of the debate. My mother had to be rushed into hospital for an operation and very nearly lost her life. The surgeon asked my father to take to the hospital any drugs that my mother had been taking. When he did so, the surgeon pointed to one of the drugs and said, "That is

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the one that has caused the duodenal ulcer." Therefore, I question whether all the drugs prescribed in the great torrent which go down British throats are really needed.
Recently, at a meeting in this House, two working pharmacists told us of their experiences with drug prescribing. They said that it was a common practice in any pharmacy covering an average number of persons to have people coming in two or three times every week with suitcases, with bags, and sometimes with prams, full of medicines. Perhaps auntie Mary or uncle Bill had died and it was felt that the best thing to do with the drugs was to take them back to the pharmacy to see whether they could be used.
There is a campaign, which I strongly back, for the disposal of unwanted medicines and pharmaceuticals. The campaign, known as DUMP, is active in various parts of the country. There was a recent campaign in the Bradford area, and 1,950 lb of unused medicines were handed in. Those medicines were costed, and in that one region alone the cost was £170,000. We cannot go on wasting money at that rate. It is ridiculous.
My right hon. Friend and the Government have had six charges levelled against them in relation to the proposed regulations. The first is that the money saved may not be used on the NHS. My right hon. Friend exploded that allegation at once. The money that is saved will indeed be used on the NHS. [Interruption.] I know that it is painful for Labour Members to try to understand that money does not grow on trees, and that even needed medicines have to be paid for somehow. They should recognise that this is an important saving and that the money is needed elsewhere in the NHS.
The second charge is that the Government are seeking a two-tier system so that only the wealthy will be able to get the drugs they need to make them better. My right hon. Friend and others have made it clear on many occasions that the limited list will meet all medical needs, and that there is no question of a two-tier system coming into operation. Many of the fears instilled into elderly and sick people by doctors are totally unfounded.
Mr. Harry Greenway: Will my hon. Friend give way?
Mrs. Knight: No, because I want to finish my speech.
The third charge is that the Government have refused and still refuse to consult. No one can accuse my right hon. Friend of that. There have been offers of consultation and there have been consultations. His door has been open, and time and again—[Interruption.] His door has been open—
Mr. Doug Hoyle: Will the hon. Lady give way?
Mrs. Knight: No. The hon. Gentleman has already heard what I said.
Every doctor in the country was consulted. Every one had the opportunity to make representations about the list and about what would be in the list. If the medical profession wished to consult on the—
Mr. Hoyle rose—
Mrs. Knight: I have made it clear that I shall not give way.
If the medical profession—
Mr. Hoyle rose—
Mr. Deputy Speaker: Order. The hon. Lady has made it clear that she will not give way.
Mrs. Knight: I am anxious to assist you, Mr. Deputy Speaker, in the task of calling all hon. Members who wish to speak.
My right hon. Friend the Secretary of State has also said that if the medical profession wishes to consult on the mechanism for dealing with exceptional individual problem cases, it can do so. There could be no Minister more ready to listen to what others outside have to say than my right hon. Friend, so that charge goes as well.
The charge was made that this scheme will ruin the drug companies. Indiscriminate generic prescribing would do so, and that is why those of us who are interested in this matter are aware that the Greenfield suggestions could not be introduced. We recognize — although we think that they have been wrong in the way that they have handled this campaign — that the pharmaceutical companies make a substantial contribution to our economy through exports and in medical research. The list will help, not harm, pharmaceutical companies.
The fifth charge is that this is a new, revolutionary and unique attack on the freedom to prescribe. I am sorry that Labour Members are so ignorant about this matter. They should know that nowhere in the world can doctors prescribe anything that they wish for their patients at taxpayers' expense. Hospital doctors have had similar restrictions — [HON. MEMBERS: "Reading."] If Labour Members go on like that, I shall read on for a great deal longer, and they will be sorry.
The restrictions that have always obtained —[Interruption]. Mr. Deputy Speaker, if I cannot read, I shall repeat, because Labour Members are making such a racket that I shall not be heard and what I am saying is very important.
Hospital doctors have had similar restrictions to those now being imposed on GPs. Hospital doctors have approached my right hon. Friends and myself asking why the Government do not bring in for GPs the regulations to which they have to submit in hospital. We must also bear in mind that of 17,000 drugs being prescribed reasonably regularly, only 1,000 will be affected by the list.
Finally, it is said that nobody else agrees with what is being done, in particular, none of the professional organisations. However, apart from the bodies mentioned by my right hon. Friend — the Royal College of Physicians and the Royal College of Surgeons — as agreeing with what the Government are doing, the pharmaceutical services negotiating committee, which knows a great deal about drugs, and the dispensing pharmacists agree with it because they have to work at the sharp end.
I congratulate my right hon. Friend on his patience and determination in getting together a new regulation, which will benefit the Health Service and improve prescribing.
8.44 pm
Dr. Roger Thomas: We had a ray of light at the end of the Secretary of State's speech, when he said that he would set up a conference to look into various aspects of prescribing. Having listened to most of his speech, I was in a doleful mood, and I was taken a little unawares by what he was proposing. For my sake, and perhaps for others who were taken aback by what the Secretary of State said, I hope that the Minister, when he winds up, will enlarge upon that point.

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As a general practitioner, I feel that this matter is worth investigating. Over the past 15 or 25 years, prescribing in general practice has become chaotic. It has become a quagmire. The main reason for this is that every year hundreds of preparations for family medical practitioners to use are added to the list. Every month, a book called Mims is published. It has nearly 300 pages and contains a list of between 17,000 and 20,000 preparations.
As general practitioners, we also have at our disposal a book that is published by the much maligned Association of British Pharmaceutical Industries, which is a huge tome of 16,000 pages. I would never say that therapeutics was one of my strong subjects at medical school, but at least in those days therapeutics was simple. We appreciated that there were certain confines to it, but now it has flooded over the plain. It is no longer confined to the river bed. It has flooded the whole area, which means that doctors are falling down on their job and their work. They are not able to get adequate knowledge of even 3 per cent. of the drugs that are available to them out of a list of 17,000. It is an impossible task.
We often say that Members of Parliament need research assistants. I assure the House that general practitioners as well as Members of Parliament need research assistants if they are to be able to understand the complexities of prescribing. The fault lies also in our medical education. Young doctors are not taught enough about the economics of the medical profession. It is essential that they realise the immense amount of money that they will have to spend on their patients when they qualify. It is said that on average a GP will spend about £40,000 a year on his patients. That is a tremendous amount of money, but the pressures on GPs through the activities of the pharmaceutical industries — they have magnificent techniques — are immense. Saatchi and Saatchi are duplicated many times within the pharmaceutical industry. Doctors become victims of calculated advertising techniques used to put across the highlights of the properties of certain drugs to the detriment of other drugs.
At the front of the vast book published by the pharmaceutical industry is a little warning that medical representatives should not knock the products of rival firms. However, some medical representatives do not stick to the Queensberry rules in this matter.
I am one of those who feel that, for the sake of bringing a degree of rationality back into prescribing, we must have limited lists, but not limits that are pushed through at the behest of Ministers in the Elephant and Castle, who feel that it is high time that they delivered a sharp left and gave the medical profession a bloody nose. They tried to do that about the introduction of substitute doctors, but they had to retreat. They tried to do it with a limited list of drugs which could be prescribed, when they listed 30 and had to expand it fourfold.
What has gone wrong here is that this method should have been rehearsed. There should have been consultations with all branches of the pharmaceutical, medical and paramedical professions. At the end of the day, I am sure that we could all have agreed a method to bring some rationality to prescribing and, by so doing, increasing the safety of our patients.
I have great sympathy with what the hon. Member for Birmingham, Edgbaston (Mrs. Knight) said about elderly people who are on eight or nine different drugs. This form
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of polypharmacy is one of the curses of the medical profession. What we do not appreciate is that often these drugs have adverse effects one upon the other. Until we research them, we are on very unsafe ground.
In advocating a limited list I suggest to the Minister that most certainly he should extend it if there are savings to be made and if those savings can be translated into extra cardiac surgery, extra renal dialysis, and so on. But we must make sure that if these savings are to be made, they are not made at the expense of the poor patient. They must be made at the expense of the drug companies, because they are still the people who will benefit.
By all means have limited lists. However, I cannot help feeling that the proposals before the House are little more than window dressing. I ask Ministers to go to the heart of the matter. In that way, they will have far more support in the House and throughout the country.
8.52 pm
Sir Dudley Smith: My right hon. Friend the Secretary of State did not disguise the fact that there had been real problems in getting this list together and before the House. I suggest that that is very much of his Department's own making. In fact, we heard a great deal from my right hon. Friend about the refusal to co-operate and to discuss the subject. I am indebted to the British Medical Association, which wrote to me only yesterday saying:
"Neither Ministers nor officials have communicated, consulted or discussed prescribing … with us since 4 February 1983, despite our sending detailed comments on Greenfield to the Department on 25 February 1983."
That is the answer. Perhaps the BMA was wrong to sulk in its tent, but it was understandable. It is a complete disgrace that neither Ministers nor officials took into their confidence a great organisation such as the BMA.
I declare an interest. It is well known in the House that I have been associated with the British pharmaceutical industry for nearly 20 years. At one stage in my life, I worked in it full time. I also advise a number of companies involved in pharmaceuticals. However, that does not debar me from speaking what I believe to be the absolute truth in these circumstances.
I am against the regulations for two basic reasons. The first is that they erode the prescribing independence of members of the medical profession. The position has improved since the initial shock of that rather absurd list introduced the first time round, which bore no relation to reality. Thank goodness, it has been improved upon. However, I fear that future health Ministers of whatever political persuasion will undoubtedly wish to undermine that freedom further as time goes by, ostensibly in the name of economy but probably in reality for more bureaucratic reasons.
Mr. Greenway: Does my hon. Friend agree that, above all, there must be no inclusion on any list which results in tampering with the right to prescribe drugs, such as life-saving antibiotics, preparations for the treatment of arthritis, and so on? It could happen.
Sir Dudley Smith: My hon. Friend is right, and that is my point. It may be that some of what we are dealing with today is trivial. We all know of so-called drugs which have not been prescribed for years. They have been on lists, but they are, to all intents and purposes, dead. They present no problem. I have asked a number of

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parliamentary questions about them. There is no information available on them. However, when we come to the life-savers, who is to say that a future Health Minster will not lay down his diktat to members of the medical profession and tell them exactly what they can and cannot do?
My second objection is that the regulations do great harm to one of our really successful industries which we can ill afford to damage. We have not got so many industries which are successful. Here is one which has been a winner. I do not suggest for a moment that it should not be kept in control and that there should not be proper supervision because of its unique relationship with the Department of Health and Social Security, but I believe that this is not the way to do it.
My right hon. Friend said that his Department was the sponsoring Department of the pharmaceutical industry. Listening to some of the remarks in this debate, one would have thought that my right hon. Friend was its main enemy.
Mr. Douglas Hogg: My hon. Friend says that this proposal is very damaging to the drug industry. I have some difficulty in understanding that.
Mr. Nicholas Winterton: That does not surprise me.
Mr. Hogg: It may not surprise my hon. Friend—
Mr. Winterton: He knows nothing about it.
Mr. Hogg: My hon. Friend is a man of very little understanding.
Mr. Winterton: Except that I have pharmaceutical industries in my constituency, which he does not.
Mr. Hogg: My hon. Friend makes my point that he is a man of limited understanding.
Mr. Winterton: Clever boy.
Mr. Hogg: I was putting a specific question to my hon. Friend the Member for Warwick and Leamington (Sir D. Smith), which I am sure he will treat more seriously than my hon. Friend the Member for Macclesfield (Mr. Winterton). My hon. Friend the Member for Warwick and Leamington said that the proposal was very damagingߞ
Mr. Winterton: Arrogant, just like his father.
Mr. Hogg: My hon. Friend said that it was damaging to the pharmaceutical industry—
Mr. Winterton: He was wrong more often than he was right.
Mr. Hogg: We know that these seven classes apply only to 10 per cent. of the drugs prescribed. Bearing in mind the exemptions, which cover about 70 per cent. of the drugs prescribed, and the fact that pharmaceuticals enjoy an international market, I do not see why the proposals should damage the industry.
Sir Dudley Smith: It is true that the industry is not being swept aside. No one could pretend that. However, a number of companies will be affected quite seriously. Their production is being eroded. If I am not interrupted too many times, I shall give my hon. Friend a few figures which may help bring him on to my side. I shall not give way again, because that was a rather long intervention, from various sources.
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There must be effects on the profitability of the various companies which operate in the United Kingdom. The move will depress the industry and undoubtedly it will curb its expansion and hamper its sales. The pharmaceutical industry has a very good export record. But, worst of all, the regulations will make those responsible for the industry, particularly the multinational companies, think very hard about the wisdom of further investment in the United Kingdom, especially where original research is concerned. We should not lightly dismiss that point.
My ministerial colleagues at the DHSS may feel that the regulations will be carried, and no doubt they are right. My only regret is that too many of my right hon. and hon. Friends do not fully understand this very complex matter. I make no criticism of that, as the subject is very complex. However, I can assure my colleagues that, although they may well demonstrate their ministerial virility, the whole sorry episode will be long remembered. If the pharmaceutical industry in this country eventually declines, they will have to carry that unhappy tag of responsibility with them for many years. They will have been the architects of its decline—
Mr. Tracey: Will my hon. Friend give way?
Sir Dudley Smith: I shall not give way, as I do not wish to speak for too long. In such a debate, giving way to interventions can encourage others to make further interventions, and the hon. Member speaking is left up in the air.
The United Kingdom's pharmaceutical industry is one of the most highly developed and rapidly growing sectors of British manufacturing industry. That perhaps is the answer to my hon. Friend the Member for Grantham (Mr. Hogg). The majority of companies that operate in the United Kingdom operate worldwide. Until now, they have regarded the United Kingdom as pretty enlightened. The industry employs about 75,000 people, and no other industry in the United Kingdom has a higher proportion of qualified scientific staff.
The price of medicines has always been an easy target in this country compared with the cuts that could be made in more sensitive areas, and particularly in NHS staffing. That is where the major costs are, as can be seen from looking at the figures that my right hon. Friend the Secretary of State gave. Although I was not particularly enchanted with the speech of the hon. Member for Oldham, West (Mr. Meacher), it was true when he said that general practitioners in this country are at the bottom of the spending league per head of the population. The United States is at the top with 16·6 prescription items per capita, and then the league goes right down to Italy, West Germany, and France. Australia is just above the United Kingdom with 7·7 items, and the United Kingdom has 6·9 items per capita. Therefore, we have nothing to be ashamed about in terms of the amount of money involved in the pharmaceutical products dispensed by doctors operating within the NHS.
I say to my hon. Friend the Member for Grantham that a recent survey showed that the Government's limited list proposals have been responsible for investment projects to the value of £143 million in pharmaceutical production or research being either cancelled or postponed since last November. It may be a "limited" list, but it is the thin end of the wedge. If £143 million have been lost, what will be lost next year and the year after that? We need to pay

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attention to that point. We have had great economic trouble in this country. I support the Government, and believe that they are doing the right thing in that respect, but I shall vote against them tonight because this is a crass move on their part.
We very much need to take account of the experience of other countries. I think of the sorry story of the Australian pharmaceutical industry. It was clobbered very hard and there was excessive state intervention in Australia. As a result, many companies were driven away, and the Australian pharmaceutical industry is now nothing compared with what it used to be, to the detriment of Australian residents. We must be very careful that that does not happen here. We have taken the first step. Let it be the only step, and let us ensure that in future we attend to things rather more circumspectly than in this case.
9.3 pm
Mr. Michael Meadowcroft: The Government seem to have an infinite capacity to botch good ideas. In their passionate haste to implement the limited list they have introduced a statutory instrument that is defective on one major and two minor grounds. Without the assurance that my right hon. and hon. Friends and I have asked for on the vital question of an appeal or of some override, we shall be unable to support the regulations.
I turn first to the whole principle of prescribing by a limited list. If any assessment were made of the political line-up on this issue, one would have expected to find a Labour Secretary of State introducing the measure on the ground of curbing the excesses of the drug industry, and one would have expected it to be opposed vehemently by a Conservative Secretary of State, defending the commercial interests involved. Indeed, I cannot see why Conservative Members are so concerned about the advertising campaign that has been launched by the ABPI if they believe that the object of private enterprise is to maximise profits and the amount of cash that comes in from profit-making enterprises.
The concept of a limited list for good prescribing challenges two well worn and deeply held beliefs about the nation's health. The Government deserve some commendation for their courage in standing up to the twin spectres of clinical freedom for GPs and the limitless expectations of health resources. They might appear to be self-evident truths, but they inhibit new attitudes to healthy living and the power of any health service to assist.
In the health sphere, more than any other, expectations grossly outrun resources. There is a case for higher NHS spending, particularly to buy time until new attitudes can be implemented, but at any level the treatment of the sick is intrinsically constrained by infinite resources. Whatever limit one sets for NHS spending, and however far one wishes to extend spending, it is impossible to deal with what everybody expects or to cope with the demands made upon it.
The trouble is that the limits are currently imposed in random and illogical ways. For instance, GPs can prescribe and order treatment regardless of cost, but if the district health authority has to reduce its staff or equipment the patients' freedom is eclipsed by the waiting list. It is odd and illogical to try to inhibit clinical freedom by the blunt instrument of the waiting list. In practice, inevitably,
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the glamorous side of the NHS gains a disproportionate amount of resources and the preventive side — the geriatric and mental handicap work—suffers.
Those involved in other services that we have to support from public resources such as housing, education and social services do not believe that whatever invention comes on to the market should be available to all. Alas, that is the general expectation within the Health Service. It is intellectual and political cowardice to continue as we have over 10 years of declining national resources. No Government of any political colour will be able to continue in that way.
The key is in allocating finite resources to achieve the greatest benefit for the greatest number. The limited list is a conscious decision to change from prescribing expensively for the few to improving the health of the many.
I cannot understand why the Government should have decided to put up prescription charges by such a draconian amount at the same time as trying to save money through the limited list. The Government say that they might save £75 million by the limited list. I doubt that sum, but to pretend that they then should raise £19 million by increasing prescription charges is a ham-fisted way to argue about the public's health.
The family practitioner committees' drugs bill is open-ended and demand-led. There is little incentive to prescribe generically or economically. Alas, GPs are excessively influenced by drug companies' advertising. Surveys show that drugs that are currently advertised in the press are those that are most often prescribed out of order with the general run of prescribing.
Mrs. McCurley: The popular drugs that are often heavily subsidised and advertised are quite effective. When a drug is not effective general practitioners and other practitioners of the medical arts cease to use it and it is withdrawn from circulation by the drug companies.
Mr. Meadowcroft: I wish that that were true generally. The suggestion is that advertising by the drug companies leads doctors to prescribe drugs simply because of their novelty value. We are pressed to accept that doctors prescribe because of careful scrutiny of the thousands of drugs available. Alas, the evidence does not bear that out.
The overspend on the notional budget for GPs is taken off the hospital budget which causes more spending to be thrown back on the family practitioner committees. The hospitals have automatically and voluntarily adopted generic substitution and their own limited lists. The financial benefits may be limited, and possibly not anything like that predicted by the Secretary of State. However, at least it is something that challenges the belief that we can simply continue to pour more and more money into the NHS and thereby gain continuing advantage.
It is important to challenge the attitude towards the use of drugs. The current edition of World Health Forum, the magazine of the World Health Organisation, states bluntly that:
"Throughout the world, unnecessary drugs are prescribed for self-limiting conditions. Sometimes the physician uses the prescription as a substitute for counselling or to satisfy the expectations of the patient. Usually it is a mixture of the two, where both doctor and patient have come to see a prescription as an essential outcome of the visit. The most common examples are antibiotics for the common cold, sedatives for mild insomnia and vitamins for nearly everything."

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Faced with that, something needs to be done about some form of limitation on prescribing.
The view that a prescription is a substitute for doctors' advice, sympathy and expertise is not only illusory but harmful. One of the problems of our modern age is the tremendous dependence on professionalism and expertise as a belief that they can actually do more than they can. Ivan Illich's polemic about the overestimation of the powers of the health services deals with the failure to come to terms with genuine health care. He says:
"The pharmaceutical invasion leads industrialised man to medication by himself or by others that reduces his ability to cope with a body for which he himself can still care."
A MORI poll last month showed that 3·5 million adults — 8 per cent. of the population — have taken tranquillisers for more than four months at some time in their lives.
Dr. M. S. Miller: The hon. Gentleman is not doing justice to the experts. He is not in the medical profession, so he does not accept that medical students, in their training, are taught from the beginning that sometimes the best form of treatment is masterly inactivity. I assure the hon. Gentleman that doctors keep that uppermost in their minds. Nearly every doctor I know clearly tells the patient that it is his own defences that will cure him. All that the doctor can do is to give a little assistance.
Mr. Meadowcroft: Doctors who take that attitude are precisely those who do not need the encouragement of the proposals—it is the other doctors for whom the list is important.
Pharmacists have told me that on one prescription for one patient there has been prescribed an anti-diarrhoeal and a laxative, or an antussin and an expectorant. That is ludicrous. We are aiming to deal not with the good doctors but those who overprescribe or who see a prescription as a means of getting a patient out of the surgery. The NHS, regardless of the resources made available to it, can be expected only to supply what patients need and not what patients want.
The matter of dispensing doctors has already been mentioned. If those who live in urban areas can obtain what they want because they have access to a pharmacy, it would be illogical to say that those who do not live in urban areas cannot receive what they want because they have to obtain it from a dispensing doctor. I appreciate the Secretary of State's point in putting the commercial problem before doctors, but I see no way around that unless he intends to do something about all two-tier medicine. There cannot be a differentiation between rural and urban areas.
The ability of drugs to improve health is constantly being challenged by efforts to improve preventive medicine— healthier eating, nutritional food labelling, well woman clinics, and so on. The Consumers Association publication, "The Wrong Kind of Medicine?" is crucial to understanding those efforts. The author, Charles Medawar, writes:
"The benefits of our huge drug list are essentially to do with trade, not health. The advantages of a restricted drug list include having fewer bad drugs and a reduction in drug-induced disease; and better information about drug use and less confusion about which drugs to use."
If this were a Bill, I should have no problem in voting for its Second Reading and seeking to amend it in Committee, but it is not a Bill and the regulations as they stand are defective. First, they do not deal with the
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problem of patent life, which will have to be faced if this principle is extended to other categories. If the Government believe that it is right in principle to limit prescribing in some categories, I cannot see why they say that they do not wish to extend it to other categories. If it proves effective in this regard, it seems inevitable that it will be extended to other categories. To deal with the drug companies' research problem at the same time as extending the categories it would be necessary to extend the patent life of drugs so as not to inhibit research.
Secondly, the regulations do not deal with pharmacists' remuneration, which will be significantly affected if the proposals are effective. A GP who tries to prescribe as little as possible and to prescribe generically has told me that the pharmacist across the road from his surgery told him that, although he agrees with the doctors' approach, it is putting him out of business because the method of remuneration for pharmacists is not adequate to cope with the proposed changes.
The most significant defect, however, is that no appeal mechanism is likely to be in operation when the regulations come into operation. My hon. Friend the Member for Berwick-upon-Tweed (Mr. Beith) raised this at DHSS Question Time last Tuesday and said that it would help alliance Members to support the regulations if the Secretary of State would give an undertaking that an override mechanism would be in place when the regulations came into force. No such undertaking has been given and I do not see why the Secretary of State should shelter behind his desire to force the BMA to negotiate with him on this. Once he accepts the possibility that the list may not be complete he ought to delay its implementation until an appeal procedure is in place.
A list may be 95 per cent. or even 99 per cent. comprehensive and satisfactory, but if one cannot claim that it is 100 per cent. correct an override mechanism is essential. I believe that every other national limited list has such a machanism as part and parcel of its operation. The key principle of the NHS, providing for need, means that such a mechanism is crucial. If the Secretary of State would delay implementation until such a mechanism is in place, we could support the proposals, but we cannot support the way in which the Government have introduced the measure although the principle behind it is to be commended.
9.18 pm
Mr. Jonathan Aitken: I am pleased to follow the hon. Member for Leeds, West (Mr. Meadowcroft), not least because it was a relief to return to the real issues and to thoughtful debate after the somewhat hysterical and at times unintentionally hilarious opening comments from the Labour Front Bench.
I agreed with much of what the hon. Gentleman said, but I part company with him in his failure to understand why some Conservative Members were concerned about the ABPI campaign. Only a few weeks after the initial announcement by my right hon. Friend the Secretary of State, Members in all parts of the House were caught in the crossfire of what was nothing less than a propaganda war. As the saying goes, in all wars truth is the first casualty, and I believe that it has been the need to sort out truth from fiction which has led to parts of today's debate being somewhat overheated.
The parliamentary lobbying campaign set new and dangerous precedents. The first shots in the propaganda

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war were fired by the ABPI. However, I believe that the pharmaceutical industry—for which the ABPI purports to speak—has a somewhat better case than the one so far made on its behalf in an entirely counter-productive advertising campaign. The leaders of the ABPI seem to have been infected throughout that campaign by Scargillitis. In matters of exaggeration, hyperbole, and, at times, misrepresentation, the only difference between the ABPI and the NUM is one of degree, not of principle.
Against that background of propaganda, I am glad that my right hon. Friend stood firm against the tidal wave of pressure unleashed against his proposals. I am glad that megaphone lobbying is to be defeated in tonight's vote. I am glad that our Ministers have the common sense to hold the ring between competing interest groups. They have done their job well. They have struck just about the right balance between the interests of the pharmaceutical industry, the concerns of the medical profession, the need to make efficient use of the resources of the NHS, which the hon. Member for Leeds, West rightly identified as the kernel of the matter, and, above all, the worries of patients — the least vocal but most important group to be affected by the regulations.
I have a constituency interest in the pharmaceutical industry.
Mr. George Foulkes: Aha.
Mr. Aitken: At his age, the hon. Gentleman should be able to see the difference between a constituency interest and a financial interest.
My constituency contains the great pharmaceutical company of Pfizers — a well-managed and successful company that employs 1,500 people in an area where jobs are precious.
Mr. Beaumont-Dark: It is one of the worst.
Mr. Aitken: Pfizers is not one of the worst. To all intents and purposes, Pfizers is unaffected by these regulations. Its total sales of some £70 million a year could be affected to the tune of about £250,000 a year. The impact will be infinitesimal.
Pfizers is a good company. It invests regularly every year and its sales and exports increase every year. Last year it invested more than £10 million in its plant at Sandwich, a large part of which was spent on the new research department which my right hon. Friend very kindly came to open.
Dr. M. S. Miller: Does not the hon. Gentleman take seriously the possibility of Pfizers not going ahead with a £20 million development, to which the representatives of Pfizers have referred?
Mr. Aitken: I take that possibility extremely seriously. I am glad that the hon. Gentleman, like myself, appears to take some cognisance of the good case for the pharmaceutical industry.
As Pfizers is largely unaffected by the regulations, one might expect the company to be somewhat laid back about them, but it is deeply concerned about what it describes as the wider picture of the growing climate of hostility towards drug companies. Even making allowances for a degree of multinational paranoia, it should be noted that there is a degree of hostility towards the drug companies
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in this country, although not, I believe, within the Government. It certainly exists on the Opposition Benches. For example, the hon. Member for Oldham, West (Mr. Meacher) was quoted in The Observer yesterday as making some remarks that reek of ignorant prejudice, accusing the drug companies of "ripping off' the NHS because they are allowed a return of 16 per cent. on their investment. In fact the drug companies, which are operating in what is undoubtedly a high-risk business, have suffered four compulsory price reductions via the pharmaceutical price reduction scheme in the past three years and are now only allowed to make profits — on those of their products that are successful — at a level smaller than those that the Government allow to companies in the defence industries. No great bonanza is taking place.
Pfizers regards the regulations as part of a wider picture that causes concern. The company sees business becoming more difficult; the Government becoming more interventionist; and confidence declining. One local sign of the state of confidence is that, as the hon. Member for East Kilbride (Dr. Miller) has pointed out, Pfizers' current plan to build a £15 million pharmaceutical finishing plant at Sandwich is in jeopardy and has a large question mark hanging over it.
When drawing my right hon. Friend's attention to these anxieties, I am not for a moment suggesting that he is wrong or was wrong about the limited list, but that business confidence — and the investment and employment that go with it — is a fragile plant in today's pharmaceutical industry. We need a strong manufacturing base and do not want it eroded. When the dust of this battle has settled, my right hon. Friend the Secretary of State and my right hon. and learned Friend the Minister should consider some confidence-building measures for this great industry. It needs some reassurance beyond the time-honoured parliamentary phrase, "I have no plans to do so at present." We need some assurance that the limited list is not the thin end of the wedge and that large extensions of it are not envisaged.
I hope that my right hon. Friend will examine other means of increasing confidence in the industry. For example, he might consider some recent United States legislation on patent term restoration and extension to see whether we might benefit from similar measures. Just because the ABPI has made an enormous hash of its propaganda, we should not lose sight of the fact that it is strongly in our national interest to have a strong, vigorous and healthy pharmaceutical industry.
Mr. Nicholas WintertonMy hon. Friend has rightly mentioned Pfizer. Does he agree that one of the most successful pharmaceutical companies — Imperial Chemical Industries — which is also unaffected by the proposed limited list, is also in principle totally opposed to what the Government are doing, as it believes that it will be damaging to its future investment and the additional employment that it could create?
Mr. Aitken: When I hear phrases such as "totally opposed", I can hardly believe that the rather modest nature of the limited list is enough to trigger such enormous opposition.
Mr. Winterton: It is totally opposed.
Mr. Aitken: My hon. Friend has made his point. We must try to see the issue in the proportion that it deserves.

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I am sad that leaders of the British Medical Association have had their moments of going over the top at their end of the propaganda war. When I recently heard Dr. John Marks, the chairman of the BMA, solemnly telling BBC television viewers that it is only a matter of time before amputation patients would be compelled to wear Fowler artificial limbs, I realised that the clock at Tavistock square had struck 13 and that the BMA too had got a touch of Scargillitis.
Members of the BMA are much more sensible than their leadership. Of course there are anxieties but, with few exceptions, doctors in Thanet tp whom I have spoken are not in outright opposition to the plans. That is logical, for in medical terms there is no great issue of principle here. All the slogans about the end of clinical freedom and the beginnings of a two-tier NHS do not stand up to serious examination when one studies the limited list. It is a modest proposal. However, there are lingering doubts among doctors on, for example, how to discharge responsibilities to special case patients such as the terminally ill patient who may be dependent on one sedative or analgesic. I am glad that the appeals procedure is likely to take care of that.
Above all, there is a vague general worry that the regulations are a first step on the road to more centrally directed prescribing restrictions. My right hon. Friend's assurance should put an end to some of those worries.
The key issue is the efficient deployment of resources in the NHS. We should all recognise that £75 million worth of savings on the drugs bill is money badly needed in other areas of health priority. If the Beecham's powders and the male sex hormones on the list have now to be bought over the counter so that patients can have more kidney machines—
Mr. Winterton: How often are they prescribed now?
Mr. Aitken: —more ventilators for premature babies and more and better arrangements for cervical screening, most patients will recognise and accept the trade off, whatever the pressure groups and lobbyists may say. My right hon. Friend has a duty to be a good housekeeper for the patients of the NHS. That is a great deal better than being a parrot for the ABPI, which is what the hon. Member for Oldham, West was today. In a world of finite resources, good housekeeping means difficult choices about areas of priority. Nearly every other country has some form of limited prescribing to keep its drugs bills in check and to get health priorities right. My right hon. Friend has got it just about right.
9.29 pm
Dr. M. S. Miller: The Secretary of State and the.hon. Member for Thanet, South (Mr. Aitken) complained about the ABPI campaign, but surely they are both seasoned enough Members to be able to relegate such propaganda activity to its proper position. I must have received as much information from the industry as anyone else, but I did not read it, and I relegated most of it to the place where it belonged. However, the industry had every right to lobby hon. Members, and I did not notice the Secretary of State or the hon. Member for Thanet, South complaining when the National Coal Board went overboard with its advertisements during the miners' strike or when other organisations, such as British Telecommunications, went overboard.
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I have no pecuniary interest in the drugs industry, but I jump to the defence of the underdog. Conservative Members may not regard the ABPI as an underdog, but the Government are prepared to emasculate the trade unions and they did not blink a collective eyelid at spending £4 billion to bring down the miners. Any organisation that wishes to withstand the Government's might needs a bit of help.
The Secretary of State made great play of the fact that my hon. Friend the Member for Oldham, West (Mr. Meacher) did not leap to the attack when the Government announced their intentions. Perhaps, like me, my hon. Friend did not believe that the Secretary of State would go ahead with his ridiculous scheme. The hon. Members for Thanet, South and for Leeds, West (Mr. Meadowcroft) described the scheme as a mouse of a proposal. I am not opposed to a clean-up of the methods of prescribing, but this is not the way to do it.
The Secretary of State said that the drugs bill amounted to £1,500 million out of a total NHS budget of £17 billion. In percentage terms, that is a reduction. When I was in practice, the drugs bill was 50 per cent. more than what was paid to doctors. Drugs accounted for 12 per cent of total costs and doctors for 8 per cent.
Conservative Members have said that no country can afford to produce for its citizens an unlimited list of drugs. But there has not been such a list in this country for at least 25 years. When the NHS started, it was said that there would be an unlimited list, and doctors used to prescribe Ribena and many other commodities that were not drugs. However, that soon stopped and we have settled into a pattern. It may not have been entirely satisfactory, but we do not live in a perfect world. Expecting a cohesive system in the NHS, without any waste, is expecting the impossible. One has only to compare the British Health Service with health provisions in other countries—they are not services—to find that in every way ours is less expensive than that of any other country in the western world.
Mr. Tracey: I recognise the hon. Gentleman's knowledge of this matter, but the 1983 Labour party manifesto stated that the Labour party would seek to make drugs more economic. Will the hon. Gentleman explain what that means in the light of what he has just said?
Dr. Miller: I shall come to some aspects of that shortly. If the hon. Gentleman is not then satisfied, I invite him to question me again.
I do not understand why the Government embarked on this matter, creating such antipathy to it from the medical profession and causing patients a great deal of anxiety. I accept that drug firms may have gone overboard in fostering that anxiety, but it was started by the Government's stated intentions.
There are other ways of reducing the drugs bill. I am not opposed to reducing the cost of drugs to the country. Other ways include careful monitoring of prices, checking research and development costs, allowing for the reasonable recouping of the costs of research and development, watching carefully, and having consultations with drug firms and the medical profession. Sometimes it would be a good idea also to consult patients.
As the hon. Member for Thanet, South pointed out, profits have been cut four times already. Why not use that system? Why embark on this sort of activity which,

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whether Conservative Members like it or not, creates a two-tier system? It is all very well to say that many drugs can be bought for less than the prescription charge, especially when the prescription charge is raised to £2, but people on supplementary benefit do not pay prescription charges and they will have to pay for these drugs, if they want them.
I am in favour of a campaign to persuade the medical profession to prescribe generic drugs as far as possible, but we should persuade, not force, it to do so. It should certainly not be done by substitution. The practitioner, not the pharmacist, must write the prescription and state what medicines he wants for his patients.
We must be careful where drugs are manufactured. Generic drugs can be manufactured in parts of the world which cause headlines, such as that which appeared in the The Observer yesterday. It stated:
"Wave of killer capsules sweeps the Third world."
We know that can happen. The article states:
"Growing quantities of faked antibiotics—potentially lethal to those who take them—are being smuggled into Africa and other parts of the third world."
These "killer capsules" are being manufactured in places as far apart as Taiwan and South Korea. We must be extremely careful about that when we buy generic drugs. It is possible to embark on a policy of generic drugs, but we have a highly responsible and large drugs industry, and the Government may be putting it at risk.
The issue of polypharmacy — of people taking medicines which they may not need or the effects of which are not well established—has been referred to obliquely. Doctors prescribe for some patients who take drugs because of the psychological factor in treatment. I must emphasise that this is an extremely important element in the treatment of patients. As I said in an intervention in the speech of the hon. Member for Leeds, West, doctors try not to prescribe potent or potentially dangerous medicines.
I should draw to the attention of the House an interesting article on this subject which appeared in last week's General Practitioner. It talks about placebos, which are often prescribed. The doctor who wrote the article describes his patient as a pleasant middle-aged woman who, five and a half years ago, was diagnosed as a hypertensive. He said:
"She had been registered in another practice and her raised blood pressure had been picked up at their `NIRC hypertension trial' screening clinic."
It was a Medical Research Council trial screening clinic. After she was discovered to have significantly raised readings, she was started on treatment in a double-blind trial. That meant that neither the doctor nor the patient knew what drug the patient was receiving. It was either a placebo or an anti-hypertensive drug.
The doctor continued:
"When she left the practice area and registered with me, her previous GP dropped me a line to say that as the five years on the trial was up, they had broken the double-blind code and had discovered that she had been taking a placebo, and that this could obviously be discontinued at an appropriate time. An appropriate time presented itself a few days later when she turned up to see me to get a repeat supply of her tablets. I took her blood pressure"—
which was normal at 125/80—
"told her I had been in touch with her previous doctor, and that we both felt her blood pressure had settled so well that she could
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probably try without her treatment. She seemed quite happy with this, stopped taking the tablets, and arranged to see me after a month for a check up."
Then the doctor said:
"You've guessed it. Her blood pressure after a month off the placebo was 195/110. I waited a week and checked again. 190/110. There was no doubt about it, she needed treatment again. When I told her this she wasn't in the least surprised, told me her tablets had suited her so well and had made her feel so much better that she would like to go back on the same ones now."
He gave her the same tablets, and her blood pressure went down again.
Another case is even more intriguing, but I shall not labour the point. This is something that doctors see time and again. Incidentally, that doctor had a good recommendation to make to the Secretary of State. He believes that a proportion of patients should be given placebos and that some of them will get well. I do not say that I agree with him.
The list has some ludicrous aspects. For example, one drug on the list is called Capramin; another drug, which is exactly the same and cheaper, is not on the list. One wonders why there should be such discrimination.
The doctor-patient relationship is precious, and Conservative Members will accept that it must be fostered. The British medical profession in not a business as it is in the United States. There is no incentive in Britain to give patients treatment that they do not need, because no money is involved. The doctor gets the same capitation fee from the Health Service whatever he prescribes for his patient.
Let there be limits but very generous limits within which the doctor should be permitted to prescribe. The doctor's freedom to prescribe what he believes to be best for his patient should be paramount. At the end of the day it is the patient in this relationship who matters.
Mr. Nicholls: On a point of order, Mr. Deputy Speaker. While placebos are being discussed, should it not be pointed out that there are no hon. Members sitting on the Liberal Benches, despite their great interest in this matter, and that they have not been in their place for a considerable period of time?
9.45 pm
Mr. Michael Morris: It is always a pleasure to follow the hon. Member for East Kilbride (Dr. Miller). He held the attention of the House by emphasising the importance of the patient-doctor relationship. Before I go any further, I should like to declare an interest. Long before the limited list was drawn up I was an adviser to two pharmaceutical companies and I have been married for 24½ years to a dispensing practitioner who is a senior partner in a group practice. I have lived with this industry and the doctor-patient relationship for as long as any hon. Member. May I also pay tribute to Ministers and officials for the courtesy I have received in all the representations that have been made to them. It is right that that fact should be placed on the record.
Originally savings of £100 million were looked for. Those savings have now been reduced to £75 million. Ministers said from the start that there had been extensive consultations following the Greenfield report. The statement made on 8 November by my right hon. Friend came like a bolt from the blue to the Opposition, Conservative Members, the British Medical Association, the pharmaceutical industry, the community health

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councils and to everybody who takes an interest in medicine in the United Kingdom. At that time my right hon. Friend said that the initial list was open to discussion and that he would give everybody 12 weeks, including Christmas, in which to put forward proposals to modify the list. However, he said that we would not be told what the criteria for that modification would be. When I asked my right hon. Friend about the extensive reports that had been undertaken overseas, I was told that they were confidential to the countries concerned. Some of us were a little sceptical and thought that this was because holes would be found in the reports if they were published.
Ministers also said on 8 November that they had not decided how the review was to be carried out. However, after further reflection an independent review body was set up. There was already in existence the Committee on Safety of Medicines and the Committee on Review of Medicines. A number of other medical organisations were in existence but our party had to set up yet another quango, despite the fact that the Government's own medical advisory committee had recommended against the whole concept. But even that quango was not set up properly. After it had been set up somebody remembered that one-fifth of the savings were to come from benzodiazepenes and that there was no psychiatrist on the panel. He was appointed immediately.
What happened is almost history but the proposals produced the biggest adverse reaction from the pharmaceutical industry, doctors, community health councils and patients that this country has ever seen since the introduction of the National Health Service. Everything stopped for the limited list. Representations were made that it should be abandoned. People flew in from the United States and Europe. Members of the Social Audit and the World Health Organisation rubbed their hands in glee as they saw true Socialism being put into practice.
The consultation period resulted in the limited list being extended from 31 to just over 100 products. The new list bears so little resemblance to the initial list as to make the mind boggle. I ask seriously what possible faith can Members of Parliament, doctors, patients or anybody who takes an interest in medicine in Britain have in the chief medical officer and those who advised my right hon. Friend the Secretary of State on the initial list. Presumably it was not a cockshy; it was meant to be a serious suggestion for a limited list. If it was not, it is a disgrace that it was put forward in the first place.
Now we have a better limited list. By definition, it cannot meet all clinical needs. Every hon. Member who has spoken is right. It may meet 98 or 99 per cent., but it cannot meet 100 per cent. of clinical need.
My right hon. Friends on the Front Bench may be asking why I will not accept the new extended limited list. Let me try and explain. First, it removes clinical freedom from general practitioners. Aneurin Bevan was sensible enough when he set up the NHS to recognise that that was one of the basic principles of a successful doctor-patient relationship.
Secondly, the list is supposed to save £75 million. It will not. Look what has happened in Germany which has a comparable system. The Germans are not fools. They are every bit as efficient as we are in the United Kingdom and in most cases a darn sight more efficient. They set themselves a target of savings of over 500 million deutschmarks. They achieved 50 per cent. of that. They
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are not idiots in Canada, either. They set themselves a target and they achieved about 50 per cent. of that. What did Holland find? They found that costs rose and they have abandoned the section similar to our limited list. No, we shall not obtain savings anywhere near the figure that is talked about.
I hope that when my right hon. and learned Friend the Minister for Health replies he will explain in some detail what monitoring he will do on the limited list to demonstrate the savings. Some of us will be looking carefully to make sure that the savings on the pharmaceutical prices regulations scheme are not transferred across to the savings that are sought on the limited list.
Thirdly, there is the point about the fallback position. The hospital formularies have such a position, as has been said. I was astounded when I heard my right hon Friend say—I hope that I quote him correctly—that because the BMA has not consulted him he is not in a position tonight, nor will he be on 1 April, to announce a fallback position for those who have intolerances or allergies, which are the two most likely problem areas. That is an irresponsible position but there are enough doctors in the Department to have at least done the groundwork on the fallback position. It would be irresponsible to introduce this scheme on 1 April and make patients suffer because of an argument between my right hon. Friend and the BMA. That is not acceptable to the House and it should not be acceptable to the country.
Fourthly, apparently there are to be amendments to the statutory instrument that we have before us tonight. The Joint Committee on Statutory Instruments highlighted two problems that it had with the proposals. How often will those amendments come forward? Will that be a quarterly process? This statutory instrument has errors and it is questionable to have Parliament push through inaccurate legislation.
Fifthly, what will happen to all the research that is going on in these categories? At present 130 compounds are in some form of trial in Britain. What is the criteria for those products to get back on to the list? Is it to be the nebulous criteria of need that the DHSS has, or is it to be a scientific criteria? It should be a scientific criteria and I hope that when my right hon. and learned Friend the Minister for Health replies he will make that clear.
The list is riddled with errors. The hon. Member for East Kilbride mentioned Capramin and Levius, the cheaper one being the one that is on the black List. Presumably it should have been the other way round, but that is just a minor clerical error. Vitamised iron and yeast tablets have been blacklisted. Vitamised iron tonic tablets with yeast—the same thing the other way round—have not. There are other examples with which I shall not bore the House because representations have been made to the Department. Presumably, in due course, they will be put right, but they should have been right before they were brought before the House.
Mr. Nicholls: Will my hon. Friend give way on that point?
Mr. Morris: No.
Finally, and most insidiously, despite the Minister's disclaimers, there is another force at work. There is substitution of generics for branded products, and that is a vital area. This country needs branded drugs if it is to

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maintain the industry as a sunrise industry. If we take away the right to brand, we take away fundamental research from this country. If we do that, we begin to undermine the successful exports industry. Then we take away employment, and we take away investment, as my hon. Friend the Member for Warwick and Leamington (Sir D. Smith) said earlier.
I find it incredible that some of my hon. Friends do not understand that there is no such thing as a single generic product. Some of us remember when, not so long ago, the below-specification Indian bandages came into Britain. The country will be flooded with all sorts of different generics. The Minister says that they will all have to be licensed. That is only partially true. The premises of a wholesaler in Belgium or Italy will have to be licensed but no one will check what that wholesaler imports, and he will then export unchecked products into the United Kingdom.
Some of us remember the 1960s and the scandal that the Birmingham medical officer of health exposed over Tetracycline and the imports of sub-standard products from Poland. Could it happen again? Of course it could. While the active ingredients in a generic are supposed to be the same, their palatability, their rate of release and their rate of absorption can differ very greatly.
Every manufacturer in the United Kingdom—and we are all proud of the standards of production of our pharmaceutical industry—is inspected under the good manufacturing practice laws. I ask the Minister: who will do the inspection of the overseas plants? How many inspectors are there? I should be grateful if we could have a firm answer to those questions.
The policy is wrong. The regulations would be open to a charge of hybridity if an affirmative resolution were required this evening; unfortunately, it is not. It may be open to challenge, as has been said, under article 30, dealing with competition. But, whatever challenges may be made, the regulations have been introduced in a shambolic way and put through with unprecedented speed.
I do not believe that the savings are there to be made. The impact of the regulations has already caused loss of employment for one manufacturer and stopped investment —and to what purpose? Patients are worried, and they will be even more worried after 1 April. They may settle into the new regime—let us hope they do—but at best many thousands will have to move from a settled regime into an unsettled one. Others, whether my right hon. Friend likes it or not, will be forced to buy, so for the first time we shall have, even if in a modest manner, a two-tier Health Service.
When 10,000 people in Northampton, with no instigation from me, sign a community health council petition complaining about the regulations — [Interruption.] I hope that the Secretary of State is not making an adverse comment about my constituents or about the community health council in Northampton. He can make comments about my speech, and sometimes the truth does hurt. Ours is supposed to be the party of enterprise with a caring face. We should hide our faces with regard to these regulations. If they are not rejected, as they should be, they will return to haunt the Government as amendment after amendment is laid before
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the House, night after night, as the savings fail to materialise, as the adverse drug reaction reports increase, as people lose their jobs and investment goes elsewhere.
10 pm
Mr. Eddie Loyden: I take part in the debate for two reasons. First, like my hon. Friends, I believe that the Government's handling of this matter has been ham-handed and arrogant, to say the least. They have caused great but avoidable distress and concern among many people who have been confused by the statements. It is no good the Government arguing that either the drug manufacturers or anybody else has overreacted to their statements. The fault clearly lies with the Government because of the way that they have handled this matter.
A great deal has been said about the effects of the regulations on the drugs industry, doctors and so on, but little has been said about the effects on patients. Most hon. Members have received letters which show that many people are concerned and will remain concerned while this list prevails.
Secondly, I have an interest in that I have a drug manufacturing company in my constituency and I am concerned about the jobs of constituents. I do not apologise for saying this when there are 4 million unemployed. It was not the will of those employed in the drug industry to join that industry. Like most working people, they found their way into it because of the communities in which they live and the job opportunities there. They have no control over their destinies. Therefore, it is my responsibility to fight for the jobs of those people, and I hope that my hon. Friends will agree with me.
We have seen the reaction of people who have spent many years in the drugs industry, who have been unnecessarily concerned and disturbed by the Government. Regardless of what the Government have been saying, this measure is merely a way to cut Health Service expenditure, and the hand of the Treasury is involved in the affair. There is no medical or other justification for the arguments advanced by the Government, and this is clearly a Treasury policy. We all know where that policy will lead us.
There has been a move towards great dependency on drugs, and that is part of how we approach health matters. There has been no serious attempt to seek alternatives, and maintaining dependency on drugs has become part of the role of the NHS. I have seen or heard nothing under this Government to suggest that there are positive and acceptable alternatives to the drugs industry. Unless those alternatives have been pursued and established, we shall have to depend on the manufacture and use of drugs. In other countries many lessons have been learnt.
We should not let this occasion go by without expressing some concern about the way in which drugs are monitored and about how the drug companies and the Committee on Safety of Medicines appear to disregard the extensive misuse of drugs. However, those are not the issues under discussion in this debate.
If there is to be a movement away from drug dependency, and if we see more moves towards preventive medicine, we should join Conservative Members if they say that that is the direction that they intend to take. However, there is no evidence that that is the reasoning behind the Government's proposal.

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More and more people are becoming aware that the main, if not the only, purpose of this exercise is in the first instance to cut the costs of the National Health Service. There is no suggestion that there will be any benefit in the longer term.
The National Health Service has been under constant attack from this Government since 1979. The Secretary of State and his junior Ministers always argue that more money is being spent on the NHS. However, the right hon. Gentleman should recognise that we have an aging population and that there are new illnesses which need the constant attention of the service. As new remedies for, new methods of curing and new ways of stabilising diseases are brought in, they will bring in their wake further costs. There should be no limit on our perspective of the needs of the Health Service. It must be primarily to improve the health of the people.
The Government's proposal is a ham-handed way of dealing with the problem. I hope that the House will consider most carefully what is being said by hon. Members on both sides of the House. If nothing else does, the contributions that we have heard from Government supporters ought to influence the Secretary of State.
I take into account at all times the jobs of those employed in the pharmaceutical industry, for the reasons that I have stated already. The Government's proposal will have a widespread effect throughout the drugs industry. Until there are alternative jobs, I shall continue to take that line.
10.8 pm
Mr. Douglas Hogg: When the provisional list was published last November, I had grave anxieties about it. I found it objectionable on two counts. First, it did not pay sufficient heed to the needs of people in rural areas. Secondly, I thought that the list of 30 medicines within the seven classes was insufficient to meet clinical needs. The House has to decide whether the revised list takes account of those two major criticisms.
The first of them clearly is met. My right hon. Friend has made it clear that in a rural area a dispensing doctor will now be permitted to prescribe and supply to a patient drugs which are not on the National Health Service.
Mr. Harry Ewing: At a charge.
Mr. Hogg: Yes, at a charge. That is perfectly true. But what worried people in rural areas was that they would be unable to obtain their medicines without going into the nearest towns. My right hon. Friend has met that criticism. On that point, there is no cause for anxiety.
Mr. Kennedy: Will the hon. Gentleman give way?
Mr. Hogg: I shall give way in a moment.
But a much more serious anxiety is whether a list of medicines, set by the Government, can meet the clinical needs of patients. I have little doubt that when we were dealing with the list of 30, the answer was no. The criticism was powerful and vociferous. It concentrated on pain-killers and laxatives. It was pointed out that there was an inadequate range of both. Had the list remained unexpanded, I would have voted against it. But the Government have moved substantially and we now have, I think, 128 on the white list. We must ask ourselves whether that list meets the patients' needs. That is a matter of judgment. Unlike the hon. Member for East Kilbride (Dr. Miller), I am not a doctor, but I have talked to doctors
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in my constituency and read the literature. I have also tried to listen to sensible criticism. I think the ultimate judgment is that for the vast majority of patients, their clinical needs will be met by the drugs—
Mr. Ewing: What about the rest? Do we just let them die?
Mr. Hogg: If the hon. Member for Falkirk, East (Mr. Ewing) does not mind, I shall take the argument in stages.
I am confident that well over 90 per cent. of patients will find that their needs are met by the white list. I accept that that leaves a small number of patients for whom the white list may not be adequate. We cannot quantify it, but I think that more than 90 per cent. will have their needs met. I suspect, therefore, that we are dealing with a core of 3, 4 or 5 per cent. The House must pay attention to that real and serious figure, but it is, nevertheless, small.
We must then ask where we go from there. Does that fact disqualify the policy, or can the problem be met in some other way? My conclusion is that it can be met in some other way, and that the problem does not disqualify the policy. The other way is the appeal system. My right hon. Friend the Secretary of State will know that ever since publication of his provisional list, I have pressed him for an appeal system. One can call it various things—residual discretion, or whatever—but it is quite clear that an appeal system is needed. Without it, the policy is not particularly attractive.
We have to face the fact that we are going into this policy without an effective appeal system. After all, there will not be an appeal system on 1 April. The question that then arises is whether, as an appeal system will not be available on 1 April, we should refuse to support the policy. But again, the answer to that must be no.
There are two reasons why the absence of an appeal system is not fatal. First, I do not believe that an appeal system can be made to function efficiently, or will be acceptable to the medical profession, if doctors have not played a part in devising it. The BMA has not been active in consultations with the Government. I suspect that until these regulations are passed, the BMA will not be ready to enter into negotiations with the Government. Therefore, it is the BMA's fault that has prevented an agreed appeal system from being put into place.
Mr. Nicholls: I, too, have pressed the Minister to adopt an override position to take account of the problem. If the BMA ultimately decides not to co-operate, surely it cannot be allowed to hold the whip hand over the working of this proposal. Does my hon. Friend agree that if it will not co-operate, the appeal procedure may have to be forced upon it?
Mr. Hogg: I agree with that.
Mr. Nicholas Winterton: What knowledge does my hon. Friend have of the industry? Because the Government have displayed very little, we have little confidence.
Mr. Hogg: I have greater confidence than my hon. Friend the Member for Macclesfield (Mr. Winterton) has in the good faith of the medical profession.
Mr. Robert Hughes: On a point of order, Mr. Deputy Speaker. I am seeking to follow the hon. Gentleman's argument closely, but unfortunately when he turns his back on me I cannot hear what he says.
Mr. Hogg: I apologise to the hon. Gentleman. I hope that he will accept that I meant him no discourtesy.

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I was accepting the point made by my hon. Friend the Member for Teignbridge (Mr. Nicholls) about the appeal system. If the medical profession is unwilling to negotiate a workable appeal system, I hope that my right hon. Friend the Secretary of State will impose one. But I do not think so ill of the medical profession. I am fairly confident that when these regulations are passed, a viable appeal system will be negotiated with the doctors.
Mrs. McCurley: Does my hon. Friend agree that the Government set out, in their policies for two general elections, to rid the country of bureaucracy? What my hon. Friend suggests is tantamount to additional bureaucracy. It will cost a great deal and it is extremely complicated.
Mr. Hogg: That is a fair argument generally, but we must consider the appeal system in the context of the proposals. I think that the proposals are good, subject to the existence of an appeal system. I see no reason why that appeal system should be bureaucratic. I see no reason why it should not be expeditious and accepted by the medical profession. If it meets those criteria, the appeal system will be viable. I hope that the medical profession and the Government come to terms quickly on the question of an appeal system.
Mr. Geoffrey Lofthouse: Is the hon. Member for Grantham (Mr. Hogg) saying that he is satisfied that no one will be denied the drugs that their doctors believe they need because they cannot afford them?
Mr. Hogg: That is what I am saying. If there is a viable appeal system, and since we are talking about a greatly expanded list, nobody will suffer.
I do not believe that this is an unwarrantable attack on a profession. All professions accept some constraints on their ability to act as they wish. For example, in my profession no one asserts that a solicitor or barrister should have an unqualified right to prescribe legal aid simply because a person comes within the financial eligibility criteria. That is left to the legal aid committees, and we accept that.
No one suggests that doctors are entitled to order as many kidney machines as they want simply because patients need them. We accept financial constraints and that the taxpayer and the Government have a voice.
My hon. Friend the Member for Warwick and Leamington (Sir D. Smith) is rightly anxious about the drugs industry. But is his anxiety realistic? We are dealing with only seven classes of drugs. They are not the major drugs, but drugs that cover about 10 per cent. of the market. Exemptions total about 70 per cent. The drugs industry is international in its scope. The seven classes do not involve the major life-enhancing, life-preserving drugs on which major research is being conducted. I have respect for my hon. Friend, but he overestimates the danger that could be done to the drugs industry.
I am sorry that my hon. Friend the Member for Thanet, South (Mr. Aitken) is not here, because I agree that we are dealing not with an issue of great principle but with a pragmatic issue. If it be right that the saving is real—
Mr. Nicholas Winterton: It is not.
Mr. Hogg: My hon. Friend the Member for Macclesfield must accept that we disagree—
Mr. Winterton: I would take a bet.
Mr. Hogg: I would never bet with my hon. Friend the Member for Macclesfield because I might not see my bet when I won it. I like to bet with people who pay up when they lose.
Mr. Winterton: On a point of order, Mr. Deputy Speaker. My hon. Friend the Member for Grantham (Mr. Hogg) has described me as a dishonourable Member of the House, and I ask him to withdraw his remark immediately.
Mr. Hogg: If I so described my hon. Friend, I withdraw my remark. However, I was not conscious of doing so.
We are dealing with a pragmatic issue. If there is to be a substantial saving—and I believe that there is—if there is no real danger of injury to patient care—and I do not think that there is—and if the fears of my hon. Friend the Member for Warwick and Leamington about the drugs industry are misconceived—and I think that they are—the proposals are sensible and should attract the support of the House.
10.20 pm
Mrs Renée Short: My hon. Friends the Members for East Kilbride (Dr. Miller) and for Carmarthen (Dr. Thomas) are two doctors who grace the Opposition Benches. They emphasised strongly that in trying to bring about the changes that the Secretary of State is introducing, he has gone about it the wrong way if he wished to win the support of the medical profession.
That is rather surprising because it is the Opposition who are usually accused of not knowing how to talk to doctors, how to deal with them or how to carry them with them. We have had a lesson in how not to gain the support of the doctors from the Government on the issue of drugs. Had the medical profession been consulted in the first place, it would have gone along with the proposals. The fact that the Secretary of State did not consult the medical profession has created unnecessary opposition and animosity that has led many people to believe that the proposals have no merit.
I do not go along with that view because I believe that the proposals are very much in line with many of the ideas put forward by the Opposition. We support generic prescribing while at the same time understanding that that will create difficulties for the drugs industry.
As my hon. Friend the Member for Liverpool, Garston (Mr. Loyden) said, employment problems are involved. Indeed, members of my union — the Transport and General Workers' Union—are widely employed in the drugs industry and we must take their problems on board.
The Health Ministers have shown ineptitude, which is rather surprising, in their handling of the problem. How could they have thought that by coming to the House on 8 November to announce their limited proposals they would get away with it? The British Medical Association was represented on the working party which produced the Greenfield report in 1983. The report recommended that limited lists should not be introduced. The Minister for Health said on 22 November 1983:
"We are not convinced that such a list confining the judgment of doctors would be in the best interests of patients." — [Official Report, 22 November 1983; Vol. 49, c. 112.]

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What has happened since then to change his mind? It is certainly not an animated discussion with the profession. We know that neither Ministers nor their officials have consulted with the profession about the prescribing of drugs since January 1983.
The Opposition support the Greenfield report. If it had been handled properly, many doctors would have cooperated in the introduction of its proposals.
It has not been made clear to interested parties that the Government are proposing a swingeing increase in prescription charges. The Secretary of State did not mention prescription charges today. I understand that it is proposed that there should be a charge of £2 per item—not per prescription. Therefore, it will be a higher increase than that indicated by Ministers.
According to my information, a large number of commonly prescribed drugs on the Minister's list cost much less than the proposed prescription charge. Some cost as little as 79p for a month's supply. A month's supply of digoxin would cost only 40p and a month's supply of the diuretic bendrofluozide would cost only 14p. It is clear, therefore, that a prescription charge of £2 per item would be a rip-off for the patient. The Minister must realise that patients cannot be exploited in that way by what would effectively be a tax on patients.
Even if the House approves the Government's highhanded action, I understand from my hon. Friend the Member for Oldham, West (Mr. Meacher) that the proposals will have to go to the European court. Perhaps the Minister for Health will tell us how much delay that will entail.
I hope that the Minister will be persuaded that he has handled this matter incompetently and that he will have continued difficulties with the medical profession if he does not consult it. I hope that he will go back to the profession to discuss how the proposals should be introduced to ensure that the necessary drugs are provided for all patients in the relevant categories and that the cost will be presented in such a way that patients are not out of pocket, paying £2 per item when that is exorbitant compared with the actual cost of the drugs.
10.26 pm
Mrs. Anna McCurley: I am seriously disappointed that a great gulf has become evident between a large section of the medical profession, the DHSS and the Scottish Home and Health Department.
I can understand why doctors used the form of lobbying that they did. They are not politicians and they are usually very slow to rise to the bait. On this occasion, however, there was so little time to consult that they found themselves led by the nose by others lobbying against limited list prescribing.
Many general practitioners are satisfied — although not all of them are convinced—that the revised limited list covers most eventualities. More particularly, certain groups of hospital doctors believe that they will be seriously hampered by the list. In the past few weeks I have spoken to consultants and junior hospital doctors in Scotland. Unlike some of the panel who made these controversial decisions, those doctors see and treat patients every day. They have a very heavy clinical load, so they know what they are talking about. Those who are particularly anxious about the restrictions are
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psychiatrists, those responsible for the care of the elderly in hospital, and those who treat painful arthritic conditions, cancer, stomach disorders, and so on.
It would be most unwise for the Government not to listen to what those doctors say as they are the main prescribers of the categories of drugs subject to axing. Personally, I cannot avoid listening because my husband is a consultant psychiatrist of many years' standing. Even at a distinguished level in politics there is woeful ignorance about the nature of psychiatry and geriatric medicine, so I shudder to think what it must be like at other levels. Failure to distinguish between psychiatry, psychology and psychoanalysis has bedevilled the profession in the public mind, so I take this opportunity to make Members of Parliament aware of the situation.
I was amused when I saw some of the glorious remedies on the revised list. I saw on the proscribed list some of the remedies that my grannie used as patent medicines. At that stage I did not believe that they had ever been subject to Health Service prescription charges. At first I thought, "Good show. That is right. We should get rid of those things." However, when I consulted members of the profession, they told me that they could not prescribe those medicines anyway. It was then that I thought that the list was a bit of a con.
Everyone has had a good laugh at the oddities that are still available in the original published list of banned substances, but it should he realised that many of the substances are effectively banned either because they fall into the non-prescribable preparation category, such as foodstuffs, or are not advised, being directly publicly advertised.
Everyone is in favour of rational drug prescribing and ensuring the best uses of finite resources. It is widely accepted that part of this is generic prescription. The Government are right to attempt to restrict the list, but the list before us is another matter and to many it is unacceptable. Setting aside the unacceptability in principle, I believe that the administrative structure that would have to be set up for continuous review of appeal and rejection beggars description.
Doubtless such a structure and the time that it would involve would prove a delight to the bureaucrat, but it would be unacceptable to the patient and his doctor. I believe that that would be the view of many hon. Members were they to be aware of it. Family doctors and hospital medical staff alike will be affected. A significant number of prescriptions for proposed banned drugs are initiated by hospital consultants, either as a continuation of treatment after discharge or as a recommendation following outpatient or domiciliary consultation.
The National Health Service consultant will therefore be clearly restricted in his choice. Here is a problem that he might face if a drug is not on the limited list and is decided to be appropriate. Should the patient be in a privileged position to pay, how can that be administered within hospitals? Patients successfully maintained on a banned analgesic or laxative must be allowed to continue after hospital admission to use that drug. If drugs are available privately to outpatients, they must be available also to inpatients. Do the Government therefore propose to set up two separate prescribing systems which invariably mean twice the cost, twice the administration and twice the risk? Is it envisaged that hospital

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pharmacists will deal with private sales, or will the relatives of some patients be sent out for a "take-away" from the high street chemist?
Monitoring on the ward which drugs are owned by the patient and which are the property of the hospital would be well nigh impossible. The overall cost of implementing any of these schemes would be considerable. The benzodiazepine tranquillisers have a particularly poor public image and we know that at times they have a justifiably bad press. Indeed, I have many times counselled my constituents—some of whom have come to me in a frightful state—against the use of just such tranquillisers. I do not know whether it is ethical or not to do so. However, misuse is a continuing cause for concern. Restriction would not improve matters as the chosen few are very popular on the illicit market. Benzodiazepines are not merely crutches for the mildly anxious. In various forms they are essential for anxiety states and other forms of mental disorder and for the relief of a number of physical conditions. I believe that quite recently skin diseases have been treated by them. There is considerable variation in these drugs, and restriction to the present proposed list is unacceptable to many.
Paradoxically, one member of the group—Clobazam — may be prescribed for epilepsy only. Are random checks on GPs proposed? Will neurological evidence be demanded in each case? Faced with the restricted list, the prescribing doctor might end up having to prescribe from another category of substances to avoid the restriction to achieve the symptoms of relief. Barbiturates, from the unrestricted list, would be a bad buy for the Health Service if chosen in preference to the benzodiazepines. Similar cases can be made for analgesics and laxatives. Regrettably, the restricted list applies to groups of compounds which superficially appear unimportant but which are often vital in treatment, especially in the elderly.
The Bulletin of the Royal College of Psychiatrists states:
"The proposals put forward are unacceptably rigid in view of the range of widely differing clinical conditions that are treated with one compound and of the complex and varied nature of compounds that may be needed to treat a single clinical condition. For instance, in the case of benzodiazepines, what applies to the treatment of a neurosis does not necessarily apply to the treatment of epilepsy or spastic paraplegia, nor is it appropriate to their use in intubation procedures. Benzodiazepines vary widely in their profile of action, their formulation and aspects of pharmacokinetics. Moreover, the pharmacokinetics of drugs varies in sometimes unpredictable ways, e.g. in the elderly."
Combination drugs cannot be done away with. Any doctor who is treating arthritis will say that. One GP in my constituency told me that he took more than 20 shots to get the correct medicine for a sufferer. That is not as bad as it sounds. It is an example of a careful doctor who understands the nature and variety of medical products Even then, especially in the elderly, tolerance of drugs alters and the search for another appropriate drug which will ease a condition begins again. To take away the doctor's choice is not good for the patient.
Some hospital doctors whom I know think that there is no logic to the list. I am speaking of some who are involved in research as well as clinical work. It worries them that the analgesics available are of the opiate, or addictive, variety. Rheumatologists to whom I have spoken and who use non-steroidals say that they do not do
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everything and that they require the use of a variety of analgesics. The opiates cause constipation, as do some antacids. A wider variety of laxatives is needed, especially for cancer patients for whom constipation is often a result of drug therapy and primary disease. The same is true for patients with hiatus hernia and stomach ulcers. The number of antacids has been chopped, but each antacid has specific side effects. Sometimes constipation and sometimes the opposite results.
To treat a patient as an individual requires a broad spectrum of drugs. Many hon. Members might say that too many are produced, but I hope that they remember that, for every one drug that sees the light of day, 10 are rejected at the research stage. Of those that appear, those which are unpopular or are regarded as less than efficacious by the medical profession get withdrawn.
Many of my hon. Friends have been supportive of drugs companies. I am not a hack in this—I have no interest in drugs companies. Dista makes Distalgesic, which has been taken off the prescribing list, but, through its profits from that drug, it has made another drug called Penicillinamine. That drug is kept on the market, at no proft to the company, to help a few specific patients who are suffering from the very rare Wilson's disease—an accumulation of copper in the body. Sufferers of rheumatoid arthritis also benefit from it.
Another drug, Prostcyclin, which has given us the means to understand better how the body and blood vessels work, is a natural substance discovered by researchers at Wellcome, who won the Nobel prize for their work. It is used in cardiac transplants, and Wellcome ploughs the profits from other drugs into research on such products. Hospitals do not have that sort of money and researchers in the NHS do not have the money that drugs companies have. We depend on drugs companies to do the research for us and the restrictions of the limited list will, I fear, severely curtail their ability to do such research.
I am upset that the problem has induced fear in the elderly. I strongly encourage the Government to explain matters properly, at least in a leaflet, to the elderly patients who have been caused most anxiety by the upheaval and give them at least a little comfort.
I hope that we never find that drugs are available to private practice but not to the NHS. It would be a difficult ethical conflict for doctors to choose between prescribing the best treatment available for patients and prescribing the treatment that patients could afford. I hope that we can ensure that that does not happen.
I urge the Minister to have another look at the list. After all, mistakes have already occurred. The British Pharmaceutical Journal wrote:
"It is unfortunate that the draft black list contains the no doubt inevitable crop of errors, which illustrates the difficulties of bureaucratising medicine. Thus, Optimax, possibly because of its vitamin components, is erroneously included. For the same possible reason, Reactivan is black listed, contrary to any indication in the original limited list proposal that it would be. What is to be made of the fact that Frisium capsules are black listed but apparently to be available for treatment of epilepsy without doctors having to indicate the diagnosis but having to indicate the Schedule that refers to epilepsy! The drug is white listed, but black listed under its brand name, under which name it can be supplied. Again, dextropropoxyphene and paracetamol tablets are in the white list, but Distalgesic and Cosalgesic which are the only products of the stated formula available on the market are black listed! So the medicine cannot be ordered as Distalgesic or Cosalgesic but can be supplied as such."

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That seems to be a strange anomaly in the system and I hope that it will be ironed out.
I believe the medical profession when it says that it is anxious to cut the drugs bill. I hope that it will do that, but we must ensure that patients who have come to expect and deserve the best from the Health Service continue to enjoy that right.
10.43 pm
Mr. Willie W. Hamilton: Unlike the hon. Member for Renfrew, West and Inverclyde (Mrs. McCurley), I propose to make a party political speech, because the debate is about the Government's approach to the National Health Service and to the principles on which it is based and on which the Labour party wishes to treat it.
Aneurin Bevan would turn in his grave if he had heard the speech of the Secretary of State who whinged on about the savings that he would make and would transfer to the patient. We know that neither proposition bears a minute's examination.
We all remember when the Minister for Health made extravagant claims about charging overseas visitors, and what a cock-up that was. The hon. Member for Northampton, South (Mr. Morris) made a devastating attack on what he sees as the creation of a two-tier system: a first-class Health Service for the rich, who can afford to pay whatever is asked, and a second-class service for the poor, the unemployed and the old. That is why, especially in Scotland, there has been the most enormous turmoil since the scheme was announced in great haste and without any sort of consultation with doctors, patients or anyone else.
Simply because the fellow who will be the star tomorrow wants £100 million from the Secretary of State, the Secretary of State thought that this was the best way to find it and, as every hon. Member knows, almost overnight announced this take-it or leave-it scheme. After that, he discovered that his sums and the number of drugs included were all wrong, and so he tripled them. He had a row with the Secretary of State for Scotland because he did not realise that the Health Service in Scotland and its problems were completely separate and needed separate treatment. It is a great tragedy that we are not having a separate Scottish debate and a Minister replying for Scotland, because there are particular Scottish aspects of the matter.
The Parliamentary Under-Secretary of State for Scotland was written to by one of my constituents, Dr. G. Lindsay Smith MB ChB D Obst, but he did not reply to the specific questions that he raised. When we put the specific cases to the hon. Gentleman, he drafted a circular letter which he sent to all Scottish Members, without fail, irrespective of our specific representations. That was a contempt of hon. Members who sought to do their jobs. The doctor was treated no less cavalierly by the hon. Gentleman.
On 21 January the doctor wrote back to the Parliamentary Under-Secretary and said
"I must stress the following points:—
1. For N.H.S. patients, the statutory list of drugs must alter the doctor/patient relationship by seriously interfering with a doctor's clinical freedom."
No one can deny that. He continued
"2. The treatment of individual N.H.S. patients will be constrained by the rigidity of a statutory list."
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It is not Willie Hamilton who writes that, but a doctor of consequence who knows what he is talking about and who is at the sharp end. He continued:
"3. The machinery for a national list can only he slow to respond to meet changes in clinical practice and new therapies.
4. Rather than use simple cheaper therapies, more expensive and complicated drugs may be used in an effort to reduce patients' financial hardship. These may well cost a great deal more.
5. Once this list has been introduced there is nothing to prevent the Government extending it to cover other groups of drugs."
Despite the Minister's assurance this afternoon, we do not believe him. Despite what he says, this is the thin end of a sinister wedge.
The letter continued:
"As to the question of generic prescribing I myself will be willing to do so once the Government has shown that it has taken steps to ensure the quality of imported drugs."
We all accept that, do we not? I have had experience of the prescribing of generic drugs, which did not provide adequate treatment when compared with the branded alternative. I have quoted that letter to show the reaction of a responsible doctor to the absurd and irresponsible treatment of Members of Parliament and doctors by the Scottish Office, which did not reply to questions about genuine problems.
In passing, I should say that one or two Conservative Members have declared a financial interest in Boots and other drug companies.
Mr. Donald Stewart: There were three.
Mr. Hamilton: I heard only two. There is an enormous pressure group in the House, comprised mainly of Conservative Members, which plugs the line of the drug companies. One of them read the apologia for the drug companies tonight. I hope he earned his corn. We do not know what fees the companies pay them, but we have a right to know what sort of pressure groups are operating in the House on such matters.
I agree with the Secretary of State to this extent: in this matter, the drug companies have displayed a despicable attitude in trying to pretend that they are looking after patients' interests. They are looking after their shareholders' interests, and nothing else. To their great shame, general practitioners have allowed themselves to be used, to some extent, by the drug companies. Some general practitioners in Fife sent me the petition forms that were provided by the drug companies. There was no comment on them; they simply put out the forms in their surgeries, got their patients to sign them and then sent them to me. It was counterproductive. I wrote back to the doctors and said, "If you want to influence me, do not send me petitions that were handed to you by the drug companies."
If the Secretary of State wants to save money, he need look no further than the balance sheets of the drug companies, which have made fortunes out of the National Health Service. I was a member of the Committee on Public Accounts when it received confidential information from the drug companies, which was excluded from our reports because the profits were so large that it would be devastating if the House knew precisely what they were. Some of them were making well over 100 per cent. profit on some drugs. The Secretary of State has a fertile furrow to plough if he wishes to save money in the NHS. Do not consider cutting out patients' drugs; consider the profits

733
of the drug companies. We cannot even test their efficiency, because many of them are international companies over which we have no control.
At a dinner given by the Institute of Chartered Secretaries and Administrators — I expect the Minister was talking to them because they will have to administer the scheme—the Minister for Health described the drug companies as, "hysterical," "alarmist" and "misleading." I congratulate him on being right on all counts. But the Government's response is not to tackle them. They try to save money through a bureaucratic nightmare, as the hon. Member for Renfrew, West and Inverclyde said. Incidentally, I hope that she will vote against the Government tonight. If her speech was her vote, she would be in our Lobby. However, I suspect that she will not, because she expects a little promotion and must behave herself. The hon. Member for Northampton, South (Mr. Morris) can say goodbye to any promotion prospects that he may have had.
Mr. Nicholas Winterton: The hon. Gentleman has made a vicious and I believe unjustified attack on the pharmaceutical industry. I wish that he would spell out some of the accusations that he makes about it. I would say only that ICI, the largest single employer in my constituency, has just contributed £130,000 from its profits to the East Cheshire hospice, which is being constructed for the terminally ill. Does he believe that that is obscene?
Mr. Hamilton: No, it is the profits that are obscene. ICI can give away that money only because it has got a nice, cosy relationship with the Department of Health and Social Security, which guarantees it a profit of 20 per cent. It is the only industry in Britain that is guaranteed an overall profit of 20 or 21 per cent. It is even more mollycoddled than the farmers. Reference was made earlier to money not growing on trees. Sometimes I think that it does. The Government say that it is important to save £25 million or £50 million on the National Health Service but in 1985–86 this country is to spend £552 million on protecting 1,200 Falkland islanders who live 8,000 miles away. In 1986–87 £450 million will be spent on those 1,200 people and in 1987–88 we shall spend another £300 million on them, a total for those three years of £1,300 million.
Mr. Butterfill: On a point of order, Mr. Deputy Speaker. Does consideration of the expenditure on the Falkland Islands have any relevance to this debate?
Mr. Hamilton: The hon. Gentleman may not like these figures but it behoves the Opposition to repeat them time and time again whenever the Government attack the social services. If only a fraction of that expenditure were to be translated to the National Health Service for the protection of the good health of the people of this country instead of for the protection of 1,200 people who live 8,000 miles away, there would be no talk about penalising the old and the poor and those who will suffer because of this nightmare of a scheme. The Government have made a cock-up, they know that they have made a cock-up and they should withdraw the regulations. If the Minister were to say that the Government propose to withdraw them, he would be greatly thought of by the people of this country.
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They would say, "There's a man who is big enough to realise what a monstrous nonsense this is and who is willing to confess."
10.57 pm
Dr. Brian Mawhinney: I hope that the hon. Member for Fife, Central (Mr. Hamilton) will forgive me if I do not take up his remarks, but it is very hard to debate a matter with someone who categorically refuses to believe the statements of right hon. and hon. Members. However, he referred to one matter which was mentioned by the hon. Members for Oldham, West (Mr. Meacher), to whom I always listen very carefully, and for East Kilbride (Dr. Miller). They said that they would prefer a policy that led to a continuous reduction in the profits of the pharmaceutical companies. The problem with a policy of that kind is that it allows the pharmaceutical companies to decide whether they should reduce the number of drugs manufactured in a balanced way or whether they should leave some areas of clinical concern totally uncovered. I do not believe that such a policy would commend itself to the Government.
My comments will be directed towards the medical profession and the role of the profession in the development of policy. General practitioners in particular have had a bad press. That is unfair because there are many good general practitioners in Britain whose reputations have been damaged by the actions of a minority. I say that asking the House to bear in mind that I have spent all my working life teaching medical students. So I have a commitment to the medical profession in its training which cannot be gainsaid and which does not put me in the corner of being an antagonist towards the medical profession.
That having been said, it is a matter of considerable service that a number of general practitioners have behaved in the way that they have in the past few months. We have rightly castigated La Roche for sending out that letter to general practitioners to be forwarded to Members of Parliament. The fact is that general practitioners accept that letter and they bear the responsibility for that lack of judgment. Some of them, as has been mentioned, have improperly influenced people, particularly elderly constituents, inducing a state of fear that in many cases has been quite misplaced. I remember being told some weeks ago by a doctor with great glee that he had just told an elderly patient that morning that the drug that he was prescribing would not be available to her after 1 April. I asked him for the basis for that statement and he had none.
The third thing that has brought disrepute on all the profession has been the activities of the leaders of the BMA. I say "the leaders" because again many general practitioners in my constituency and elsewhere have taken the opportunity of consultation to write to my right hon. Friend the Secretary of State, to respond to the consultation list, to make sensible suggestions and to express genuine concerns which were taken into account in the production of the extended list. I can understand that the BMA may have felt that it should have had more consultation, but there comes a time —I hope Labour Members will accept this—when a refusal to consult and take part in the consultation process on behalf of patients becomes a self-indulgence, and that is what we have seen in recent weeks.
One must ask why that is the case. It is the case in part because the medical profession has, rightly, a privileged place in the NHS, which could not exist without it, and in

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relation to the Government. I think that my right hon. and learned Friend the Minister for Health would agree that over the years when the medical profession has clashed with succeeding Governments it has frequently been the Government who have given way rather than the medical profession. I think, for example, of the recent dispute over where consultants' contracts should be held, on which, as my right hon. and learned Friend knows, I believe the Government made the wrong decision, and the many additional payments to the tune of almost £100 million a year to general practitioners for doing what many of us would think was part of their normal contract.
I am pleased that the Government have reaffirmed to the medical profession that while they wish to consult, and while they wish and need to take the profession with them, ultimately it is the Government and Parliament who govern, not the medical profession.
A minority of the medical profession have got themselves into that particular difficulty because of their special relationship as medical practitioners with the drug companies and because they have what I can only term a spurious belief that in some sense their clinical freedom is threatened. That is not the case, and I agree with my hon. Friend the Member for Grantham (Mr. Hogg).
In the hospital sector consultants have come together and have voluntarily agreed in many cases to forgo the drug that they would have chosen in order to come up with an agreed list. It could be argued that that was an abrogation of their clinical freedom. The fact is that nothing in principle that is different is being asked of the general practitioners than is already voluntarily agreed by the hospital consultants. That is why I say to my right hon. and learned Friend that his appeal mechanism is necessary, and I greatly welcome it. Just as the hospital consultants found it necessary to have an appeal mechanism for 3 or 4 per cent. of the cases where the doctors wanted to prescribe, so I accept that there will be a minority of cases with general practitioners that need to be covered by an appeals mechanism. Therefore, I welcome it. The BMA has given a commitment that after tonight it will cooperate with my right hon. and learned Friend. If the will is there on both sides, I believe that an appeal mechanism could still be in place by 1 April.
Doctors are central to the Health Service, and it is a matter of considerable concern that at present relations between Government and Parliament, on the one hand, and the profession, on the other, are such that the degree of mutual trust and credibility that is necessary for the benefit of our constituents who are patients has been damaged. The BMA leaders appear no longer to believe Ministers when they speak. That position must be changed. It must be made clear to doctors that their position is not threatened but that they are not on a pedestal which puts them above the democratic will of this House. It needs to be brought home to them that they have a greater economic accountability than they seem to perceive. Changes in medical education are needed to bring home that economic accountability. Our constituents who are patients also need to be educated as to the limits of what medicine can achieve.
The House should understand that, while the limited list will make a substantial contribution to saving, it is not the end of the story. There will be need to direct our attention again to the prescribing habits in the primary sector. To that end I would encourage my right hon. and learned Friend to think next time by way of incentives to the
736
doctors to co-operate — perhaps financial incentives, because most people respond to financial incentives. [Interruption.] Some thought needs to be given to the way in which we can build on this initiative in order to tackle, at an even more fundamental level, the prescribing habits in the primary sector.
11.7 pm
Mr. Charles Kennedy: The hon. Member for Peterborough (Dr. Mawhinney) seems to want to save money, yet he concludes with a proposal that would seriously undermine any potential savings to be made from the new regulations. He wants to have his cake and eat it.
I heard one or two speeches from the Conservative Benches in favour of the Government but, despite those efforts, the handling of the issue by Health Ministers has been both insensitive and inept. As the alliance has prayed in particular against the Scottish regulations, I should like to go back to the references that were made on points of order, at the beginning of the debate, to the incompetence with which the Health Minister for Scotland has handled the issue. It gives rise to very great concern.
I object strongly to the approach adopted by Back Bench Members and by Ministers—that somehow the public, the elderly and the sick are so stupid as to be completely duped by the propaganda of the pharmaceutical industry. They are also questioning the ability of hon. Members of this House, when they receive mail from their constituents, to discriminate between a campaign inspired, organised and oriented with the purpose of trying to frighten Members of Parliament, and the genuine concern being expressed by patients.
To hear the Secretary of State for Social Services, who sits in a Cabinet that owes so much to Saatchi and Saatchi, saying that it is intolerable that marketing methods are being brought into the world of politics, and that it is unacceptable that doctors should threaten Members of Parliament by saying that they will pin up the Member's reply in their surgery so that the public know what he thinks about an issue, is to know the contempt that Health Ministers feel.
The evidence given to the Joint Committee on Statutory Instruments by the official from the Department of Health and Social Security was that the Scottish Health Minister, at the time of the revised limited list, had said:
"I am confident that the assurances that I have given all along that the final list will meet all medical needs have been fully honoured."
That can be compared with what the assistant secretary at the Department said when giving evidence. He said:
"I think that there may be difficulties, but we cannot at the moment gauge the extent of that. This has only just been drawn to our attention, and we have not had an opportunity to collate it in any detail."
The Minister of Health shakes his head, but I can quote from the report, as I have done. It is disgraceful that he is lounging on the Treasury Bench shaking his head, when the Scottish Health Minister should have been at the Dispatch Box explaining the shambles and administrative chaos that his Department has created by this proposal.
What should have been introduced is what the alliance has argued for all along—generic substitution, which need not be indiscriminate and need not damage the interests of the pharmaceutical industry. As my hon. Friend the Member for Leeds, West (Mr. Meadowcroft)

737
made clear, the important thing to look at is patent life and the amount of return that the pharmaceutical companies will get on their research.
Ministers are surprised, but are they not aware of what the Department of Trade and Industry is doing? In a written reply to me last week, the Under-Secretary of State told me concerning drug patent life that the Government's standing advisory committee on patents is seeking the opinions of the industry with a view to trying to seek to extend them.
In other words, the Government are realising, in reverse order, that instead of trying to go for a limited list, they should first have gone for the conference to which the Secretary of State referred, then examined patent life extensions for the industry, and then, with those reassurances, started off towards a sensible system of generic substitution, based on the Greenfield report. That would have commanded support across the Floor of the House and would have allayed many fears that have been unjustifiably, and ridiculously, aroused by Ministers by the way in which they have handled the matter.
The way that Ministers have handled this matter is nonsensical. The fact that the person who seems to be presiding over the greatest administrative chaos of all, at the Scottish Home and Health Department, is prepared only to make remarks from a sedentary position, and does not have the guts to come to the Dispatch Box, is a poor show for the Health Service in Scotland. On that basis alone, I and my hon. Friends will oppose the regulations.
11.13 pm
Mr. Frank Dobson: I shall not attempt to summarise all the speeches that have been made in opposition to the Government's proposals—virtually every speech that has been made.
The Labour party objects to the Government's proposals for four major reasons. First, they have been a bodge-up. Secondly, they undermine the principles of the NHS and will damage patient welfare. Thirdly, the main savings from the proposals will result not from people getting cheaper drugs but from many of the most badly off patients getting no NHS drugs. Fourthly, they will lead to even more unethical and objectionable activity by some drug companies. If people think they can smear us by some form of pharmaceutical McCarthyism on grounds that we are in cahoots with the drug companies and they listen to what we say, they will soon discover that our interests are different from theirs.
I deal first with the bodge-up. The first extremely limited list produced by Ministers was totally indefensible, so much so that even they have not attempted to defend it. Then we had a shambolic consultation arrangement. For a year before the Government introduced these proposals, they had not talked to the medical profession about restraining drug costs. Not a word had passed between them. Then they suddenly announced what was to happen, and they expected everyone to say, "We accept the principle. We are bound to. We should just like to make a few minor adjustments." Those who object on principle do not like making minor adjustments. But what reveals the Government's incompetence most clearly is their failure from the outset to recognise the need to establish local appeals machinery before the list came into operation.
738
It is no good Ministers blaming the British Medical Association for not coming up with proposals. Ministers are responsible for the organisation of the National Health Service, and they are responsible for prescribing, as they are demonstrating by these proposals. They are responsible for the arrangements necessary to protect patients. They have quoted all sorts of arrangements for limited lists made abroad. Each of those systems has an appeals machinery for those limited number of people who cannot cope with the drugs on whatever limited list prevails.
Finally, we have had the farce revealed today of the inconsistency between the Scottish and England lists. We discover, for instance, that a Scottish doctor, presumably in Scotland, can dispense Vicks cold care capsules but that his English equivalent cannot. Conversely, the English doctor can dispense Vicks inhaler, but the Scottish doctor cannot. I am not suggesting that the old rieving instinct is so dominant in the Borders that we shall have cross-border drug running as a result of the Government's incompetence. But it is an indication of how stupid their proposals—
Mr. John Home Robertson: Will my hon. Friend give way?
Mr. Dobson: I gladly give way to an old riever!
Mr. Home Robertson: As my hon. Friend knows, I live very close to the English border. I am registered with a general practitioner from across the border in Berwick-upon-Tweed, in England. When I get a cold, what will he be able to prescribe for me? Will it come out of the Scottish list or the English list?
Mr. Dobson: I am afraid that I cannot help my hon. and somewhat bifurcated Friend. If he really wants to know, he must ask Bodgers Anonymous on the Treasury Bench.
The National Health Service is based on the principles that the best health services should be available to all and that money should not be the passport to better treatment. Most people accept those unimpeachable principles, and no one in political life dares challenge them—at least in public. Unfortunately, some people, including the Government, seek to undermine those principles by stealth.
When considering these proposals, we should bear in mind that this Government have promoted the establishment of commercial hospitals, they have promoted private insurance, they have abolished National Health Service spectacles, and now they are proposing two-tier prescribing.
The limits proposed by the Government will apply only to drugs prescribed on the National Health Service. Doctors will be able to prescribe any drug but, if it is not on the list, the patient will have to pay for it.
That is the main reason for Labour's opposition to these proposals. They would bring back two-tier care into every National Health Service surgery, from which we all thought it was banished permanently in 1948. Patients who cannot afford to buy privately are bound to be disadvantaged.
If a drug is worth while, it should be available on the National Health Service. If it is not worth while, it must be dangerous, fraudulent or superfluous and consequently should not be available to any patient, NHS or private. I

739
also believe that the Government's approach reflects a lamentable ignorance of real life. But there is nothing novel about that. They proclaim that their current proposals do not affect the more important or life-saving drugs. So what? Most health care is about not life and death, but pain and relief from pain, and comfort instead of discomfort. I do not know when the Ministers here tonight last went to see their doctors, but it is highly unlikely that their lives depended on the outcome.
It must be accepted by all those who consider the problem that there has been too much unnecessary prescribing, heavily promoted by the pharmaceutical industry. Everyone knows that. It should be reduced as a result of action by doctors, restraint by the drug industry and a better informed public. We need to get away from people thinking that they have not been treated properly if they come away from the doctor without a prescription. But we can do that only by starting with younger people. The Government's proposals to outlaw the prescribing of proprietary medicines, obtainable without a prescription, will start at the wrong end, among the old. For most of their adult lives they have been used to obtaining prescriptions every time they visit their doctors. No less than 81 per cent. of those who obtain proprietary brands on prescription get them on free prescriptions. Their decent, kind, humane, and sensible doctors provide them, for example, with free cough mixtures to stop them from coughing all night.
Despite the Government's efforts to divert public attention, it is clear that many familiar remedies, particularly for the old, for symptoms of minor ailments, will no longer be available, and people will have to go without. For a rich society such as ours—we are still one of the richest countries in the world—to target its efforts to cut the drugs bill on free remedies for the oldest and poorest, seems perverse, even by this Government's standards.
It is also safe to predict that if the current proposals go through, the drug companies will respond by stepping up their promotion, on television and elsewhere, of the excluded products. At a drugs industry conference on 22 January, which was addressed by the Parliamentary Under-Secretary of State, delegates heard lectures from leading marketing experts on
"Limiting the Damage—the Marketing Options"
and on
"Developing the Market for Private Prescriptions—Can it be Done?"
As people at that conference were paying £137 a throw to attend, I can assure hon. Members that the marketing experts did not say, "I'm sorry lads, you'll need to throw the towel in." Their object is to create a demand which cannot be satisfied within the NHS, but which can be met by more over-the-counter sales and private prescriptions.
In case anyone should doubt that—apparently there is a doubting Thomas or Fred on the back row—I shall quote what one of the marketing consultants said. He said that only about 2,500 of the 30,000 general practitioners regularly write private prescriptions
"but that number is going to increase and you will get your share if you think creatively."
That marketing consultant also said that doctors should be offered free samples with "starter packs" for patients, and with leaflets and posters in doctors' surgeries and chemists shops to encourage them to seek private prescriptions. Sales forces should apparently "educate" — note that
740
word — doctors' receptionists on the cost of private prescriptions when patients seek repeat prescriptions of drugs that are banned. Health insurance companies should apparently be approached to provide reimbursement for drugs, and banned products should be attractively repackaged to persuade patients that they are getting value for money if they buy drugs privately.
The other person giving such advice—a Mr. Ron Clifford, marketing director of Eli Lilly, another drug company, said that companies should consider free gifts, redeemable coupons, and advertising allowances to chemists to "entice" people to buy over-the-counter medicines, and should use a much wider range of press and television advertising. For those reasons, we are convinced that, whatever the Government's motives, the introduction of a limited list within the NHS will lead to grotesque unethical promotional activity by drug companies whose products are excluded from the list.
The Labour party has made it clear for some years that it does not object in principle to a selected drug list. However, if it is to be anything other than voluntary, conditions must be imposed. First, it should apply across the board, not just to drugs prescribed under the NHS.
Secondly, the criteria for including drugs should be made public, not furtively in private. The criteria should include safety, efficacy, the ease with which the drugs can be administered and palatability, even if that means using a branded product. The cost should be secondary.
Thirdly, machinery for selecting and assessing drugs for inclusion in the list should be established. That machinery should involve representatives of the drug companies, the relevant trade unions and patients, as well as the Government. The machinery should provide for the open assessments of drugs. The organisation should be empowered and equipped with the resources to deal with applications for inclusion in the list, appeals against exclusion from the list and, if necessary, to commission or conduct clinical trials. The machinery should also be able to establish local and national means of meeting the needs of the small number of patients who need drugs outside the list. Unfortunately the Government's proposition meets none of those sensible criteria.
The Government's desire to save money by reductions in the prices paid to drug companies and by the extension of generic substitution is recommended in the Greenfield report. The propositions in that report command the support of almost everyone in the medical profession, yet they have been rejected—for reasons that no one seems to understand.
If the Government are interested in rational prescribing, they could help GPs to improve their prescribing. Doctors are hampered by the absence of regular and easy access to their own prescribing data, because the prescribing pricing authority has not yet been computerised.
The Government have referred to support from some peculiar outfits. The Minister of State gave a most curious reply to the hon. Member for Hazel Grove (Mr. Arnold), who asked for
"a statement on the conclusions of the article, 'Prescribing: the Power to Set Limits', by J. M. Harding and others in the British Medical Journal of 9 February, a copy of which he has received."
The Minister of State said:
"The article referred to by my hon. Friend concludes that generic prescribing and a limited list of drugs may improve the quality of prescribing and be the only way to curb prescribing costs."

741
For good measure, he added:
"We fully agree with these conclusions." — [Official Report, 25 February 1985; Vol. 74, c. 65.]
Unfortunately for the Minister, those who prepared the paper have written to me from their practice in my constituency. The most material sentence states:
"We are extremely angry that our paper has been misrepresented in this way to support a position in complete contradiction to the one we hold."
So much for the Minister's reading of these articles.
When Conservative Members denounce the response of the BMA and of the Royal College of General Practitioners as wholly reactionary and unhelpful, all I can say is that it is not the most reactionary doctors who have made the strongest representations to me, it is the extremely progressive doctors working in good premises, running group practices and, in many cases, with their own voluntary selected list of drugs. They are the doctors who are most violently opposed to the imposition of the Government's ill-thought-out list.
Something else that we cannot ignore is the impression that the Government have created that if they do this everything will be all right with prescribing, dispensing and the pharmacy aspects of the NHS. The fact is that in many parts of the country many people still have difficulty obtaining their prescriptions. Rural pharmacies are still in retreat and dispensing doctors remain dissatisfied with their position. All sorts of things are wrong with that part of the NHS. The Government are doing precious little, other than to introduce this scheme.
We believe that, in the long run, the public interest would be served by taking a major stake of the British pharmaceutical industry into the public sector. Just as the NHS and its non-competitive principles have produced a better health service for our people than any competitive commercial system anywhere in the world, we are convinced that those principles could be applied to substantial parts of the pharmaceutical industry.
The Government complain about escalation in drug prices. Let them remember the largest escalation. When they first took office, prescription charges were 20p per item. They are now £2 per item. There is not one item on the drugs bill that has shown an increase of 1,000 per cent., yet that is what we have had from the Government.
The Government's proposals are unacceptable. They were ill thought out in the first place, they will damage the NHS, they will undermine the welfare of the patients and the burden of the savings will fall on those least able to bear it. There is nothing odd about that. That has been the Government's attitude to everything relating to the NHS, social security and the social services since they took office. This proposition is on all fours with what they have been proposing. We believe that these ill-thought-out and ridiculous proposals should be rejected and that the House should stick by the basic principles of the NHS which have served us so well until now. They are that the best health service, including the best pharmaceutical aspects, should be available to all and that money should not be the passport to better services.
If the Minister really believes in these proposals, he should insist that they apply to the private sector also. But he will not do that, because, like his colleagues, he is committed to a two-tier system. This is part of that story, and that is why we reject it.
11.34 pm
The Minister for Health (Mr. Kenneth Clarke): At times the speech of the hon. Member for Holborn and St. Pancras (Mr. Dobson) reminded me of one of the blacklisted drugs. The marketing and packaging were rather better than were justified by the contents, some of which seemed a little out of patent—old and familiar arguments which, had they been adopted, would have resulted in unnecessary public expenditure.
At times, however, the hon. Gentleman seemed to be drifting very close to agreeing with us, leading one to wonder why we were debating this prayer at a not altogether civilised hour with a view to dividing the House at the end of it. I am not surprised about that as almost all our vehement critics — especially those in the Opposition, who find themselves in embarrassing alliance with the more extreme critics in the industry — sail rather close to supporting roughly what we have proposed. That is also not surprising. There should not be differences in the House on this, let alone the ferocious differences shown by some sections of the professions and the industry.
I do not know whether anyone can contradict this, but I have not yet met a doctor or a pharmacist in practice who does not agree that something ought to be done to reduce the growth of the NHS drugs bill. That should be the starting proposition for the whole debate. At present the bill is £1·5 billion, rising each year by about 5 per cent. more than inflation. As my hon. Friend the Member for Birmingham, Edgbaston (Mrs. Knight) has said, we all know and can describe, either anecdotally or as a result of drug recall schemes, that a great deal of wasteful overprescribing of all kinds has been going on.
The starting point should be that we are searching, in the interests of the NHS, for some greater economy than has been achieved so far in the total drugs bill. I have been at the Department for about three years and my right hon. Friend the Secretary of State for about three and a half years. Throughout that time we have had substantial discussions about economies in the drugs bill. Just about every interest has been mentioned repeatedly throughout those discussions, as well as in debates in the House.
Before my right hon. Friend the Secretary of State made his announcement we had reached the stage when people were all very clear about what they were against when it came to doing anything to achieve greater economies in the drugs bill, but it was difficult to find any clear consensus about what people supported, which would have real, practical consequences of benefit to patient services.
For that reason, we concluded that it was time for a decision to be taken. Contrary to the assertions of the hon. Member for Holborn and St. Pancras, the interests of the service itself demanded that somebody should take a decision that would work. We set out a policy with one clear purpose — none of this two-tier rubbish that the hon. Member for Holborn and St. Pancras always argues about and none of the sudden streaks of hostility towards the industry that one or two of my hon. Friends thought that they saw behind it. Our purpose was to achieve a saving of up to £100 million—it now seems more likely to be about £75 million—for the NHS each year without damaging patient care. By avoiding unnecessary expenditure on drugs dispensed, the money could go into developments in other forms of care.
Mr. Richard Hickmet: I support the Government's policy on this issue but inasmuch as the drugs bill amounts to £1·4 billion, or whatever the figure may be, and inasmuch as within that figure about 9 per cent. is represented by promotion—£135 million — 21 per cent. — £32 million — by advertising, £60 million by representatives and 11 per cent. —£17 million—by literature, will my right hon. and learned Friend examine that area for savings? Could we not find £100 million there as well?
Mr. Clarke: We have examined that area—we are continuing to do so — and we have acted upon that examination. We are reducing by 10 per cent. the amount of promotional activity that is supported by NHS drug prices in the forthcoming year. We cannot make savings of the order that my hon. Friend describes but he has referred to an area that is ripe for savings and it is one in which we have acted. The drug companies spend a great deal of money on promotion and this has some good effect in that new drugs are introduced to the market. The companies persuade quite a few members of the medical profession vehemently to campaign on their behalf when the companies' interests are threatened. Indeed the companies, have an easy sell in the form of the hon. Member for Oldham, West (Mr. Meacher), who appears to use the marketing and promotional activities of the ABPI when it comes to putting together his speeches on this subject.
It is clear that our policy is aimed at saving £75 million. That is the sum that will be available for other forms of basic care in the service. Every time that the Government come forward with such proposals there is a tendency for everyone to urge us to spend more upon the NHS, despite the fact that Government spending is now 20 per cent. ahead of inflation compared with the spending of the previous Labour Government. Every time that we do anything that might raise additional revenue — for example, examining charges—we receive criticism from Labour Members. Whenever we examine any measures that might save expenditure within the service by avoiding unnecessary spending, thereby diverting money to better patient services — for example, when we discuss tendering or residential services — we find critics, invariably on the Opposition Benches—but sometimes on the Government Back Benches as well. They all declare a constituency interest or a personal, financial one in the pharmaceutical industry. It seems that they are somewhat worried when we start to examine expenditure in this area.
We are pursuing a saving of £75 million for the Health Service and its patients in an area where, so far as I am aware, every professional agrees that savings can and should be made. Our critics should be saying that it is about time that something was done and that positive action should have been taken before now instead of raising objections and preparing to vote against the proposal that is before us.
We have spent a protracted time in discussions to seek an effective method of making savings that will not jeopardise patient care. We had many discussions before the Greenfield report and we had many after it. Generic substitution was recommended by the Greenfield committee and rejected by the BMA, the industry and by us, the Government, for reasons to which I shall return. Thereafter, we continued to search for ways in which we
744
might be able to make advances without jeopardising professional or industrial interests that are important to Britain.
I have been accused of rejecting a limited list in responding to the hon. Member for Carmarthen (Dr. Thomas). I rejected the concept in reply to a parliamentary question from the hon. Gentleman and I still reject it across the entire range of therapeutic categories. Before we made our announcement shortly before Christmas, we decided that the selected list approach was not justified across every therapeutic category. Had we gone outside the categories that we have chosen—tonics, vitamins, cough medicines, tranquillisers and sedatives, for example—we would have threatened research into life-saving drugs and entered very much more difficult professional areas. I do not regret the reply to the parliamentary question which has been much quoted by the ABPI and, therefore, by Labour Members this evening.
We also examined international experience which, again, has been much misquoted today by the use of briefs. The hon. Member for Oldham, West talked of Sweden. Sweden is much more restrictive than we are in its use of drugs. It has a licensing system which requires safety and efficacy and will not license products unless there is a demonstrated need. It has a selected system across the whole range of therapeutic products.
Nor is it true, as has been suggested, that the Netherlands is abandoning the selected list system. It is making one change and keeping to the system. I do not agree with those who say that the Germans cannot demonstrate any savings. That is not the opinion of the German Government, but that of some of the lobbyists who have been briefing some hon. Members who have taken part in this debate. It is not true tht arrangements such as this wiped out the industry in Canada. There was a change in the licensing system in Canada, not just a change in the selection of products.
International experience shows that we are unique in taking the full range of products at the behest of each practitioner—all paid for on the NHS. I even got an executive of an American drug company to admit that our arrangement—by which we take any product that comes on the market at any price so long as a doctor can be induced, often by heavy promotion, to prescribe it at the expense of the NHS—is pretty silly. We examined the practice of other countries and endeavoured to introduce a variant of other systems that we think appropriate to the NHS.
Of course, we noticed that 40 per cent. of hospitals have formularies that extend across the full range of therapeutic categories. They are far more extensive than what is proposed. We also considered the fact that many good general practices, including the ones mentioned by the hon. Member for Holborn and St. Pancras have their own formularies. On that basis, my right hon. Friend made his announcement in November. Thereafter followed a process of consultation, discussion and consideration of the proposal, which produced our final selected list a few weeks ago.
The Government believe in consultation. I believe that consultation improves the quality of decision-making. We all know what happens when one consults on such matters. There is an inevitable tendency for those who do not like the drift of policy to demonstrate or mount expensive and irresponsible press campaigns rather than discuss while the policy is evolving. We consulted and got a substantial

745
number of the medical profession to respond. We got agreement from some royal colleges. Others, which oppose us, gave opinions about the content of the list.
I actually met the BMA. It has been one of those occasions when an organisation refuses to consult and discuss, but which one nevertheless meets with embarrassing frequency. I have attended three formal meetings with my right hon. Friend or officials and I have addressed the BMA at Tavistock house. It restricted what it would talk to us about, but that was its choice. I met the Pharmaceutical Society of Great Britain and the pharmaceutical services negotiating committee. We did not make a political judgment about the contents of the final selected list, but put together an expert panel.
I can tell my hon. Friend the Member for Renfrew, West and Inverclyde (Mrs. McCurley) that each member of the panel was a practising clinician. Three were GPs, one a pharmacist and another a psychiatrist—the interest she mentioned — and we accepted the unanimous professional view of that panel based on the reactions to the consultation about what ought to go on the list. That was sensible, and I discover to my astonishment that the Liberal party, and, if we believe the last speech from the Labour party, the Labour party, favour a list, but believe that the manner in which we have put ours together entitles them to vote against this one.
Mr. Robert Hughes: The Minister makes much of consultations, but I sent him a number of letters—not standard letters — from GPs who were worried about their own specific patients because certain drugs were left off the list. They asked for a clinical explanation, but I have not had a single reply from the Minister. That is why the Government's proposals stand condemned.
Mr. Clarke: It is in the nature of organised letter-writing campaigns that it becomes impossible to give detailed replies to each letter. Hon. Members were objecting earlier to standardised replies. If one gets thousands of standardised letters, one sends standardised replies.
Many of the letters from individual patients who had been told that their drug was not available were based on untruthful allegations, because the consultation and the final selection of drugs had not taken place. Many of the drugs cited by GPs or by patients who had been advised by GPs were not affected by our proposals.
Mr. Robert Hughes: Will the Minister give way?
Mr. Clarke: No, I am not giving way again.
I think that, with the exception of my hon. Friend the Member for Renfrew, West and Inverclyde, every one of my hon. Friends who spoke against our proposals declared an interest in the pharmaceutical industry, on either a constituency or a personal basis. I do not object to that; the industry is important to our economy and requires the protection of the DHSS, as the sponsoring Department, not least because it has considerable export earnings and provides considerable employment.
However, the facts that the DHSS is the sponsoring Department, that the industry has been successful during a recession, that it earns considerable sums for this country and that we need to foster a strong, research-based industry to gain export earnings do not mean that the industry's
746
profit margins and promotional activities are inviolate or that the NHS can never be free to consider the product range. We have a twin duty — to look after the legitimate interests of the industry and to make sure that the NHS does not buy products that it does not require or pay excessively for those products. We are following that balance of interests.
I have been questioned about profit margins and promotional costs and asked whether we will look for alternatives.
Mr. Malcolm Thornton: As someone who has neither a constituency nor a financial interest in the pharmaceutical industry, may I tell my right hon. and learned Friend that the industry is a little worried about the somewhat arbitrary nature of the way in which certain products have been excluded from the list or included in it? There are some major inconsistencies. Will my right hon. and learned Friend give an assurance that the review body or the appeals machinery will allow that matter to be looked at carefully?
Mr. Clarke: It has certainly not been done arbitrarily. The final selection of the list was made on clear criteria which have been set out in answers to parliamentary questions. The selection was made by members of a professional panel using their medical and scientific judgment. They received submissions from all the companies affected, making claims for the therapeutic quality of their products. Of course companies argue about inconsistencies if they find that their products have been unsuccessful compared with others.
The review procedure, which we shall set up as soon as we can, when we have consulted about its details, will be able to keep the list under continual review. It will be able to look at cases if people wish to return to the argument with the review committee. But the decisions will be made on professional, medical and scientific grounds and we shall put a drug on the white list—that is, those selected for prescription on the NHS—only if we are satisfied that it meets a clinical need that no other product can meet or that it meets more cost-effectively a clinical need that is also met by other products.
We are looking at the price we pay and the profit margins we allow under a system that we inherited from the Labour Government. We took over from that Government the PPRS scheme which had not been reviewed for many years and was producing extremely generous returns for an industry which most Labour Members usually curse. They often threaten to nationalise substantial parts of that industry. We have reduced the target rate of return for the industry from 25 per cent., which was appropriate when we had higher inflation, to between 17 and 18 per cent. now. Profit margins and price levels must be reduced. A 25 per cent. target rate of return when inflation was at 15 per cent. or more, is no better than a 15 per cent. rate of return now, although it has not decreased so far. The profitability of the industry was increasing while inflation fell, and we cannot be accused of being hostile by reviewing profit levels. If promotional activity reaches £130 million, the time has come to check it.
The climate remains favourable for investment—
Mr. Dobson: Does the right hon. and learned Gentleman agree that he means that in real terms the profits of the drug companies have increased, although their notional profit levels have been reduced?
Mr. Clarke: The profits of the drug industry remain fair because, unlike the Labour Government, we have reviewed the PPRS. We are adjusting prices, not revealing a new hostility to the industry. We believe that the industry is valuable, and that investment will continue to be attracted to the United Kingdom because of the reputation of the NHS, our licensing arrangements, and the attraction of the United Kingdom as a base for research and for academic work, on which so much of the drug industry depends.
I agree with my hon. Friend the Member for Thanet, South (Mr. Aitken) that one must make a practical judgment about how to create a fair climate for the industry, but that does not rule out changes of policy of this sort, which hold the balance fairly between the industry and the NHS. The industry suggested, not alternative ways of saving money, but ways of raising £70 million or more, not at the expense of the companies. It suggested reducing wholesalers' profit margins and stopping the NHS supply of medicines for trivial and self-limiting conditions. It wanted to take products off the NHS list and to attack the exemptions for children and the elderly.
Neither of the Opposition parties nor that part of the medical profession which is opposed to the proposals have put forward alternatives. I expected arguments in favour of generic substitution, but only the hon. Member for Ross, Cromarty and Skye (Mr. Kennedy) believes that that is still his party's policy. Generic substitution suggested by Greenfield was opposed by the BMA and ABPI. It would create great problems if a doctor prescribed one drug and a different formulation was dispensed by a chemist, and those problems could not be resolved. It would have damaged research in key areas. Given that the BMA and, I thought, the Labour party were advocating voluntary generic prescribing, and that compulsory generic prescribing can save only between £30 and £35 million, voluntary generic prescribing would save peanuts.
We can answer the criticisms of the hon. Member for Holborn and St. Pancras by setting up the appeals mechanism of the sort that we have said we are anxious to discuss with the BMA. I am sorry that the BMA has come so late. In the past the appeals mechanism has been mentioned by many doctors, but they suggested one when the full list was available. At that time, the list had not been subjected to the opinion of the panel and was not extended to its present full selection. We have since received a few letters, and last Thursday the BMA responded to our invitation to talks about an appeal mechanism. We shall certainly hold such talks.
I therefore believe that we have handled the policy as well as possible. We seem to be strikingly near to the policy of both Opposition parties, who are finding foolish reasons for opposing the measure. The hon. Member for Leeds, West (Mr. Meadowcroft) made it clear that the alliance is in favour of a selected list approach. Certainly, I read a speech by the right hon. Member for Plymouth, Devonport (Dr. Owen), whose absence today is notable, which set out, in the ABPI's propaganda, his clear views that the time had come to get rid of "me-too" drugs and
748
those which had enjoyed a spurious form of protection. But the Labour party suddenly set out criteria for a limited list system today, which comes late in the day.
Another Member whom we have missed is the right hon. Member for Stoke-on-Trent, South (Mr. Ashley), who normally has considerable influence in the Labour party on such matters. On 27 November 1984 he said to my right hon. Friend the Secretary of State:
"Is the Secretary of State aware that his first attempt to introduce a rational prescribing policy is to be very warmly welcomed, that he should strongly resist the selfish and distorted propaganda of the pharmaceutical industry, which is now screaming blue murder, and that the only advice he should accept about implementing this very good proposal is independent advice?"—[Official Report, 27 November 1984; Vol. 68, c. 761.]
The right hon. Gentleman may have had an excellent reason for staying away, but it was probably out of shame at what the Labour Front-Bench spokesmen said.
The hon. Member for Fife, Central (Mr. Hamilton) cited Nye Bevan. I am sure that Nye Bevan would not have liked the speech of the hon. Member for Oldham, West, which was taken from an ABPI brief—
It being Twelve o'clock, MR. DEPUTY SPEAKER put the Question pursuant to order [12 March].
The House divided: Ayes 205, Noes 332.

Division No. 160]

[Midnight

AYES

Adams, Allen (Paisley N)

Craigen, J. M.

Alexander, Richard

Crowther, Stan

Alton, David

Cunliffe, Lawrence

Anderson, Donald

Cunningham, Dr John

Ashley, Rt Hon Jack

Dalyell, Tam

Ashton, Joe

Davies, Rt Hon Denzil (L'lli)

Atkinson, N. (Tottenham)

Davies, Ronald (Caerphilly)

Bagier, Gordon A. T.

Davis, Terry (B'ham, H'ge H'l)

Banks, Tony (Newham NW)

Deakins, Eric

Barnett, Guy

Dewar, Donald

Barron, Kevin

Dixon, Donald

Beckett, Mrs Margaret

Dobson, Frank

Beith, A. J.

Dormand, Jack

Bell, Stuart

Douglas, Dick

Benn, Tony

Dubs, Alfred

Bennett, A. (Dent'n & Red'sh)

Duffy, A. E. P.

Bermingham, Gerald

Dunwoody, Hon Mrs G.

Bidwell, Sydney

Eastham, Ken

Boothroyd, Miss Betty

Ellis, Raymond

Boyes, Roland

Evans, John (St. Helens N)

Bray, Dr Jeremy

Ewing, Harry

Brown, Gordon (D'f'mline E)

Fatchett, Derek

Brown, N. (N'c'tle-u-Tyne E)

Faulds, Andrew

Brown, R. (N'c'tle-u-Tyne N)

Fields, T. (L'pool Broad Gn)

Brown, Ron (E'burgh, Leith)

Fisher, Mark

Bruce, Malcolm

Flannery, Martin

Buchan, Norman

Foot, Rt Hon Michael

Caborn, Richard

Forrester, John

Callaghan, Jim (Heyw'd & M)

Foster, Derek

Campbell, Ian

Foulkes, George

Campbell-Savours, Dale

Fraser, J. (Norwood)

Canavan, Dennis

Freeson, Rt Hon Reginald

Carlile, Alexander (Montg'y)

Freud, Clement

Carter-Jones, Lewis

Garrett, W. E.

Cartwright, John

George, Bruce

Clark, Dr David (S Shields)

Gilbert, Rt Hon Dr John

Clarke, Thomas

Godman, Dr Norman

Clay, Robert

Gould, Bryan

Clwyd, Mrs Ann

Gourlay, Harry

Cocks, Rt Hon M. (Bristol S.)

Grylls, Michael

Coleman, Donald

Hamilton, James (M'well N)

Conlan, Bernard

Hamilton, W. W. (Central Fife)

Cook, Robin F. (Livingston)

Hancock, Mr, Michael

Corbett, Robin

Hardy, Peter

Corbyn, Jeremy

Harman, Ms Harriet

Cowans, Harry

Harrison, Rt Hon Walter

Cox, Thomas (Tooting)

Hart, Rt Hon Dame Judith

749

Hattersley, Rt Hon Roy

Owen, Rt Hon Dr David

Healey, Rt Hon Denis

Park, George

Heffer, Eric S.

Patchett, Terry

Hogg, N. (C'nauld & Kilsyth)

Pendry, Tom

Holland, Stuart (Vauxhall)

Penhaligon, David

Home Robertson, John

Prescott, John

Howell, Rt Hon D. (S'heath)

Radice, Giles

Howells, Geraint

Randall, Stuart

Hoyle, Douglas

Redmond, M.

Hughes, Robert (Aberdeen N)

Rees, Rt Hon M. (Leeds S)

Hughes, Roy (Newport East)

Richardson, Ms Jo

Hughes, Sean (Knowsley S)

Roberts, Ernest (Hackney N)

Hughes, Simon (Southwark)

Robertson, George

Janner, Hon Greville

Rogers, Allan

John, Brynmor

Rooker, J. W.

Jones, Barry (Alyn & Deeside)

Ross, Stephen (Isle of Wight)

Kaufman, Rt Hon Gerald

Rowlands, Ted

Kennedy, Charles

Ryman, John

Kilroy-Silk, Robert

Sedgemore, Brian

Kirkwood, Archy

Sheerman, Barry

Lambie, David

Sheldon, Rt Hon R.

Lamond, James

Shore, Rt Hon Peter

Leadbitter, Ted

Short, Ms Clare (Ladywood)

Leighton, Ronald

Short, Mrs R.(W'hampt'n NE)

Lewis, Ron (Carlisle)

Skinner, Dennis

Lewis, Terence (Worsley)

Smith, C.(Isl'ton S & F'bury)

Litherland, Robert

Smith, Sir Dudley (Warwick)

Lofthouse, Geoffrey

Smith, Rt Hon J. (M'kl'ds E)

Loyden, Edward

Snape, Peter

McCartney, Hugh

Soley, Clive

McDonald, Dr Oonagh

Spearing, Nigel

McGuire, Michael

Stewart, Rt Hon D. (W Isles)

McKelvey, William

Stott, Roger

Mackenzie, Rt Hon Gregor

Strang, Gavin

Maclennan, Robert

Thomas, Dr R. (Carmarthen)

McNamara, Kevin

Thompson, J. (Wansbeck)

McTaggart, Robert

Thorne, Stan (Preston)

McWilliam, John

Thornton, Malcolm

Madden, Max

Tinn, James

Marek, Dr John

Torney, Tom

Marshall, David (Shettleston)

Wallace, James

Martin, Michael

Wardell, Gareth (Gower)

Maxton, John

Wareing, Robert

Maynard, Miss Joan

Weetch, Ken

Meacher, Michael

Welsh, Michael

Meadowcroft, Michael

White, James

Michie, William

Williams, Rt Hon A.

Millan, Rt Hon Bruce

Wilson, Gordon

Miller, Dr M. S. (E Kilbride)

Winnick, David

Mitchell, Austin (G't Grimsby)

Winterton, Mrs Ann

Morris, Rt Hon A. (W'shawe)

Winterton, Nicholas

Morris, Rt Hon J. (Aberavon)

Woodall, Alec

Morris, M. (N'hampton, S)

Young, David (Bolton SE)

Murphy, Christopher

Nellist, David

Tellers for the Ayes:

Oakes, Rt Hon Gordon

Mr. Frank Haynes and

O'Brien, William

Mr. Allen McKay.

Orme, Rt Hon Stanley

NOES

Adley, Robert

Benyon, William

Aitken, Jonathan

Best, Keith

Alison, Rt Hon Michael

Bevan, David Gilroy

Amery, Rt Hon Julian

Biffen, Rt Hon John

Amess, David

Blackburn, John

Ancram, Michael

Blaker, Rt Hon Sir Peter

Arnold, Tom

Body, Richard

Ashby, David

Bonsor, Sir Nicholas

Aspinwall, Jack

Bottomley, Peter

Atkins, Rt Hon Sir H.

Bowden, A. (Brighton K'to'n)

Atkins, Robert (South Ribble)

Bowden, Gerald (Dulwich)

Atkinson, David (B'm'th E)

Boyson, Dr Rhodes

Baker, Rt Hon K. (Mole Vall'y)

Brandon-Bravo, Martin

Baker, Nicholas (N Dorset)

Bright, Graham

Baldry, Tony

Brinton, Tim

Banks, Robert (Harrogate)

Brittan, Rt Hon Leon

Batiste, Spencer

Brooke, Hon Peter

Beaumont-Dark, Anthony

Brown, M. (Brigg & Cl'thpes)

Bellingham, Henry

Browne, John

Bendall, Vivian

Bruinvels, Peter

750

Bryan, Sir Paul

Hargreaves, Kenneth

Buchanan-Smith, Rt Hon A.

Harris, David

Buck, Sir Antony

Harvey, Robert

Budgen, Nick

Hawkins, C. (High Peak)

Bulmer, Esmond

Hawkins, Sir Paul (SW N'folk)

Burt, Alistair

Hawksley, Warren

Butcher, John

Hayes, J.

Butler, Hon Adam

Hayhoe, Barney

Butterfill, John

Heath, Rt Hon Edward

Carlisle, John (N Luton)

Heathcoat-Amory, David

Carlisle, Kenneth (Lincoln)

Heddle, John

Carlisle, Rt Hon M. (W'ton S)

Henderson, Barry

Carttiss, Michael

Heseltine, Rt Hon Michael

Cash, William

Hickmet, Richard

Chalker, Mrs Lynda

Hicks, Robert

Chapman, Sydney

Higgins, Rt Hon Terence L.

Chope, Christopher

Hill, James

Churchill, W. S.

Hind, Kenneth

Clark, Hon A. (Plym'th S'n)

Hirst, Michael

Clark, Dr Michael (Rochford)

Hogg, Hon Douglas (Gr'th'm)

Clark, Sir W. (Croydon S)

Holland, Sir Philip (Gedling)

Clarke, Rt Hon K. (Rushcliffe)

Hordern, Peter

Clegg, Sir Walter

Howard, Michael

Colvin, Michael

Howarth, Alan (Stratf'd-on-A)

Conway, Derek

Howell, Rt Hon D. (G'ldford)

Coombs, Simon

Howell, Ralph (N Norfolk)

Cope, John

Hubbard-Miles, Peter

Cormack, Patrick

Hunt, David (Wirral)

Corrie, John

Hunt, John (Ravensbourne)

Couchman, James

Hunter, Andrew

Cranborne, Viscount

Hurd, Rt Hon Douglas

Critchley, Julian

Jackson, Robert

Currie, Mrs Edwina

Jenkin, Rt Hon Patrick

Dickens, Geoffrey

Jessel, Toby

Dicks, Terry

Johnson Smith, Sir Geoffrey

Dorrell, Stephen

Jones, Gwilym (Cardiff N)

Douglas-Hamilton, Lord J.

Jones, Robert (W Herts)

du Cann, Rt Hon Sir Edward

Jopling, Rt Hon Michael

Dunn, Robert

Joseph, Rt Hon Sir Keith

Durant, Tony

Kellett-Bowman, Mrs Elaine

Dykes, Hugh

Kershaw, Sir Anthony

Edwards, Rt Hon N. (P'broke)

Key, Robert

Eggar, Tim

King, Roger (B'ham N'field)

Emery, Sir Peter

King, Rt Hon Tom

Evennett, David

Knight, Gregory (Derby N)

Eyre, Sir Reginald

Knight, Mrs Jill (Edgbaston)

Fallon, Michael

Knowles, Michael

Farr, Sir John

Knox, David

Fenner, Mrs Peggy

Lamont, Norman

Finsberg, Sir Geoffrey

Lang, Ian

Fookes, Miss Janet

Latham, Michael

Forman, Nigel

Lawrence, Ivan

Forsyth, Michael (Stirling)

Lee, John (Pendle)

Forth, Eric

Leigh, Edward (Gainsbor'gh)

Fowler, Rt Hon Norman

Lennox-Boyd, Hon Mark

Fox, Marcus

Lester, Jim

Franks, Cecil

Lewis, Sir Kenneth (Stamf'd)

Fraser, Peter (Angus East)

Lightbown, David

Fry, Peter

Lilley, Peter

Gale, Roger

Lloyd, Ian (Havant)

Galley, Roy

Lloyd, Peter, (Fareham)

Gardiner, George (Reigate)

Lord, Michael

Gardner, Sir Edward (Fylde)

Luce, Richard

Garel-Jones, Tristan

Lyell, Nicholas

Glyn, Dr Alan

McCrindle, Robert

Goodhart, Sir Philip

Macfarlane, Neil

Gorst, John

MacGregor, John

Gow, Ian

MacKay, Andrew (Berkshire)

Gower, Sir Raymond

MacKay, John (Argyll & Bute)

Greenway, Harry

Maclean, David John

Gregory, Conal

McNair-Wilson, P. (New F'st)

Griffiths, E. (B'y St Edm'ds)

Madel, David

Griffiths, Peter (Portsm'th N)

Major, John

Grist, Ian

Malins, Humfrey

Ground, Patrick

Malone, Gerald

Gummer, John Selwyn

Maples, John

Hamilton, Hon A. (Epsom)

Marland, Paul

Hampson, Dr Keith

Marlow, Antony

Hanley, Jeremy

Marshall, Michael (Arundel)

Hannam, John

Mates, Michael

751

Maude, Hon Francis

Shelton, William (Streatham)

Mawhinney, Dr Brian

Shepherd, Colin (Hereford)

Maxwell-Hyslop, Robin

Shepherd, Richard (Aldridge)

Mellor, David

Sims, Roger

Meyer, Sir Anthony

Skeet, T. H. H.

Miller, Hal (B'grove)

Smith, Tim (Beaconsfield)

Mills, Iain (Meriden)

Soames, Hon Nicholas

Mitchell, David (NW Hants)

Speed, Keith

Moate, Roger

Spencer, Derek

Monro, Sir Hector

Spicer, Jim (W Dorset)

Montgomery, Sir Fergus

Spicer, Michael (S Worcs)

Moore, John

Squire, Robin

Morrison, Hon C. (Devizes)

Stanbrook, Ivor

Morrison, Hon P. (Chester)

Steen, Anthony

Moynihan, Hon C.

Stern, Michael

Mudd, David

Stevens, Lewis (Nuneaton)

Neale, Gerrard

Stevens, Martin (Fulham)

Needham, Richard

Stewart, Allan (Eastwood)

Neubert, Michael

Stewart, Andrew (Sherwood)

Newton, Tony

Stewart, Ian (N Hertf'dshire)

Nicholls, Patrick

Stokes, John

Normanton, Tom

Stradling Thomas, J.

Norris, Steven

Sumberg, David

Onslow, Cranley

Taylor, John (Solihull)

Oppenheim, Phillip

Taylor, Teddy (S'end E)

Oppenheim, Rt Hon Mrs S.

Tebbit, Rt Hon Norman

Ottaway, Richard

Temple-Morris, Peter

Page, Sir John (Harrow W)

Terlezki, Stefan

Page, Richard (Herts SW)

Thatcher, Rt Hon Mrs M.

Parris, Matthew

Thomas, Rt Hon Peter

Patten, Christopher (Bath)

Thompson, Donald (Calder V)

Patten, J. (Oxf W & Abdgn)

Thompson, Patrick (N'ich N)

Pawsey, James

Thorne, Neil (Ilford S)

Peacock, Mrs Elizabeth

Thurnham, Peter

Percival, Rt Hon Sir Ian

Townend, John (Bridlington)

Pollock, Alexander

Tracey, Richard

Porter, Barry

Trippier, David

Portillo, Michael

Twinn, Dr Ian

Powell, William (Corby)

van Straubenzee, Sir W.

Powley, John

Viggers, Peter

Prentice, Rt Hon Reg

Waddington, David

Price, Sir David

Wakeham, Rt Hon John

Prior, Rt Hon James

Waldegrave, Hon William

Proctor, K. Harvey

Walden, George

Pym, Rt Hon Francis

Walker, Rt Hon P. (W'cester)

Raison, Rt Hon Timothy

Wall, Sir Patrick

Rathbone, Tim

Waller, Gary

Rees, Rt Hon Peter (Dover)

Walters, Dennis

Rhodes James, Robert

Ward, John

Rhys Williams, Sir Brandon

Wardle, C. (Bexhill)

Ridley, Rt Hon Nicholas

Warren, Kenneth

Ridsdale, Sir Julian

Watson, John

Rifkind, Malcolm

Watts, John

Rippon, Rt Hon Geoffrey

Wells, Bowen (Hertford)

Roberts, Wyn (Conwy)

Wells, Sir John (Maidstone)

Robinson, Mark (N'port W)

Wheeler, John

Roe, Mrs Marion

Whitfield, John

Rossi, Sir Hugh

Whitney, Raymond

Rost, Peter

Wolfson, Mark

Rowe, Andrew

Wood, Timothy

Rumbold, Mrs Angela

Woodcock, Michael

Ryder, Richard

Yeo, Tim

Sackville, Hon Thomas

Young, Sir George (Acton)

Sainsbury, Hon Timothy

Younger, Rt Hon George

St. John-Stevas, Rt Hon N.

Sayeed, Jonathan

Tellers for the Noes:

Shaw, Giles (Pudsey)

Mr. Carol Mather and

Shaw, Sir Michael (Scarb')

Mr. Robert Boscawen.

Question accordingly negatived.

National Health Service

  NATIONAL HEALTH SERVICE (SCOTLAND)
  Motion made, and Question put forthwith pursuant to order [12 March],
  That an humble Address be presented to Her Majesty, praying that the National Health Service (General Medical and Pharmaceutical Services) (Scotland) Amendment Regulations
  752
  1985 (S.I., 1985, No. 296), dated 1st March 1985, a copy of which was laid before this House on 4th March, be annulled.—[Mr. Kennedy.]
  The House divided: Ayes 197, Noes 324.

  Division No. 161]

  [12.13 am

  AYES

  Adams, Allen (Paisley N)

  Foulkes, George

  Alexander, Richard

  Fraser, J. (Norwood)

  Alton, David

  Freeson, Rt Hon Reginald

  Anderson, Donald

  Freud, Clement

  Ashley, Rt Hon Jack

  Garrett, W. E.

  Ashton, Joe

  George, Bruce

  Atkinson, N. (Tottenham)

  Gilbert, Rt Hon Dr John

  Bagier, Gordon A. T.

  Godman, Dr Norman

  Banks, Tony (Newham NW)

  Gourlay, Harry

  Barnett, Guy

  Hamilton, James (M'well N)

  Barron, Kevin

  Hamilton, W. W. (Central Fife)

  Beckett, Mrs Margaret

  Hancock, Mr, Michael

  Beith, A. J.

  Hardy, Peter

  Bell, Stuart

  Harman, Ms Harriet

  Benn, Tony

  Harrison, Rt Hon Walter

  Bennett, A. (Dent'n & Red'sh)

  Hart, Rt Hon Dame Judith

  Bermingham, Gerald

  Haynes, Frank

  Bidwell, Sydney

  Healey, Rt Hon Denis

  Boyes, Roland

  Heffer, Eric S.

  Bray, Dr Jeremy

  Hogg, N. (C'nauld & Kilsyth)

  Brown, Gordon (D'f'mline E)

  Holland, Stuart (Vauxhall)

  Brown, N. (N'c'tle-u-Tyne E)

  Home Robertson, John

  Brown, R. (N'c'tle-u-Tyne N)

  Howell, Rt Hon D. (S'heath)

  Brown, Ron (E'burgh, Leith)

  Howells, Geraint

  Bruce, Malcolm

  Hoyle, Douglas

  Buchan, Norman

  Hughes, Robert (Aberdeen N)

  Caborn, Richard

  Hughes, Roy (Newport East)

  Callaghan, Jim (Heyw'd & M)

  Hughes, Sean (Knowsley S)

  Campbell, Ian

  Hughes, Simon (Southwark)

  Campbell-Savours, Dale

  Janner, Hon Greville

  Canavan, Dennis

  John, Brynmor

  Carlile, Alexander (Montg'y)

  Jones, Barry (Alyn & Deeside)

  Carter-Jones, Lewis

  Kaufman, Rt Hon Gerald

  Clark, Dr David (S Shields)

  Kennedy, Charles

  Clarke, Thomas

  Kilroy-Silk, Robert

  Clay, Robert

  Lambie, David

  Clwyd, Mrs Ann

  Lamond, James

  Cocks, Rt Hon M. (Bristol S.)

  Leadbitter, Ted

  Coleman, Donald

  Leighton, Ronald

  Conlan, Bernard

  Lewis, Ron (Carlisle)

  Cook, Robin F. (Livingston)

  Lewis, Terence (Worsley)

  Corbett, Robin

  Litherland, Robert

  Corbyn, Jeremy

  Lofthouse, Geoffrey

  Cowans, Harry

  Loyden, Edward

  Cox, Thomas (Tooting)

  McCartney, Hugh

  Craigen, J. M.

  McDonald, Dr Oonagh

  Crowther, Stan

  McGuire, Michael

  Cunliffe, Lawrence

  McKay, Allen (Penistone)

  Cunningham, Dr John

  McKelvey, William

  Dalyell, Tam

  Mackenzie, Rt Hon Gregor

  Davies, Rt Hon Denzil (L'lli)

  Maclennan, Robert

  Davies, Ronald (Caerphilly)

  McNamara, Kevin

  Davis, Terry (B'ham, H'ge H'l)

  McTaggart, Robert

  Deakins, Eric

  McWilliam, John

  Dewar, Donald

  Madden, Max

  Dixon, Donald

  Marek, Dr John

  Dobson, Frank

  Marshall, David (Shettleston)

  Dormand, Jack

  Martin, Michael

  Douglas, Dick

  Maxton, John

  Dubs, Alfred

  Maynard, Miss Joan

  Duffy, A. E. P.

  Meacher, Michael

  Eastham, Ken

  Meadowcroft, Michael

  Ellis, Raymond

  Michie, William

  Evans, John (St. Helens N)

  Millan, Rt Hon Bruce

  Ewing, Harry

  Miller, Dr M. S. (E Kilbride)

  Fatchett, Derek

  Mitchell, Austin (G't Grimsby)

  Faulds, Andrew

  Morris, Rt Hon A. (W'shawe)

  Fields, T. (L'pool Broad Gn)

  Morris, Rt Hon J. (Aberavon)

  Fisher, Mark

  Murphy, Christopher

  Flannery, Martin

  Nellist, David

  Foot, Rt Hon Michael

  Oakes, Rt Hon Gordon

  Forrester, John

  O'Brien, William

  Foster, Derek

  Orme, Rt Hon Stanley

  753

  Owen, Rt Hon Dr David

  Spearing, Nigel

  Park, George

  Stewart, Rt Hon D. (W Isles)

  Patchett, Terry

  Stott, Roger

  Pendry, Tom

  Strang, Gavin

  Penhaligon, David

  Thomas, Dr R. (Carmarthen)

  Prescott, John

  Thompson, J. (Wansbeck)

  Randall, Stuart

  Thorne, Stan (Preston)

  Redmond, M.

  Thornton, Malcolm

  Rees, Rt Hon M. (Leeds S)

  Tinn, James

  Richardson, Ms Jo

  Torney, Tom

  Roberts, Ernest (Hackney N)

  Wallace, James

  Robertson, George

  Wardell, Gareth (Gower)

  Rogers, Allan

  Wareing, Robert

  Ross, Stephen (Isle of Wight)

  Weetch, Ken

  Rowlands, Ted

  Welsh, Michael

  Ryman, John

  White, James

  Sedgemore, Brian

  Williams, Rt Hon A.

  Sheerman, Barry

  Wilson, Gordon

  Sheldon, Rt Hon R.

  Winnick, David

  Shore, Rt Hon Peter

  Winterton, Mrs Ann

  Short, Ms Clare (Ladywood)

  Winterton, Nicholas

  Short, Mrs R.(W'hampt'n NE)

  Woodall, Alec

  Skinner, Dennis

  Young, David (Bolton SE)

  Smith, C.(Isl'ton S & F'bury)

  Smith, Sir Dudley (Warwick)

  Tellers for the Ayes:

  Smith, Rt Hon J. (M'kl'ds E)

  Mr. Archibald Kirkwood and

  Snape, Peter

  Mr. John Cartwright.

  Soley, Clive

  NOES

  Adley, Robert

  Carlisle, Kenneth (Lincoln)

  Aitken, Jonathan

  Carlisle, Rt Hon M. (W'ton S)

  Alison, Rt Hon Michael

  Carttiss, Michael

  Amery, Rt Hon Julian

  Cash, William

  Amess, David

  Chalker, Mrs Lynda

  Ancram, Michael

  Chapman, Sydney

  Arnold, Tom

  Chope, Christopher

  Ashby, David

  Churchill, W. S.

  Aspinwall, Jack

  Clark, Hon A. (Plym'th S'n)

  Atkins, Rt Hon Sir H.

  Clark, Dr Michael (Rochford)

  Atkins, Robert (South Ribble)

  Clark, Sir W. (Croydon S)

  Atkinson, David (B'm'th E)

  Clarke, Rt Hon K. (Rushcliffe)

  Baker, Rt Hon K. (Mole Vall'y)

  Clegg, Sir Walter

  Baker, Nicholas (N Dorset)

  Colvin, Michael

  Baldry, Tony

  Conway, Derek

  Banks, Robert (Harrogate)

  Coombs, Simon

  Batiste, Spencer

  Cope, John

  Beaumont-Dark, Anthony

  Cormack, Patrick

  Bellingham, Henry

  Corrie, John

  Bendall, Vivian

  Couchman, James

  Benyon, William

  Cranborne, Viscount

  Best, Keith

  Currie, Mrs Edwina

  Bevan, David Gilroy

  Dickens, Geoffrey

  Biffen, Rt Hon John

  Dicks, Terry

  Blackburn, John

  Dorrell, Stephen

  Blaker, Rt Hon Sir Peter

  Douglas-Hamilton, Lord J.

  Body, Richard

  du Cann, Rt Hon Sir Edward

  Bonsor, Sir Nicholas

  Dunn, Robert

  Bottomley, Peter

  Durant, Tony

  Bowden, A. (Brighton K'to'n)

  Dykes, Hugh

  Bowden, Gerald (Dulwich)

  Edwards, Rt Hon N. (P'broke)

  Boyson, Dr Rhodes

  Eggar, Tim

  Brandon-Bravo, Martin

  Emery, Sir Peter

  Bright, Graham

  Evennett, David

  Brinton, Tim

  Eyre, Sir Reginald

  Brittan, Rt Hon Leon

  Fallon, Michael

  Brooke, Hon Peter

  Farr, Sir John

  Brown, M. (Brigg & Cl'thpes)

  Fenner, Mrs Peggy

  Browne, John

  Finsberg, Sir Geoffrey

  Bruinvels, Peter

  Fookes, Miss Janet

  Bryan, Sir Paul

  Forman, Nigel

  Buchanan-Smith, Rt Hon A.

  Forsyth, Michael (Stirling)

  Buck, Sir Antony

  Forth, Eric

  Budgen, Nick

  Fowler, Rt Hon Norman

  Bulmer, Esmond

  Fox, Marcus

  Burt, Alistair

  Franks, Cecil

  Butcher, John

  Fraser, Peter (Angus East)

  Butler, Hon Adam

  Fry, Peter

  Butterfill, John

  Gale, Roger

  Carlisle, John (N Luton)

  Galley, Roy

  754

  Gardiner, George (Reigate)

  LyeII, Nicholas

  Gardner, Sir Edward (Fylde)

  McCrindle, Robert

  Garel-Jones, Tristan

  Macfarlane, Neil

  Glyn, Dr Alan

  MacGregor, John

  Goodhart, Sir Philip

  MacKay, Andrew (Berkshire)

  Gorst, John

  MacKay, John (Argyll & Bute)

  Gow, Ian

  Maclean, David John

  Gower, Sir Raymond

  McNair-Wilson, P. (New F'st)

  Greenway, Harry

  Madel, David

  Gregory, Conal

  Major, John

  Griffiths, E. (B'y St Edm'ds)

  Malins, Humfrey

  Griffiths, Peter (Portsm'th N)

  Malone, Gerald

  Grist, Ian

  Maples, John

  Ground, Patrick

  Marlow, Antony

  Gummer, John Selwyn

  Marshall, Michael (Arundel)

  Hamilton, Hon A. (Epsom)

  Mates, Michael

  Hampson, Dr Keith

  Maude, Hon Francis

  Hanley, Jeremy

  Mawhinney, Dr Brian

  Hannam, John

  Maxwell-Hyslop, Robin

  Hargreaves, Kenneth

  Mellor, David

  Harris, David

  Meyer, Sir Anthony

  Harvey, Robert

  Miller, Hal (B'grove)

  Hawkins, C. (High Peak)

  Mills, Iain (Meriden)

  Hawkins, Sir Paul (SW N'folk)

  Mitchell, David (NW Hants)

  Hawksley, Warren

  Moate, Roger

  Hayes, J.

  Monro, Sir Hector

  Hayhoe, Barney

  Montgomery, Sir Fergus

  Heathcoat-Amory, David

  Moore, John

  Heddle, John

  Morrison, Hon C. (Devizes)

  Henderson, Barry

  Morrison, Hon P. (Chester)

  Heseltine, Rt Hon Michael

  Moynihan, Hon C.

  Hickmet, Richard

  Mudd, David

  Hicks, Robert

  Neale, Gerrard

  Higgins, Rt Hon Terence L.

  Needham, Richard

  Hill, James

  Neubert, Michael

  Hind, Kenneth

  Newton, Tony

  Hirst, Michael

  Nicholls, Patrick

  Hogg, Hon Douglas (Gr'th'm)

  Norrnanton, Tom

  Holland, Sir Philip (Gedling)

  Norris, Steven

  Hordern, Peter

  Oppenheim, Phillip

  Howard, Michael

  Oppenheim, Rt Hon Mrs S.

  Howarth, Alan (Stratf'd-on-A)

  Ottaway, Richard

  Howell, Rt Hon D. (G'ldford)

  Page, Sir John (Harrow W)

  Howell, Ralph (N Norfolk)

  Page, Richard (Herts SW)

  Hubbard-Miles, Peter

  Parris, Matthew

  Hunt, David (Wirral)

  Patten, Christopher (Bath)

  Hunt, John (Ravensbourne)

  Patten, J. (Oxf W & Abdgn)

  Hunter, Andrew

  Pawsey, James

  Hurd, Rt Hon Douglas

  Peacock, Mrs Elizabeth

  Jackson, Robert

  Percival, Rt Hon Sir Ian

  Jenkin, Rt Hon Patrick

  Pollock, Alexander

  Jessel, Toby

  Portillo, Michael

  Johnson Smith, Sir Geoffrey

  Powell, William (Corby)

  Jones, Gwilym (Cardiff N)

  Powley, John

  Jones, Robert (W Herts)

  Prentice, Rt Hon Reg

  Jopling, Rt Hon Michael

  Price, Sir David

  Joseph, Rt Hon Sir Keith

  Prior, Rt Hon James

  Kershaw, Sir Anthony

  Proctor, K. Harvey

  Key, Robert

  Pym, Rt Hon Francis

  King, Roger (B'ham N'field)

  Raison, Rt Hon Timothy

  King, Rt Hon Tom

  Rathbone, Tim

  Knight, Gregory (Derby N)

  Rees, Rt Hon Peter (Dover)

  Knight, Mrs Jill (Edgbaston)

  Rhodes James, Robert

  Knowles, Michael

  Rhys Williams, Sir Brandon

  Knox, David

  Ridley, Rt Hon Nicholas

  Lamont, Norman

  Ridsdale, Sir Julian

  Lang, Ian

  Rifkind, Malcolm

  Latham, Michael

  Rippon, Rt Hon Geoffrey

  Lawrence, Ivan

  Roberts, Wyn (Conwy)

  Lee, John (Pendle)

  Robinson, Mark (N'port W)

  Leigh, Edward (Gainsbor'gh)

  Roe, Mrs Marion

  Lennox-Boyd, Hon Mark

  Rossi, Sir Hugh

  Lester, Jim

  Rost, Peter

  Lewis, Sir Kenneth (Stamf'd)

  Rowe, Andrew

  Lightbown, David

  Rurnbold, Mrs Angela

  Lil ley, Peter

  Ryder, Richard

  Lloyd, Ian (Havant)

  Sackville, Hon Thomas

  Lloyd, Peter, (Fareham)

  Sainsbury, Hon Timothy

  Lord, Michael

  St. John-Stevas, Rt Hon N.

  Luce, Richard

  Sayeed, Jonathan

  755

  Shaw, Giles (Pudsey)

  Thorne, Neil (Ilford S)

  Shaw, Sir Michael (Scarb')

  Thurnham, Peter

  Shelton, William (Streatham)

  Tracey, Richard

  Shepherd, Colin (Hereford)

  Trippier, David

  Shepherd, Richard (Aldridge)

  Twinn, Dr Ian

  Sims, Roger

  van Straubenzee, Sir W.

  Skeet, T. H. H.

  Viggers, Peter

  Smith, Tim (Beaconsfield)

  Waddington, David

  Soames, Hon Nicholas

  Wakeham, Rt Hon John

  Speed, Keith

  Waldegrave, Hon William

  Spencer, Derek

  Walden, George

  Spicer, Jim (W Dorset)

  Walker, Rt Hon P. (W'cester)

  Spicer, Michael (S Worcs)

  Waller, Gary

  Squire, Robin

  Walters, Dennis

  Stanbrook, Ivor

  Ward, John

  Steen, Anthony

  Wardle, C. (Bexhill)

  Stern, Michael

  Warren, Kenneth

  Stevens, Lewis (Nuneaton)

  Watson, John

  Stevens, Martin (Fulham)

  Watts, John

  Stewart, Allan (Eastwood)

  Wells, Bowen (Hertford)

  Stewart, Andrew (Sherwood)

  Wells, Sir John (Maidstone)

  Stewart, Ian (N Hertf'dshire)

  Wheeler, John

  Stokes, John

  Whitfield, John

  Stradling Thomas, J.

  Whitney, Raymond

  Sumberg, David

  Wolfson, Mark

  Taylor, John (Solihull)

  Wood, Timothy

  Taylor, Teddy (S'end E)

  Woodcock, Michael

  Tebbit, Rt Hon Norman

  Yeo, Tim

  Temple-Morris, Peter

  Young, Sir George (Acton)

  Terlezki, Stefan

  Younger, Rt Hon George

  Thatcher, Rt Hon Mrs M.

  Thomas, Rt Hon Peter

  Tellers for the Noes:

  Thompson, Donald (Calder V)

  Mr. Robert Boscawen and

  Thompson, Patrick (N'ich N)

  Mr. Carol Mather.

  Question accordingly negatived.

  STATUTORY INSTRUMENTS, &c.
  Motion made, and Question put forthwith pursuant to Standing Order No. 79(5) (Standing Committee on Statutory Instruments, &c.)
  STATUTORY INSTRUMENTS, &c.

    WEIGHTS AND MEASURES
    That the draft Weights and Measures (Solid Fuel) (Carriage by Rail) (Amendment) Order 1985, which was laid before this House on 22nd February, be approved.
    Question agreed to.

    SOCIAL SECURITY
    That the draft Pneumoconiosis, Byssinosis and Miscellaneous Diseases Bmefit (Amendment) Scheme 1985, which was laid before this House on 22nd February, be approved. — [Mr. Sainsbury.]
    Question agreed to.

  WELSH GRAND COMMITTEE
  Ordered,
  That, during the proceedings on the matter of the consequences of the Budget and the Government's economic policies in Wales, the Welsh Grand Committee have leave to sit twice on the first day on which it shall meet; and that, notwithstanding the provisions of Standing Order No. 67 (Meetings standing committees), the second such sitting shall not commence before Four o'clock nor continue after the Committee t as considered the matter for two hours at that sitting. —[Mr. Sainsbury.]

PETITION

  Central Workshops, REME, Newark
  12.26 am
  Mr. Richard Alexander: I beg to ask leave to present a petition on behalf of Newark town council concerning the proposed closure of 33 Central Workshops, REME, in Newark.
  The petition reads:
  And your petitioner prays that your honourable House will (i) Urge the Secretary of State for Defence to reconsider his decision to close 33 REME Central Workshops and (ii) afford the hon. Member of Parliament for Newark the opportunity to speak thereon in the House.
  And your petitioner, as in duty bound, will ever pray.
  I do not oropose to address the House on the petition — I appreciate that that is not allowed on these occasions — but I assure the House that it has my unqualified support. I hope that, as the petitioner requests, time will be given for the matter to be debated in the House and for the responsible Minister to reply.
  To lie upon the Table.

Dulwich Picture Gallery
Motion made, and Question proposed, That this House do now adjourn.—[Mr. Sainsbury.]
12.27 am
Mr. Gerald Bowden: I rise on the Adjournment to draw attention to the financial plight of the Dulwich picture gallery.
The gallery, which houses a remarkable collection of very high quality works of art of international repute, is a living tribute to the public spiritedness of private patrons in the past. Indeed, it was a curious sequence of events which allowed this collection to be housed in Dulwich.
Noel Desenfans, between about 1750 and 1790, collected a number of pictures for the king of Poland. However, before the king could house them in Poland, he was deposed and the kingdom was abolished. The pictures remained in London and were eventually passed on to Desenfaus' friend, Francis Bourgeois, who was seeking a suitable place in which to house them where they could be used for public instruction, and so that young artists could look at the pictures and learn from the old masters of the past.
At this time, discussions took place with the Government of the day suggesting that they might like to house the pictures or make use of them. Unfortunately, in those days the request fell on deaf ears. I am sure that today the ears of the Government are more alert to the collection that we are discussing in this debate. The pictures were eventually housed in Dulwich. Interestingly enough, the founder of Dulwich college and the Alleyn's College of God's Gift Foundation, Edward Alleyn had himself built up a small collection of pictures. Those pictures had been augmented over the years, from 1630 onwards, and were housed in Dulwich college.
The bequest of Francis Bourgeois meant that the Dulwich collection was enhanced by a magnificant range of new works. A new gallery was built for them in about 1811, which became the first gallery to be open to the general public. It was established some 10 years before the National gallery.
That bequest is a matter of great pride to Dulwich. There is great pride in a possession which is there not on a limited parochial basis, but which forms an international collection which we are proud to house in my constituency. It consists of 650 works of art, about 350 of which are on view. They are mainly 17th and 18th century paintings of high quality.
The gallery has about 25,000 visitors a year. It is run on a very limited staff and budget. The number of full-time staff amounts to a mere eight. The cost of running the gallery is about £105,000 per annum. Of that, about £58,000 is contributed by the foundation of the Alleyn's College of God's Gift. The foundation supports three schools almost entirely, and several other charitable foundations. The amount that can be contributed towards the gallery is strictly limited by the Charity Commissioners. There is no opportunity to expand resources from that source.
The shortfall of about £47,000 is made up in a variety of ways. There are several investments. The GLC has given a grant of £6,500 per annum. There are also admission fees to the gallery, and several special fundraising events. But I should like, in particular, to allude to the work of the Friends of the Dulwich Gallery. That
758
is a very lively body of volunteers and friends who contribute not only financially to the membership of the friends, but in terms of time and service in helping to maintain the gallery. They sell postcards, conduct tours, arrange flowers and generally do all that is necessary to make the gallery as secure as it can be through their voluntary help. They also organise several fund-raising events, including concerts and lectures in the gallery, and so on.
That means that the gallery is not just a dead picture gallery, but is a lively home where many cultural activities take place. It is perhaps interesting to note that the Minister's predecessor, my right hon. Friend for Southend, West (Mr. Channon) — now Minister for Trade—was enrolled as the thousandth member of the gallery when he visited it in 1983. I wonder whether any other Ministers feel that they, too, in that personal way, want to join the Friends. They would be most welcome.
One of the main problems about the future of the gallery is that it lacks any financial security or endowment. Under its imaginative and energetic director, the gallery has plans to extend its present range of activities and to develop its potential as a cultural centre, educational base, and a leisure-tourist attraction in south-east London. In order to fulfil those plans, it is necessary to have some endowment to ensure the gallery's security. Unfortunately, a Rembrandt has been stolen on, I think, no less than four occasions. There is a feeling that it has now gone for good. It may not have been destroyed; it may be secretly gloated over in solitude somewhere. The necessity for security is very real and important.
We also need to improve the maintenance of the buildings. Facilities should be provided for organised school parties in order to improve the educational role. There must be some augmentation and adaptation of the buildings. A building works plan is needed.
Publicity is needed. Recently an education officer has been appointed whose responsibility is to contact schools so that the gallery may be thought to be a place of excitement where people can learn and enjoy themselves. It is necessary to approach the matter on more than an educational wavelength. We must publicise the gallery on a wider front. That also costs money.
Mr. Toby Jessel: I very much enjoyed visiting the gallery last month when I saw a most impressive collection of paintings. My hon. Friend said that 25,000 people a year visited the gallery. Does that figure include the increasing number of school parties?
Mr. Bowden: The figure includes school parties for the current year. It is hoped that with the development of opportunities for school children to visit the gallery, with an education officer to cater for their needs, the number of visits by school children could be greatly increased. We see a potential for educational purposes in south-east London. That would be of benefit.
The gallery and its friends are conscious of the need to raise an endowment of about £500,000. An appeal committee was formed, under the vigorous leadership of Mr. Peter Bowring, which in March 1984 launched that £500,000 appeal.
A number of fund-raising events and enterprises have been organised in the last year to tap the good will and financial resources of those who wish the gallery well. Indeed, Mr. Speaker organised a reception in his

759
apartments here for those interested in the appeal. That was a great encouragement and boost to the morale of the appeal committee and assisted in raising money.
We are now a year into the appeal and almost half the sum sought has been raised. About £225,000 has been raised to date. A number of fund-raising events are due to take place. Twenty-six pictures are being sent on tour in the United States to stimulate interest and to ensure that there is an awareness of Dulwich in Washington and Los Angeles, and from coast to coast.
I urge the Government to support the Dulwich gallery. We have support in goodwill and general will wishing. But a token of financial support to show that the Government see this as an important aspect of our heritage would boost and encourage the commitment of those who are raising money in other ways. I ask the Government to consider this seriously and to give support to the Dulwich picture gallery.
12.38 am
The Parliamentary Under-Secretary of State for the Environment (Mr. William Waldegrave): I am delighted to be able to respond to this short debate. I congratulate my hon. Friend the Member for Dulwich (Mr. Bowden) on raising a topic which is of importance not only to his constituency and to all the south London constituencies but to Britain's heritage. He was correct to say that the gallery opened before the National gallery. It can claim to be the oldest picture gallery in the country.
My hon. Friend gave a full and interesting account of its origins and of the great man, Edward Alleyn, who left an endowment which has done so much good in many other areas, above all in the great schools funded by his foundation. He recounted the contribution of Sir Francis Bourgeois and listed the great pictures now to be found in the gallery. Indeed, the gallery is in a fine building designed by Sir John Soane, whose own house in Lincoln's Inn Field is another interesting museum.
Most of the charity from which the gallery derives its income is devoted to the schools. It is understandable that in recent years mounting costs have taken their toll. The gallery has sought other income — from investments, catalogue sales, commissions, charges and a small grant from the GLC. It has been doing what it can to meet the ever-mounting costs that such a collection must incur.
My hon. Friend mentioned the sad tale of the wandering Rembrandt whose return we hope to see. Lady Bracknell might have some remark to make about the loss, four times, of the Rembrandt. It clearly shows the need to expend money on security arrangements, sad as that might be.
My hon. Friend rightly mentioned that those who have held the post of arts Minister have shown their commitment to the gallery. The late Lord Wolfenden in 1982 first approached my right hon. Friend the Member for Southend, West (Mr. Channon), then the Minister with responsibility for the arts, about the plight of the gallery. My right hon. Friend became the 1,000th friend of the gallery. I should be delighted to join the list of friends. My hon. Friend did not mention the minimum donation, so I
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might be incurring serious expenditure. I follow the suggestion of my noble Friend Lord Bruce-Gardyne who recommended that Government Ministers should be impelled to support projects on which Government money was expended. He thought that it would improve the quality of Government investment. It is a stimulating idea. I am perfectly willing, in this small matter, to put my money where my mouth is and to join the interesting list of friends of the gallery. Perhaps my hon. Friend will arrange for the necessary paperwork to be sent to me.
Sir Antony Buck: I am glad to hear that my hon. Friend is to contribute to the gallery. Others who have not done so already might also do so. I understand that the charity is called "Of God's Gift", and now it is to be of ministerial gifts also. Many of us hope that there will be a generous contribution from the Government to ensure the future of the gallery in its superb building.
Mr. Waldegrave: I know that my hon. and learned Friend has close family links with the gallery. I do not know whether I am in danger of making jokes in bad taste, but of God's gifts the Lord will provide and a noble Lord is involved in this.
I am pleased to see that my right hon. Friend the Member for Worthing (Mr. Higgins) is present. He is a governor of the foundation. I am delighted to announce that my noble Friend has agreed to make available, out of the special grants budget of the Office of Arts and Libraries, a special contribution to the appeal. It is well known that the principal burden of running the great museums falls on the recurrent budget of the Office of Arts and Libraries, but my noble Friend has some relatively restricted funds available to help with special appeals. He has authorised me to say that the Government will contribute £25,000 to bring the appeal up to and perhaps a little past the halfway mark, which I hope will be symbolic of the Government's commitment and will help towards achieving the final appeal level.
I wish the very distinguished committee—on which not only Mr. Speaker but many other good friends of the arts in the House are represented—well in completing the second part of the appeal and congratulate those involved on their vigour in taking action themselves to help the future of that great museum.
I should add that it may be worth the appeal committee's while to investigate my noble Friend's business sponsorship scheme under which matching grants are available for sponsorship. It might not fit so well with a simple grant to the fund, but a matching sponsorship grant might be relevant to some part of the gallery's work.
With that little bit of advice, with thanks to my hon. Friend the Member for Dulwich for raising this important subject and with very strong good wishes and hopes for the future of this important gallery, I am delighted to have been able to respond to this short debate.
Question put and agreed to.
Adjourned accordingly at fifteen minutes to One o'clock.

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Preamble
The House met at half-past two of the clock: The LORD CHANCELLOR on the Woolsack.
Prayers—Read by the Lord Bishop of Lincoln.

Building Industry: Statutory Requirements
Lord Dean of Beswick: My Lords, I beg leave to ask the Question standing in my name on the Order Paper.
The Question was as follows:
To ask Her Majesty's Government whether they have any plans to deal with people operating in the building industry who do not observe the statutory requirements.
Lord Skelmersdale: My Lords, the Government are always concerned to ensure that all those in the building industry fully comply with their statutory duties. However, assuming that the noble Lord's concern in asking this Question is fiscal, Her Majesty's Government are deploying more staff and simplifying the system to reduce tax evasion.
Lord Dean of Beswick: My Lords, I am grateful to the noble Lord for that reply, but is he aware that calculations are that last year in total householders in this country spent on building extensions and improvements to their homes approximately £5 billion and that £2 billion of that was on the black economy, resulting in a loss of £800 million in income tax to the Chancellor of the Exchequer? Can he give an undertaking that this type of thing will be looked at with the utmost thoroughness in order to recoup such money at a time when local authorities are having their own money withheld from them which could be used for building purposes?
Lord Skelmersdale: Yes, my Lords, I fully agree with the noble Lord. Tax evasion is a very serious problem. As I said in my original Answer, we are taking steps to deal with it. In the past two years an extra 400 staff have been redeployed by the Customs and Excise and in the period from 1979 to 1988 approximately 1,700 additional Revenue staff will have been redeployed in local tax offices, the PAYE audit force and the board's investigation office on anti-evasion work to combat the black economy, which, as I said, is a very serious problem.
Lord Broxbourne: My Lords, in the context of the Question of the noble Lord opposite, will Ministers continue their support for the work of the National Housebuilding Council and, where possible, reinforce it in prescribing suitable standards of house building and construction, particularly in view of their new status and responsibilities accorded under recent legislation?
Lord Skelmersdale: Yes, my Lords, I am most certainly ready to praise the work of the National Housebuilding Council, and the Government are fully
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in accord with the work that it is seeking to do, especially its recently announced insurance work.
Viscount St. Davids: My Lords, when my noble friend uses the word "redeployed", does he mean that extra staff have been taken on or that these people have been taken from work elsewhere? Can he, if possible, in that case tell us where they have been taken from?
Lord Skelmersdale: My Lords, I understand that the Customs officers to whom I referred are extra staff, whereas the 1,700 additional Inland Revenue staff will have come from other posts. But the point is that their great knowledge and experience will be brought to bear on this problem in those areas, whereas before they were more widely deployed, if I may use the word.
Lord Graham of Edmonton: My Lords, is the Minister aware that action by his department in these matters will be applauded by all legitimate builders and building organisations such as the Institute of Maintenance and Building Management, the Building Employers' Confederation and the Federation of Master Builders? Will he bear in mind that what are required are incentives to comply with the taxation system and that what we do not want to see in the Budget this year is that which appeared last year—the imposition of VAT on building extensions, which certainly led to an increase in cowboys and the black economy syndrome?
Lord Skelmersdale: My Lords, I cannot pre-empt my right honourable friend's Budget Statement tomorrow, but last year's Budget brought an equalisation of tax effects between VAT and other taxes—for example, income tax and corporation tax—so I do not think that the noble Lord is right in saying that it was all bad.
Lord Graham of Edmonton: It increased the black economy, my Lords.
Lord Bruce of Donington: My Lords, will the noble Lord confirm that he understood the phrase, "statutory requirements", in the Question tabled by my noble friend to include the observance of safety standards and other such matters?
Lord Skelmersdale: Yes, my Lords, I am well aware of that, and it also includes training. So far as health and safety are concerned, the Factory Inspectorate deploys about 90 inspectors on construction works. They visit sites and head offices of all sizes of construction firms. They have substantial powers, including powers in magistrates' courts, against firms and individuals who seriously contravene legal requirements. Their effort will be continuous, especially in the small firm sector where there is a particular problem.
Lord Diamond: My Lords, when the noble Lord said in reply to the supplementary question of the noble Lord, Lord Dean, that he fully agreed with him, did he mean that he was endorsing the estimates of the extent of black market tax evasion? If not, what is his estimate?
Lord Skelmersdale: My Lords, I have no personal estimate, but Sir Lawrence Airey has estimated that it is between 6 and 8 per cent. of gross domestic product. If it was 7 per cent. of last year's GDP, the tax loss on that sum could have been as high as £6 billion. The £800 million to which the noble Lord, Lord Dean, referred is a particular amount for those people who have been—dare I use the phrase?—quasi-identified. In other words, it is what we actually know is going on. The other figures are gross estimates.
Lord Dean of Beswick: My Lords, may I ask the Minister whether it is not also a fact that there are other statutory financial obligations that this kind of builder is escaping, such as NHI contributions, training board levies, and so on? The £800 million about which I am talking is only part of a wider picture.
Lord Skelmersdale: Yes, my Lords, that is absolutely right. By definition the term "cowboy" means that the people in question are operating outside the law. The great worry is that by tightening the law in this respect you will increase the cowboy element.

Russia Committee: Records
2.44 p.m.
Lord Gladwyn: My Lords, I beg leave to ask the Question standing in my name on the Order Paper.
The Question was as follows:
To ask Her Majesty's Government why it is not possible to make available for public inspection the conclusions and recommendations of the Russia Committee of the Foreign Office for the period of Lord Gladwyn's chairmanship (1948–49).
The Minister of State, Foreign and Commonwealth Office (Baroness Young): My Lords, a number of the 1948 and 1949 papers of the Russia Committee fall within the terms of the general approval given by the Lord Chancellor in 1967 for the retention within Government departments of records relating to security and intelligence matters for longer than 30 years. The question of the release of records which interest the noble Lord was reviewed in 1982 and again in 1984 by two of my ministerial colleagues at the Foreign and Commonwealth Office. Both were unable to find grounds to vary the original decision to withhold these records.
Lord Gladwyn: My Lords, while thanking the noble Baroness for that not unexpected reply, may I ask her two very short supplementary questions? In the first place, is it not perhaps a little absurd not to allow the chairman of what was, after all, the first—and, I think, very successful—policy planning body of the Foreign Office, at any rate to refresh his memory of recommendations and conclusions of that body, more especially if he gave an assurance that he would never make any use of or refer in any way to these papers without the consent of the Foreign and Commonwealth Office? However that may be, since, as I think I recall, there were normally representatives
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of MI5 and MI6 on this committee, including, from time to time, I rather suspect, the notorious Soviet agent Mr. A. R. Philby himself, would it not be desirable for the Government to recommend searchers after truth, and historians generally, to have recourse to the Ministry of Foreign Affairs in Moscow, where the documents would presumably be readily available?
Baroness Young: My Lords, of course I note what the noble Lord, Lord Gladwyn, has said. As he will appreciate, access to papers retained under the provisions of the Public Records Act 1958 is permitted only to those who need to see them for official purposes. Perhaps I may say that over the past 18 months my department has done its best to be as helpful as possible to the noble Lord, and my Ministerial colleagues in the Foreign Office have held a very extensive correspondence with him. With regard to his second supplementary question, I think that he has answered it himself.
Lord Cledwyn of Penrhos: My Lords, I should be grateful if the noble Baroness would make this clear. Is she saying that the noble Lord, Lord Gladwyn, cannot now have access to papers of a committee of which he himself was chairman, even if he makes plain and gives an undertaking, as obviously he would, and as he could on Privy Council terms, that if the Foreign Office so decides, he will not impart any of the information he obtains?
Baroness Young: My Lords, the answer to the question of the noble Lord, Lord Cledwyn, is as I have already given it to the noble Lord, Lord Gladwyn. It is a question of the law and what is allowed under the Public Records Act 1958.
Lord Thomas of Swynnerton: My Lords, bearing in mind that some papers in this series, including the terms of reference, are in the public domain, would it not be possible for the Government to consider a technique practised in the United States, where, when there are papers which would otherwise be available but which contain items or names which even now it would be considered undesirable to reveal, the Government can suppress those items and those names by means of blacking them out?
Baroness Young: My Lords, I note what my noble friend has to say on this matter. Of course what is right for the United States is not necessarily right for us. However, perhaps he would agree that it would be wrong to tamper with a historical record.
Lord Paget of Northampton: My Lords, did the noble Baroness say that there had already been an "eccentric" correspondence with the noble Lord, Lord Gladwyn, on this subject, or did I mishear her?
Noble Lords: Extensive.
Lord Paget of Northampton: Oh, "extensive". I thought she said "eccentric"; it sounded much more realistic. When the noble Baroness replied she said the Government could not vary their position. Apparently she was then talking, as the Question indicated, about

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general publication. It now emerges that what has been asked is that the noble Lord, who is an ex-ambassador, and the man who drew up this report, should be allowed to have a look at his own report. How in heaven's name does that affect this country's security? This has reduced the whole thing to a farce.
Lord Gladwyn: Hear, hear!
Lord Paget of Northampton: My Lords, surely there should be a little revision here?
Baroness Young: My Lords, I do not think I have anything further to add to what I have already said to the House.
Lord Morris: My Lords, if the noble Lord in question had made his own notes at the time, this Question would not arise at all.
Lord Kennet: My Lords, one appreciates that the question is very complex, but can the noble Baroness say anything about the differences which appear to exist in the regulations affecting first, ex-Ministers; secondly, ex-ambassadors who wish to look at their own ambassadorial papers; and, thirdly, ex-ambassadors such as my right honourable and noble friend who want to look at their own old papers written before they became ambassadors? If the differences are as wide as I think they are, is it not verging on the absurd?
Baroness Young: My Lords, I cannot give the detailed information that the noble Lord, Lord Kennet, seeks without notice; but the position with regard to the release of papers is of course as I have described it in two supplementary answers that I have given.
Lord Mayhew: My Lords, is the noble Baroness aware that the proceedings of this Committee of which I, too, was a member would not have been reported to Moscow by Mr. Philby? This task would have been entrusted to Mr. Guy Burgess whose work was very closely associated.
Baroness Young: My Lords, I am very glad that the noble Lord. Lord Mayhew, can regard as a joke what may have happened with those two people in question.
Lord Diamond: My Lords, the House is obviously very concerned with what the noble Baroness is saying. I am a little concerned about her statement that she cannot refer to the answer in detail with regard to the difference between Ministers and senior diplomats. Will the noble Baroness accept from me, without bothering about the detail, that a Minister is fully entitled to look at his own papers at the time he was a Minister? Why then should there be this extraordinary difference between a Minister and a senior diplomat?
Baroness Young: My Lords, I did not say that I would not answer the question. I said that I could not answer a detailed question like that without notice. That is quite a different matter. I have described the position as it exists.
Lord Teviot: My Lords, as I have had the privilege of serving on the Lord Chancellor's advisory council on public records for nine years, would my noble friend confirm that the Act of 1958 relates to the 50-year rule while the 1967 Act relates to the 30-year rule? Is she aware that if the noble Lord, Lord Gladwyn, referred himself to the Master of the Rolls, the chairman of that committee, and asked for a review of the situation, he might fare slightly better? That is the rule of this country. It is the rule of the land. Equally, will my noble friend confirm what I think is the case—that no post-tzarist regime records are available in Moscow, which explains why, every January, Russians come here to see what we have opened up after 30 years?
Baroness Young: My Lords, it would be unwise of me I think to comment on what may or may not be Russian practice. I can confirm that if the Lord Chancellor wishes for a further opinion about the retention of records by the department, he may arrange for the Secretary of the Cabinet to look into the matter and advise him.

US Arms Supplies: Representations
2.52 p.m.
Lord Molloy: My Lords. I beg leave to ask the Question standing in my name on the Order Paper.
The Question was as follows:
To ask Her Majesty's Government whether they will consider making representations to the United States about arms supplies to Right-wing organisations and governments in South America and in the Middle East.
Baroness Young: My Lords, sales of arms, except to the Warsaw Pact countries and certain other destinations, which are subject to multilaterally agreed control, are a matter for national governments within their obligations under international law. In cases where arms sales by the United States might threaten United Kingdom interests, we naturally make our views known to the United States Government.
Lord Molloy: My Lords, while I thank the noble Baroness for that reply, is she not aware that some extreme Right-wing countries and extreme Right-wing guerrilla organisations have been guilty of the most appalling atrocities wrought upon ordinary people with arms supplied by the American Government? Is she aware that one classic example is Guatemala, where, after the butchering of tens of thousands of Indians with arms supplied by the United States, aid was stopped by President Carter but has now been restarted by the present administration? In so far as this constitutes a very serious threat to Belize which must involve the British Government, should we not continue protestations about this awful behaviour of the American CIA which is damaging their country and many other free nations as well?
Baroness Young: My Lords, the United States Government are well aware of our concern about the possible consequences of military aid to Guatemala,

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not least for the British garrison in Belize. We continue to keep in close touch with the United States Government about this matter.
Lord Bottomley: My Lords, would not the Minister agree that Israel is the only truly democratic country in the Middle East? Is she aware that Israel is prepared to give technical skill and economic aid to all the countries in the Middle East to make the area really prosperous? Are these not additional reasons for meeting the request of my noble friend Lord Molloy?
Baroness Young: My Lords, on the specific question that the noble Lord, Lord Molloy, has asked, the sale of arms by the United States to any country is of course basically a question for the United States Government.
Lord Avebury: My Lords, will the noble Baroness confirm that our Government have expressed themselves in favour of the Contadora process on several occasions and that one element in that process is that none of the countries in the region of Central America should allow its territory to be used for acts of aggression against a neighbour? If that is so, will the Government not make strong representations to our friends in Washington that they should desist from arming terrorists who are using the countries of Honduras and Costa Rica for their terrorist actions against the people of Nicaragua?
Baroness Young: My Lords, I can confirm that we support the Contadora process, but we share with the United States administration the common objective of a peaceful settlement in Central America; indeed, on Contadora principles. There is a need for restraint on all sides in the present situation. In particular, we want Nicaragua to end the substantial build-up of arms, troops and foreign military advisers and to stop supporting attempts to destabilise neighbouring democratic governments.
Lord Kennet: My Lords, the Minister of State says that when we think that American arms exports will hurt our interests, we let the United States administration know. She has mentioned Guatemala. Can she tell the House of any other countries where we have made such representations?
Baroness Young: My Lords, we have made our position clear in regard to arms sales to Argentina.
Lord Molloy: My Lords, will the noble Baroness not agree that my original Question simply asked our Government to consider making representations on the evidence that is available to them? Only a few weeks ago, for example, the United States arms control and foreign policy caucus in Congress condemned United States policy and said that those responsible in that sphere were misleading the United States Congress as well as the United States people. Should we not give them our support by making representations? Or can the Government at least consider making representations to the United States on the basis of these reports?
Baroness Young: My Lords, as I have indicated, we have made representations. On the particular point about Guatemala, we most recently expressed our concern about military aid by voting in favour of a resolution adopted at the United Nations General Assembly in December 1984 which called on Governments to refrain from supplying arms or other military assistance to Guatemala so long as serious human rights violations continued.
Lord Molloy: My Lords, I agree with the noble Baroness on what she says about Guatemala. She is absolutely correct. What the American foreign affairs committee complained of was the behaviour of the American CIA under someone's command in El Salvador. Does she not think it is worth making representations about that?
Baroness Young: My Lords, I have indicated the Government's view on these matters. I do not think that there is anything further that I can add.

Chemical Weapons: Public Protection
2.58 p.m.
Lord Mottistone: My Lords, I beg leave to ask the Question standing in my name on the Order Paper.
The Question was as follows:
To ask Her Majesty's Government when they hope to issue civil defence guidelines on detection, warning and protective measures against chemical attack.
The Minister of State, Home Office (Lord Elton): My Lords, in the absence of a ban on chemical weapons, we are considering the questions of detection and warning of chemical attacks and protective measures against them. It is too early to say when this will be completed, but I shall of course keep your Lordships informed of progress.
Lord Mottistone: My Lords, in view of the fact that the Soviets have over a quarter of a million tonnes of chemical munitions, is it not a matter of importance that we should have the report to which my noble friend I think referred, accelerated? Therefore guidance can be given to local authorities combining protection for the public against chemical attack in the general consideration of their civil defence activities which they are now taking on.
Lord Elton: My Lords, it is important that we should have the report. However it is also important that the report should be right and that the guidance should be accurate and capable of being implemented. In view of the extent of the work needed and the variety of sources to be consulted, I am not able to give a date for the report.
Lord Jenkins of Putney: My Lords, does the noble Lord agree that in regard to chemical weapons—indeed, the same may apply to some other weapons as well—it is somewhat difficult to know whether the research and development that is being carried out is being carried out for defensive or offensive purposes?

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In the event of the Government unhappily deciding to proceed any further in this matter, will they draw a sharp distinction between defensive preparations and any suggestion of offensive preparations?
Lord Elton: My Lords, there is no question of our using defensive research for offensive purposes.
Lord Mayhew: My Lords, does the noble Lord agree that the likelihood of chemical attack is somewhat greater than the likelihood of nuclear attack? Are the Government not giving too much priority to defence against nuclear attack as compared with defence against chemical attack?
Lord Elton: My Lords, without wishing to claim expertise in the matter, I think I am right in saying that the chemical weapon is generally more likely to be used in battlefield conditions. Of course, if there was a battlefield in the United Kingdom then the civilian population would in any case be exposed.
Lord Renton: My Lords, have not even the peacetime disasters shown that the most terrible damage can be done on a wide scale by chemical attacks, explosions and so on? Can my noble friend say whether the NATO defence committee, of which we are members, is taking any steps in this matter by way of research and advice and protection?
Lord Elton: My Lords, the Civil Defence Committee of NATO is developing guidelines on a wide range of civil defence matters, among them methods for the protection of the civil population against the effects of modern weapons.
Lord Mottistone: My Lords, is my noble friend able to tell us whether the recommendations from NATO will be part of what is put together as recommendations to local authorities by his department?
Lord Elton: My Lords, I am not certain what the process of assembly will be, but I can assure my noble friend that what is recommended will be congruent with that advice.
The Earl of Onslow: My Lords, I should like to ask whether any element of chemical warfare was built into the recent exercises which were carried out concerning defence against notional nuclear attacks. Surely it would not be wise to assume that chemical warfare would not be used and that only nuclear warfare would be used. Should we not amalgamate the amount of civil defence that is required to apply to both categories of warfare?
Lord Elton: My Lords, I am not familiar with the entire programme of the recent exercises, but I can assure my noble friend that we are not unaware of the extent of the threat of chemical weaponry, of which, as my noble friend Lord Mottistone has reminded us, the Soviet Union retains a considerable quantity, and also the capability of delivery.

Future Business
3.3 p.m.
Lord Denham: My Lords, at a convenient moment after 3.30 this afternoon my noble friend Lord Glenarthur will, with the leave of the House, repeat in the form of a Statement an Answer to a Private Notice Question in another place on cervical screening.
It may be for the convenience of your Lordships if I make a short statement about the re-arrangement of certain items of business this week. The Report stage of the Administration of Justice Bill, which in the event was not finished last Thursday, will now be concluded as first business tomorrow. In consequence, the Committee stage of the Trustee Savings Banks Bill, which was to have taken place tomorrow, will now be taken as first business next Thursday. Finally, I should mention that the Committee stage of the Land Registration and Law of Property Bill will not now be taken this afternoon, and no alternative date has yet been fixed.

Lerwick Harbour Order Confirmation Bill
Brought from the Commons; read a first time, and (pursuant to the Private Legislation Procedure (Scotland) Act 1936) deemed to have been read a second time, and reported from the Committee.
Reserve Forces (Safeguard of Employment) Bill [H.L.]
Report received.
Shipbuilding Bill
Read a third time, and passed.

Local Government (Choice of Electoral Systems) Bill [H.L.]
3.5 p.m.
Lord Blake: My Lords, I understand that no amendments have been set down to this Bill and that no noble Lord has indicated a wish to move a manuscript amendment or to speak in Committee. Therefore, unless any noble Lord objects, I beg to move that the order of commitment be discharged.
Moved, That the order of commitment be discharged.—(Lord Blake.)
On Question, Motion agreed to.

Immobilisation of Vehicles illegally parked (London Boroughs of Westminster, and Kensington and Chelsea) (Continuation) Order 1985
3.6 p.m.
Lord Brabazon of Tara Lord Brabazon of Tara rose to move, That the draft order laid before the House on 25th February be approved. [14th Report from the Joint Committee.]
The noble Lord said: My Lords, this order will continue the police powers to clamp illegally parked vehicles in central London until May 1987. Your Lordships will recall that the wheelclamp powers were introduced at the request of the police to provide them with an additional tool to combat illegal parking. This, in central London in particular, was seriously impeding traffic flow and making it difficult for lorries to load and unload goods and for law-abiding motorists to find a legal parking space.
Your Lordships will also recall that when the wheelclamp powers in the Transport Act 1982 were under consideration in this House we made provision for an initial, two-year experiment in an area to he designated by order. My right honourable friend the Member for Guildford, the then Secretary of State for Transport, subsequently designated an experimental area consisting of parts of Westminster and Kensington and Chelsea. The area chosen was one where the problem of illegal parking was causing most concern. The experimental order expires on 15th May, and the approval of both Houses is needed if the police powers are to be continued.
As many of your Lordships will know, the Transport and Road Research Laboratory was asked to undertake a "before and after" survey of the effects of clamping. The laboratory's report examined the first six months' experience of clamping, and was published in October 1984. The TRRL report concluded that, following the introduction of clamping, compliance with parking regulations improved. The time taken up by illegal parking on yellow lines fell by 40 per cent. and that in residents' bays by 30 per cent. Traffic speeds increased, with implied annual savings in motorists' costs of £9 million to £15 million at 1979 prices, plus savings of £2 million to £3 million on fuel and wear and tear on vehicles. The laboratory thought that the reductions in illegal parking were probably due to the visual impact of the clamp and its consequent deterrent effect on other drivers.
My right honourable friend the Secretary of State for Transport consulted widely on these TRRL findings and the response was substantially in favour of continuing the use of wheelclamps in central London for at least a further period, so as to assess the effects over a longer period of time. Of 34 responses from individuals, firms and official organisations, 26 favoured continuation at least for a longer period, only five were against clamping, and the other comments were neutral. The responses to my right honourable friend's consultations very much welcomed the reductions in illegal parking with the consequent easing of problems for delivery drivers and for residents, and the improvements in road safety and traffic flow.
However, concern was expressed in some of the responses about the effects on trades such as service engineers; the possible deterrent effect on shoppers; the severity of the penalty; the fact that an illegally parked car might be present for longer as an obstruction if clamped than it would otherwise; and the possible damaging effect on the relations between the public and the police.
Your Lordships will recall that several of these factors were debated when this House was considering wheelclamps in 1982 during the passage of the clamping powers. Particular fears were expressed then, for example about the harm which might be caused to relations between the public and the police. I can reassure your Lordships that the fears have proved largely groundless. The police have carried out clamping with care and sensitivity, and it is doubtless largely due to this that clamping has on the whole been accepted by the motoring public without the dire effects that some people predicted three years ago.
Your Lordships may also recall that in our 1982 debates much concern was expressed that clamping should be used against persistent offenders and against diplomats. It would not he appropriate for the police to concentrate solely on persistent offenders, as they must deploy their resources where this will produce most benefit in terms of traffic conditions. However, many such motorists have in fact been clamped as outlined by my honourable friend the Minister of State for Transport in another place last Tuesday.
As regards diplomats, it was very disappointing when we had to suspend clamping diplomatic vehicles because of legal advice that this was in fact contrary to the Vienna Convention on diplomatic relations. The Government therefore urgently reviewed the problem of the number of diplomatic vehicles in London and my noble friend Lord Elton announced changes in the system of special "D" and "X" registration plates designed to reduce the number exempted from parking regulations. Immunity from clamping is now restricted to vehicles with "D" registration plates and these are limited to those diplomats with full immunity; the number of "D" plates issued has also been curtailed both for cars used officially and for diplomats' private vehicles. Those not entitled to full diplomatic immunity, but only to immunity when on official duty, now receive "X" registration plates and are liable for clamping. Forty such vehicles were clamped in the last quarter of 1984.
More generally, however, the Government remain concerned about the number of fixed penalty notices cancelled on grounds of diplomatic immunity. This is being taken into account in the current review of the Vienna Convention, its operation and enforceability, and as a result it is hoped to tighten up measures to deal with parking offences by diplomats.
The TRRL research on the effects of clamping could not of course predict the extent to which the welcome improvements in parking compliance and journey speeds would persist in the longer term. Various organisations who wrote to my right honourable friend took this point up and suggested that a further period of assessment was needed before any firm decison could be taken about the use of clamps on a permanent basis. The Government are mindful of the

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strong arguments that have been advanced both for and against clamping. Any decision on such a drastic measure should only be taken with great care. But we believe from the results so far that a two-year extension of the present order is justified. This will enable the effects of clamping to be further assessed, with further monitoring from the Transport and Road Research Laboratory.
If your Lordships' House approves this continuation order—as the other place has already done—traffic authorities will be able to apply to my right honourable friend the Secretary of State for Transport for the use of clamps to be extended by order to other areas. If any such requests are received, my right honourable friend will consider them on their merits in the light of the traffic and parking situation in the areas concerned and taking into account the resources and back-up needed; that is, the police manpower, the vehicles, the pounds, etc.
Wheel clamping has so far been shown to be a useful means of complementing existing methods of enforcement—that is, the issue of fixed penalty notices and towing away. As with vehicle removal charges, the clamp fee is designed to cover police costs. As explained by my honourable friend the Minister of State for Transport in another place, the present declamping fee of £19·50 is based on an estimate of costs made before the start of the experiment. The fees for both clamping and vehicle removal have recently been reviewed and as announced by my honoruable friend, it is likely that the clamping fee will have to be increased from £19·50 to £25 and the removal charge by a broadly proportionate amount. My right honourable friend the Home Secretary will be consulting on the new charges proposed. The fee to be charged is not part of the present order and will be covered by a subsequent order to be laid before your Lordships' House.
I should like now to turn to the more positive side of the Government's approach. It is not enough just to punish those who flout the parking regulations. We need to see that the legitimate demand for parking spaces in central London is met and that ways are found to improve mobility in central London generally. We need to try to find better ways to help all road users go where they need to and better ways to ensure that motorists pay for the space they use when they park on the highway. My right honourable friend intends to tackle these urgent issues and encourage local authorities to adopt a positive approach to these problems.
I applaud Westminster City Council's initiative, as outlined by my honourable friend the Minister of State for Transport in the other place last week, in identifying nearly 1,400 extra on-street spaces which can be created by converting unnecessary yellow lines into parking spaces, and the further steps they are now taking.
The clamping powers were introduced by the Government only after the most careful consideration. It seems from the initial results that clamping has shown real benefits in reducing illegal parking and improving traffic conditions. The extension of the powers for a further two years will allow a further period of assessment before a final decision is taken. It
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will also enable further work to be done on ways of improving mobility in central London and new parking arrangements, as well as assessing methods of enforcement.
Meanwhile the police must be given every support in their efforts to restore respect for parking regulations. Clamping has assisted them and I ask your Lordships to approve the order.
Moved, That the draft order laid before the House on 25th February be approved.—(Lord Brabazon of Tara.)
3.16 p.m.
Lord Carmichael of Kelvingrove: My Lords, I thank the Minister for his careful explanation of the order and for the valuable information which he gave us when introducing it. An order on a subject such as this is understandable to most Members because we nearly all drive and move around London. Indeed, we must perforce come to Westminster and in the course of doing so we see the traffic conditions. Such an order gives us the opportunity to review the problems and to ask the Minister some questions, many of which he has already answered.
The problems arise in any city, but especially in London and the very heart of the City of London. Throughout London there is the great problem of just how much on-street parking should be allowed and can be allowed. I was very glad to hear the Minister's concluding remarks which he told us how Westminster City Council has identified 1,400 new parking places. That is very important. However, a number of questions arise. The major question which always arises whenever parking—both on-street and particularly off-street—is discussed, is how may people actually need to bring cars into central London every day and how much control there can be over it. That is not a criticism merely from this side of the House, which used to have the reputation—but I hope that it has not now—of being anti-motorist. It is very important to recognise that we are just as involved as everyone else in trying to get a good deal for the motorist.
I was a Member of the Select Committee which dealt with this problem and it became very obvious that the commercial interests in London were very concerned about the problem of street parking. In the old days it was merely a case of making provision for the loading and unloading of goods in the central area and also making provision for the fire brigade and the ambulance service to be able to get in and out. However, a new dimension has arisen particularly with the construction of high rise office blocks, hotels and so on. That point was brought home very forcibly by the Chamber of Commerce and by various other business interests in the centre of London. They made the point that there must be a free flow of traffic to give access to maintenace engineers because there is the particular problem of lifts. Perhaps even more important nowadays, we must bear in mind that the automation of offices is reaching the stage where there could be a very big breakdown, and maintenance and repair staff must be able to get through very quickly or a whole section of the office community will be put out of business. That could lead to great difficulties.

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When the original order was brought forward a point was made about untaxed vehicles. The noble Lord, Lord Elton, on 15th December 1983 at col. 344 said:
"As to widening the experiment to cover untaxed vehicles, again I can say that when a vehicle is clamped and found to be untaxed, it means big trouble for the owner".
Will the Minister either now or later let us know whether there has been any real advance in the tracing of untaxed vehicles since the introduction of clamping?
The Minister was slightly shy when he spoke about the difficulty of persistent offenders. When the original order was introduced we were promised that there would be a genuine attempt to look at persistent offenders. It must be very difficult and galling for the odd offender, who usually does his best always to be law abiding, to know damn well that there are certain owners of vehicles who somehow or other manage to get away with it week after week and, indeed, for long periods. Therefore, with modern communication between traffic wardens and with the police radio network, it should be possible to find persistent offenders.
All this is not to decry the clamp. It is merely to make people feel that at least fairness is being observed when the clamp is being used. I think that if people feel that the rules are being obeyed by everyone, they have little to grumble about. They know the rules before they start; we are all obeying the same rules.
One thing that is very annoying—I do not know whether the Ministry has thought of doing anything about it—is that in certain parts of London meter feeding is still very widespread. We know the streets in which it is done; people walk out and put extra money into meters. There should be some way to prevent this.
The whole problem of parking causes great frustration and great annoyance. Part of the Government's duty should be to try to convince people that while bringing a car into the centre of a city is always a hazardous business, at least there is a certain degree of fairness when they do so.
Having made those few remarks, I think that we are very much in favour of the extension of this order so that greater time may be given and the novelty will wear off. We must thank the TRRL and others in the motoring organisations for their co-operation. Both the RAC and the AA have been very helpful and reasonable in their objections. I do not always agree with them, but they have been very reasonable in their observations on this matter. We certainly give a welcome to the extension for the period which the Minister suggests, so that these bodies, and the Ministry, are able to find out more about the behaviour of motorists and the results of clamping.
3.22 p.m.
The Earl of Halsbury: My Lords, I should like to draw attention to a point made by the noble Lord, Lord Carmichael, about the sense of heavy-handed injustice which comes from the maladministration of the system that we have. I quite agree that there is a problem. I quite agree that clamping may be a partial solution to this problem, but at the risk of laying bare
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my scars I want to tell your Lordships how the system can be made to work out at the moment.
For reasons your Lordships understand, I am a bachelor who lives by himself. I do my own housekeeping, catering and cooking, and I enjoy giving little lunch parties from time to time at which my guests can consume what I have cooked for them. This entails my housekeeping, shopping, catering and so on, and ends up with a visit to your Lordships' House, I hope in time for prayers.
One day I stopped my car in a little back street called Phillimore Walk, on a yellow line, to cross the road to cash a cheque at my bank in order to go on to my little shopping centre. I drew in behind a car already there. I came back five minutes later to find the car still there, my own car clamped, and the car behind me unclamped. So I was one out of three; and the car that was not clamped was there before I was. I disarranged nobody. I was not holding up the traffic. Phillimore Walk is a little back street which does not carry very much traffic.
The instructions as to how to go to pay my fine were so obscure that, having taken a taxi to Marble Arch, I wasted half an hour wandering around the innumerable tunnels under Marble Arch station, trying to locate the place where I could pay my fine. I then asked, "When can I get the car unclamped?" I was told "We can't tell you anything about that, you must go there and wait". I said, "I can't; I am host at a lunch party". They said, "That's your funeral, not ours." I said, "When you have unclamped me can you not put a phone call through so that I can go and collect my car?" They replied, "No, we never do that. All we can do is to tell them to get a move on and unclamp you". I then said, "If you can communicate with them, they can communicate with you. Both of you can communicate with headquarters and surely you can put a call through to me to tell me that I have been unclamped." "No, we never do that", they said. This is the bureaucracy. It is their convenience, not the subject's convenience, that is consulted. They said, "All you have to do is to go and wait". I said, "I can't. I have lunch to cook."
What do you do in these circumstances, my Lords? Your civic duty, your social duty and your public duties to this House are in conflict with one another and so you just have to throw in the sponge and go home and cook lunch. Then you go back after lunch and find that you have been unclamped, but nobody has left a notice to say, "Fine paid, give him an hour's grace"—no, nothing like that. The local warden slaps a £10 fine on you straight away.
It is an old principle of what people feel to be natural justice that the punishment should not exceed the crime. When you think that that cost me £29.50 plus taxi fares, it seems too much to pay for the price of harmlessly parking on a yellow line before cashing a cheque and then driving straight away. I was not there for five minutes.
There is another point. I do not know whether I am in order, but I feel that I have the leave of the House here. The noble Lord the Minister referred to making the motorist pay for parking on the public highway. I do not know quite in what sense he meant that, but I do pay for parking on the public highway. I pay £50 a

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year, I think it is, to the Royal Borough of Kensington and Chelsea for the right to park in the street where I live. This gives me the right to park at all hours of the day when I do not need to because I am either out shopping or attending your Lordships' House. The time I need to park is when I come home late from your Lordships' House and find that every single parking bay with a licence attached to it is occupied by somebody without a resident's parking permit. All right, one can find a way round that, but the wardens are told to take people on yellow lines first; and then "ticket" people who are wrongfully in a parking bay second. This means that the innocent who have been pushed out of the place they paid a right to park in are fined, and those who are parking in their place do not get fined.
On the occasion when I caught an early morning train after a late night session here to attend the big "thump" last year when the Central Electricity Generating Board drove an express train into a nuclear flask to see whether it burst, leaked, or whatever, I counted six cars on one side of my street and seven on the other not bearing residents' parking permits but occupying residents' parking bays. I could not shift them. I parked my car on a yellow line the night before. I had to leave it there. Of course, when I got back—a £10 fine.
The noble Lord talked about persistent offenders. In a statistical sense of course I am an offender. What else can I do? I come back from a session at your Lordships' House to find every bay I have paid the right to park in occupied by somebody who has not paid for it. I therefore simply regard the £10 fines I get as a statistical expectation. It is just part of the cost of motoring. I do not believe that is the way to instil good feeling between the motorists and the authorities who are concerned with law. I hope that I have not taken up too much time on this matter. I have dealt as decently as I know how with the noble Lord and I hope that he will report it on.
Lord Boyd-Carpenter: My Lords, of course I lack the culinary and many other skills of the noble Earl who has just addressed us, and I want to put to my noble friend one very simple, but it seems to me basic, point. As he explained to us, the purpose of these clamping provisions is to prevent obstruction of our streets. All of us, of course, are with him there. Obstruction of traffic in the streets of London is not only a matter of intense irritation, but also of considerable economic damage. But this particular instrument for doing so seems to me to have in it almost entertaining aspects of paradox. If the clamping is to be applied, as I assume it is, only to cars which are obstructing the traffic it is a little difficult to see why a step should be taken which makes it impossible for the owner to move the car and cease to obstruct the traffic. The purpose seems to be defeated by the action taken by the authorities.
For years we have had a perfectly satisfactory method of dealing with vehicles obstructing the traffic; that is, to tow them away. If they are towed away, as a matter of definition they cease to obstruct the traffic. But, instead of that, to use the clamp seems to be self-defeating.
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I yield to none of your Lordships in respect for the Transport and Road Research Laboratory. When I was Minister of Transport many years ago I had the highest regard for them. But it seemed that the figures which my noble friend quoted are not as convincing as they sounded when he gave them in his usual persuasive way. The clamping takes quite a lot of police effort and time. We see these cars driving about London marked "Clamp Units", generally with two policemen and often also a couple of pretty police women with them, and this involves considerable effort.
If the same effort were applied simply to towing away obstructing vehicles is it not at least possible that the same saving in traffic time, and therefore economic saving, might be achieved? I still retain the gravest doubts about this experiment. It is almost self-contradictory in the way it is applied, and I suspect that it is a misapplication of police effort which could be far better applied more directly by simply removing vehicles which do the obstruction.
Lord Morris: My Lords, is my noble friend aware that for many years the City of Paris clamped vehicles there but they have now completely given it up as a bad job, I believe for the reasons which have been mentioned by the noble Lord, Lord Boyd-Carpenter? Did the Ministry consider initially, for want of a better term, the Parisian experience in arriving at their determination to experiment? If not, have they considered it in the course of the experimentation before coming to their current view upon which we are about to decide?
Lord Peyton of Yeovil: My Lords, I should like first of all to express my sympathy with the noble Earl, Lord Halsbury, for the great inconvenience he has suffered, and to say how sorry I am that those directing this unit lacked the kind of second sight to realise quite the outrage they were perpetrating. I am extremely sorry to find myself at some difference with the noble Lord. Lord Boyd-Carpenter.
The noble Lord will be more familiar than I am with the problems of London's traffic. At the time that he was Minister of Transport, so far as I recollect, the job had not been totally filleted and made quite impossible. At a later stage London's traffic problems were, so far as I am aware, removed from the Ministry of Transport—the Minister being a rather vulnerable single figure—and passed over to a committee of the Greater London Council. Decency forbids me from going into the merits or otherwise of that particular body at this moment, but I am not greatly in favour of committees when it comes to enforcing laws of this kind. They are anonymous bodies, they are not particularly vulnerable to criticism, and they are not easily arraigned.
Therefore, I look with some favour upon the clamping experiment. I personally rather wish that more extensive use were made of it, not in the small by-streets to which the noble Earl referred but in large highways where quite unnecessary obstruction is caused—and they are main highways even if they are narrow. I believe that the use of this device is a considerable deterrent even though, as my noble friend Lord Boyd-Carpenter pointed out, there is some

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temporary obstruction of the traffic as a result of the use of the device.
I hope that we shall proceed with it with some boldness, and that perhaps more extensive use can be made of it and not less. I think we have too much sympathy with those who persistently make it difficult, if not impossible, to move around the streets of our capital city.
3.35 p.m.
Lord Brabazon of Tara: My Lords, I knew that this was going to be a fairly controversial order when I rose to move it. May I try to answer as many questions as possible which have been raised by noble Lords. The noble Lord, Lord Carmichael, asked about the vehicle excise duty. If the police find a vehicle during the process of clamping which has not got an excise duty licence they report the case to the department's London enforcement office, which is responsible for enforcing these licences. I have not got any figures with me about how many apply in this particular instance. If I can find them out I shall let the noble Lord know.
The noble Lord also asked about persistent offenders and the payment of outstanding fixed penalties. The police are continuing their efforts to identify persistent offenders and are considering how improved technology might help them to identify the relevant vehicles more speedily. Meanwhile, many persistent offenders have already been caught both through police efforts and because continually flouting the parking regulations increases the statistical probability that they will be clamped. As my honourable friend mentioned in another place on one day when 127 vehicles were clamped, 45 had five or more unpaid fixed penalty notices outstanding including 18 with 20 or more.
The noble Lord also mentioned the subject of meter feeding. This is something which is illegal and the wardens must do what they can to prevent it. I do not know about the particular street the noble Lord is talking about. Perhaps he would like to have a word with me afterwards and we might see if we can do something.
I fully sympathise with the noble Earl, Lord Halsbury, in what happened to him. I am surprised it happened to him. As I understand it, vehicles left on yellow lines are supposed to get a ticket first, and a certain amount of time is meant to elapse before the clamp is attached. I can only sympathise with the noble Earl. As for illegal parking in residents' areas, the TRRL report showed that clamping appears to have cut that down by 30 per cent., so I hope it is a step in the right direction from that point of view.
My noble friend Lord Boyd-Carpenter mentioned obstruction. The point about the clamp is that it is not supposed to be used where a vehicle is causing an obstruction. It should not be used. Those vehicles will be towed away. It is only supposed to be used on yellow lines, or at parking meters, or in residents' areas, so it should not be used where the vehicle is causing an obstruction.
Lord Boyd-Carpenter: My Lords, is my noble friend saying that if I park my car in a position where it will definitely obstruct traffic, I shall be absolutely free from the risk of being clamped?
Lord Brabazon of Tara: My Lords, in that situation, the noble Lord should be towed away. Yes, he should be free from the danger of being clamped, but with 700 clampings a week I dare say that one or two go wrong.
My noble friend Lord Morris mentioned the experiment in Paris. I was not aware that they had given it up. As your Lordships are aware, this order is to renew clamping for a further period of two years so we shall see what the TRRL will come up with during that time.
I should like to thank my noble friend Lord Peyton of Yeovil for his support. He said he would like to see more extensive use. As I said in my original speech, as from May, when the renewal takes place, if other authorities want to introduce it and they can satisfy us that it is necessary we shall look at that matter.
On Question, Motion agreed to.

Cervical Screening
3.39 p.m.
The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Glenarthur): My Lords, with the leave of the House. I shall now repeat, in the form of a Statement, the Answer which is being given to a Private Notice Question in another place on cervical screening. The Answer is as follows:
"Last year we gave all health authorities updated, comprehensive guidelines on an effective screening programme based on the advice of an independent expert advisory group. This followed the circular which we issued in December 1981 telling authorities to establish local recall arrangements for cervical screening by April 1983. All authorities should therefore now be offering a full screening service to all women with a recall service to those at highest risk.
"Responsibility for operating the cervical screening programme rests with individual health authorities. It is obviously important for each authority to have effective arrangements for following up positive tests which should always be notified to the clinician who initiated the test, who should then ensure that follow-up action is taken.
"We are looking into the circumstances of the Oxfordshire cases to see whether there are any general lessons to be learnt. We were already preparing a questionnaire to all authorities to update our information on screening services and we shall be issuing that shortly".
My Lords, that concludes the Answer.
Lord Ennals: My Lords, may I thank the Minister for repeating the Answer given in another place which inevitably leads to a large number of questions. I am sure he will agree that a disturbing and sad situation has been revealed in Oxfordshire that looks like the tip of a frightening and large iceberg. Does the noble Lord the Minister accept that cervical cancer is the one form of cancer which not only is easy to detect with a simple smear but can be cured if treated in good time? Does

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he accept that far too many women with cervical cancer are somehow falling through the net? He must agree with this as he referred to an up-dating.
Will he confirm that, although 3 million tests are carried out annually, about 2,000 women die from cervical cancer in England and Wales each year? Is he aware that Mr. Frank Dobson, the shadow Health Minister in another place, has carried out a thorough review which shows, among many other things, that while in general the provision of testing is "hopelessly inadequate", Oxfordshire is not exceptional but it was one of the 20 authorities which did not respond to his request for information? His report shows that pathology laboratories are overloaded with work and are often understaffed. In one case, in Worcestershire, there was a backlog of more than 1,000 tests.
Is the Minister further aware that, according to a recent article in the British Medical Journal, of 1,000 women in the Nottinghamshire area who had a first abnormal result fewer than two-thirds had been followed up? As in the Oxfordshire case, some 4 per cent. of positive tests were not acted upon by the general practitioners. Is it not true that all health authorities should now install a computer call and recall system? May I ask the noble Lord what reply was sent to the Women's National Commission proposal to his department in January this year that women should be called for cervical testing at five-yearly intervals, starting at the age of 21? Is it really true that, in the light of this deplorable situation in which every year many women's lives are placed at risk, the DHSS has said, as was reported in the press last night, that no new initiatives were proposed to introduce guidelines or in any way to alter the present system of availability of testing and following up positive tests?
Finally, does this not show a deeply disturbing situation? Will the noble Lord ensure not just that there is a careful examination of the three cases in Oxfordshire of which we know, but that there is a thorough survey followed by some immediate action affecting women throughout the country?
Lord Winstanley: My Lords, on behalf of my noble friends on these Benches I should like to join the noble Lord, Lord Ennals, in thanking the noble Lord, Lord Glenarthur, for repeating this important Answer in reply to a Private Notice Question in another place. We share the view expressed by the noble Lord, Lord Ennals, that in recent years the women least at risk of developing a carcinoma of the cervix are women who have been having cervical smears with almost clockwork-like regularity, whereas those most at risk have often not been having smears at all, and the recall or warning process for those women most at risk of developing a carcinoma of the cervix has been virtually non-existent. In so far as this Statement and it related action will remedy that situation, obviously on these Benches we warmly welcome that.
In relation to other aspects of the matter which were referred to by the noble Lord, Lord Ennals, perhaps I could ask the noble Lord, Lord Glenarthur, to look a little further. The cervical cytology campaign has now been going on for nearly 20 years. I was closely associated with it when it first started, as indeed was the noble Lord, Lord Ennals. It has undoubtedly
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achieved many results, but I think the noble Lord, Lord Glenarthur, will agree with me that we have not yet had authoritative figures over those nearly 20 years which can demonstrate conclusively whether the mortality and morbidity rates of carcinoma of the cervix have declined as a result of the campaign. I do not for a moment say that they have not, but it is high time that cost-effective studies were carried out on routine procedures of this kind which are highly consumptive of scarce resources and manpower.
One of the problems of cervical smears is that an increasing number of the smears are proving in the end to have ambiguous results which leave the doctor and the patient in something of a dilemma. Should they ignore a suspicious smear and wait to see what happens or should they take action—which can sometimes have long-term consequences for women who have not had children, and so on—just in case the smear proves to be a bad one? These are the difficulties.
The noble Lord, Lord Ennals, is right in saying that cervical carcinoma is relatively easily diagnosed and that it can be treated. We should like to know whether all this effort that has gone into the cervical cytology campaign throughout the country has had the effect of reducing the mortality and morbidity rates from these diseases as a result. Perhaps when the noble Lord and his ministerial colleagues in the department are looking into this matter they would consider the general assessment of the whole campaign. It is important to all of us to know what the results have been.
3.47 p.m.
Lord Glenarthur: My Lords, I am grateful to both noble Lords for their reception of the Answer which I have just repeated. I agree with both noble Lords that it is a disturbing and sad situation when things such as this come to light. Whether or not it is the tip of an iceberg is a worry which I understand the noble Lord to have. But in this case, as he will be aware, three women in Oxfordshire have developed cervical cancer after doctors apparently did not tell them that their tests were positive. One of the women has died and the other two are seriously ill. There may be more to it than has been possible to ascertain over the last couple of days for obvious reasons. It would not be proper for me to go into any more detail than I have given because not all the answers are known. But I assure both noble Lords that my right honourable friends the Secretary of State and the Minister of State for Health are looking carefully at this matter.
I entirely agree with both noble Lords that this particular form of cancer as such is easy to detect and is easy to treat. It is possible that people could fall through the net, but the difficulty in many cases is one of attitudes. The national recall scheme was stopped because it simply was not working. Only 20 per cent. of those being recalled were going back to be tested. It was for that reason that my right honourable friend the Secretary of State and others decided that the best scheme to adopt was a local system which could be refined within the prevailing circumstances at district level. That is what we have been pursuing, and that is what the issue of the circular last July to health authorities was in aid of.

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The noble Lord asked me a number of questions which I shall endeavour to cover, but I hope I shall be forgiven if I do not in the end cover them all. I shall write to the noble Lord if I do not. He asked me particularly about the Women's National Commission. I can say that a reply has not actually been sent yet. There is as yet no proof that a call system, as opposed to a recall system, would be effective. The noble Lord, Lord Ennals, asked me about the necessity for having computers for the recall system. We do not believe on face value that a recall system by computer is necessary to achieve that recall. There are other methods which have been in existence without computers, in many cases for a long time, and those that set up a really competent arrangement should be capable of setting up a recall system without them.
We have advocated already screening for all sexually active women at five-yearly intervals—particularly bearing in mind that, whereas it is aimed primarily at the people in the most-risk group, those aged about 35 and over and those with more than three pregnancies, there are others who are younger who may also be active and need to come forward. However, I think he will agree that the prime thrust ought to be at those who are in the greatest-risk group. He quoted figures for deaths, as did the noble Lord, Lord Winstanley. The figure in 1983 was 1,959; but if that total is broken down, 1,415 of those deaths were in the 35 to 74 age group which I think makes the point quite well.
To turn to new initiatives, we are looking carefully at the system. We are monitoring the way in which it is working and we shall be pursuing the individual health authorities to make sure that the systems that they have are adequate. The question of delays in laboratory processing is one on which the department has had some reports. We have had reports of difficulties in processing cervical smear tests up and down the country from time to time. In visits that I have made to laboratories, I have seen that there have been some backlogs—but I think not quite as serious as some people make out. However, it is very much a matter for individual health authorities to determine their own priorities for the deployment of their resources to meet this need and lots of other serious needs as well. The fact is that in this particular case it is going to take some time before we get to the very bottom of it. I can assure both noble Lords that it is being looked at with some vigour. We hope that in the meantime all those who can take these tests will come forward and follow the practice which the department has advocated.
Baroness Seear: My Lords, was the noble Lord really talking about an age group of between 35 and 74 years of age? That would not be a group, that would be a regiment.
Lord Glenarthur: My Lords, I did say that. Perhaps I can give the breakdown to the noble Baroness. The deaths in 1983 were three in the age group 22 to 24; 43 in the age group 25 to 29; 78 in the age group 30 to 34; and then 1,415 (the vast majority) between the ages of 35 and 74; and 420 in the over 75-group. That is
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statistical information however the noble Baroness would like to categorise it.
Lord Dean of Beswick: My Lords, I too am grateful for the Statement which has been made by the noble Lord the Minister on this very serious and dangerous illness. Can he tell us whether the figure he has quoted for deaths is an increase or a decrease on previous years? When the Minister in his answer referred to "health authorities", was he referring to regional authorities or to district authorities? I listened to his reply to the noble Baroness who has just put a supplementary question. The noble Lord said that it is up to each particular authority to decide its own priorities regarding this and other services for which it is responsible related to its own allocation of resources. Is it not the case that if it is left to the district or area authorities, and not the regional authorities, we could not only have a national imbalance but a regional imbalance for the treatment of this very dangerous and serious disease? And if there is shown to be an imbalance of any kind, is it not the fact that it ought to be corrected urgently on a national basis?
Lord Glenarthur: My Lords, I am sorry, I forgot to give the figure. The figure of deaths has declined by 13 per cent. over 10 years. I can tell the noble Lord opposite that cervical screening is the responsibility of the district health authority. I do not see anything that is particularly unusual about that. That is the way most of the system works.
Lord Dean of Beswick: My Lords, perhaps I may put this to the Minister. If he said that the level of activity on this particular illness or disease would be at the prerogative of the district authority and dependent on the resources that they have allocated for this and for other uses and responsibilities that they have to carry out, would this not indicate that, depending upon geographical location, there could be a different level of service all over the country? Does he really think this is desirable?
Lord Glenarthur: My Lords, it happens in every case within the health service. It is up to the local health authorities to decide their priorities. It would be wrong for Ministers in the DHSS to lay down from the centre what should apply right across the board. It is the system that prevailed also when the noble Lord's party was in power so that I do not know quite what the noble Lord was so concerned about. It is a system which has prevailed for many years. It is the only way to run it. We could not run from here precisely a particular recall system in district health authority "X" somewhere in the North-West of England. It would be quite improper that we should. It is right that we should give them the resources and they should determine what their priorities are within the range of resources that are given to them.
The fact is that this system has been going on, as we have heard, for the past 15 or so years. The figure of deaths over the past 10 years has declined by 13 per cent. We agree that it ought to be greater; we agree that it is an easily treated problem and that is why we issued the circular in July which set out the re-affirmation of our existing policies and went into the detail of how monitoring of screening programmes should take

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place. We shall certainly follow up all that has been learned from the instances in Oxford. I can assure all noble Lords that that is what we shall do.
Baroness Phillips: My Lords, I wonder whether I may underline what the noble Lord, Lord Winstanley, has said. I too was in at the beginning of the original campaign a long time ago. I should like to suggest to the Minister that perhaps the time is ripe to go back to the women's organisations who are admirable campaigners when their help and support is enlisted. This case will have highlighted the necessity for them to get the message through to every woman; and I would seriously suggest that the Minister, through his department, looks again at the marvellous campaign which was got off the ground originally through the women's organisations.
Lord Glenarthur: My Lords, I think that the noble Baroness is making a very valuable point because of the 2,000 or so deaths to which I have referred, about 60 per cent. were of people who had not had tests. The problem is one of getting the older women to go for recall. It is one of attitudes, really. As I have said, 94 per cent. of deaths are in the older age group so I think that what the noble Baroness says may well be right. We are funding the Women's National Cancer Control Campaign to publicise the need for screenings and I hope that that will have some effect.
The Earl of Halsbury: My Lords, may I observe that an age-group block is frequently referred to by medical statisticians as a cohort, and I think the reference to it by the noble Baroness as a regiment is not perhaps altogether inapposite.
Lord Ennals: My Lords, I wonder whether I may follow up on the point made by the noble Baroness about the breakdown of the total figures. Quite obviously the largest figures were in the age group between 35 and 74. Could there not be a tighter breakdown in this higher age group? I should be fascinated to know the figures for the 35 to 40 age group. As the Minister said, it is perhaps at the age of 35 where the greatest danger lies. I should have thought that the figure for the 35 to 40 group is a crucial one. Can he say whether the DHSS issued a statement, as I quoted, saying that there were going to be no new initiatives as a result of this sad situation?
Lord Glenarthur: My Lords, I shall certainly try to find out the breakdown of statistics of deaths between 35 and 40 or 35 and 45 or whatever the noble Lord would like. I hope that that might also meet the concern of the noble Baroness, Lady Seear. I am afraid that I do not have the figures before me. For reasons which I do not understand, they have not been worked out in that way. Why precisely that should be so, I do not know.
However, I have some information which may be useful to both the noble Lord and the noble Baroness and which gives the breakdown for the age group 35 to 39, which might help. I think I had better show the information to them afterwards, because it will take me more than a minute or two to work out what it means; but I will certainly do that.
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So far as not following up advice is concerned, we are in fact about to put out a questionnaire, as I indicated just now. I am not quite sure what information the noble Lord has received which is contrary to that, but I can assure him that we do monitor the matter carefully, and the fact that we are about to put out a questionnaire indicates how seriously we take it.
Baroness Seear: My Lords, I do not wish to be frivolous about what is a very serious subject, but I should like to follow up what my noble friend Lord Winstanley said. The statistical information on this is, quite frankly, totally inadequate. We want far better figures so that we can find out what in fact is the result of this long campaign. When the noble Lord tells us that most deaths occur in the older age group, your Lordships' House is very good evidence that this happens in many groups, even those that are not subject to cervical smears.
Lord Glenarthur: My Lords, I did not mean to treat it in a frivolous way at all myself. I merely gave the figures, which happened to be broken down in the way that I indicated; that was the way they were presented to me. However, I have here a table which shows deaths from malignant neoplasm of cervix uteri between the years 1973 and 1983 in all ages. A breakdown of ages is given, and I can tell the noble Baroness that in the age group 35 to 39 the number of deaths in 1983 was 92; for the age group 40 to 44 it was 104; for the age group 45 to 49, 127; for the age group 50 to 54, 155; for the age group 55 to 59, 184: and for the age group 60 to 74 the figure was 717. I will certainly let the noble Baroness and the noble Lord, Lord Ennals, have a photocopy of that immediately after this Statement has been completed.
Lord Mulley: My Lords, since this is a matter of general and not specific interest to the two noble Lords, would it not be better for a written Question to be put down, and then the Answer would be available not only to us but to people outside?
Lord Glenarthur: My Lords, certainly that is one possibility, but I think that the best way to deal with it, in view of the arrangements that now exist, is for me to write to both the noble Lords, and a copy of my reply will be placed in the Library.
The Countess of Mar: My Lords, could the noble Lord say whether he has information on the breakdown of social classes from which the women who died came?—because I very strongly suspect that it is women from the lower social classes who are the ones who are dying from cervical cancer. I was recently in hospital in a bed next to a woman who died from cancer of the cervix, and it was extremely unpleasant. We were told by her relations that she just did not know what symptoms to expect, or indeed anything else, until it was too late. Would it not be a good idea if we tried to aim publicity at those people and not at the people who already have enough intelligence to go to their doctor when anything is wrong?
Lord Glenarthur: My Lords, I think the noble Countess may be right, and perhaps that is a role which could be played by the women's organisations,

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as the noble Baroness, Lady Phillips, described. I have no information on the social classes at present, but if it is available I will certainly let the noble Countess know.
Lady Saltoun: My Lords, would it not be possible to enlist the help of women's magazines in telling women what symptoms to look out for?
Lord Glenarthur: My Lords, I am sure that is a good idea. Whether or not they actually undertake it I personally do not know, but I hope they would take note of what the noble Lady has said.

Road Races (Northern Ireland) Order 1977 (Amendment) Bill [H.L.]
4.4 p.m.
Lord Dunleath: My Lords, I beg to move that this Bill be now read a second time.
While not wishing to detain your Lordships, I feel it would be only courteous for me to try and give a few words of explanation of what lies behind this apparently brief and bland Bill. I am grateful, I may say, to Her Majesty's Government for having afforded the opportunity to propose that this Bill be read a second time at such an early date.
The background to it is that over the last 16 years we in Northern Ireland have been living through what might be described as a dark age; and those of us who live in the Province and have a stake in it have been doing our best to try to make good things happen. Unfortunately, so many bad things have happened and unfortunately, also, bad news inevitably gets more publicity than good news. Therefore, I hope I may be forgiven for spending a couple of moments in outlining some of the more constructive, desirable and civilised things that have been happening in Northern Ireland and of which we who live there have perhaps some reason to be proud.
Having said that, I must say that during this period of "dark age" we have been deeply grateful for the moral, material and indeed sacrificial support that we have received from those of your Lordships and the rest of the community living in Great Britain—and when I say "sacrificial support" I would add that we mourn every bit as much the death of any soldier who comes from England, Scotland or Wales as we do the death of any member of the Northern Ireland security forces, whether they be members of the police or of the Ulster Defence Regiment, because the British Army is our army and we mourn the casualties there as much as we do those among our own kinsmen. We are grateful for the support that we have received—and the financial support has been very considerable. But we do not want to be beggers. We want to be able to stand on our own feet, and those of us who live in Northern Ireland have endeavoured to try to encourage constructive activity, to encourage civilisation and to encourage movement towards better things.
As I say, good news does not always receive as much publicity as bad news, and that is inevitable. I would
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quote one or two good things that have happened. Well before the troubles started, a distant relation of mine, who is my guest here today, started an organisation called the Ulster Enterprise Voluntary Committee. She roped in, apart from myself, a couple of other prominent people in Northern Ireland, and we tried to promote good ideas and good initiatives from people in Northern Ireland. We had limited success, but the important thing is that the germ of that idea was developed and, I think, has now blossomed in the Local Enterprise Development Unit. That is notable for its success in promoting small industries and good ideas with initiative as their background in Northern Ireland. To someone like my relation, to whom I have already referred, I think a great deal is owed for the initiative that was undertaken some 20 or 25 years ago.
In addition to that, other civilised things have taken place in Northern Ireland. On the cultural level, we have seen the magnificent early Victorian palmhouse in the botanic gardens being restored. We have seen the opera house being restored. Also, St. Anne's Cathedral in Belfast, through a great act of faith on the part of the dean, the very reverend Samuel Crooks, has been completed, and this in a most unpropitious period. And dear to my heart is the fact that William Hill's grand organ in the Ulster Hall, dating from 1861, has been fully restored and is now once again firing on all cylinders. Coupled to that, I might mention that only yesterday afternoon, instead of going to Down Cathedral at Downpatrick to shout insults at Cardinal O'Fiaich, I went to the depot of the Railway Preservation Society of Ireland and placed my hand on the regulator of locomotive No. 85, which was one of our first high-speed express passenger locomotives dating from 1932, and having been out of service since 1962 she is now in steam once again and going. This, to me, was a particularly gratifying moment.
But having run over one or two of the gratifying things that have happened in recent years, I would look back to the 1920s and recall that our predecessors, like Lord Craigavon, also realised that it was important to try to present a favourable image of the Province, because after all in the early 1920s the future of Northern Ireland was far from secure. They took a number of steps and invested a considerable amount of time, effort and money in trying to set up the Province as a viable unit.
One of the things they did was to attract the Tourist Trophy race to Northern Ireland. It had previously been held in the Isle of Man, but the circuit had proved to be such that the race was unable to continue thereon. Lord Craigavon with his colleagues, Lord Londonderry, the inventive and famous Harry Ferguson and others, identified a racing circuit in the Ards area which eventually was considered to be the best racing circuit in Europe until the Mirburgring was established. Of the two European races, it was equal with Le Mans in public esteem and prestige, but of the two Ards was the more testing and demanding circuit on both motor-cars and drivers. It was supremely successful, attracting up to half-a-million spectators for each event. The ships from Liverpool, Glasgow and Heysham shuttled backwards and forwards bringing spectators, drivers, crews and

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journalists to Northern Ireland and this was the biggest sporting event ever to have been held at any time in the British Isles.
There is a great deal of nostalgia for the Ards TT Race. There are still many people who remember it and the younger generation, who have heard about it, ask their elders eagerly what it was like. Such is the nostalgia that in 1978 we—and when I say "we" I mean members of the Ulster Vintage Car Club—decided to commemorate the golden jubilee of the first Ards TT race by having a commemorative run. We tried to get a road closure order in the interests of public safety, but unfortunately the 1977 Road Races (Northern Ireland) Order precluded any additional road closures. None the less, I must say that the Minister, the department and indeed the police were sympathetic and we had a most successful event.
Unfortunately, however, despite repeated appeals, the general public did not accede to our request to keep off the circuit and, while three demonstration runs were conducted by authentic TT cars of the period, the public wanted to join in with their modern cars. Such was the atmosphere of the occasion and the enthusiasm that was generated. But, quite honestly, what with children, dogs and people on bicycles, I was scared that an accident might have occurred. But the police were superb on that occasion, with the result that it was a great success and, by the grace of the Lord, there was no untoward incident.
Since then, there have been many calls from the general public, from enthusiasts both in Northern Ireland and overseas, to repeat such an occasion. Indeed, one came from a recently retired divisional commander of the RUC who asked, "Could you do this again?" But, as president of the Ulster Vintage Car Club, I must say that I myself would not be prepared to lend support to a repeat performance unless the roads could be closed in the interests of public safety. Therefore, what I am suggesting now is that if this amendment Bill should go through it would be entirely at the Minister's discretion whether or not to grant a further road closure order, which would enable us to have a 50th anniversary golden jubilee race of three or four laps on the Ards circuit next year as a commemoration.
In saying that, I would point out to your Lordships who may not be familiar with the motor racing situation—though I know that many are—that vintage racing is not only much safer but also more spectacular than modern racing, because speeds are that much lower and using authentic vintage tyres you can drive sideways very much more safely with complete impunity, and indeed with pleasure, whereas modern cars hang on for very much longer and then, when they do break away, it is very much more difficult to "catch" them. So what we are envisaging is that we should have a race next year of three or four laps, which will be confined to authentic touring cars of between the dates of 1928 and 1936. There will be no racers and no specials but, as it was at the time, cars which any member of the public could buy out of a showroom and which were on general sale.
The safety factor of vintage racing is such that I can envisage no risk of any repeat of the most regrettable accident that occurred after the war on the Dundrod
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circuit when speeds had risen to a considerable extent and when TT cars were no longer ordinary touring cars on sale to the public but had developed into sports racing cars. On that occasion, unfortunately, a vehicle spun and stalled halfway across the road and the other competitors were unable to pull up without running into it.
I can envisage no problem of that sort, nor indeed can I envisage any risk of the sort of accident which occurred in 1936, when a Riley broke a shock absorber, developed front wheel tramp, got out of control and drove into the crowd who were standing on the pavement at the side of the road in Newtonards. That would never occur now. Our attitude towards spectator safety has completely changed since the 1930s, and in no circumstances would spectators be allowed to stand on the pavement with cars racing past them and with nothing between the spectators and the competitors but a road. That would not occur and that would not be a problem because the topography of the Ards circuit is such that in many sections the land rises gradually from around the circuit, thus providing a natural amphitheatre. So there would be no difficulty of that kind.
Finally, I would say that this proposal has received the unanimous approval of the Northern Ireland Assembly and of both the councils involved, Ards Borough Council and Castlereagh Borough Council. This is purely an enabling Bill to give the Minister the discretion to allow an additional road racing order should he think fit. Of course, the Minister would take into account the views of the Royal Ulster Constabulary, of the Royal Automobile Club, of the Ulster Association of Car Clubs, and of all interested parties, before deciding whether or not to grant such a road closure. But what I am asking your Lordships to do this afternoon is to give a Second Reading to this purely enabling measure so that if, in his wisdom, the Minister decides to agree to an additional road closure, it would give us in Northern Ireland what we want—a chance to help ourselves.
We do not want to be beggars. We want to be able to establish our own status and reputation as a place where people are welcome to come and, as so many have said, where they are glad to come. We are convinced that this will attract a tremendous number of tourists—not thousands but hundreds of thousands—and world-wide the press coverage would, I am convinced, be entirely favourable. Having said that, I beg to move that this Bill be now read a second time.
Moved, That the Bill be now read a second time.—(Lord Dunleath.)
4.22 p.m.
Lord Prys-Davies: My Lords, we have been told that this is a Bill to amend one of the 10 articles of the Road Races (Northern Ireland) Order 1977. It is a modest Bill. It is not a supercharged Bill but it may be better for not belonging to that category. It often seems to me that in the midst of the draconian and alien emergency legislation and the lawlessness of the past 15 years or so, the Road Races (Northern Ireland) Order 1977 is an attractive piece of legislation.
The order deals with road races on public highways by four-wheeled motor-cars, by motorcycles and by

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pedal cycles and with hill-climbing competitions within a defined area. Notwithstanding the militancy and the tension, I have a feeling which is reinforced by the words of the noble Lord, Lord Dunleath, that in its own modest way the Road Races Order, together with other achievements, has helped to make Northern Ireland a more civilized Province to live in. Indeed, in the words of the noble Lord, "It has helped to make good things happen".
It has been the practice since at least 1977 for the department to make up to 10 orders in a calendar year declaring that any roads specified in the order may be used for motor races during the days specified in the order. The year 1977 is not a long time ago; and this evening the noble Lord, Lord Dunleath, invites the House to agree that the number of such orders should be increased from 10 to 11. That is not a radical change. We have listened to a constructive speech in support of the proposed amendment.
The noble Lord, Lord Dunleath, has painted a picture of the benefits which will ensue if the Bill is passed. But the greatest benefit of all is that it would, albeit in a small way, contribute to or promote normality in the Province; and on that count, even if there was no other supporting factor, I believe that the Bill would deserve the support of the House. The noble Lord has referred to other benefits. It will help in particular with the development of tourism.
So far as I know, this Bill has not generated controversy. Indeed, this is reinforced by what the noble Lord has told the House this evening. The English football team Tottenham Hotspur, and athletic teams have had to pull out of Northern Ireland engagements, which is sad and disappointing, but so far as I know there is no evidence that motor racing is a cause of division. Indeed, we may find that a new Ulster TT will attract the crowds and the tourists by their thousands.
I therefore welcome the Bill introduced by the noble Lord. It has a good deal going for it. I do not know whether the exercise of the power given by the Bill would cause difficulties for the police or for the communities that would be affected, but I am sure that the Minister would consult widely before deciding whether or not to exercise the road closure power which the Bill gives him. I am sure that all objections would be assessed and taken into account. I am sure that we on these Benches agree that the Minister ought to be given this power.
Lord Hampton: My Lords, perhaps I may come in just briefly. I speak for myself and not for my party. I was not able to get hold of the order which we are amending but I have listened with interest to the first two speakers and, as an amending Bill, I would support the Bill wholeheartedly.
4.27 p.m.
The Parliamentary Under-Secretary of State, Northern Ireland Office (Lord Lyell): My Lords, first of all, I am sure that all of your Lordships would wish to join me in congratulating the noble Lord, Lord Dunleath, upon his admirable presentation of the little Bill that is before us this afternoon. I hesitate to say "little Bill" but it is commendably short compared
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with much of the legislation to which the noble Lord, Lord Prys-Davies, referred, and which the noble Lord, Lord Dunleath, knows occupies so much of your Lordships' time at odd hours of the day and night, matters such as the appropriation orders with which we dealt last week.
I think that your Lordships are also very grateful for the way in which the noble Lord, Lord Dunleath, set out his proposals in the context of Northern Ireland. I have to say on a personal note that the Lord, Lord Dunleath, does much to enrich the life of Northern Ireland both at his home and with his tremendous collection of motor-cars. Indeed, it was only last autumn that I must have passed upwards of 200 cars proceeding through the southern suburbs of Belfast to, I think, a gathering at the home of the noble Lord.
We are full of admiration for the noble Lord because of the manner in which he has developed this proposal for the commemoration of the fiftieth anniversary of the running of the last motor race in the series of the Ards Tourist Trophy events in Northern Ireland. The noble Lord also mentioned the last race on the Dundrod circuit. I recall that race in 1955 and, as the noble Lord pointed out, the motor-cars racing just thirty years ago were far different from what one could actually buy in the showrooms, and were far removed from the normal type of vehicle that most of us would drive about the countryside.
Some months ago the noble Lord mentioned to me the possibility of just such a commemorative event, taking the form of a racing competition or event of that type, by motor-cars of the period to which he has referred over the roads of the old Ards TT circuit. Your Lordships may not know that it is just to the east of Belfast.
I did, indeed, attend the debate—I think that is the right word to describe it—in the Northern Ireland Assembly at which the noble Lord proposed this event. It gave rise to much comment, all of it favourable to the noble Lord. The event he has outlined to your Lordships this afternoon would require the roads in question comprising the old Ards TT circuit to be closed to all normal traffic.
I am sure that your Lordships were impressed by the intent of the noble Lord's proposal and by his very graphic presentation of his proposal. Indeed, I have much sympathy with what he seeks to achieve. The prospect of the classic marques of sporting motorcars, of, I believe it was, 1931 to 1936 and onwards, competing in their full racing trim is a most attractive one. It would doubtless appeal to people of all ages in Northern Ireland. It is a fact that the legend of the Ards TT races and of the feats of the racing heroes of those days are still a part of Ulster folklore. The event proposed by the noble Lord, Lord Dunleath, would no doubt strike an evocative chord in the hearts of many senior and more youthful citizens in the Province.
I am equally persuaded that, as the noble Lord has himself suggested, such an event would attract many visitors to Northern Ireland, but I ask your Lordships to consider just some of the factors which have to be considered by the Government and by those of us responsible for the running of sporting motor events of the kind we are allowed to run, and indeed do run, in Northern Ireland.

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All all times the Government have to consider the convenience, welfare and safety of all kinds of road users. Above all, they have to consider those people who live along the roads which would have to be closed, not forgetting the many people who live in residential districts who would be effectively isolated were the roads comprising the Ards TT circuit to be closed. These are very difficult and intricate considerations. Indeed, they are taken fully into account in all cases of applications for the closure of roads for motor racing under the existing governing legislation.
In mentioning motor racing I hope that I can clear up one misapprehension which arose in the mind of the noble Lord, Lord Prys-Davies. The 10 occasions on which the roads may be closed for racing in Northern Ireland relate to races for motor cycles and motor cars as we know them. I believe that the noble Lord mentioned cycle racing. That comes under separate legislation. In the case of all 10 events covered under the 1977 order, they are for road racing motor cycles of up to 750cc—motor cycles and superbikes. I am sure that the events covered by motor cars are in the line of rallies. As far as I am aware, there is only one motor racing circuit in Northern Ireland, and that is at Kirkestown. There may still be a circuit for hill climbing; I am not quite sure. In any case, the 10 events I have mentioned are covered by motor vehicles, be they motor cycles or motor cars.
It is basic to an understanding of the noble Lord's proposal to appreciate that the area served by the roads which would have to be closed to normal traffic have changed enormously since the 1930s. From my own point of view, I remember going to Newtonards in the 1960s and the changes even since then have been colossal. Indeed, the changes are all the more marked when one considers that the roads were last used for the purposes of motor racing nearly 50 years ago.
In those days the area was largely rural in nature and was relatively lightly populated. But now the old Ards TT circuit is encompassed to a large extent by the Greater Belfast region. As the noble Lord, Lord Dunleath, will be aware, much of the circuit is heavily populated. It is urbanised and has large industrial and commercial enterprises abutting the circuit. The circuit also contains—if I may put it that way—two major hospitals, both serving wide areas and having great importance in the whole area of Northern Ireland.
I shall give your Lordships a brief illustration of what would be involved and the number of persons who might be affected by closure of the roads. The circuit would commence at a point approximately one quarter of a mile from my office in Belfast, in the village of Dundonald. We first come to the Ulster Hospital, which is the first turning on the left on the old circuit. The front entrance would have to be closed and access for ambulances and any people who might require treatment would have to be by the rather twisty and narrow roads, of which I have experience myself, to the rear of the Ulster Hospital.
In the village of Dundonald one then comes to the Wellworths shopping centre, which is of no mean size. This would be effectively isolated during the period of
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the road closures. In fact, Dundonald is considerably larger than a village. To help matters—or perhaps not—the Royal Ulster Constabulary station abuts directly on to the route, which would effectively restrict the RUC in any operations they may wish to carry out.
Leaving Dundonald, one comes to some 1,500 houses in the Ballybeen Estate which would be entirely enclosed by the roads which would have to be closed. Leaving Dundonald behind, the route turns left, as one leaves Belfast and Dundonald, and then reaches Quarry Corner, and runs down Bradshaws Brae, which I am advised is relatively trouble-free, provided one's brakes hold and one does not suffer the kind of mechanical misfortune with which the noble Lord regaled the Northern Ireland Assembly; I shall not do so this afternoon.
One then arrives at Newtonards. The first obstacle there is the Woolco shopping centre. This was inside the old cirucuit and would fall inside the new circuit. Any noble Lord who has been in Newtonards at a weekend will appreciate just how busy is this main shopping centre, which draws shoppers from the whole of the Ards peninsula and area, and from most of the east of Belfast. Similarly, the Ards Hospital would fall inside the circuit.
The noble Lord, Lord Dunleath, will know also that there is a Saturday market in the town square. That would have to be cancelled, though that might perhaps be one of the easiest things to do—or it might not be. Once again, the RUC station there would be effectively restricted and closed down. It would fall inside the circuit, and I understand that most of the access roads to it would be affected by road closures.
Leaving Newtonards, we find two large housing estates of approximately 1,600 houses. These are the Scrabo and the Westwinds housing estates, which would be effectively cut off. The road then proceeds, leaving Strangford Lough on one's left, into the town of Comber. Here there are two estates, the Copeland and Enler estates, of some 800 houses which would also be severely restricted in terms of access during the period of the road closures.
The route from Comber back to Dundonald is, I am advised, relatively trouble free; that is, until one approaches Dundonald itself, which becomes increasingly densely populated. At the Dundonald end we come right back with the Ballybeen Estate on the right this time, before reaching what I would imagine to be a particularly sharp corner at Dundonald. That is just a brief view of the obstacles, if one can call them that, around the circuit.
I think that the noble Lord would accept that it would interfere with things over what might be a considerable period of time. I say a considerable period of time, because I think he suggested that the roads might have to be closed for a shorter or longer period over each of the two days. It would be interfering with the daily activities of a very large number of people. It would affect the livelihood of many of them and the functioning of the vital services that we take for granted. All those problems would have very serious implications. The nature of any such disruption would place very serious burdens on the

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RUC. There could be problems also for the fire service and any emergency hospital cases. There would be problems going to and from hospital. That would tax resources a good bit further.
I draw the attention of the noble Lord and of all your Lordships to one aspect of the Bill before your Lordships. As the noble Lord has set it out it would increase permanently from 10 to 11 the number of road-closing orders that may be granted—I do not say will be granted—in any one year. The present limit of 10 has stood unchallenged for very many years and we believe that it has proved satisfactory. We believe that the limit reflects the wishes of both your Lordships' House and another place to balance the needs of motor sport with the disruption to the public and the services which people demand, even given the tourist potential which the noble Lord pointed out and, above all, the great popular appeal in Northern Ireland which even I have found. Any road closures would affect the public and the services. I am not aware of any demand for the number to be increased. The present 10 road-closing orders permitted under the legislation are granted for long-established motor car and motor cycle events. The circumstances in which they are applied at present do not involve disruption or the problems which I have sought to outline to your Lordships on a scale at all comparable to that which would be encountered under the proposal so ably put forward by the noble Lord.
In the course of my remarks I have drawn attention to the reluctance of the Government to accept a continuing increase in the number of road-closing orders that may be made in Northern Ireland. I have given an indication of what I am sure the noble Lord will accept are the practical problems that would result from a single closure order in favour of the event which he described to us. For that reason, with considerable regret, I have difficulty in supporting the Bill.
The Government have every sympathy with what the noble Lord is seeking to achieve and what we believe in many respects would be a pleasurable, certainly a colourful and for many thousands of people a nostalgic and memorable event. I thank the noble Lord for explaining the Bill to us this evening and, above all, for his continuing efforts in this direction. But I ask him whether he can seek to develop the proposals which he has so ably outlined to us in a manner which would avoid the difficulties which I have tried to spell out to your Lordships. I hope that I have not been too pessimistic, but I am sure that the noble Lord will appreciate these various choke points—as I think they are called—which would present great problems mainly to the RUC. I have had a very close briefing from the RUC. I asked all kinds of questions, and I am afraid that the RUC was not able to be any more sympathetic than I was able to be. For the reasons which I have sought to explain, I am afraid that I cannot say that the Government can actively support, or indeed accept, the noble Lord's Bill, let alone as it is drafted at the moment, as it would permanently increase the number of road-closure orders allowed every year under the 1977 order from 10 to 11.
4.45 p.m.
Lord Dunleath: My Lords, I am grateful to noble Lords who have been kind enough to respond to my proposal for a Second Reading of this Bill. The noble Lord, Lord Prys-Davies, clearly appreciated the motivation behind the Bill. One point on which he touched is tremendously important. It is that motor sport is a unifying element in Irish society, north and south. There is no differentiation between Association football and Gaelic football. For as long as motor sport has been going its enthusiasts have joined together in a spirit of co-operation, friendship and comradeship. We look at this as an extension of that. I am grateful to the noble Lord for taking up the point.
I am also grateful to the noble Lord, Lord Hampton, for his general expression of support. I know that he also understands what we are on about. I am grateful to the noble Lord. Lord Lyell, for having replied in such detail and with such care. The main burden of what he said—and I know that he was sympathetic—was realistically to draw attention to the difficulties which could be involved. He mentioned the people residing in and around the circuit and the businesses conducted there. I can only say that to date I have been conscious of a tremendous groundswell of support from the people living there and the businesses there. This has been reported to me and I have myself heard it firsthand. But I shall certainly pursue the matter and take a further census of public opinion. The general reaction that I have had is entirely favourable. I have called on shopkeepers, publicans and others who live around the circuit and they say not to worry; whatever inconvenience there might be would be negligible compared with the extra business which would be generated. That tends to be the attitude that I have experienced so far.
I entirely agree that hospitals are another matter. As the noble Lord suggested, there is access to the Ulster Hospital via the Stoney Road. It is a fairly narrow road, but the access is there. But having said that, and also acknowledging that the Ards Hospital at Newtonards would be cut off, let me say that there is nothing unusual about having ambulances on a circuit during the course of a race, if only to cart away our fallen comrades. That has been traditional for many years. Indeed, the Monaco Grand Prix conducts itself through the streets of Monte Carlo without any apparent difficulty; so I do not think that this would be an insuperable problem.
Again, the soundings that I have taken indicate that the authorities would be prepared to consider and discuss it, without of course in any way committing themselves as to whether they consider it would be feasible, as indeed is the case with the RUC, who, as I say, were superb on the last occasion in 1978 and who have been entirely sympathetic and understanding. I should not like to commit them to anything at all. It would he quite wrong of me to do so. However, while being non-committal, they were, at the same time, prepared to explore the possibilities, and this is a process that I should like to pursue.
The noble Lord was quite right in saying that the existing 10 road closure orders under the 1977 Road Races (Northern Ireland) Order are, on the whole, non-disruptive because they involve roads which

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traverse parts of the Province which for the most part are not particularly built up. I fully appreciate the difference between the Ards circuit as it was in 1936 and the way it is in 1985 and will be in 1986. This is a factor which we have in no way overlooked.
However, having listened with great interest and, indeed, gratitude to what has been said, perhaps I may venture to propose that if your Lordships were good enough to give this Bill a Second Reading, I should be very happy to look further into the questions that have been raised and do my best to answer them at Committee stage. I think that it would be a pity just to leave the matter as this juncture. During my speech I did not go into the questions which I had been expecting because I was aware of the time, as indeed, I am now. Therefore, if I may crave the indulgence of your Lordships to give the Bill a second reading, I should be very happy to deal in much more detail during Committee stage with any questions that might be raised. My Lords, I beg to move.
On Question, Bill read a second time and committed to a Committee of the Whole House.

Licensing (Amendment) Bill [H.L.]
4.52 p.m.
Lord Harmar-Nicholls: My Lords, I understand that no amendments have been set down to this Bill and that no noble Lord has indicated a wish to move a manuscript amendment or to speak in Committee upon it. Therefore, unless any noble Lord objects, I beg to move that the order of commitment be discharged.
Moved, That the order of commitment be discharged.—(Lord Harmar-Nicholls.)
On Question, Motion agreed to.

Pneumoconiosis, Byssinosis and Miscellaneous Diseases Benefit (Amendment) Scheme 1985
4.53 p.m.
Lord Glenarthur: My Lords, I beg to move that the Pneumoconiosis, Byssinosis and Miscellaneous Diseases Benefit (Amendment) Scheme 1985 be agreed to.
The purpose of this amendment is to make changes to the principal scheme, the Pneumoconiosis, Byssinosis and Miscellaneous Diseases Benefit Scheme 1983, by the addition of a further disease for which benefit may be paid. This disease is lung cancer, when accompanied by asbestosis or bilateral diffuse pleural thickening.
The principal scheme provides for benefit to be paid out of the National Insurance Fund for disablement or death caused by certain diseases, if they result from employment before 5th July 1948 and neither workmen's compensation nor benefit under the industrial injuries scheme is payable.
On 1st April 1985 lung cancer, when accompanied by asbestosis or bilateral diffuse pleural thickening, will be added to the list of prescribed industrial diseases for which benefit can be paid under the
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industrial injuries scheme. Section 5 of the Industrial Injuries and Diseases (Old Cases) Act 1975 provides for any disease which is a malignant or potentially malignant neoplasm, and which is prescribed under the industrial injuries scheme, to be included in the principal scheme. Lung cancer, when accompanied by asbestosis or by bilateral diffuse pleural thickening, is such a disease and is therefore being included in the principal scheme.
We are also taking the opportunity in Article 5 of the amendment scheme to revoke Article 6(1)(a) of the principal scheme. This article provided for the payment of a child dependency allowance where the beneficiary was in receipt of an allowance for total disablement under the scheme, but not unemployability supplement. The child dependancy allowance of 15p weekly payable was the same as that payable to someone in receipt of sickness benefit under the social security scheme. This allowance was abolished in November 1984 and, as a result, Article 6(1)(a) of the principal scheme became redundant and is now being revoked. My Lords, I commend this order and I beg to move.
Moved, That the draft scheme laid before the House on 25th February be approved. [14th Report from the Joint Committee.]—(Lord Glenarthur.)
Baroness Jeger: My Lords, I am sure that we all welcome any extension of assistance to people suffering from industrial disease. However, I should like to ask the Minister one or two questions. The amendment scheme before us today has to be cross-referenced with the principal scheme. I noticed that Schedule 4 to the principal scheme is to be amended so as to provide that benefit will apply where death is after 1st April 1985. It seems to me that where people have not only lung cancer but also suffer from other distressing diseases, surely they should warrant the kind of assistance which will be given to people who manage to live until after 1st April 1985. I am sure that that would be the wish of all noble Lords. I am very sorry if I have misread anything, but I have looked very carefully at Schedule 4 to the principal scheme and at the amendment of Schedule 4 which is before us today.
I should have thought that where there has been a definite diagnosis there could be some generosity to people who might well be nearing the end of their lives. I should have thought that it would be more realistic to accept that definite diagnosis of lung cancer plus the other illnesses should be sufficient to ensure sympathetic consideration.
I wonder how we are proposing to help widows and dependants of people whose cases will now be brought within the scheme. I notice that in the principal scheme the allowance for widows and children was fixed in 1983 at £300. That is in Paragraph 9 on page 10 of Statutory Instrument 136. I wonder whether the Government are considering uprating that amount, even if only to keep pace with inflation, as has happened in some other aspects of the social security system. I also wonder what steps the Minister is taking to make this change known perhaps to the employers and through trade unions, so that any people who may be unaware of the changes will get to know their rights.

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While I welcome any extension of the scheme, my main problem is my regret about the rather brutal date that has been written into this proposal. It seems to me that there is nothing sacrosanct about 1st April 1985. I should have preferred, as I think would have my noble friends, that it should be from the date of diagnosis and from the date of the onset of the disease that people in their last months should receive assistance. I very much regret that that is apparently not to be so. I only hope that I am wrong, but I shall wait with attention to hear what the Minister has to say.
Lord Davies of Leek: My Lords, perhaps the noble Lord the Minister would like to answer the noble Baroness first.
Baroness Jeger: My Lords, perhaps my noble friend would care to speak at this stage.
Lord Davies of Leek: My Lords, when I was Under-Secretary in another place, I moved a Bill dealing with pneumoconiosis. In the case of asbestosis, we found that not only a docker working in asbestos suffered lung trouble, but so did his wife. That was because when his wife laundered his trousers after he had been working on ships there was asbestos dust in the turnups. She herself suffered and ultimately died. We had cases like that. I cannot find anywhere in our legislation any cover for wives of people working in asbestos who may themselves suffer from asbestosis through laundering the clothes of their husbands. I shall leave it at that in order not to delay the House, but I have I think made the point.
5 p.m.
Lord Glenarthur: My Lords, I am grateful to the noble Baroness, Lady Jeger, and to the noble Lord, Lord Davies of Leek, for their comments. To answer the noble Baroness's prime point and what she described as the rather brutal date, it is not intended to be brutal in any way. The fact is that we are not making this legislation retrospective. There are huge difficulties in making legislation retrospective. The noble Baroness will be aware of the comments that are generally received in this House when we make legislation retrospective. It is not something that people like.
We are dealing with a disease that does, I know, take many years to develop. The other diseases covered by the prime scheme to which reference has been made are very slowly developing malignant diseases. When new things come to light, as in this case, it is not always possible to make them retrospective.
As to widows and dependants, so far as I am aware—I hope that I have it right; if not, I apologise in advance and I shall get it right when I can find out the details—the increases are linked to the various Social Security Acts. Any increases in social security benefits will be reflected in the prime scheme. That is what normally happens. I have no reason to believe that it is not the case in this instance. I imagine that there will be no great difficulty in making the scheme known. Those associated with this problem are only too aware of the need to make claims where claims can be made.
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I shall note the noble Baroness's remarks. If there is anything particular that should be done here that is not normally done, I shall take steps to put that in hand. I believe that the amendment to the scheme will be promulgated in the usual way.
The noble Lord, Lord Davies of Leek, asked particularly about dependants and their connection with asbestosis should they be involved in handling the clothing and such like of the prime beneficiary. I should like to study the noble Lord's remarks. My understanding is that no payment is made at the moment for wives or dependants. There can he a one-off payment on the death of a contractor of the disease itself. I do not think that the payments can be made to someone who handles the laundry or anything like that. However, I take the point that the noble Lord made.
Baroness Jeger: My Lords, before the noble Lord sits down, is he telling the House that a man has to die after 1st April 1985 before he can benefit from this scheme? And how does he benefit from it if he is dead? Is the only benefit to be that of the £300 plus whatever increment there might be to his widow and family? It would be a good thing if this matter could be looked at again. I cannot withdraw my regret about this aspect of the scheme.
Lord Glenarthur: My Lords, the allowance, as I understand it, will he paid to the person who suffers from the disease, not when he dies. The fact is that the legislation cannot be made retrospective earlier than 1st April. This is the normal practice in these cases. I see no reason for making it different in this case.
Baroness Jeger: My Lords, I am sorry to come back, but this is a question of Schedule 4 of the principal scheme which states dates after which death from diseases must have occurred. The amendment before us today provides that 1st April 1985 shall apply for the matter we are discussing. As for retrospection, surely in the case of war injuries and certain industrial injuries, we do look back a bit?
Lord Glenarthur: My Lords, I do not think that we look hack quite as far as the noble Baroness would want because of the difficulties involved. The noble Baroness is right in saying that if someone dies before 1st April they will not have been able to claim because the allowance will not have come into effect until 1st April.
On Question, Motion agreed to.

AIDS: Prevention and Control
5.5 p.m.
Baroness Cox Baroness Cox rose to ask Her Majesty's Government what steps they are taking to prevent and control the spread of the disease AIDS.
The noble Baroness said: My Lords, I am grateful to have the opportunity to raise these issues as discussion of them is timely for a number of reasons. First, there has been a great deal of understandable public anxiety about the nature and spread of the acquired immune deficiency syndrome, generally known by its acronym,

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AIDS. Secondly, this anxiety has been exacerbated by misinformed press publicity which has fostered the belief that AIDS is highly infectious. Thirdly, this belief has in turn led to uncertainty about the appropriate ways of responding to people who are, or who are suspected to be, suffering from AIDS. Finally, new information is becoming available which should help to clarify the situation and, by putting it in context, to offer some reassurance.
Therefore, I thought that it might be helpful to begin the debate with a brief outline of the nature and extent of AIDS. This will be very general. I am grateful to see that other noble Lords will be speaking later, including noble Lords who are medical practitioners, who will be able to provide any further details that they think are appropriate.
In essence, AIDS is a very rare condition which prevents the body's own internal defences against infection from working effectively. This loss of resistance renders a person more likely to succumb to illnesses which he would normally fight off quite easily. Two of the illnesses which most commonly afflict AIDS patients are relatively rare diseases. Kaposi's sarcoma is a type of cancer mainly of the skin, but it can also affect other parts of the body. The other is pneumocystis carinii pneumonia, which I shall refer to as PCP, a serious infection of the lungs. Many AIDS patients have one or both of these diseases.
The origins of AIDS can be traced back to 1981 in the United States of America, when a number of previously healthy homosexual men were reported as suffering from one or both of these conditions. Five cases of PCP were reported in Los Angeles, and, at about the same time, 26 cases of Kaposi's sarcoma were reported in New York and California, four of those affected also having PCP.
Within a few months, the Center for Disease Control at Atlanta had detected 159 similar cases, and a new disease was formally identified in terms of the following characteristics: first, a reliably diagnosed disease that is at least moderately indicative of an underlying cellular immune deficiency, for example, Kaposi's sarcoma in a patient aged less than 60 years, or an opportunistic infection; and, secondly, no known underlying cause of the cellular immune deficiency nor any other cause of reduced resistance reported to be associated with the disease. This definition has been accepted by most other countries and by the World Health Organisation Collaborating Centre for AIDS.
By January 1985, about 7,000 cases of AIDS had been reported in the United States of America, about 700 in Europe and 118 in the United Kingdom. Classification into groups with the highest risk of catching the disease shows that about 75 per cent. are practising homosexual or bisexual men. Other groups at risk include drug abusers who inject drugs into their veins, sexual partners of persons with AIDS, some people who have lived in Haiti or Central Africa, especially Zaire, the Congo, and Rwanda, and haemophiliacs who have received infected blood products. The risks to haemophiliacs have been a cause of considerable anxiety, and it is therefore worth noting that in Britain no one in this category has developed symptoms fulfilling the criteria of the
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disease as given above, although several patients have developed antibodies after receiving blood transfusions. However, it is hoped that very soon this risk will be effectively minimised by adequate screening.
It is too early to predict with any accuracy the rate of spread of the disease; but it is reasonable to hope that Britain will not see the same escalation as occurred in the United States of America because now more information is available and more precautions can be taken. However, it must be recognised that the disease has a long incubation period of several years, and some increase must be expected. Epidemiologists indicate a figure perhaps of the order of 1,000 to 2,000 cases by 1988 unless there is a scientific breakthrough in the meantime.
Although these figures are obviously disturbing, they need to be seen in context. For example, deaths from measles in the past four years numbered 70, compared with 51 from AIDS. Moreover, any predictions about the future spread of the disease need to be treated with great caution. Epidemiologists have stressed the need for great care in the interpretation of predictions—a point which has been well made in the article entitled, AIDS for All by the year 2000?, in the British Medical Journal on 9th February 1985. It is most important to emphasise that AIDS is not highly infectious in the same way as, say, smallpox used to be. It is not transmitted by aerosol infection; in other words, one does not become infected by sitting in the same room as an AIDS sufferer, by sharing a meal, by shaking hands or talking together. So there is no need to treat a person who is suffering from AIDS as if he or she were a leper or some kind of pariah figure. The main way in which AIDS has been transmitted has been through sexual intercourse between male homosexuals, especially those who have many different partners. It has also been transmitted to people suffering from drug addiction, who have shared needles, and by contaminated blood products.
Although the virus known as HTLV 3, which is considered to be a primary causative agent of AIDS, has been isolated from blood, semen and saliva of patients with AIDS, there is no evidence that the disease is transmitted through the saliva. This is a very important point when discussing the implications of AIDS for people involved in first aid and other emergency procedures such as mouth-to-mouth resuscitation. This brings me to the question of the anxieties felt by many people with responsibility for caring for patients who have, or who are suspected of having, AIDS. Anxiety is a natural concomitant to uncertainty. Thus, while little was known about the ways in which AIDS might be transmitted, it was understandable that many people working in health care and in the voluntary services should feel apprehensive about becoming infected through direct contact, especially such close contact as is involved in cardio-pulmonary resuscitation. Thus, certain unions, wishing to protect their members, instructed them not to take such risks. But now more information is available and various guidelines have been issued which should allay such anxieties. If followed, they should ensure that patients receive the specialist care they need and that staff are protected from risk of infection.
Two such documents issued recently are the interim guidelines issued by the Advisory Committee on Dangerous Pathogens (ACDP) and the nursing guidelines on the management of patients in hospital and the community, issued by the Royal College of Nursing. These two documents give comparable and complementary advice. The ACDP guidelines are naturally aimed at all staff who come into contact with people who have AIDS, or with specimens of their excreta. The Royal College of Nursing guidelines are naturally more concerned with nursing care and with trying to meet patients' physical, psychological, social and spiritual needs; and they also draw attention to the particular needs of patients' families and friends. Both documents discuss specific points concerned with health and safety of staff and other patients, with advice on important practical matters such as disposal of plastic aprons, gloves, soiled linen and dressings. Particular attention is paid to procedures for venepuncture, with useful advice on the care of needles.
An important point, which is made by both sets of guidelines, is that the responsible clinician should ensure that all staff who are likely to be involved with the care of a patient suffering from AIDS should be notified of the nature of his condition and made aware of the potential hazards. There have been a number of cases reported where nurses who have been caring for AIDS patients have not been informed of the diagnosis. Such a situation clearly puts them at unnecessary risk, and it also means that they cannot take the precautions needed to protect other patients appropriately. It is to be hoped that these situations will not recur, especially now that the guidelines are available for reference. These guidelines are to be warmly welcomed.
Also welcome are the initiatives taken by the voluntary services such as St. John Ambulance and the British Red Cross Society, which reassure first-aiders that nowhere has there been a recorded case of AIDS transmitted through first-aid treatment, including mouth-to-mouth resuscitation. They also seek to allay anxieties felt by some of their members about the use of models for instruction purposes by reminding them of standard procedures which have already proved to be effective in maintaining hygiene and safe practice.
It is to be hoped that these authoritative documents and statements will reassure front-line workers and will act as a corrective to the sometimes sensational and inappropriate responses which have occurred in some quarters. However, it must be recognised that they are still interim guidelines. They cannot stand as definitive statements while the condition of AIDS and its transmission are so problematic. I wish therefore to ask my noble friend the Minister whether any research is being done in this area of identification or clarification of the requirements of safe practice for health care workers, members of the emergency services and first-ciders.
Finally, I should like to turn very briefly from consideration of the protection of health care workers to the sensitive issue of patients' needs. People who have been infected with the AIDS virus may find themselves anywhere on a continuum from feeling physically fit and free of symptoms to episodes of
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illness of various kinds, to terminal illness and death. One of the most frightening aspects of AIDS is the fact that it can have a very long incubation period, and so people in the high risk groups may live in constant fear of having the disease with nothing to show for it but are perhaps just waiting for it to erupt. It has indeed been said that there are two diseases: AIDS, and the fear of AIDS. Given this deeply worrying situation, initiatives such as that taken by the Health Education Council are very welcome. Its booklet entitled, Some Facts about Aids, gives a very clear account of the nature of the disease, indicates those people who are most at risk, and gives advice on what to do if anyone is worried about the possibility of having the disease. It also gives practical advice on other matters, such as sexual behaviour and giving blood.
Another source of helpful advice, particularly for homosexuals, is provided by the Terence Higgins Trust, which runs an AIDS information telephone line and support groups for people with AIDS, and their friends and families.
One of the most regrettable aspects of the development of AIDS has been the tendency in some quarters for those who suffer from the disease to be treated as pariah figures. This may in part be due to ignorance and to fear of infection; it may also be related to the social stigma which may still attach to homosexuality. It is profoundly to be hoped that such attitudes towards the victims of this disease will change and that they will be accorded all the care which they need—care which needs to embrace not only them but their loved ones, in a particularly sensitive way, given the difficulties and problems inherent in their predicament.
It was largely because of this unhappy predicament of AIDS sufferers and the fear and uncertainty experienced by those who care for them that it seemed appropriate to raise these questions in your Lordships' House. I greatly look forward to learning more about these and related matters from the noble Lords and Baronesses who will be taking part in this debate, and I am most grateful to them for doing so. I also look forward to hearing from my noble friend the Minister the latest information concerning the control and prevention of this tragic disease, which is causing such widespread suffering, fear and anxiety. In this situation ignorance is the opposite of bliss—it is worry, uncertainty and even agony. It is my earnest hope, therefore, that the provision of more information may help to alleviate some of these problems and to reduce some of the suffering emanating from misinformation and the fear of the unknown.
5.22 p.m.
Lord Rea: My Lords, the noble Baroness, Lady Cox, has performed a very useful and timely service by putting down this Unstarred Question, and we should all be grateful to her for giving such a crystal clear account of the problem. We are used to hearing speeches of such quality from the noble Baroness, and her speech today has been no exception.
The noble Baroness has mentioned some points which should reassure us. In particular, she said that AIDS is not a highly infectious condition and that it spreads only through very intimate contact or through blood or blood products, or contaminated syringes or

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needles. In other words, normal social, rather than sexual, intercourse with affected or high-risk groups is perfectly safe. As the noble Baroness has pointed out, there is no need to make pariahs of the whole "gay" community.
Unfortunately, the discovery of the acquired immune deficiency syndrome has been used by many intolerant people as an excuse for what has been described as "gay bashing". I join with the noble Baroness in condemning such action in the strongest possible terms. Its extent was revealed recently in an unusually frank article in Time Out on 28th February, which also gave some extremely useful advice to high-risk groups.
I am sure that at the conclusion of this mini-debate the Minister will put us in the picture about current research into the condition and about possible avenues that may lead to the development of an antiviral agent that may be useful, or a vaccine. That is some distance ahead, but there is a great deal of work going on at present. The condition has caused great interest throughout the scientific community, and in the end it may lead to greater understanding, not only of AIDS but also of other virus diseases, and may assist the development of the relatively young science of immunology. It is also likely to prove a further boost towards research into the endemic diseases of Africa, to the great benefit of the African people as well as ourselves.
One of the causes of anxiety is that like some other so-called "new" diseases that have recently been described—such as lassa fever or legionnaire's disease—it is possible to depict it as a visitation by an enraged and vengeful god creating a new weapon to punish us for our sins. In fact, all these diseases have turned out to have been present for many years, usually in a tropical environment, but they have been unrecognised in those places amidst a whole host of other diseases. It looks as though AIDS is another of those diseases—"an old disease from Africa", as one BMJ article has suggested. It is highly likely that, in an area of high mortality with much serious illness, including malnutrition—an area such as Chad or Zaire—immune deficiencies would be overlooked.
The first death from an AIDS-like illness in a European was of a surgeon working in Equatorial Africa in 1977. The almost simultaneous occurrence of the condition in Haiti and the United States seems to have occurred after some American citizens visiting Zaire came home and passed the virus to the "gay" community in the United States. As Haiti was often used in the 1970s as a holiday haven by the American "gay" community, it was thus perhaps passed via the United States to Haiti and was not originally endemic in that country. That is only a hypothesis, but it is quite a likely one.
As the noble Baroness, Lady Cox, has pointed out, one of the major difficulties is that the incubation period is unusually long—from one to five years—and carriers are usually unaware that they have been infected. Small wonder that genitourinary clinics throughout the country are besieged by people wanting to know whether they are incubating the disease! A further problem is that the test for evidence of infection by HTLV III (the virus now thought to be
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responsible) is not yet a definite indicator of infection. Even if the antibody is present, it is not certain whether the subject will contract the disease or can pass it on. Those are some of the reasons why a reliable test has not yet been made available for general use either in genitourinary clinics or in the blood transfusion service. Work is going on as rapidly as possible in several laboratories evaluating suitable tests. I am told that later this year we may well have one that will be available for use. However, it cannot be 100 per cent. reliable, and those who are servo-negative—that is, who do not have the antibodies—but who are in the high-risk groups will still need to take sensible precautions and should certainly not donote blood.
While on the topic of blood products, a reassuring fact is that although one-third of the haemophiliacs who have been tested have been found to be positive for HTLV III, nearly all haemophiliacs in this country have received factor VIII made from pooled blood products imported from the United States. Despite the fact that one-third of haemophiliacs have the antibody, only three seem so far to have developed the full syndrome of AIDS. Another comforting fact is that although more than 100 minor "accidents" involving health staff looking after AIDS sufferers have occurred—such as pricking themselves with needles that have been used for collecting blood samples from patients—not a single case of AIDS has so far been reported as a result.
I do not want to criticise the way in which the DHSS has handled the problem. It is always convenient to point accusing fingers. Prompt and appropriate action has been taken in blood transfusion centres by the publication of the guidelines for health staff, to which the noble Baroness referred (and some people even say that those guidelines are too stringent), and by the encouragement of excellent research which is now going on at the Communicable Disease Surveillance Centre at Colindale, and other laboratories.
What I think the Government could do is to encourage the production of more guidance material for risk groups giving quite explicit advice; provide support for more counselling staff at the GU clinics; and take strong action against victimisation, so that the disease "Fear of AIDS" rapidly diminishes, while at the same time appropriate and effective action is taken to control the real disease of AIDS.
5.30 p.m.
Lord Winstanley: My Lords, I am very conscious of the fact that this is not a short debate but an Unstarred Question—an Unstarred Question admirably, and if I may say so, very professionally put to your Lordships' House by the noble Baroness, Lady Cox. If I wished to take issue in any way with the noble Baroness, Lady Cox, in what she said, and indeed to an extent with what was said by the noble Lord, Lord Rea, in his speech, I think that in some cases they gave answers to questions with perhaps a greater degree of certainty than I think our present state of knowledge entitles them actually to possess. The noble Baroness said quite clearly that there is no question, that this disease cannot be transmitted by droplet infection. She may very well be right. I think she probably is right. I certainly hope she is right, but I should like a little more certainty before we tell people with absolute

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certainty that this is the way it is spread, or that is the way it is spread, and so on.
This being an Unstarred Question I shall content myself as far as I can with merely underlining some of the questions which have already been put and perhaps putting one or two more myself to the Minister who, at the end, will reply. There is a great deal which I think we need to know about this fairly new, and undoubtedly very alarming, disease.
The first thing I should like to know—and I do not think that the noble Lord the Minister is going to be in a position to tell me at the end of this debate, and probably not at the end of the debate in 12 months' time; but at least he could make a start—is what steps are being taken to find out the following information. I, and many others, should like to know the precise nature and identity of the responsible virus. There are those who I think believe they do know. Is it a new virus? Is it an old virus that has undergone some kind of mutation? Or is it something that has become much more virulent than it used to be? The noble Baroness in her mention of measles pointed to the fact that diseases change. Not only do diseases change, but the response of human beings who contract various diseases changes very frequently also.
The noble Baroness mentioned measles. I think it is my recollection that when measles was first introduced into Fiji three-quarters of the population died. They died because they had never previously been subjected to that comparatively minor disease and therefore it had a very serious effect on that particular population.
I make those points merely to illustrate the fact that once one has identified a particular virus, one has not necessarily defined clearly what its effects are likely to be. But I should like to know what is the present state of our knowledge of the nature and identity of this particular virus.
Secondly, I should like to know what is the present state of our precise knowledge about the mode of transmission of this disease. I realise that the noble Baroness has suggested that we already know a lot. So, too, has the noble Lord, Lord Rea; and he knows a lot about a great many things. I have been in medicine perhaps longer than the noble Lord, Lord Rea, and longer perhaps even than the noble Baroness, Lady Cox; has been in nursing, but I am bound to say that the more I have found professional colleagues to be absolutely certain about things, the more I personally have been inclined to doubt them, and the more often I have sometimes found that they have subsequently proved to be wrong.
I should therefore like to ask the Minister what is the present state of our precise knowledge about the mode of transmission of this particular disease? In particular, one really wants to know whether or not this is a disease which is exclusively sexually transmitted. If it is not, it is high time we said so—and said so loud and clear. But if we are going to say that, then of course we have to say by what other means it can be transmitted. I am not saying that we must carry out some kind of alarmist propaganda to frighten people and to suggest that it can be picked up in all kinds of strange ways. But I believe that in your Lordships' House we have a duty to try to find out the real facts before we can decide what is the best way in which to communicate
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those facts to the public as a whole and, indeed, what are the best steps to take.
Thirdly, I should like to be told a little more as to what we know about the length of the incubation period. The noble Baroness, Lady Cox, told us with absolute conviction that it was seven years. I thought that that was what she suggested. I should like to know at least—
Baroness Cox: My Lords, perhaps I may say that I said that it is presently thought to be any time between six months and six years, according to present state of knowledge.
Lord Winstanley: My Lords, the noble Baroness confirms my view that the state of our knowledge on the length or shortness of the incubation period is extremely limited; and that is something about which I should like to know more.
Lord Rea: My Lords, our state of knowledge as to the length of the incubation period is not lacking. It is fairly definitely known that it is very variable and can be between six months and six years, and that is knowledge which is scientifically backed up. It may be anything between those times; there is a variable length of time.
Lord Winstanley: My Lords, it would appear that the noble Lord, Lord Rea, is a rather more willing absorber of knowledge than I am. I have heard things, too, but I do not necessarily regard them as entirely finite and proved for all time.
Let us move on. I think we want to know a little more about high risk groups. Certainly enough has been said to realise that we know of one high risk group. We also, of course, know of another—the unfortunate people who suffer from haemophilia. Because of their need for blood products, Factor VIII and so on, and the method by which this is supplied to them, they are of course at risk. With regard to that particular group which is at risk—persons suffering from haemophilia—the well-known expert, Dr. Peter Jones, has already done admirable work with his book Aids and the Blood, A Practical Guide. It is a very comprehensive work which gives all the answers which those suffering from haemophilia, or those associated with persons who suffer from haemophilia, might wish to know.
It is time that similar guidance was compiled for any other groups who may happen to be at risk. Of course, there are many other people who require blood transfusions and blood products of one kind or another. They, too, will want to know the news, whether it he good or bad news. They are entitled to know it; and so are we.
To get the answers to all these questions we really need a great deal of research and effort and I think I am right in saying that these are not things that can be done very hurriedly. It takes a great deal of time and, if we look back at the experience we have had with other diseases, we see that it has not always been quick. Sometimes when we thought we had the answers we in fact did not have them.
I am moving from virus diseases to bacterial diseases. Let us take whooping cough, for example.

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When we finally found the responsible organism and discovered the vaccine, we found that we had created new difficulties which also had to be looked at. Let us go back to viruses and consider infantile paralysis—acute anterior poliomyelitis (to give it its proper name) or polio, as it is more commonly called. We identified that virus a very long time ago and then it took a very long time indeed to devise and to develop an acceptable, and efficient and wholly safe vaccine. A great deal of research was done by ourselves, by the Americans, and indeed by the Russians in the Soviet Union, before we finally had the present oral vaccine with the outstanding, successful results.
I quote that particular example merely to show that this is not a very easy matter in which one can find all the answers very rapidly and then provide the solutions rapidly. It takes time. Not only does it take time; it takes investment and it takes money.
The noble Baroness, at the end of her speech, expressed the earnest hope that the ministry would be able to provide the answers. I think that in order to provide the answers the Minister and his colleagues will have to provide some of the cash. At Question Time a day or two ago questions were raised about extra funds in this regard for the Medical Research Council. The noble Earl, Lord Caithness, in reply to a question which I put, said, entirely in good faith and most sensibly, that additional funds had been provided for this purpose. That is precisely the answer that any sensible, well-intentioned Minister would give. It is the obvious assumption that when the nation is faced not with a crisis, but with a peril of this kind, funds will be provided with which to combat it. The noble Earl has since told me that that was his honest and sincere opinion, as I am absolutely sure it was, but in fact they were not extra funds; it was merely that the Medical Research Council had spent extra money out of its existing funds.
That I wholly accept, and I wholly accept that the noble Earl in his answer was giving a sincere answer and what he thought was a sensible answer. Surely, my Lords, it was, but extra funds have not yet been given either to the Medical Research Council or to the National Blood Transfusion Service, who may indeed need them for further research, or perhaps to the Blood Products Laboratory, who are going to have to do a lot of thinking in relation to this disease.
What kind of a society do we live in if we can readily provide extra funds for policing picket lines, for Trident, or for maintaining a substantial military presence in the Falkland Islands—I am not going into these matters—and not provide extra funds to combat a menace which may perhaps ultimately spread far beyond the Falkland Islands in its significance? We do not yet know anything like enough with certainty about this particular disease. We are not going to know enough until we have made the necessary investment in research. Having carried out the research and got the answers from that research, we shall have to have further investment in order to provide further answers.
I shall say no more save to welcome the noble Baroness's timely Question and to welcome in advance the answers we are going to get from the noble Lord when he comes to reply. I hope that he will be
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able to tell us that his ministerial colleagues in the department are sufficiently seized of the importance of this particular problem, that proper efforts are being made and that the necessary finance is being provided to deal with what is in fact an emergency.
5.42 p.m.
Lord Richardson: My Lords, I am sure you were all much impressed by the lucidity and the manner in which the noble Baroness, Lady Cox, introduced this Question. It was in fact no surprise to me. She is the daughter of an illustrious surgeon who wrote a textbook of medicine whose brevity and lucidity were such that it enabled me to compete with my Cambridge examiners 51 years ago. My only anxiety this evening is that many of the points that I wished to make were made by her, and that you, my Lords, will have the same sensation that doubtless my examiners had that I had read the book but had not understood it nearly so well as the author had.
There are many lessons and there are some questions which arise from this discussion this evening. One is the creation of anxiety. A great deal of appalling anxiety has been created in connection with this disease. Of course there is appalling anxiety. It is a very dangerous condition indeed. Not least is the question of the incubation period, which was taken up by the noble Lord, Lord Winstanley. To have to wait for three weeks to know whether your child is going to get measles is an anxious business, but to have to wait at least six months and perhaps even six years to know whether you or your child—your son in most instances—will have to face this terrible disease must be appalling. Therefore, much support, as has already been emphasised, is needed for those who are potential sufferers—and that potential is known—and for their families.
Dr. William Hams was quoted in The Times of the 6th as saying—and this is a question—
"Has the media any idea of the terrible problems it gives us through irresponsible reporting?"
Those terrible problems are not only problems which lead to questions being asked, and pressures being exerted, which are at that time virtually unanswerable and could therefore be misleading or productive of anxiety, but if they are sufficient they could lead to wrong decisions.
It is a matter of great gratitude that we should feel that the medical advisers and the Ministers at the Department have not made this into a notifiable disease despite the pressures. If they had, disaster—and that is not an exaggerated term—would follow, because the confidentiality which must surround this sort of situation would have been broken, or at any rate threatened, and the essential process which applies in all venereal disease situations of contact tracing would become even more difficult, and the risks of spread and of failure to recognise those at risk would have been enormously and, as I have already said, disastrously extended.
Again the pressures which can arise from reporting which is alarmist and ill-informed can lead to all sorts of unnecessary precautions, diverting attention and resources from the areas where they are most needed. The noble Lord, Lord Winstanley, raised the point about the numbers, the degree of infectivity, and how

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the disease is transmitted. At the present time, it is clear that it is transmitted sexually by homosexuals, or by blood in presumably large doses as in transfusions. The answer to the question whether there can be a great many more groups which are at risk is at any rate partially given by the fact that if it was transmitted by the sputum—the virus is there in the sputum—then there would be a vast quantity of patients with this disease, at any rate in the United States where the incidence is so much higher than it is here. Therefore, the ordinary, non-statistical, common-sense answer that it just has not spread as it would if it were to do so by droplet infection, or through the sputum, can in that sense be reassuring.
Again it has been said—and I think it was the noble Lord, Lord Rea, who said so—that of the tens of thousands of health workers in America who have been in contact with patients, and a few thousand in this country, none has acquired AIDS. It is apparently—and at this point it is wise to say "apparently"—considerably less infective than is hepatitis B, a condition which has plagued us for many years but about which we now know a great deal.
Before this debate I talked to the professor of virology at my old hospital, Saint Thomas's, and he said, "The disease is not very spreadable". That is a heartening little sentence. He went on to say that the precautions which should be taken in the wards and in the laboratories could well be described as good housekeeping. This is in step with the much larger experience that the United States has had. Doctors there and the professor of virology, Professor Banatvala, stress that it is the established precautions about which we—doctors, nurses and hospital workers—should all know must be applied thoroughly, with understanding and with tight discipline, but that more than that does not seem to be necessary. Where such precautions were applied more stringently in the States they have now largely been given up. I said "the precautions that we ought to know". There should be much more education about the simple precautions and their rationale for all those who work in hospitals. I do not exempt doctors or even nurses from that need.
Mention has been made—and here the noble Lord, Lord Winstanley was strong—about the importance of research. It is very remarkable that difficult though viruses are to work with in the laboratory, this virus was isolated as recently as May last year and now already its entire genetic structure is known. That was a considerable feat and the rate at which it was achieved was encouraging. But that does not mean to say that we are anywhere near the point where we have a vaccine as a preventive or a drug as a curative. A great deal of research is needed. Perhaps the Minister will be able to help, as the noble Lord, Lord Winstanley, asked, and tell us what research is being done. We know that it is going on into tests: the significance of false positives and negatives; the latter easily understood and the former more difficult. Indeed epidemiology can and should help us by working out some of the utterly unploughed ground of the natural history of the disease: that is how it can affect the individual in varying degrees.
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It was very recent that we felt that every case was invariably fatal. This was easily understood because the diagnosis was made by the fatality of the disease. But now things are slightly different. I should like to quote from Dr. Don Jeffries, a virologist at St. Mary's Hospital, a hospital that is taking a great lead in the AIDS problem. He wrote in The Times:
"There has been a significant number of people with AIDS antibodies plus immune disturbances"—
those one will feel very gloomy about—
"who, followed up over a year or two, have gone back to normal. We don't know what these changes mean"
—more research—
"but it is very encouraging that people with at one time quite profound laboratory defects and with swollen lymph glands can return to normal."
As I have said, a vaccine and a drug may be a long way off. They certainly were in the hepatitis-B researches leading to a vaccine. The difficulty is that the virus is in the body cell and to kill the parasite one must be careful not to kill the cell at the same time.
Intensive research—even if it is not leading very rapidly to a cure—through more understanding of epidemiology and on the immune responses of the body and how they are disturbed, greater knowledge of the possibilities of the patients with the extraordinary disease called Kaposi's sarcoma in Africa which is related to this condition to possibly mild cases with little but blood changes to show that the patient has ever been infected may—and I think will—come out with epidemiological study.
I should-like to end by emphasising the point made so clearly by the noble Baroness, Lady Cox, that support, advice and counselling for the relatives, sufferers and potential sufferers is absolutely essential. This is going on. Great initiative has been shown; and it is of major inportance, as I am sure the noble Lord the Minister understands, that it should receive all possible encouragement.
5.56 p.m.
Baroness Dudley: My Lords, I am most concerned about the risk to our young men and boys in catching AIDS. I believe that in America the number of cases has doubled every six months since 1980, and that 97 children under the age of 13 have caught it. Could something be done about it in this country before our young people are affected in similar proportions? Is it possible for the Government to issue an information leaflet on AIDS, its nature and causes, to parents of schoolchildren? Perhaps a film giving details of the virus could be shown in schools and colleges of education where boys and young men may be exposed to approaches from homosexuals. Already in Britain I believe there have been 132 cases with 58 deaths, and the public is anxious and confused about the disease and how it is transmitted. As male homosexuals are the main people at risk, they must be made fully aware of the dangers so that the progress of the disease can be checked. All "gay" communities should take a responsible attitude to safeguard those who are likely to be affected by any irresponsible actions. If possible, stricter checks could be made on giving blood.
Recently a baby was born in Birmingham with the AIDS virus in its blood after its mother had received contaminated blood from an AIDS victim. More

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research could perhaps be done on the screening of blood and the treatment of AIDS sufferers. Perhaps the Government should now consider a review of the current law relating to homosexuals and children to ensure that the risk of AIDS is taken into account. Is there any danger from acupuncture and pierced ears and those sort of things?
5.58 p.m.
Baroness Masham of Ilton: My Lords, this Question on AIDS which has been put down by the noble Baroness, Lady Cox, follows from a Question which I asked on 13th February. That followed from one asked last year by the noble Baroness, Lady Dudley. We have had three Questions asked on the acquired immune deficiency syndrome by three female peers. Females are a small percentage in your Lordships' House and it is interesting that 100 per cent. of the questions on this important subject have been asked by women.
Looking into a new disease is fascinating, but in this case it is extremely worrying. In AIDS the immune or defence system becomes defective leaving the way open for potentially serious invaders which the body normally rejects. One arm of our two-armed defence system is affected. These are the T-cells which normally are primed to repel invasion by viruses and other organisms. The other arm, in which the B-cells work, is left relatively intact so that most bacterial invasions are still repulsed. Therefore, it is the T-cells which cannot combat a viral attack. AIDS, for the people who do not know, stands for "acquired immune deficiency syndrome". "Acquired" signifies that it is caught as an infection rather than inherited; "immune deficiency" means that the body cannot defend itself properly; and "syndrome" means the illnesses that result. One of the greatest concerns is that at the present time there is no diagnostic test for AIDS yet available. We hope that scientists and doctors throughout the world will work closely together to find preventive measures and a cure.
I wonder whether this vital matter was discussed between our Prime Minister and the President of the United States of America when they last met. War against disease should be considered as important as any other sort of war. It would be wrong if any countries working on a vaccine did not work together because of the monetary gain on finding a vaccine. With the amount of fear and suffering that this virus is causing, the sooner a remedy is found, the better the world will be.
There is a great deal which can be done by many people to relieve some of the human suffering until a cure is found. The Government, through its machinery, can help. We should look at the positive things that can be done. I quote a few lines from a very useful book AIDS and the Blood, written by Dr. Peter Jones and published at the Newcastle Haemophilia Reference Centre in association with the Haemophilia Society and the Terence Higgins Trust:
"AIDS hurts. It intrudes on the security and privacy of families. It attracts ill-informed and sometimes cruel comment. Faced with the possibility of AIDS, people experience bitterness and anger. Sometimes anxiety or depression threatens to overwhelm them".
People with fears about AIDS should be able to talk about it in confidence to well-informed people. I do
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not think that a worried woman who may suspect her husband of having dual relationships with herself and homosexuals should have to go to a special clinic, a VD clinic. She might not go. Could there not be a confidential centre in each health region where these people could be referred by their general practitioners?
I hope that this debate will be useful and will help people to understand a little more the needs and the problems created by AIDS. The symptoms and signs of AIDS listed by the Centers for Disease Control and the American Association of Physicians for Human Rights are: (1) profound fatigue, persisting for weeks with no obvious cause; (2) unexplained weight loss (more than 101b in two months); (3) drenching night sweats that may occur on and off for several weeks; (4) fever lasting for more than 10 days; (5) cough lasting for more than two weeks and not due to smoking—this may be associated with shortness of breath, persistent sore throat and difficulty in swallowing and the white spots of "thrush" may be visible in the mouth; (6) persistent diarrhoea; (7) swollen lymph nodes (glands) lasting more than a month; (8) purplish or pink blodges in the skin.
These symptoms and signs could mean many things and, in themselves, they do not mean that AIDS is present or that the person concerned is going to develop AIDS. They may not be of consequence, but anyone experiencing prolonged ill-health and worried about AIDS should seek consultation with a doctor quickly. There is a vital need for considerate and correct counselling up and down the country. Many people are worried. They need to have their questions answered. Fear grinds away. Innocent people may have had blood transfusions; hundreds of haemophiliacs and people suffering from Christmas disease will have had Factor VIII and IX. I have been asked by someone who has worked in Africa as a missionary if gamma globulins could carry the virus.
My Lords, the fear of the unknown is very great. I think it would be wise and helpful if the Government would set up a series of conferences in different parts of the country for medical, nursing, social and technical staff so that they can be kept up to date with information and can gain counselling skills. Junior staff will always need continual back-up from senior staff. Many people who are going to have operations are asking if they can have their own blood collected a few weeks beforehand and use that blood should the need arise. This seems a reasonable request and perhaps the Minister would look into it to see whether it is practicable.
It is known that the bowel wall is very thin and delicate and can easily have lesions and I think I am correct in saying that the purple blotches in Kaposi's sarcoma are only present when homosexuals develop AIDS. As much as possible should be done to prohibit at-risk groups from giving blood. Perhaps if people are bisexual and married and have been giving blood for years, they do not want their wives to suspect them if they have been living double sex lives. It seems to me that counselling ought to take place at blood-donating sessions to make at-risk donors realise what danger they might inflict on innocent people. This is most important now as no diagnostic test for AIDS is yet available.

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I should like to ask the Minister whether the AIDS virus has changed and whether the AIDS antibodies which are found are themselves immune. They are passive. What is making them unable to fight? This mystery illustrates the need to encourage doctors and scientists who work in the field of virology: their work is most vital and should be considered a top priority. Blood is the lifeline of the National Health Service. When I sustained my injury I also had a mammoth internal haemorrhage. It was blood transfusions which saved my life.
The impact of AIDS on the blood transfusion service will not be limited to the cost of testing AIDS alone. It is hoped that a test will be available during 1985–86 and it is thought that the cost will be about £2 extra on every unit of blood. In order to prevent any possibility of infection from blood products, heat treating will be necessary. This process of heat treating reduces the potency of the substance by approximately 20 per cent. and therefore 20 per cent. more blood will be required to produce the same level of product, and I do not think that red blood corpuscles can be treated in this way as it would damage them.
My Lords, I think that for years we have been taking our blood transfusion service for granted. A great deal of amazing work goes on and I should like to pay tribute to the dedicated people who do such an excellent job. Perhaps in the past they have been neglected and perhaps that is why we are not yet self-sufficient in blood products and are still importing them from America and, sadly, we have also imported the AIDS virus. This extra need for plasma and the extra work that AIDS is imposing on the regional blood transfusion services means that they need more money. Is the extra money going to have to come from the normal regional budget; or is the money going to be forthcoming from the Treasury? Is there going to be something special in the Budget tomorrow for "blood money"?
I cannot see any reason why people should be fearful of donating blood. I read in The Times today that Britain's blood transfusion service is facing a serious shortage. I am sure that if an appeal is widely made, many "clean" people will come forward to give their blood. We cannot do without an adequate supply of blood. This is a good opportunity to say that new needles are used each time for blood donation. They come in sterilised packs and after being used once only they are thrown away. This knowledge should be widely advertised to help recruit donors.
I am sure the Minister will agree with me that screening for AIDS should not be done at blood transfusion centres. If the problem spreads, so should the services required. The stress on the staff dealing with many cases must put an enormous extra workload on a hospital. Tribute ought to be paid to Dr. Pinching and his staff at St. Mary's Hospital, Paddington, who have been dealing with 45 AIDS patients. The large cities like London seem to attract the high risk groups. More resources will be needed for the acute services, and I hope the Government will learn now from the experience gained at St. Mary's Hospital.
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There does also seem to be a problem over disinfecting some instruments such as flexible endoscopes, which are used to examine the bowel for cancer. The endoscopes are used many times in each session and the disinfectant which is efficient in regard to AIDS is causing some problems to nurses who have allergies to it. With the constraints on the National Health Service budget, these are all added problems. Please, will the Government look into all these matters?
With AIDS, prevention must be of paramount importance. It must be remembered that many nurses over the years will have become accustomed to a routine of dealing with used needles after taking blood. It is while putting them back into the sheath that the nurses can prick themselves. The needles should be placed in a rigid container for disposal. The instructions should be simple and straightforward so that nurses do not forget. With the problem of hepatitis B and drug addicts, most general practitioners have become more careful over the disposal of needles because drug addicts scavenge dustbins for used needles for drug use. It is advisable to take used needles to a hospital for disposal. This precaution should help to lessen the risk of spreading AIDS.
Dr. Peter Jones from Newcastle, when talking to me last week, said that he enjoyed talking to patients and felt that close communication was vital especially for mothers with young children. I felt that maybe AIDS brings the worst out in some people but with a doctor like Dr. Jones it is showing the good and positive side of human understanding.
The Haemophilia Society has among its members many high-risk people. I just want to say that AIDS has put extreme pressure on that small society, which is producing information and advice for its members. They are most grateful to the Government for their helpful grant, which was most timely.
When the part-time prison chaplain died from AIDS, it was understandable that prison personnel were concerned because very little positive information about the virus had then been circulated. Inmates and staff live in very large human factory-style institutions, with people coming and going like a conveyor belt. Information has now been circulated. Far more cases from the AIDS virus have been confirmed in America, but no one working in the American penal system has contracted it as a result of their work. With our large prison population and a great variety of inmates, it is really very remarkable how few outbreaks of infections there have been in our prisons.
Having said that, and knowing of some overcrowding, I would humbly ask whether perhaps it would be wise to increase the washing facilities for prisoners. Hot soap and water could be a precaution well worth taking. As it is, in some prisons the inmates only get one shower a week. I hope the Government will endeavour to do everything possible to prevent and control the spread of AIDS and the neurosis which goes with it.
6.15 p.m.
Lord Kilmarnock: My Lords, we are all grateful to the noble Baroness, Lady Cox, for introducing this

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short debate on this very important subject. I should like to start by agreeing with her that great damage is done by the misinformation and the hysteria which has been fostered by the popular press. I think that point was also made by the noble Lord, Lord Richardson. Some extrapolations have been quite extraordinary as a result of this disease. I think one of them produced a certain figure for the year 1990, and had it been extrapolated to the year 2,000 it would have produced 100 million AIDS sufferers—that is to say, almost more than twice the population of these islands. So the press has obviously not been doing us a good service in spreading these sorts of rumours. And of course, as has already been pointed out, exaggeration tends to lead to victimisation of the groups at risk. The noble Baroness, Lady Cox, also referred to this. The noble Baroness also said, as have other speakers, that more information is becoming available fairly rapidly from other parts of the world and in particular from America, from the National Cancer Institute of Bethesda, Maryland. That is welcome news, but of course it does not mean that we should relax our own efforts.
The noble Baroness and, I think, the noble Lord, Lord Rea, and also the noble Baroness, Lady Masham, mentioned haemophiliacs, who are particularly at risk from imported blood products, not only from AIDS but also from hepatitis, as they have been for many years. I wonder whether the noble Lord, Lord Glenarthur, can tell us about the current situation in respect of heat treatment of imported blood products. The long-term answer is obviously the development of self-sufficiency in Factor VIII; but of course we are not there yet. Is the noble Lord satisfied with the arrangements for the treatment of imports, in particular from the United States?
Still on the subject of haemophilia, I understand that in the long term, in the next 10 years perhaps, we can expect synthetic Factor VIII to become available. Can the noble Lord assure us that when this is the case there will be no financial obstacle to the widest possible use of what will, after trials, be a clinically safe material carrying no risk whatsoever?
I want to address the rest of my brief remarks to the question of research funding, which was referred to by my noble friend Lord Winstanley and also by the noble Lord, Lord Richardson. My noble friend mentioned the reply that he had received from the noble Earl, Lord Caithness, in regard to a Question put by the noble Baroness, Lady Masham, on the 13th February, when the noble Earl, Lord Caithness, said at col. 182 of Hansard:
"We do not intend to starve the Medical Research Council of funds: in fact we are giving it more funds on this particular matter."
Later during the exchanges on the same Question, in response to a supplementary question of mine, he said this (and again I quote, from col. 183):
"I believe I am right in saying that they are extra funds, and we shall continue to give extra funds wherever there is a special project on this which is worth it".
After that exchange, the noble Earl, Lord Caithness, came to me, very commendably, and said he thought he might have misinformed the House and that he might have been wrong in relation to the additionality of the funds that he was talking about. He suggested
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that I should put down a Question for Written Answer which would enable him to put the record straight.
Accordingly, on 5th March I put down a Question, which I shall now quote, and then I shall give the noble Earl's Answer, to which I think he will have no objection, which I received today. The Question which I put down was as follows:
"To ask Her Majesty's Government, whether, in view of the references made by the Earl of Caithness on 13th February 1985 (Official Report, Cols. 182 and 183), to the provision of additional funds to the Medical Research Council for research into AIDS, they will now state the level of funding for this purpose for the years 1984–85 and 1985–86".
The first part of the noble Earl's Answer is as follows:
"The Medical Research Council have authorised grants for AIDS research at a total estimate of £369,000 of which £59,000 will be provided by my right honourable friend the Secretary of State for Social Services".
So we have there a figure of £369,000. I checked this with the Medical Research Council, and they came up with a figure of £387,000. The difference is not great, and I am sure there is an explanation for it, so I do not want to pursue that.
But what I should like to draw the attention of the House to is the figure of £59,000 which has been provided by the noble Lord's department, the DHSS, because I think we should try to consider whether we think that is sufficient. I think I am right in saying that it means that there is an element of additionality to the tune of £59,000, though the rest of the funding is all coming from within the Medical Research Council's main budget.
As I understand it—and perhaps the noble Lord will correct me if I am wrong—that £59,000 from his department is distributed as follows: £45,000 going towards the project headed by Professor Ardler at Middlesex on research into all aspects of the disease, and £13,500 going to the project headed by Dr. Craske at the Public Health Laboratory in Manchester on haemophilia. I understand that those are the two areas in which the noble Lord's department is making a contribution. That is useful information which we are glad to have, but I should like to ask the noble Lord whether, in view of some of the remarks that have been made in this debate, he considers that that sort of contribution from the Department of Health and Social Security is really sufficient in the circumstances.
In the second part of his reply to me the noble Earl, Lord Caithness, said as follows:
"The grants authorised are for periods of 2 and 3 years; it is not possible to estimate expenditure for 1984/85 and 1985/86 as two of the grants have not yet incurred expenditure and their starting dates are unknown".
That is perfectly clear. We all know that these projects are carried on over a period of time and that the money is used up only gradually. But I should like to seek the noble Lord's assurance that additional funds will be available for good, new projects if and when they come forward, and indeed for any trials which may be required resulting from epidemiological research.
I go back to the point that I made earlier. We are learning a lot from the United States of America, but I suggest to the noble Lord—and I hope he will agree—that we really must have our own research capability fully open and available for trying to find a cure for AIDS. I particularly noticed that the noble

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Lord, Lord Richardson, said that the virus had been isolated only in May last year, which is not very long ago, so there is a great deal to be said on the plus side. But as the noble Lord also said, we are still nowhere near to a vaccine or to a drug, so it seems that we should not relax our efforts and, particularly, that there should not be any drying up of funds if promising research is coming forward.
Finally, I should like to ask the noble Lord this question. I understand that there is a working party of the Medical Research Council which is monitoring all these areas of research, and I believe that five research projects are in progress at the moment. I also understand that there is a new group within the DHSS which, presumably, is monitoring the progress of the disease and of the research into it. I should like to ask the noble Lord to say a little more about this command post which is said to exist inside the department. Is it in constant touch with the Medical Research Council, and will he guarantee that there will be no shortage of additional funds, if and when they are genuinely required and there are real research projects which need them?
6.25 p.m.
Lord Ennals: My Lords, like other noble Lords and Baronesses, I think we all owe a very great deal of thanks to the noble Baroness, Lady Cox, for opening this debate and for doing it, as the noble Lord, Lord Richardson, said, with such skill, knowledge and sensitivity. It has been interesting that four of the speakers have been professional people, with two general practitioners, a consultant and a very senior nursing Baroness. The noble Baroness, Lady Masham, referred to the minority of women in your Lordships' House. If we look at today's debate we see that they have distinguished themselves, as they usually do. That means that male laymen like myself are in a very small minority in today's debate, so we must just do our best.
The main reason for congratulating the noble Baroness is that we in this House and Members of the other House, and all those who are concerned, have the major task of educating ourselves—which I think we have been doing—and of educating the public. After all, we are dealing with a virus which is relatively new; for which, as the noble Lord, Lord Rea, said, no preventive vaccine has yet been found; and for which there is as yet no known cure. Its importance is added to by the fact that, though the disease is still comparatively rare—I think the noble Baroness gave the figures of 7,980 cases in the United States and 118 in Britain in January—all the signs are that the numbers will, certainly for a period, continue to rise quite sharply. It is for this reason that we have to be very careful about some of the horrendous reports to which reference has been made.
The noble Lord, Lord Winstanley, posed some questions to which I would certainly not dare to give an answer, but from what one knows the epidemiological features so far indicate that the disease is virtually unknown outside the group that a number of noble Lords have defined—homosexuals, intravenous drug abusers, people from the Caribbean and from central Africa, and haemophiliacs.
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Nevertheless, as the noble Baroness, Lady Cox, said, the existence of this disease, even though AIDS seems not to be contagious, has created a tremendous degree of concern, and indeed fear, among those who think that they may be severely at risk. We must know some, and we must also know that there are tens of thousands of others who today are living in desperate fear, partly because they have been misled, their misleading having been stimulated by some of the horrendous, over-dramatised press reporting. Part of the duty of your Lordships in a debate like this is to seek to set the record straight, in so far as people are prepared to listen to what we have to say.
The dangers are put into perspective in the authoritative article in the British Medical Journal, which was referred to by the noble Baroness, Lady Cox, on 23rd February 1985, and I want to re-quote just two sentences:
"The fact that tens of thousands of hospital workers in America and several thousands in Britain have been exposed to the virus and yet none has developed AIDS is reassuring, for it suggests that it is appreciably less infectious than Hepatitis B".
I have no hesitation in repeating that because this should be clearly understood by those full of fear.
The article ends by saying:
"Doctors have a responsibility to put the record straight, to help people view the disease in perspective. Patients with AIDS not only need our professional help, but also our sympathy and understanding".
I was glad that the noble Lord, Lord Rea, referred to "gay bashing". I heard only a few days ago of a public house in East Anglia that has a sign over its bar which says, "No homosexuals allowed". It is this kind of danger which we must seek to allay.
As early as 21st April 1984 an editorial in the British Medical Journal said:
"Even though our experience of patients is limited, we have our own examples of hysteria taking over from reasoned judgment of the facts".
The editorial then referred to the fact that some 94 per cent. of American patients so far fall within the group which we have already mentioned. From American experience we can narrow down the group very substantially.
Personally I am most grateful to the Royal College of Nursing for their excellent guidance, which has been referred to by the noble Baroness, Lady Cox, which has value for people far beyond the nursing profession. I hope that these guidelines will be widely read not just by people who need to know, but by people who seek to know. Perhaps I may briefly paraphrase one or two of the points made in the guidelines. Referring to health education, they say that those who comprise the main at-risk groups should be advised to observe certain precautions within their particular life style:
"No one in the at-risk group should at the present time donate blood unless for research purposes or allow their organs to be used for transplantation. Such education and advice must make the subjects aware that they have an important role to play in preventing further the spread of that condition".
So far as homosexuals are concerned—and again I shall paraphrase—there should be no contact with body fluids—saliva, semen, faeces and urine. These subjects should be strongly advised,
"to avoid sexual contact with men from North America. These restrictions also apply to heterosexuals within the at-risk group".

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The guidelines go on to say that health education is much more effective when the adviser stresses the things which can be done to maintain or promote a meaningful relationship and at the same time to encourage safe sexual practice. There are of course substitutes for those who feel deep affection for their male partner and we should not underestimate at all the grave problems that are faced by some of those who are living in perfectly stable homosexual relationships.
There is also some advice to intravenous drug abusers. The best advice that the health care adviser can offer is that the subject should seek help with the problem, and the adviser can give information on drug abuse centres. Of course, even more important advice is to give it up, but having said, "Give it up", one recognises that everyone is not going to give it up and that to do so is difficult. Where such advice from drug abuse centres is not welcome or relevant, hygiene education is essential and drug users should be advised to use only sterile equipment, as was pointed out by the noble Baroness, Lady Masham, including needles, when preparing drugs. There is more helpful and sensible advice and I think that it is our task to ensure that it is widely communicated throughout the community, especially to those who are at risk.
I want to say a word about a subject that has been mentioned by a number of your Lordships. I want to endorse the appreciation of the work of voluntary organisations and of volunteers in this field. Reference has been made to the Terence Higgins Trust, the role of which has been very important. It is the only organisation which has been able to concentrate virtually entirely on this problem. Reference has been made to the Blood Transfusion Service which, although run departmentally, is a voluntary service. Reference has been made to the Haemophilia Society. They are faced with people with grave worries at the present time. I admire the way in which they are helping to put the facts before those unfortunate people.
I want to deal now with the Government's responsibilities. I say straight away that I welcome the guidance to nurses and other action, particularly that concerning the Blood Transfusion Service which I think was rapid and exactly what was needed. I wish to make a number of other points. First, funds must be found to provide special units for handling what we know will be an increasing number of cases. Reference has been made by both the noble Lord, Lord Richardson, and the noble Baroness, Lady Masham, to the very heavy burden that is now falling on St. Mary's. This emphasises the need for other recognised equipped units which can deal with this increase.
Secondly, I endorse all that has been said by the noble Lord, Lord Winstanley, the noble Baroness, Lady Masham, and the noble Lord, Lord Kilmarnock, about research. I shall not repeat what they said.
Thirdly, I wish to make an urgent plea to the Government to take no action on the proposals of a DHSS cost-cutting working party in relation to the Public Health Laboratory Service. The recommendation that has been made in the working party's report, which I think has not yet been published, is that the PHLS should hand over its 52 laboratories in
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England and Wales to local health authorities. I do not think that the local health authorities, in view of their own financial difficulties, will appreciate this new burden being placed upon them.
Members of the governing board of the service are warning that such a move might seriously jeopardise the agency's ability to monitor the spread of infectious diseases, particularly AIDS. Scientists and technicians in the local laboratories test some six million specimens a year for viruses and for bacteria. Their skills in microbiology and their equipment make them uniquely qualified to track down the AIDS virus. I say to the noble Lord the Minister that I hope nothing will be done for cost-cutting reasons to undermine the status of the Public Health Laboratory Service, which I know from my own experience renders an extremely important service. This would be quite the wrong time to time any change.
Fourthly—and this is my penultimate point to the Government—I believe that AIDS should be a notifiable disease. Of course I noted the point made by the noble Lord, Lord Richardson, in which he took the opposite view. I have known the noble Lord, Lord Richardson, long enough to realise that in these matters he is wiser than I. I suppose that I must think again; nevertheless I say that there would be great merit in making it notifiable. I believe that it would not so much scare off from coming forward people who have or who fear they have the disease, but would do a great deal to reassure other people who are at present scared. I know that the Government are considering this matter and I hope that the Minister will say a word about it when he replies.
Finally, advice, information and guidelines must be made available not only to nurses, as has been referred to, but also to the prison service, to the police and to the fire service, because fear born of ignorance leads to decisions which add to the hysteria and panic which can only do harm to those who are patiently struggling to cope with this new and deadly disease. Therefore, anything more that the Government can do to make the facts as they are now known available to all who might have reason to fear would be action which I believe would be welcome by all Members of your Lordships' House.
6.40 p.m.
Lord Glenarthur: My Lords, the disease AIDS has certainly attracted considerable media attention and has generated much public concern and even unnecessary hysteria, as the noble Lord, Lord Richardson, suggested when he spoke. I therefore welcome this opportunity to explain some of the facts and to dispel some of the myths. I am most grateful to my noble friend Lady Cox for providing an opportunity to do this. She is certainly an expert, as is the case with so many other noble Lords who have spoken. Indeed, much of what I shall say tonight will be simply reinforcing many of my noble friend's remarks and those of others of your Lordships who have taken part.
It may be helpful if I first confirm some basic facts about the disease AIDS. AIDS is still a rare disease in this country. At the end of last month, as we have heard, 132 cases had been confirmed, of whom 58 have died. Contrary to some of the stories which have appeared in the media, AIDS is not a highly infectious

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disease and poses very little threat to members of the public who are outside the at-risk groups; it was these particular groups about which the noble Lord, Lord Winstanley, asked. The main way in which AIDS is passed is person-to-person through sexual intercourse between male homosexuals, particularly those with many different partners. Cases have also been recorded as a result of the infection being transmitted between drug misusers sharing needles and through contaminated blood products. A few cases have also occurred in the heterosexual partners of bisexual men.
Despite the attention it has attracted, much remains unknown about AIDS. What we do know is that in 1981 an apparently new disease appeared in the United States of America after separate reports of pneumocystic carinii pneumonia and Kaposi's sarcoma occurring in homosexual men. One hypothesis is that AIDS originated in sub-Saharan Africa and then spread to Europe in two ways; first, via the homosexual population in the United States and secondly, by Africans coming directly to Europe, particularly from Central Africa. The search for a causative agent resulted in the isolation of a virus from patients with AIDS and in AIDS risk groups in France and the United States. Both the French virus, known as LAV, and the United States virus, known as HTLV III, are now considered to be very similar and to be the primary causative agent, or at least one of the agents, of AIDS.
As to the incubation period about which the noble Lord, Lord Winstanley, asked, he and others who spoke were broadly right. Incubation is variously given to be between six months and five or so years. Through research under way in this country and abroad, we are confident that knowledge about the disease will improve. Research in the United Kingdom is being co-ordinated by a working party of the Government-funded Medical Research Council and is proceeding through five MRC projects. The DHSS is also funding the evaluation of AIDS antibody screening tests, and other work is going on in laboratories in various parts of the country.
As far as concerns detailed projects being conducted through the agency of the MRC, I can say that the two major projects into which the DHSS has a financial input are those being carried out by Professor Adler and Professor Tedder at the Middlesex Hospital with an investigation into the immunology and etiology of AIDS. The other is being undertaken by Dr. Krask at the PHLS in Manchester: he is making an epidemiological study of the relationship of AIDS in patients with disorders of blood coagulation to its possible acquisition through treatment with blood products.
So far as cost and the input of cash into the MRC are concerned, I am aware of the answer which my noble friend Lord Caithness gave to the question to which the noble Lord, Lord Kilmarnock, referred. I should like to look again at that particular answer because there appears to be some conflict in the figures which I cannot resolve immediately. I simply do not know why there should be this problem but I will look into this matter again and let the noble Lord know the answer.
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So far as plans for further spending on research are concerned, it is of course a matter for the MRC to decide its specific priorities within the resources available to it from its grant in aid from the Department of Education and Science. I understand that the MRC is always willing to consider soundly-based research proposals but they do of course compete with other applications. In saying that, I do not want to leave the impression with either the noble Lord, Lord Kilmarnock, or the noble Lord, Lord Ennals, that the problem of AIDS is not one that is being taken extremely seriously.
Our officials are in regular contact with the World Health Organisation AIDS Reference Centre in Paris, which collates AIDS data from European countries. They are also in contact with officials of the United States Government, and staff of the Public Health Service and Communicable Disease Centres. There is also United Kingdom membership of the Comité de la Récherche Medicale Working Group on AIDS, which is responsible for European Community medical and public health research on the disease. As well as maintaining contact with the CRM working group, members of the United Kingdom Medical Research Council Working Party on AIDS are collaborating with research workers overseas who have isolated the AIDS-related virus to which I referred.
In the light of information available, the Government are taking a number of important practical steps to prevent and control the spread of the disease. We have set up an expert advisory group, the membership of which includes experts on all aspects of the disease from all over the United Kingdom. The group and its working parties have already met several times and further regular meetings will take place. The first priority of the group is to advise on measures necessary to control the spread of the disease.
The noble Lord, Lord Kilmarnock, asked about the connection between the MRC and the expert advisory group. The members of that group include Dr. Tyrrell, who chairs the MRC's working party, I can assure the noble Lord that liaison between those two bodies is extremely good. As some of your Lordships will be aware, and as the noble Lord, Lord Richardson, said, we have considered the desirability of making AIDS a notifiable disease. The noble Lord, Lord Ennals, also referred to this point. Having consulted the expert advisory group and sought the views of doctors specialising in the field, we are satisfied that the present reporting system to the Communicable Disease Surveillance Centre is operating effectively and that we do not need any new powers at the moment to monitor the spread of the disease.
Furthermore, experience with other sexually transmitted diseases suggests that notification would not assist in control of the disease; this was the main point which the noble Lord, Lord Richardson, was making. This is because the problems of sexually-transmitted diseases, including AIDS, are different from other types of infectious disease and require expertise in tracing, treatment and counselling not normally found in local authority environmental health departments which receive reports of cases of notifiable diseases.
There is also the possibility that this reporting system would cause problems of confidentiality which

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would make those at risk reluctant to come forward for treatment. It is for these reasons that no sexually transmitted diseases in this country are subject to a statutory reporting system to local authorities. Having said that, however, we will keep the situation under constant review.
We have looked at the benefits to be gained from making the disease subject to other statutory public health provisions. The limited infectivity of AIDS, and the minimal risk it poses to the general public, limit the need for such measures. However, very rare and exceptional cases might arise. We believe therefore that some reserve provisions should be available to safeguard public health if they do. We have therefore announced our intention to lay regulations to allow a patient to be admitted or detained in hospital in such exceptional circumstances.
The Government have taken other steps to prevent the spread of AIDS. At the centre of our strategy lie a number of public health measures aimed at health professionals and "at risk" groups. At the request of the health departments and the Health and Safety Commission, the expert Advisory Committee on Dangerous Pathogens has drawn up interim guidelines to safeguard the health of medical staff, nursing staff, those to whom my noble friend Lady Cox referred, and others who may come into contact with AIDS patients and specimens taken from them. These guidelines were distributed on 16th January to all health authorities.
It is recognised that rapid advances are taking place in the understanding of the disease and the virus related to it. It is for this reason that the guidelines are interim. In answer to my noble friened's question about further research on this issue, I can tell her that the advisory committee will be reviewing the practical operation of the measures recommended in the guidelines within the next 12 months. It will take into account any new scientific information, together with evidence or comments submitted by health care workers, researchers in the field, and other interested parties.
Secondly, leaflets have been produced by the Health Education Council to promote greater awareness of the risks of the disease. These are now being made available in substantial numbers to individuals in "at risk" groups such as male homosexuals and intravenous drug misusers. They are also available to the public generally, and that of course would include young people who have worries about the disease and for whom my noble friend Lady Dudley expressed concern.
There is also a valuable role for the voluntary sector to play in this field. We have already made a grant of £15,000 to the Haemophilia Society to help its AIDS-related information and advice activities. The Terrence Higgins Trust, to which my noble friend Lady Cox and others referred and which is a voluntary organisation named after the first person to die of AIDS in this country, has also been doing important work in providing information, counselling and support to AIDS sufferers and others who have worries about the disease. Today I am pleased to announce that we shall be giving it a £25,000 grant to allow it to expand its activities connected with AIDS. I hope that
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that will be some encouragement to the noble Lord, Lord Rea, as well, who particularly mentioned how worthy he thought that its work was.
Thirdly, measures are being taken to safeguard recipients of blood and blood products. We have strengthened our efforts to dissuade persons in the AIDS high-risk groups from donating blood. The latest edition of our leaflet, AIDS—Important New Advice for Blood Donors, has been sent to all regional transfusion centres and is being distributed individually to all donors.
Fourthly, tests to screen blood donations for antibody to the AIDS virus HTLV III are being developed both in the United Kingdom and abroad. We are concerned that no test should be introduced routinely into the National Blood Transfusion Service until it has been proved to be reliable and satisfactory. We cannot accept significant rates of either false positives or false negatives. We are therefore co-ordinating evaluation work to assess these tests as they become available in this country. We have written to regional health authorities asking them to set aside funds in 1985–86 to introduce screening tests, when proved satisfactory, into their blood transfusion centres.
Finally—and this was a point that was raised by the noble Lord, Lord Kilmarnock, particularly—we have granted a number of product licences for imported heat-treated Factor VIII for haemophiliacs. It is hoped that by April this year all the Factor VIII made by the blood products laboratory at Elstree will be heat-treated. Limited supplies are available at present for clinical trials. I hope that I shall be able to reassure the noble Baroness, Lady Masham, by saying that we are taking steps to ensure that the United Kingdom is self-sufficient in all blood products as soon as possible. In particular, as I think she will be aware, we are investing £35 million in new developments at Elstree to come into production in 1986.
So far as artificial Factor VIII is concerned—which was another point raised by the noble Lord, Lord Kilmarnock—I understand that it has been synthesised in recent laboratory work, but the commercial sale of manufactured products such as artificial Factor VIII is several years away. I think that the Factor VIII that we shall be able to get from the Developed Blood Products Laboratory at Elstree is the most immediate answer to the problem.
The noble Baroness, Lady Masham, asked several other questions about blood. I am aware of the concern of those who either receive blood, or blood products, or who give it. I am grateful to her for making the point that needles are used only once. The country is already self-sufficient in whole blood. Those who are at high risk from AIDS have been told not to donate blood, as I said. Our voluntary donor system means that there is no financial incentive for them to give blood, and there is therefore only a remote chance of contracting AIDS from ordinary blood transfusions given in hospitals. As we have stressed in the past, donors cannot get AIDS by giving blood—again on the point that the noble Baroness made about needles being used only once.
So far as the screening test itself is concerned, the diagnostic test kits to detect antibody in blood to the

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AIDS-related virus are likely to be offered for sale in this country shortly. They are intended strictly for laboratory use. It is the department's intention to evaluate those test kits as soon as possible and to use an independent test centre for doing so. It will then publish a list of those which are found to be satisfactory and reliable for routine use in the National Health Service. The tests will detect the presence of AIDS antibody in a person's blood; but of course that does not necessarily mean that he or she has or will have AIDS. That is an important point to make. The tests merely show that they have been infected with the virus at some time. Those tests are likely to find the greatest application in screening blood donations when they are validated. However, they may be appropriate for use in VD clinics and in the diagnosis of illness which is suspected of being caused by the AIDS virus.
Lord Winstanley: My Lords, are the kits to which the noble Lord refers of British manufacture or imported?
Lord Glenarthur: My Lords, I think that they are imported. I am not 100 per cent. sure. I can certainly look into it and let the noble Lord know. In any case, they have to go through the same evaluation procedure, which is the important point to make.
The noble Lord, Lord Ennals, asked me particularly about St. Mary's. The vast majority of cases have been dealt with by that unit in the past. I am aware of the concern which has been expressed by the noble Lord and others. As a result of that concern and the workload which falls upon the unit, we are now discussing with the regional health authority how best the difficulty can be met.
The noble Lord also asked about the future of the Public Health Laboratory Service. A review of the Public Health Laboratory Service Board has been carried out under the normal accountability arrangements for non-departmental public bodies. We shall issue a report of the review for consultation in the near future. I can certainly arrange for a copy to be placed in the Library when it is available. We shall consider the report's recommendations in the light of that consultation. But I should not like the noble Lord to think that in any sense will that review stand those who suffer from AIDS, or may do, at any risk in the future. I too have a responsibility—a special responsibility—for the PHLS. It is a separate issue, but I can certainly make the report available when it arrives.
As to the future spread of AIDS in this country, we have very few cases and it is too early to make accurate predictions. However, this is because there is evidence to show that people in the "at risk" groups have taken notice of the health education material and have been changing their behaviour in response to the threat of the disease.
Lord Harmar-Nicholls: My Lords, may I ask a question? My noble friend may already have given the answer. Is every batch of blood in the bank tested? The point that puzzled me a bit is this. I accept what my
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noble friend has said—that people in what we call the high risk groups have the pamphlets and are generally advised, but that they are not isolated because that could stop people reporting to transfusion centres for fear of being recognised as being in a high risk group. However, if someone in a high risk group has been a regular donor and is rather proud of the badges that he has received for having given blood over the years, is that not a reason why such a person, perhaps for social reasons, would not take heed of the pamphlet? That is the same basis as the argument for not isolating people. However, that would not matter if each batch went through some kind of test before it was put into the bank. Is that done? My noble friend may have said that it is, but I was not clear.
Lord Glenarthur: My Lords, I think the first point made is that the people who donate blood in this country are on the whole responsible people and they are not going to want to put at risk those who might need blood at any time in the future. There is not a test. This is the point that I was trying to make. I described the kits that may be available, but until we have a reliable test to check whether or not the AIDS virus or the AIDS antibody is present in the blood, we cannot really take it any further.
Baroness Masham of Ilton: My Lords, may I just follow on from that because that was the major point that I made in the debate? I was concerned about the need for counselling. A homosexual might well go to give blood and not want his wife to know that he has a dual relationship. This is the big problem.
Lord Glenarthur: Yes, my Lords, I agree that it is a very big problem. But in advising people at blood transfusion centres we have to be very careful not to run the risk of some kind of panic-induced collapse in the supply of blood. At the same time we have to balance that against the very real worries of those who might contract the disease through blood or blood products. As I have said, there is really no incentive on the part of anybody to part with his blood if he is from an at-risk group. The leaflets have been made available; they are going direct to donors and they are available at transfusion centres, and I think that that is the best way of dealing with this particular problem. I certainly agree with the noble Baroness when she says that counselling is important. At the same time, one cannot be too inquisitive about people's habits.
Lord Rea: My Lords, I am sorry to come in again. There is some information on this very point. I believe that many blood transfusion centres allow donors to state in private whether or not they want their blood to be used (I quote) "for experimental purposes only". This is done confidentially so that their partner does not know about it.
Lord Glenarthur: My Lords, I was interested to hear the remarks of the noble Lord. I can say that in Scotland they have decided to require a signed declaration that the person concerned is not in the at-risk groups. But this is not directed solely or specifically at their sexual habits. It is a very difficult area; I think both the noble Baroness and the noble Lord, Lord Rea, understand that. Nevertheless, we are

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satisfied at the moment that the response we are getting from the steps that we have taken is satisfactory. I should certainly like to leave it like that at the moment, while bearing in mind the concern which has been expressed this evening.
I end rather as I started, by saying that AIDS is a serious and often fatal condition. But I must stress, as others have done, that it is extremely rare; and it is not infectious in the way measles, chickenpox, hepatitis or 'flu are. It is not passed on by infection from lavatory seats or dirty glasses, or by shaking hands with an infected person. Although the virus has been found present in saliva, there is no record, here or abroad, of the disease being transmitted through it. Nevereless, the Government believe that the steps we have taken, coupled with widespread international research, are sensible and practical means to control the spread of the disease and deserve the confidence of the public at large.

Gosport Borough Council Bill
  Lloyds Bank (Merger) Bill
    National Bank of NewZealand Limited Bill
    The Examiner's Certificates that no further Standing Order is applicable were ordered to lie on the Table.

    Cinemas Bill [H.L.]
    Returned from the Commons agreed to.
    House adjourned at four minutes past seven o'clock.

  PAROLE BOARD
  PAROLE BOARD
  THE MINERS' STRIKE: CRIMINAL OFFENCES
  THE MINERS' STRIKE: CRIMINAL OFFENCES
  SCHOOL EDUCATION: COST PER CHILD
  SCHOOL EDUCATION: COST PER CHILD
  AIDS: RESEARCH FUNDS
  AIDS: RESEARCH FUNDS
  ENVIRONMENTAL GRANT-RELATED EXPENDITURE 1985–86
  ENVIRONMENTAL GRANT-RELATED EXPENDITURE 1985–86
  NCB (ENTERPRISE) LTD.
  NCB (ENTERPRISE) LTD.
  UN DECADE FOR WOMEN CONFERENCE, NAIROBI
  UN DECADE FOR WOMEN CONFERENCE, NAIROBI
  UN CONVENTION AGAINST TORTURE AND OTHER CRUEL, INHUMAN OR DEGRADING TREATMENT OR PUNISHMENT
  UN CONVENTION AGAINST TORTURE AND OTHER CRUEL, INHUMAN OR DEGRADING TREATMENT OR PUNISHMENT
  BBC EXTERNAL SERVICES
  BBC EXTERNAL SERVICES